bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nomogram to Predict the Benefit of Intensive Treatment for Locoregionally Advanced Head and Neck Cancer
Authors: Mell Loren K. , Shen Hanjie , Nguyen-Tân Phuc Felix , Rosenthal David I. , Zakeri Kaveh , Vitzthum Lucas K. , Frank Steven J. , Schiff Peter B. , Trotti Andy M. , Bonner James A. , Jones Christopher U. , Yom Sue S. , Thorstad Wade L. , Wong Stuart J. , Shenouda George , Ridge John A. , Zhang Qiang E. , Le Quynh-Thu 
Published: August 2019

AbstractPurpose:Previous studies indicate that the benefit of therapy depends on patients' risk for cancer recurrence relative to noncancer mortality (ω ratio). We sought to test the hypothesis that patients with head and neck cancer (HNC) with a higher ω ratio selectively benefit from intensive therapy.Experimental Design:We analyzed 2,688 patients with stage III–IVB HNC undergoing primary radiotherapy (RT) with or without systemic therapy on three phase III trials (RTOG 9003, RTOG 0129, and RTOG 0522). We used generalized competing event regression to stratify patients according to ω ratio and compared the effectiveness of intensive therapy as a function of predicted ω ratio (i.e., ω score). Intensive therapy was defined as treatment on an experimental arm with altered fractionation and/or multiagent concurrent systemic therapy. A nomogram was developed to predict patients' ω score on the basis of tumor, demographic, and health factors. Analysis was by intention to treat.Results:Decreasing age, improved performance status, higher body mass index, node-positive status, P16-negative status, and oral cavity primary predicted a higher ω ratio. Patients with ω score ≥0.80 were more likely to benefit from intensive treatment [5-year overall survival (OS), 70.0% vs. 56.6%; HR of 0.73, 95% confidence interval (CI): 0.57–0.94; P = 0.016] than those with ω score &lt;0.80 (5-year OS, 46.7% vs. 45.3%; HR of 1.02, 95% CI: 0.92-1.14; P = 0.69; P = 0.019 for interaction). In contrast, the effectiveness of intensive therapy did not depend on risk of progression.Conclusions:Patients with HNC with a higher ω score selectively benefit from intensive treatment. A nomogram was developed to help select patients for intensive therapy.
Ocular tentacle malformation in Deroceras reticulatum (Mollusca: Gastropoda: Agriolimacidae)
Authors: Daglio Daniel Eduardo , Lucía Micaela De , Robinson David Gwyn , Gregoric Diego Eduardo Gutiérrez 
Published: August 2019

Malformations in animals have long been known. In gastropod, natural and induced malformations are mentioned in different systems and in ocular tentacles, mainly linked to cases of parasitism and exposure to pollutants (molluscicides and chemicals). In this study we present a new malformation not documented in the ocular tentacles of slug Deroceras reticulatum that could be due to the action of pesticides. This malformation in D. reticulatum is the first malformation to be mentioned for South America in nursery gardens.
The first cases of gynandromorphism in oil‑collecting bees (Hymenoptera, Apidae: Centridini, Tapinotaspidini)
Authors: Alvarez Leopoldo Jesús , Silva Wagner Pereira , Lucia Mariano , Aguiar Antonio J.C. 
Published: August 2019

Here we provide descriptions of gynandromorphs of two species oil-collecting bees: Lophopedia nigrispinis and Epicharis iheringii, both with partial bilateral phenotypic asymmetry. The bees have a female phenotype predominantly on mesosoma and metasoma. The specimen of L. nigrispinis has distinct characteristics on legs, suggesting a mosaic pattern of gynandromorphism. The pollen and oil loads on legs suggest that the bee was foraging normally. The gynander specimen of E. iheringii has mostly a female phenotype, except for head, with right half female type and left half male type. The specimen of L. nigrispinis was collected foraging on flowers of Bidens sp. at Parque Nacional Iguazú, Argentina with loads of pollen on legs suggesting it was reproductive and was provisioning a nest. The specimen of Epicharis iheriingi has no evidence of any oil or pollen collection, despite its mostly female phenotype.
Estresse psicológico em estudantes de cursos de graduação da área da saúde
Authors: Murakami Karolina , Panúncio-Pinto Maria Paula , Santos Jair Licio Ferreira dos , Troncon Luiz Ernesto De Almeida 
Published: August 2019

O objetivo deste estudo foi detectar a presença de estresse psicológico e sintomas associados entre estudantes de diferentes cursos de graduação da área da saúde de uma mesma instituição pública. Foi um estudo tipo corte transversal empregando questionário estruturado e inventário psicométrico. Participaram 102 estudantes de Fisioterapia, Fonoaudiologia, Medicina, Nutrição e Terapia Ocupacional, distribuídos por curso e suas etapas (inicial, intermediária e final) proporcionalmente ao número de matriculados. Os participantes responderam a um questionário de caracterização social e demográfica e se submeteram a instrumento validado de detecção de estresse e seus sintomas em adultos. A análise estatística das diferenças entre as proporções de estudantes com e sem estresse foi feita por meio do teste de Fisher (p≤0,05). O estresse foi detectado em 71 (70%) dos 102 estudantes, em proporções por curso variando entre 61% (Fisioterapia) a 88% (Terapia Ocupacional). Não houve diferenças estatisticamente significativas entre os cursos quanto a essas proporções. Não houve também diferenças entre as etapas dos cursos, com frequências variando entre 23% (início e meio) e 26% (final). Não houve diferença significativa entre as proporções de mulheres (75%) e homens (63%) com estresse. Dentre os estudantes com estresse, 57 (80%) apresentavam sintomas psicológicos, 11 (15%) apresentavam sintomas físicos e outros 11 (15%) tinham sintomas físicos e psicológicos. Estes resultados permitem concluir que proporções elevadas dos estudantes das várias etapas de diferentes cursos de graduação da área da saúde de uma mesma instituição pública apresentam estresse, frequentemente associado à presença de sintomas psicológicos e físicos. Esses dados também indicam que a presença de estresse independe da natureza do curso na área da saúde. Estes achados reforçam a necessidade de aumentar o conhecimento sobre esse fenômeno, o que permitirá planejamento mais adequado e maior eficácia de medidas institucionais de promoção da saúde mental dos estudantes.
REMUSP
Authors: Vianna Valente Gabriela 
Published: August 2019

O REMUSP é um grupo de música dos quais fazem parte alunos da FMUSP e de outros cursos da saúde da USP. Muitos estudantes compartilham a paixão pela música, e temos no REMUSP um espaço para formar amizades, superar desafios e cuidar da nossa saúde mental. Desde a dificuldade de aprender um novo instrumento até trabalhar em grupo para formar uma banda e apresentar, ou interpretar uma música, a experiência no REMUSP é capaz de acrescentar muito à vida de seus integrantes.
Consumo de macro e micronutrientes de idosos com diabetes mellitus tipo 2 atendidos no núcleo de apoio ao idoso
Authors: Burgos Maria Goretti Pessoa de Araújo , Santos Eryka Maria Dos , Morais Andréia Albuquerque Cunha Lopes , Santos Priscilla Alves , Melo Nathalia Caroline de Oliveira , Costa Marcele Batista Madeiro 
Published: August 2019

Objetivo: Avaliar o consumo de macro e micronutrientes em idosos diabéticos atendidos no Núcleo de Atenção ao Idoso da Universidade Federal de Pernambuco (NAI/UFPE). Métodos: Estudo transversal com idosos saudáveis (n=66) e com diabetes (n=55) do NAI/UFPE. Obteve-se dados de prontuários e/ou questionários de frequência alimentar. Análise dietética realizada através do DietWin Professional 2008 e para estatística utilizou-se teste t-Student, admitindo-se nível de significância para p<0,05. Resultados: Os resultados mostraram a prevalência do sexo feminino em ambos os grupos (73,8% no grupo saudável e 86,6% no grupo de idosos com diabetes), sendo idosos saudáveis com média de idade de 72,5 ± 6,2 anos, e grupo com diabetes com média de idade de 61,8 ± 5,0 anos (p<0,05). O excesso de peso prevaleceu no grupo com diabetes (67%) quando comparado ao grupo saudável (49,2%; p<0,027). A ingestão calórica dos pacientes com diabetes foi maior (1257,94 kcal) em relação aos indivíduos saudáveis (970,81 kcal; p=0,01). O mesmo ocorreu para consumo de sódio (1810,12 mg x 592,92 mg), cálcio (721,44 mg x 286,23 mg), zinco (8,73 mg x 6,26 mg), magnésio (266,22 mg x 128,60 mg), vitamina A (442,35 µg x 131,83 µg) e E (4,59 mg x 1,45 mg) (p<0,01 para todas as variáveis). Por outro lado, observou-se consumo inferior de potássio (1580,83 mg x 2349,23 mg; p<0,01) e proteína (9% x 17%; p<0,01). Conclusão: Foi identificado um padrão alimentar hipercalórico nos idosos com diabetes, acompanhado de excesso de sódio, cálcio, magnésio e zinco, com reduzido consumo proteico e de potássio.
Estado nutricional e qualidade de vida de pacientes em hemodiálise
Authors: Bernardo Mayara Ferreira , Santos Eryka Maria Dos , Cavalcanti Mikaella Carla de França , Lima Denise Sandrelly Cavalcanti De 
Published: August 2019

Introdução: Na Doença Renal Crônica Avançada, o paciente necessita de uma terapia renal substitutiva, dentre elas, a hemodiálise (HD). Apesar dos benefícios da HD, este procedimento afeta o estado nutricional e a qualidade de vida (QV) do doente.
Objetivo: Correlacionar o estado nutricional ao nível de QV de pacientes em HD.
Metodologia: Estudo transversal, com pacientes em HD há pelo menos 3 meses. O estado nutricional foi avaliado pelo índice de massa corporal (IMC), circunferência do braço (CB), circunferência muscular do braço (CMB), prega cutânea tricipital (PCT), albumina (Alb) e creatinina (Cr) séricas e a QV pelo Medical Outcomes Study-36 – Item Short Form Health Survey (SF-36). As pontuações geradas pelo SF-36 foram correlacionadas com os indicadores do estado nutricional através do Coeficiente de Correlação de Pearson e/ou Spearman´s.
Resultados e Discussão: Participaram do estudo 37 pacientes, com idade média de 50,6 ± 13,0 anos, sendo 54,1% do sexo feminino. Segundo a avaliação do estado nutricional, houve prevalência de eutrofia (48,7%) pelo IMC e desnutrição de 37,8% evidenciada pela CB e CMB. Na avaliação bioquímica, 25,0% estavam com hipoalbuminemia e 18,9% com redução da Cr. A dimensão de QV mais comprometida foi a limitação por aspectos físicos. Na análise das correlações, parâmetros nutricionais (IMC, CB e Alb) estavam ligados à QV dos pacientes.
Conclusão: IMC, CB e Alb correlacionaram-se com dimensões do SF-36, indicando que alterações no estado nutricional podem influenciar o funcionamento físico e emocional desses pacientes.
Provenance and weathering index of the Upper Cretaceous São Carlos Formation and its tectonic significance in the eastern Bauru Basin, SE Brazil
Authors: Neves Lara Ferreira , Batezelli Alessandro 
Published: August 2019

Geochemistry of major and trace elements has been used as an important tool for the study of provenance and tectonic and climatic evolution of sedimentary basins. The São Carlos Formation is an Upper Cretaceous unit that lies on the eastern border of the Bauru Basin. Despite the paleontological and paleodepositional studies performed in this unit in the last years, little is known about the correspondence between tectonic and climatic conditions acting during the first stages of sedimentation. The hypothesis of this paper is to evaluate São Carlos and Araçatuba formations and understand the evolution of the eastern border of the basin. Thus, were conducted geochemical studies using X-ray fluorescence on sandstones, siltstones, and shales from the São Carlos Formation. According to the chemical weathering index, which presented values ranging from 57.12 to 71.58%, the oxides of major elements indicate that moderate weathering processes affected the source area, possibly associated with the arid-semiarid climate. Alkaline rocks, granites, gneisses, and metasediments were the main lithotypes of the source area. Ternary diagrams show that the tectonic environment was equivalent to the passive continental margin, coinciding with the Serra do Mar and, secondarily, Alto Paranaíba Uplift regions. Based on major and trace elements, their ratios, and published data on the basin, was elaborated a paleogeographic model of the eastern border of the Bauru Basin, concluding that the source area of the sediments was constituted by intermediate and felsic rocks, sometimes recycled by sedimentary processes.
Epoetin Beta and C‐Terminal Fibroblast Growth Factor 23 in Patients With Chronic Heart Failure and Chronic Kidney Disease
Authors: Eisenga Michele F. , Emans Mireille E. , van der Putten Karien , Cramer Maarten J. , Diepenbroek Adry , Velthuis Birgitta K. , Doevendans Pieter A. , Verhaar Marianne C. , Joles Jaap A. , Bakker Stephan J. L. , Nolte Ilja M. , Braam Branko , Gaillard Carlo A. J. M. 
Published: August 2019

Background

In patients with chronic heart failure and chronic kidney disease, correction of anemia with erythropoietin‐stimulating agents targeting normal hemoglobin levels is associated with an increased risk of cardiovascular morbidity and mortality. Emerging data suggest a direct effect of erythropoietin on fibroblast growth factor 23 (
FGF
23), elevated levels of which have been associated with adverse outcomes. We investigate effects of erythropoietin‐stimulating agents in patients with both chronic heart failure and chronic kidney disease focusing on
FGF
23.

Methods and Results

In the
EPOCARES
(Erythropoietin in CardioRenal Syndrome) study, we randomized 56 anemic patients (median age 74 [interquartile range 69–80] years, 66% male) with both chronic heart failure and chronic kidney disease into 3 groups, of which 2 received epoetin beta 50
IU
/kg per week for 50 weeks, and the third group served as control. Measurements were performed at baseline and after 2, 26, and 50 weeks. Data were analyzed using linear mixed‐model analysis. After 50 weeks of erythropoietin‐stimulating agent treatment, hematocrit and hemoglobin levels increased. Similarly, C‐terminal
FGF
23 levels, in contrast to intact
FGF
23 levels, rose significantly due to erythropoietin‐stimulating agents as compared with the controls. During median follow‐up for 5.7 (2.0–5.7) years, baseline C‐terminal
FGF
23 levels were independently associated with increased risk of mortality (hazard ratio 2.20; 95%
CI
, 1.35‐3.59;
P
=0.002).

Conclusions

Exogenous erythropoietin increases C‐terminal
FGF
23 levels markedly over a period of 50 weeks, elevated levels of which, even at baseline, are significantly associated with an increased risk of mortality. The current results, in a randomized trial setting, underline the strong relationship between erythropoietin and
FGF
23 physiology in patients with chronic heart failure and chronic kidney disease.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00356733.
Clinical Outcomes During Admissions for Heart Failure Among Adults With Congenital Heart Disease
Authors: Agarwal Anushree , Dudley Carson W. , Nah Gregory , Hayward Robert , Tseng Zian H. 
Published: August 2019

Background

Heart failure (
HF
) admissions in adults with congenital heart disease (
CHD
) are becoming more common. We compared in‐hospital and readmission events among adults with and without
CHD
admitted for
HF
.

Methods and Results

We identified all admissions with the primary diagnosis of
HF
among adults in the California State Inpatient Database between January 1, 2005 and January 1, 2012.
International Classification of Disease (ICD)
codes identified the type of
CHD
lesion, comorbidities, and in‐hospital and 30‐day readmissions events. Adjusted odds ratio (
AOR
, 95%
CI
) was calculated after adjusting for admission year, age, sex, race, household income, primary payor, and Charlson comorbidity index. Of 203 759 patients admitted for
HF
, 539 had
CHD
other than atrial septal defect. Compared with patients admitted for
HF
without
CHD
, those with
CHD
were younger, more often male, and had fewer comorbidities as determined by Charlson comorbidity index. On multivariate analysis,
CHD
patients admitted for
HF
had higher odds of length of stay ≥7 days (
AOR
2.5 [95%
CI
2.0–3.1]), incident arrhythmias (
AOR
2.8 [95%
CI
1.7–4.5]), and in‐hospital mortality (
AOR
1.9 [95%
CI
1.1–3.1]). Also,
CHD
patients had lower odds of readmission for
HF
(
AOR
0.6 [95%
CI
0.3–0.9]), but similar odds of other 30‐day readmission events. Complex
CHD
patients had higher odds of length of stay ≥7 days (
AOR
1.9 [95%
CI
1.1–3.3]) than patients with noncomplex
CHD
lesions, but similar odds of all other clinical outcomes.

Conclusions

Among patients admitted with the primary diagnosis of
HF
in California, adults with
CHD
have substantially higher odds of longer length of stay, incident arrhythmias, and in‐hospital mortality compared with non‐
CHD
patients. These results suggest a need for
HF
risk stratification strategies and management protocols specific for patients with
CHD
.
Out‐of‐Hospital Cardiac Arrest in Patients With and Without Psychiatric Disorders: Differences in Use of Coronary Angiography, Coronary Revascularization, and Implantable Cardioverter‐Defibrillator and Survival
Authors: Barcella Carlo Alberto , Mohr Grimur Høgnason , Kragholm Kristian Hay , Gerds Thomas Alexander , Jensen Svend Eggert , Polcwiartek Christoffer , Wissenberg Mads , Lippert Freddy Knudsen , Torp‐Pedersen Christian , Kessing Lars Vedel , Gislason Gunnar Hilmar , Søndergaard Kathrine Bach 
Published: August 2019

Background

Healthcare disparities for psychiatric patients are common. Whether these inequalities apply to postresuscitation management in out‐of‐hospital cardiac arrest (
OHCA
) is unknown. We investigated differences in in‐hospital cardiovascular procedures following
OHCA
between patients with and without psychiatric disorders.

Methods and Results

Using the Danish nationwide registries, we identified patients admitted to the hospital following OHCA of presumed cardiac cause (2001‐2015). Psychiatric disorders were identified using hospital diagnoses or redeemed prescriptions for psychotropic drugs. We calculated age‐ and sex‐standardized incidence rates and incidence rate ratios (
IRR
s) of cardiovascular procedures during post‐
OHCA
admission in patients with and without psychiatric disorders. Differences in 30‐day and 1‐year survival were assessed by multivariable logistic regression in the overall population and among 2‐day survivors who received acute coronary angiography (
CAG
). We included 7288 hospitalized patients who had experienced an OHCA: 1661 (22.8%) had a psychiatric disorder. Compared with patients without psychiatric disorders, patients with psychiatric disorders had lower standardized incidence rates for acute
CAG
(≤1 day post‐
OHCA
) (
IRR
, 0.51; 95% CI, 0.45–0.57), subacute
CAG
(2–30 days post‐
OHCA
) (
IRR
, 0.40; 95% CI, 0.30–0.52), and implantable cardioverter‐defibrillator implantation (
IRR
, 0.67; 95%
CI
, 0.48–0.95). Conversely, we did not detect differences in coronary revascularization among patients undergoing CAG (
IRR
, 1.11; 95%
CI
, 0.94–1.30). Patients with psychiatric disorders had lower survival even among 2‐day survivors who received acute CAG: (odds ratio of 30‐day survival, 0.68; 95% CI, 0.52–0.91; and 1‐year survival, 0.66; 95% CI, 0.50–0.88).

Conclusions

Psychiatric patients had a lower probability of receiving post‐
OHCA CAG
and implantable cardioverter‐defibrillator implantation compared with nonpsychiatric patients but the same probability of coronary revascularization among patients undergoing CAG. However, their survival was lower irrespective of angiographic procedures.
Home‐Based Cardiac Rehabilitation Alone and Hybrid With Center‐Based Cardiac Rehabilitation in Heart Failure: A Systematic Review and Meta‐Analysis
Authors: Imran Hafiz M. , Baig Muhammad , Erqou Sebhat , Taveira Tracey H. , Shah Nishant R. , Morrison Alan , Choudhary Gaurav , Wu Wen‐Chih 
Published: August 2019

Background

Center‐based cardiac rehabilitation (
CBCR
) has been shown to improve outcomes in patients with heart failure (
HF
). Home‐based cardiac rehabilitation (
HBCR
) can be an alternative to increase access for patients who cannot participate in
CBCR
. Hybrid cardiac rehabilitation (
CR
) combines short‐term
CBCR
with
HBCR,
potentially allowing both flexibility and rigor. However, recent data comparing these initiatives have not been synthesized.

Methods and Results

We performed a meta‐analysis to compare functional capacity and health‐related quality of life (hr‐
QOL
) outcomes in HF for (1)
HBCR
and usual care, (2) hybrid
CR
and usual care, and (3)
HBCR
and
CBCR
. A systematic search in 5 standard databases for randomized controlled trials was performed through January 31, 2019. Summary estimates were pooled using fixed‐ or random‐effects (when I
2
>50%) meta‐analyses. Standardized mean differences (95%
CI
) were used for distinct hr‐
QOL
tools. We identified 31 randomized controlled trials with a total of 1791
HF
participants. Among 18 studies that compared
HBCR
and usual care, participants in
HBCR
had improvement of peak oxygen uptake (2.39 mL/kg per minute; 95%
CI
, 0.28–4.49) and hr‐
QOL
(16 studies; standardized mean difference: 0.38; 95%
CI
, 0.19–0.57). Nine
RCT
s that compared hybrid
CR
with usual care showed that hybrid
CR
had greater improvements in peak oxygen uptake (9.72 mL/kg per minute; 95%
CI
, 5.12–14.33) but not in hr‐
QOL
(2 studies; standardized mean difference: 0.67; 95%
CI
, −0.20 to 1.54). Five studies comparing
HBCR
with
CBCR
showed similar improvements in functional capacity (0.0 mL/kg per minute; 95%
CI,
−1.93 to 1.92) and hr‐
QOL
(4 studies; standardized mean difference: 0.11; 95%
CI
, −0.12 to 0.34).

Conclusions

HBCR
and hybrid
CR
significantly improved functional capacity, but only
HBCR
improved hr‐
QOL
over usual care. However, both are potential alternatives for patients who are not suitable for
CBCR
.
Combined Effect of Income and Medication Adherence on Mortality in Newly Treated Hypertension: Nationwide Study of 16 Million Person‐Years
Authors: Lee Hokyou , Park Jong Heon , Floyd James S. , Park Sungha , Kim Hyeon Chang 
Published: August 2019

Background
Low socioeconomic status and poor medication adherence are known to be associated with increased morbidity and mortality among patients with hypertension, but their combined effects have not been studied. We therefore evaluated the joint association of household income and medication adherence with death and cardiovascular disease in patients newly treated for hypertension.

Methods and Results

This was a nationwide cohort study using the Korean National Health Insurance database. We included 1 651 564 individuals, aged 30 to 80 years, with newly treated hypertension and no prior cardiovascular disease and followed them for 10 years. Main exposures were household income in quintiles and adherence to antihypertensive medication, estimated by medication possession ratio: good (≥0.8), moderate (0.5 to <0.8), or poor (<0.5). The primary outcomes were all‐cause and cardiovascular deaths. Higher mortality risk was observed in patients with low income (adjusted hazard ratio=1.50, 99%
CI
=1.46‐1.53; lowest versus highest quintile) and poor medication adherence (adjusted hazard ratio=1.66, 99%
CI
=1.63‐1.68; poor versus good adherence). When compared with the highest‐income and good‐adherence group, adjusted hazard ratio (99%
CI
) of death was 1.56 (1.52‐1.61) for highest‐income poor‐adherers, 1.46 (1.41‐1.51) for lowest‐income good‐adherers, and 2.46 (2.38‐2.54) for lowest‐income poor‐adherers (
P
for interaction <0.001).

Conclusions
Low socioeconomic status and poor adherence to antihypertensive medication are associated with increased mortality and cardiovascular disease risks, but patients with low income are subject to larger excess risks by nonadherence. This highlights the potential importance of promoting medication adherence for risk reduction, especially in low‐income patients with hypertension.