bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central obesity, not BMI explains cardio-metabolic risks among university employees, Ethiopia – a cross-sectional study
Authors: Janakiraman Balamurugan , Abebe Solomen Mekonnen , Chala Mulugeta Bayisa , Demissie Solomon Fasika 
Published: July 2019

Abstract
Background: Evidence suggests that the middle and low-income countries such as Ethiopia are facing the growing epidemic of both communicable and non-communicable diseases creating burden on the healthcare system. The increasing prevalence is attributed to sedentarism, lifestyle changes and the presence of other cardio-metabolic risk factors. Therefore this study was designed to assess the prevalence and association of overweight, obesity, and cardio metabolic risks and to explore if there was any agreement among the anthropometric measurements among the academic employees of the University of Gondar, Ethiopia.
Methods: An institutional based cross-sectional study was conducted using the WHO stepwise approach and recommendations on 381 academic staff of the university. In addition, physical measurements such as weight, height, waist and hip circumferences, and biochemical measures such as blood pressure and fasting blood glucose level (peripheral blood samples by finger puncture) were measured using standardized tools.
Result: The mean age of the participants was 33.5 years. The prevalence of obesity among the study participants defined by body mass index, waist circumference, waist height ratio and waist hip ratio was 13.1%, 33.6%, 51.9% and 58.5% respectively. The prevalence of diabetes was 4.7% among which 1.3% was not diagnosed prior to this study. About 53 (13.9%) of the study sample were found to be hypertensive (6.3% known versus 29 7.6% newly diagnosed). Among the participants 39.4% and 23.4% were found to be pre hypertensive and pre diabetic respectively. WC was significantly associated with HTN (AOR = 5.14; 2.50, 9.72), pre-DM (AOR = 4.03; 2.974, 5.96), DM (AOR = 3.29; 1.09, 6.01). In addition, WHtR was significantly associated with Pre-HTN (AOR = 2.69; 1.49, 4.58), HTN (AOR = 2.06; 1.01, 6.31), and DM (AOR = 1.85; .76, 4.32).
Conclusion: This study results revealed the variable prevalence between general obesity and the anthropometric indices (IDF cutoff) defining central obesity; WC, WHtR, and WHR among the participants. The result of this study suggests that the constructs of central obesity, not BMI has to be used to screen risks of cardio-metabolic risks among Ethiopians.
Keywords: Diabetes mellitus, Hypertension, pre-hypertension, pre-diabetes, Ethiopia
Serum levels of soluble programmed death-ligand 1 (sPD-L1) in patients with primary central nervous system diffuse large B-cell lymphoma
Authors: Cho Inju , Lee Hansang , Yoon Sang Eun , Ryu Kyung Ju , Ko Young Hyeh , Kim Won Seog , Kim Seok Jin 
Published: July 2019

Abstract
Background

The interaction of programmed death-1 (PD-1) and programmed death-1 ligand (PD-L1) produces immunosuppressive activity, protecting tumor cells from anti-tumor immunity and possibly releasing soluble PD-L1 (sPD-L1) from PD-L1 expressing tumor cells. Therefore, we measured serum levels of sPD-L1 in patients with primary central nervous system lymphoma (PCNSL) and explored its clinical implications.

Methods

Sixty-eight patients with newly diagnosed PCNSL had diffuse large B-cell lymphoma and were treated with high-dose methotrexate-containing chemotherapy. The measurement of sPD-L1 and cytokines was performed using serum samples archived at diagnosis, and the tissue expression of PD-L1 was also analyzed from archived paraffin-embedded tissue blocks. Disease relapse, progression-free survival (PFS), and overall survival (OS) were analyzed according to the extent of sPD-L1 in serum and PD-L1 in tissue.

Results

The median level of serum sPD-L1 (0.429 ng/mL) was higher than in healthy control patients (0.364 ng/mL). The occurrence of relapse was more frequent in the high sPD-L1 (78%) than the low sPD-L1 group (50%), though the groups did not have different clinical or pathological characteristics at diagnosis. As a result, the OS and PFS for the high sPD-L1 group were significantly lower than those in the low group. PD-L1-positive tumor cells were found in 35 patients (67%), and the extent of PD-L1-postive tumor cells was positively associated with serum sPD-L1 levels (r = 0.299, P = 0.031). Among the 34 cytokines analyzed, only the serum level of IL-7 correlated with the serum level of sPD-L1 (r = 0.521, P < 0.001).

Conclusions

Serum levels of sPD-L1 could reflect the expression of PD-L1 in PCNSL tumor cells and predict patient survival outcomes. Therefore, sPD-L1 in serum could be a feasible biomarker for determining a risk-adapted treatment strategy for PCNSL patients.
AMAFRICA, a patient-navigator program for accompanying lymphoma patients during chemotherapy in Ivory Coast: a prospective randomized study
Authors: KOFFI Kouassi Gustave , Silué DA , Laurent C , Boidy K , Koui S , Compaci G , Adeba ZH , Kamara I , Botty RP , Bognini A.S , Sanogo I , Despas F , Laurent G 
Published: July 2019

Abstract
Background

Previous studies have indicated that accompanying socially undeserved cancer patients through Patient Navigator (PN) or PN-derived procedures improves therapy management and reassurance. At the Cancer Institute of Toulouse-Oncopole (France), we have implemented AMA (Ambulatory Medical Assistance), a PN-based procedure adapted for malignant lymphoma (ML) patients under therapy. We found that AMA improve adherence to chemotherapy and safety. In low-middle income countries (LMIC), refusal and abandonment were documented as major adverse factors for cancer therapy. We reasoned that AMA could improve clinical management of ML patients in LMIC.

Methods

This study was set up in the Abidjan University Medical Center (Ivory Coast) in collaboration with Toulouse. Hundred African patients were randomly assigned to either AMA or control group. Main criteria of judgment were refusal and abandonment of CHOP or ABVD chemotherapy.

Results

We found that AMA was feasible and has significant impact on refusal and abandonment. However, only one third of patients completed their therapy in both groups. No differences were noted in terms of complete response rate (CRR) (16% based on intent-to-treat) and median overall survival (OS) (6 months). The main reason for refusal and abandonment was limitation of financial resources.

Conclusion

Altogether, this study showed that PN may reduce refusal and abandonment of treatment. However, due to insufficient health care coverage, its ultimate impact on OS remains limited.
Improved Clinical Outcome Using Transarterial Chemoembolization Combined with Radiofrequency Ablation for Patients in Barcelona Clinic Liver Cancer Stage A or B Hepatocellular Carcinoma Regardless of Tumor Size: Results of a Single-center Retrospective Case Control Study
Authors: Ren Yanqiao , Cao Yanyan , Ma Hong , Kan Xuefeng , Zhou Chen , Liu Jiacheng , Shi Qin , Feng Gansheng , Xiong Bin , Zheng Chuansheng 
Published: July 2019

Abstract
Background

To determine the safety and efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (hereafter, TACE-RFA) in treating Barcelona Clinic Liver Cancer (BCLC) Stage A or B (hereafter, BCLC A/B) hepatocellular carcinoma (HCC) patients, and to explore the range of tumor sizes suitable for combination therapy.

Methods

This retrospective study assessed the consecutive medical records of HCC patients with BCLC A/B who received TACE-RFA or TACE from September 2009 to September 2018. Progression-free survival (PFS), overall survival (OS), therapeutic response, and complications were compared between the two groups.

Results

Among 2447 patients who received TACE-RFA or TACE, 399 eligible patients were enrolled in our study, including 128 patients in the TACE-RFA group and 271 patients in the TACE group. Compared with the TACE group, the PFS and OS rates of 1,3,5,8 years in the TACE-RFA group were significantly better, with higher objective tumor regression rate and better disease control rate. RFA treatment did not increase the risk of death in patients with HCC, and both liver subcapsular hematoma and bile duct injury were improved by symptomatic treatment.. Serum α-fetoprotein level and treatment method were important independent prognostic factors for OS, whereas albumin, hepatitis B and treatment method were important independent prognostic factors for PFS. Subgroup analysis showed that patients in the TACE-RFA group always showed better OS and PFS.

Conclusions

TACE-RFA had an advantage over TACE alone in prolonging PFS and improving OS in HCC patients with BCLC A/B, and can benefit patients regardless of tumor size.
The prognosis of cancer patients undergoing liposomal doxorubicin-based chemotherapy: a systematic review and meta-analysis
Authors: Zhang Kaiping , Sun Zhi , Zhang Yin , Liang Chaozhao , Zhang Li , Chao Min 
Published: July 2019

Abstract
Background

It is well known that liposome-based delivery of cytotoxic chemotherapeutics has been proposed as a putative strategy to enhance drug tolerability and efficacy compared to the conventional chemotherapy. However, its potential effects on improving cancer patients prognosis remain largely unknown. The current meta-analysis is to explore the prognosis of cancer patients undergoing liposomal doxorubicin-based chemotherapy.

Methods

A detailed review of English and Chinese literature was conducted from PubMed, Embase, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI) up to March 21st, 2019. We evaluate its possible correlations using hazard ratios (HRs) with 95% confidence intervals (CIs). The pooled data were calculated by STATA software and Review Manager 5.3 software.

Results

Consequently, 26 studies including 7943 patients were satisfied in current analysis. We found that there were no significant differences between liposomal and conventional chemotherapy in OS (HR=0.98, 95%CI: 0.93-1.04, P=0.544) and PFS (HR=1.00, 95%CI: 0.92-1.10, P=0.945). Likewise, subgroup-analysis regarding country, cancer type and sample sizes also showed the similar results of the two paired groups.

Conclusion

Taken together, our findings have demonstrated that there was no association of undergoing liposomal doxorubicin-based chemotherapy with cancer prognosis. However, detailed and further studies are needed to confirm these conclusions.
Treatment Outcome and Clinical Characteristics of HER2 Mutated Advanced Non-Small Cell Lung Cancer Patients in China
Authors: Xu Fei , Yang Guangjian , Xu Haiyan , Yang Lu , Qiu Weini , Li Junling , Wang Yan 
Published: July 2019

Abstract
Background: HER2 mutation is found in 1-2% of lung cancer patients. Chemotherapy remains the standard of care for patients harboring HER2 mutations, while many HER2 targeted tyrosine kinase inhibitors (TKIs) have been applied to them in practice in recent years. Studies comparing chemotherapy to HER2-TKIs were limited. This study was aimed to investigate the molecular and clinical patterns of HER2 mutations in advanced non-small cell lung cancer, and compare the different outcomes between chemotherapy and HER2-TKIs.
Methods: Advanced or recurrent non-small cell lung cancer patients with de novo HER2 mutations (N=75) were included in this study. Molecular information, clinical features, and treatment outcomes were retrospectively collected from a web-based patient registry and hospital chart review.
Results: Between October 2012 and December 2018, 65 patients with in-frame insertion mutations, 8 with point mutations and 2 with gene amplification were found. The most common subtypes of insertion mutations were A775_G776insYVMA, G776delinsVC, and V777_G778insGSP. HER2 mutated patients were mostly young-aged, females, never or light smokers, and adenocarcinoma. For HER2 mutated advanced NSCLC, chemotherapy achieved better outcomes than HER2-TKIs (median PFS: 5.5 vs 3.7 months in the first line setting and 4.2 vs 2.0 months in the second line setting, P=0.001 and 0.031, respectively). Especially for the most common subtype, YVMA insertions, PFS was significantly longer in chemotherapy than HER2-TKIs both in the first line (6.0 vs 2.6 months, P=0.008) and the second line (4.2 vs 2.6 months P<0.001).
Conclusions: HER2 mutated lung cancer patients were younger, mostly females, never or light smokers, histologically adenocarcinomas dominated. Compared to existed HER-TKIs, chemotherapy might bring more benefit to HER2 mutated advanced lung cancer patients, especially the most common type of HER2 exon 20 insertions, A775_G776insYVMA subtype.
Trial registration: ChiCTR1800017709. Registered 10 August 2018.
Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana
Authors: Smith-Togobo Cecilia , Pedersen Mette Ø , Jensen Steffen G , Duduyemi Babatunde , Gyasi Richard K , Ofori Michael F , Paintsil Vivian , Renner Lorna , Nørgaard Peter , Hviid Lars 
Published: July 2019

Abstract
Endemic Burkitt lymphoma (eBL) is an aggressive B-cell lymphoma, which is a common childhood cancer in areas with intense transmission of Plasmodium falciparum parasites. Early and accurate diagnosis is a prerequisite for successful therapy, but it optimally involves advanced laboratory investigations. These are technologically demanding, expensive, and often difficult to implement in settings where eBL is prevalent. Diagnosis is thus generally based on clinical assessment and morphological examination of tumour biopsies or fine-needle aspirates (FNAs).

The purpose of the present study was to assess the accuracy of eBL diagnosis at two tertiary hospitals in Ghana. To that end, we studied FNAs from 29 eBL patients and 21 non-eBL lymphoma patients originally diagnosed in 2018. In addition, we examined 111 archival formalin-fixed and paraffin-embedded (FFPE) biopsies from Ghanaian patients originally diagnosed as eBL (N=55) or non-eBL (N=56) between 2010 and 2017. Availability-based subsets of samples were subjected to haematoxylin-eosin or Giemsa staining, C-MYC immunohistochemistry, and fluorescence in situ hybridisation (FISH) analysis of c-myc rearrangements

We found a good correlation between original diagnosis and subsequent retrospective assessment, particularly for FNA samples. However, evidence of intact c-myc genes and normal C-MYC expression in samples from some patients originally diagnosed as eBL indicates that morphological assessment alone can lead to eBL over-diagnosis in our study area. In addition, several FFPE samples could not be assessed retrospectively, due to poor sample quality. Therefore, the simpler FNA method of obtaining tumour material is preferable, particularly when careful processing of biopsy specimens cannot be guaranteed. We conclude that the accuracy of eBL diagnostic tools available in Ghana is generally adequate, but could be improved by implementation of additional pathology laboratory investigations. Improved attention to adequate preservation of archival samples is recommended.
The risks of antioxidant vitamins (ubiquinone and β-carotene) deficiency and metabolic disorders in patients with head and neck cancer
Authors: Chan Man-Yee , Lee Bor-Jen , Chang Po-Sheng , Hsiao Han-Yu , Hsu Li-Ping , Chang Chia-Hua , Lin Ping-Ting 
Published: July 2019

Abstract
Background

Cancer development is mediated by oxidative stress and inflammation, which may correlate with metabolic disorders. The aim of this study was to evaluate antioxidant vitamins status and metabolic parameters in patients with head and neck cancer according to tumor-node-metastasis (TNM) stages.

Methods

A total of 194 patients with head and neck cancer were enrolled in this study. The levels of antioxidant vitamins (ubiquinone, β-carotene, vitamin A and E), metabolic parameters, oxidative stress, antioxidant enzymes activity, and inflammatory markers were measured.

Results

More than half of the subjects had high blood pressure, central obesity, hyperglycemia, and hyperlipidemia regardless of TNM stage. With regard to antioxidant vitamins status, 46% and 94% of patients had β-carotene and ubiquinone deficiency, respectively. Patients in T3 and T4 stages had significantly lower antioxidant enzyme (catalase, p = 0.03) activity and higher inflammatory markers levels (high sensitivity C-reactive protein and interleukin-6, p < 0.01) than patients in the other stages. In addition, the level of β-carotene was negatively associated with waist circumference, and ubiquinone was positively associated with the level of high-density lipoprotein cholesterol (p < 0.05). Higher β-carotene and ubiquinone levels were negatively associated with hypertriglyceridemia and the risk of metabolic syndrome (p < 0.05).

Conclusions

A high proportion of patients with head and neck cancer had ubiquinone or β-carotene deficiency and metabolic disorders. The level of ubiquinone or β-carotene was negatively associated with the risk of central obesity, hypertriglyceridemia, and metabolic syndrome. Since patients with head and neck cancer suffer from high oxidative stress and inflammation (particularly in the T3 and T4 stages), supplementation with antioxidant vitamins such as ubiquinone or β-carotene could be preferentially applied.
Transcriptome analysis provides new insight into the molecular mechanisms in regulating carotenoid accumulation in pericarp of fruits from two pummelo cultivars Citrus grandis (L.) Osbeck
Authors: Lu Xinkun , Lu Yanqing , Lin Yanjin 
Published: July 2019

Abstract
Background

Carotenoid improves fruit external quality and benefits to human health. Although the mechanism underlining carotenoid metabolism is clear, the regulation of carotenoid accumulation remains poorly understand. Recently, ‘Huangbao’ pummelo was selected from the bud mutation of ‘Guanxi’ pummelo (yellow pericarp). The pericarp of mutant-type fruits is characterized by red colour development during fruit ripening stage. The aim of the study is to explore the molecular mechanisms in regulating pericarp colouration based on transcriptomic profile analysis of the two cultivars.

Results

Lycopene content in the pericarp of ripe fruits from ‘Huangbao’ (160.29 µg g-1 FW) was significantly higher than that of from ‘Guanxi’ (0.91µg g-1 FW). Lycopene is a main contributor for pericarp colouration. 929 differentially expressed genes (DEGs) were indentified through transcriptional profiling in the pericarp of ripe fruits from the two cultivars. Expression levels of the Genes encoding for fructose-bisphosphate aldolase, enolase and pyruvate kinase isozyme were significantly higher in ‘Huangbao’ than that of in ‘Guanxi’, which possibly promote 3-phosphate-glyceraldehyde and pyruvic acid biosyntheses. This two productions act as precursors for the biosyntheses of Isopentenylpyrophosphate (IPP) and Dimethylallyl pyrophosphate (DMAPP) in Methylerythritol phosphate (MEP) pathway. Genes ecoding for phytoene synthase and prolycopene isomerase were unexpected down-regulated in ‘Huangbao’. Gibberellin-2-β-dioxygenase (GA2OX) gene was specially expressed in ‘Huangbao’, while the transcript amounts of genes related to auxin response and auxin transport as well as several negative regulators in ethylene signaling in ‘Huangbao’ were all down regulated. Additionally, Transcription factors (DELLA, NAC, MADS-box, WRKY) and post translational modification proteins (histone acetyltransferase and E2 ubiquitin-conjugating enzyme) involved in regulating ethylene and carotenoid metabolisms were also differentially expressed in the two pummelo cultivars.

Conclusions

The main differences in the carotenoid metabolism in the pericarp of ripen fruits from ‘Huangbao’ and ‘Guanxi’ were observed in the carotenoid precursor biosynthetic pathway. Differentially expressed genes in gibberellin, auxin and ethylene metabolisms and plant hormone signaling pathways, as well as several transcription factors and post translational modification protein genes involved in regulating ethylene and carotenoid metabolisms provide targets for further exploration in revealing mechanisms underlying fruit colour development.
“Side effects-part of the package” – A mixed methods approach to adverse events among patients with DR-TB under RNTCP Gujarat, India
Authors: Jakasania Arjunkumar Hardas , Shringarpure Kalpita , Kapadia Dixit , Sharma Radhika , Mehta Kedar , Prajapati Arpit , Kathirvel Soundappan 
Published: July 2019

Abstract
Background:
Unsuccessful treatment outcomes among patients with drug resistant tuberculosis (DR-TB) are due to high rates of adverse events (AEs). However, information related to AEs is not systematically collected and managed under programmatic setting. The present study assessed the a) incidence and pattern of adverse events in first three months of DR-TB treatment initiation; b) treatment seeking behaviour for AE management; and c) explore the challenges in seeking treatment and reporting AEs.
Methods:
This mixed methods study included all patients diagnosed and initiated on treatment under RNTCP during July-September 2018 at Ahmedabad DR-TB centre. The patients were interviewed telephonically and assessed for all AEs experienced by them. In-depth interviews and key-informant interviews were conducted among patients, DOTS supervisors and programme staffs (treatment supervisors, medical officer and district program manager).
Results:
A total 207 AEs were reported by the 74 DR-TB patients. All patients experienced at least one AE during initial treatment period. Incidence rate of AEs (experienced) was 3.11 (1st month-4.6, 2nd month-2.7, 3rd month-2.02) per 100 person days. Of the 207 AEs, gastro-intestinal (59, 28.3%), ophthalmic (32, 15.4%) and otolaryngology (25, 11.9%) system related AEs were commonly experienced. Treatment was not sought in two-fifths of the AEs. Themes and subthemes related to challenges in treatment seeking or reporting of AEs were 1) Patient related-Misconceptions, accessibility and affordability of management, lack of counselling support, stigma and discrimination, and past treatment experience; 2) Health system related- lack of guideline and training for AE management, and poor coordination between hospital and tuberculosis centre.
Conclusion:
The incidence of AEs was high among patients with DR-TB in the first three months of treatment and treatment seeking/reporting was low. Adequate health education and counselling of the patient and orientation of the health systems are the need of the hour. An efficient real-time reporting and management of AE can be developed and tested for effective DR-TB control.
Keywords:
Adverse event, Drug resistant tuberculosis, Operational research, Incidence, India, Treatment seeking.