bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Physical Activity and Counselling Interventions on Health Outcomes among Working Women in Shanghai
Authors: Wang Hongying , Xiao Yi , Ren Xiaoling , Zhang Pei , Zhang Tao 
Published: August 2019

Abstract
Background：Working women in Shanghai are a special group with higher risk of suffering work stress and burnout. They were disturbed by the work-family conflicts, which results in lower health-related quality of life (HRQoL), higher job stress and burnout. This study evaluated the potential physical activity and counselling intervention effects on health outcomes of working women in Shanghai participating in a group- or an individual-based physical activity and counselling intervention compared to a control group.
Methods：A sample of 121 female workers from eight Shanghai communities was used in this study. They were randomly divided into three groups: a control group and two observation groups (individual- and group-based intervention). The observation groups accepted 12-week moderate physical activity and counselling intervention. Subjective perceptions of work stress, burnout, and HRQoL were measured before and after the intervention.
Results：In the control group (Ctr), no significant difference was found between participants for stress (p = 0.752) and burnout (p = 0.622) before and after the experiment. However, the HRQoL value decreased after the experiment, with the mean value falling from 91.59 to 87.10. After the experiment, the value of stress and burnout decreased, and the value of HRQoL increased in the two intervention groups. At the intervention’s completion, there were significant differences compared intervention groups (Exp_G and Exp_I) to control group separately regarding changes in burnout and HRQoL over time (Exp_G vs. Ctr: p < 0.01, p < 0.01, respectively; Exp_I vs. Ctr: p < 0.01, p < 0.01, respectively). For stress, Exp_G exhibited a significant difference compared to Ctr (Exp_G vs. Ctr: p < 0.01), while Exp_I did not exhibit a significant difference compared to Ctr (Exp_I vs. Ctr: p = 0.128).
Conclusion：Physical activity and counselling intervention delivered either in group or individual format could reduce stress, burnout, and improve HRQoL of working women in Shanghai, and group interventions were more effective than those targeted at individuals.
The introduction of colorectal endoscopic submucosal hydrodissection at a Western Center: results and learning curve
Authors: Ramos-Zabala Felipe , Parra-Blanco Adolfo , Beg Sabina , García-Mayor Marian , Domínguez-Pino Ana , Cárdenas-Rebollo José Miguel , Moreno-Almazán Luis 
Published: August 2019

Abstract
Background
Colorectal endoscopic submucosal dissection (CR-ESD) is an evolving technique in Western countries. The use of hydrodissection has been established as an effective technique for safe resection. However, it is unknown if the adoption of this technique can help a novice perform ESD safely without prior experience or formal tutorial. Here we aimed to determine the results of the introduction of endoscopic submucosal hydrodissection for the treatment of complex colorectal polyps and establish the learning curve for this technique, at a European tertiary hospital.
Methods
This study included data from 80 consecutive CR-ESDs performed for complex colorectal polyps, by a single endoscopist within a structured training program. The main outcome was en bloc resection rate, while secondary outcomes included complications (perforation and bleeding), knife en bloc (KEB) resection rate, knife-snare en bloc resection rate, conversion rate to endoscopic piecemeal mucosal resection (EPMR), complete resection rate, curative resection rate. To explore the impact of experience, procedures were divided into 4 groups of 20 each, with outcomes measures compared between these.
Results
The overall en bloc resection rate was 75%. KEB resection was obtained in 15%, 25%, 50%, and 80% cases in the consecutive periods (period 1 vs 4, p<0.001; periods 1, 2 and 3 vs 4, p<0.001). Conversion rate to EPMR was obtained in 40%, 25%, 25% and 5% respectively (period 1,2 and 3 vs 4; p=0.031). Curative resection was achieved in 55%, 75%, 70% and 95% respectively (p=0.037). Series results were 75% R0 resection, 23.7% conversion to EPMR, and 1.2% incomplete resection. Complications included perforations (7.5%) and bleeding (3.75%), there was no significant difference in the 4 periods of training. Multivariate analysis revealed factors more likely to result in non-en bloc versus en bloc resection were polyp size > 35 mm [70% vs. 23.4%; OR 13.2 (95% CI: 1.7-100.9); p=0. 013], severe fibrosis [40% vs. 11.7%; OR 10.2 (95% CI: 1.2-86.3); p= 0.033] and non-use of CO2 [65% vs. 30%; OR 0.09 (95% CI: 0.01-0.53); p= 0.008].
Conclusions
CR-ESD by hydrodissection can be implemented in a western centre and offers safe and effective treatment for complex polyps.
High resolution esophageal manometry and life exposure factors in non-cardiac chest pain patients with refractory gastroesophageal reflux disease
Authors: Li Yuan , Lyu Peicong , Zhang Zhifeng , Wang Liya , Sun Xiaoyu , Yang Dong , Wang Lixia , Duan Zhijun 
Published: August 2019

Abstract
Background: Refractory gastroesophageal reflux disease (RGERD) is defined by the presence of troublesome GERD symptoms despite proton pump inhibitors (PPIs) treatments for 8-12 weeks. Non-cardiac chest pain (NCCP) is the most common atypical presentations. This study was aimed at clarifying the features of High Resolution Esophageal Manometry (HREM) and life exposure factors of NCCP in RGERD patients for guiding further therapeutic strategies.
Methods: 83 RGERD patients were enrolled, in which 44 patients afflicted with NCCP as P group and 39 patients without NCCP as NP group. According to the endoscopy results, P group was further divided into reflux esophagitis group (RE group), non-erosive reflux disease group (NERD group) and Barrett’s esophagus group (BE group). HREM was performed to assess esophageal motility. Diverse questionnaires were conducted to evaluate severity of symptoms, quality of life, risk factors, degrees of anxiety and depression and so on.
Results: a)Average resting pressures of the lower esophageal sphincter (LES), residual pressures of the LES and the esophageal distal contractile integral (DCI) score in P group were significantly lower than those in NP group (p<0.05). b)Average resting pressures of the upper esophageal sphincter (UES), residual pressures of the UES, lengths of the LES and the UES showed no difference between the two groups (p>0.05). c)Compared with NP group, the patients in P group had higher exposure to alcohol, coffee, sweets, overeating and stress (p<0.05). d)Anxiety and depression status of patients in P group were remarkably severer than those in NP group (p<0.05). e)The pain intensity in RE group and BE group was higher than NERD group (P<0.05), while there was no difference between RE group and BE group (P>0.05).
Conclusions: Esophageal motility related anti-reflux barriers are much weaker in the RGERD patients with NCCP than those without NCCP, which mainly presents as the much lower average resting and residual pressures of the LES and DCI. Alcohol, coffee, sweets, overeating, stress, anxiety and depression are risk factors of RGERD-related NCCP. It’s suggested that the recovery of anti-reflux barriers and the avoidance of risk factors may be essential therapeutic strategies for improving the curative effect.
Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse
Authors: Halliwell Gemma , Dheensa Sandi , Fenu Elisabetta , Jones Sue K , Asato Jessica , Jacob Suzanne , Feder Gene 
Published: August 2019

Abstract
Background
Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services.
Methods
Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services.
Results
Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,076 per patient per year. This offset the average cost of providing hospital IDVA services.
Conclusions
Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.
Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions
Authors: Hailu Berhane Yohannes , Berhe Derbew Fikadu , Gudina Esayas Kebede , Gidey Kidu , Getachew Mestwat 
Published: August 2019

Abstract
Background : Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.Methods : A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).Conclusions : Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.
Physical, nutritional and psychological states interfere with health related quality of life of institutionalized elderly
Authors: Farias Ilky Pollansky Silva e , Montenegro Luiza Almeida Souto , Wanderley Rayssa Lucena , de Pontes Jannerson Cesar Xavier , Pereira Antonio Carlos , Almeida Leopoldina Fátima Dantas , Cavalcanti Yuri Wanderley 
Published: August 2019

Abstract
Purpose

Nursing home residents experience many problems that may influence their quality of life, in example of cognitive, mental, nutritional and physical disabilities. Concerning about elders’ wellbeing may help them living with dignity. This study aimed to investigate factors associated with Health-Related Quality of Life (HRQoL) of institutionalized elderly in a capital city of Brazilian Northeast.Methods

A cross-sectional study was conducted with 193 institutionalized elderly living in the metropolitan region of João Pessoa (Brazil). A theoretical-conceptual model was build to guide the multiple regression analysis. The following variables were tested regarding their association with the residents’ HRQoL: 1) socio-demographic characteristics; 2) data associated with general health (Performance of daily-living activities, Frailty status, Cognitive status, Nutritional status, Self-perception of oral health and Depression status). Multiple linear and logistic regressions analyses were performed in order to assess the impact of each independent variable on HRQoL, considering a significance level of 5%.Results

The mean ± SD and the median of HRQoL among institutionalized elderly people were 62.69 ± 15.24 and 62, respectively. Elderly were mostly (72.02%) female, being those with 80 years and over the more frequent (54.92%). Dependence on daily activities (OR=2.06, 95%CI=1.32-3.23), frailty (OR=1.68, 95%CI=1.15-2.45) and depression (OR=2.22, 95%CI=1.51-3.27) were statistically associated with poor HRQoL (p<0.05).Conclusions

Dependent, frail and depressed institutionalized elderly presented a greater chance to have a worse HRQoL. It is necessary to plan and implement actions that would reduce the factors associated with the low quality of life of institutionalized elderly.
The Association between Sleep Quality and Loneliness in Rural Elderly Individuals: A Cross-Sectional Study in Shandong, China
Authors: Jia Gaizhen , Yuan Ping 
Published: August 2019

Abstract
Background

There is evidence for negative associations between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural elderly. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults.

Methods

A face-to-face questionnaire survey was conducted among 1568 rural elderly people in Shandong, China. Loneliness was assessed using the Univesity of California at Los Angels loneliness scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression were conducted to examine the association of loneliness and sleep quality after adjusting for multiple confounding variables.

Results

After controlling for age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking, drinking, chronic diseases, quality of life such as variables in multivariable analysis, Poor sleep quality still predicted loneliness in rural elderly.

Conclusion

This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.
Neuraxis metastases from central nervous system tumors: a review of clinicopathological and radiographic characters of 198 cases in a single center
Authors: Liu Hailong , Zhang Junping , Liu Yongqiang , Sun Youliang , Li Cheng , Gu Chunyu , Wang Haoran , Zhang Hongwei , Yu Chunjiang , Mingshan Zhang 
Published: August 2019

Abstract
Background Neuraxis metastases (NM) from systemic and central nervous system (CNS) tumors have become increasingly common. However, a lack of systematic information restricts the development of the accurate diagnosis and treatment. The aim of this study is to facilitate the understanding of NM arising from CNS tumors in the largest cohort. Methods Based on the clinicopathological and neuroimaging findings, we retrospectively analyze the epidemiological characters, radiographic classification, therapeutic strategies and prognostic factors. Results A total of 198 cases are enrolled and the most common primary tumor is medulloblastoma (34.34%). The median age is 15.0 years and the majority of NM (79.29%) occur in the children and young adult groups. 149 (75.25%) cases suffer from intracranial metastases, and 169 (85.35%) have the intraspinal NM. The whole leptomeninges and cauda equine are the most preferential disseminated sites. Upon MRI parameters, the massive and miliary subgroup occur most frequently in the intracranial and intraspinal NM, respectively. Treatment includes surgery (21.71%), chemotherapy alone (19.19%), radiation alone (10.10%) and combined therapy (55.56%). Operations are performed in order to identify pathology and relive masses, as well as the triple chemotherapeutic scheme consisting of ifosfamide, carboplatin and etoposide is recommended to most of NM. The median overall survival is 11.6 months. The younger age, coexistence of NM with primary tumors, shorter interval from primaries to metastases, glioma, leptomeningeal seeding and nodal subtype on MRI are significantly associated with the poor prognosis. Conclusion In spite of the controversial therapies and poor outcomes, the neuroimaging classification and comprehensive treatment contribute to the efficient administration of NM.
Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study
Authors: Shinzato Julia Yoriko , Serra Katia Piton , Eugeni Caroline , Cabello Cesar , Filho Cassio Cardoso , Zeferino Luiz Carlos 
Published: August 2019

Abstract
Background

To evaluate the number of patients with early-stage breast cancer, undergoing axillary lymph node dissection for metastatic sentinel lymph nodes, who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria.Methods

A retrospective cohort study conducted in the Women’s Hospital of the State University of Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. ACOSOG Z0011 trial criteria were applied to this population and statistical analysis was carried out to make a comparison between populations.Results

A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1).Conclusions

When eligibility for ACOSOG Z0011 trial criteria was retrospectively exported to our study population, 94.3% of the patients with one to two positive sentinel lymph nodes would benefit from the omission of axillary lymph node dissection. The high rate in our study may be explained by the large number of patients with tumors up to 2.0 cm in size and the small rate of lymphovascular invasion, which are indicative of a favorable prognosis.
Disease characteristics and treatment patterns of Chinese patients with colorectal cancer: a retrospective study using medical records from China
Authors: Xu Ruihua , Wang Wei , Zhu Bo , Lin Xiaoyan , Ma Dong , Zhu Lingjun , Zhao Qingchuan , Nie Yongzhan , Cai Xiaohong , Li Qi , Fang Weijia , Li Hongyan , Wang Ning , Chen Yun , Peng Cike , Fang Honghao , Shen Lin 
Published: August 2019

Abstract
Abstract

Background: Colorectal cancer (CRC) is the third most prevalent cancer in China but few large-scale studies were conducted to understand CRC patients. The current study is aimed to gain a real-world perspectives of CRC patients in China.

Methods: Using electronic medical records of sampled patients between 2011 and 2016 from 12 hospitals in China, a retrospective cohort study was conducted to describe demographics and disease prognosis of CRC patients, and examine treatment sequences among metastatic CRC (mCRC) patients. Descriptive, comparative and survival analyses were conducted.

Results: Of 8,136 CRC patients, 44% had mCRC. Risks of recurrence after radical surgery increased with tumor, models and metastases (TNM) stage at diagnosis (p<0.001). Among mCRC patients, fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and other oxaliplatin-based regimens were the most widely-used first-line treatment (42%). Fluorouracil, leucovorin, irinotecan (FOLFIRI) and other irinotecan-based regimens dominated the second-line (40%). There was no a dominated regimen for the third-line. The proportion of patients receiving chemotherapy with targeted biologics increased from less than 20% for the first- and second- lines to 34% for the third-line (p<0.001). The most common sequence from first- to second-line was from FOLFOX and other oxaliplatin-based regimens to FOLFIRI and other irinotecan-based regimens (286/1,200, 24%).

Conclusions: As the only nationwide large-scale study among CRC and mCRC patients before more CRC biologics became available in China in 2017 and 2018, our study reported limited numbers of patients using targeted biologics and no a dominant choice for the third-line therapy. Our findings reflected a lack of consensus on the choice of third-line therapy and limited available options in China. It is evident o continue promoting early CRC diagnosis and to increase the accessibility of treatment options for mCRC patients. Our results can also be used as the baseline to assess treatment pattern changes before and after the inclusion of more third-line treatment were approved and covered into the National Health Insurance Plan in China between 2017 - 2018.