bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of dose distributions when using carbon ion radiotherapy versus intensity-modulated radiotherapy for hepatocellular carcinoma with macroscopic vascular invasion: A retrospective analysis
Authors: Shiba Shintaro , Shibuya Kei , Kawashima Motohiro , Okano Naoko , Kaminuma Takuya , Okamoto Masahiko , Kubota Yoshiki , Nakano Takashi , Ohno Tatsuya 
Published: September 2019

Abstract
Background. Studies comparing the dose distributions of carbon ion radiotherapy (C-ion RT) and intensity-modulated radiotherapy (IMRT) in patients with locally advanced hepatocellular carcinoma (LAHCC) are lacking. This study aimed to investigate the dose distributions of these modalities and identify any advantages to using C-ion RT.
Methods. Patients with LAHCC who had undergone C-ion RT between June 2010 and November 2018 were retrospectively analyzed. From among 210 patients with hepatocellular carcinoma who received C-ion RT, 10 consecutive patients with LAHCC were included. The dose-volume histogram parameters of clinical plans using C-ion RT at 60 Gy (relative biological effectiveness [RBE]) and simulated plans using IMRT at 60 Gy and 50 Gy were compared. We evaluated the three plans in terms of the following parameters: the percentage of the minimum dose that covered 95% of the target volume (D95); mean liver dose (MLD); and percentage of the normal liver volume that received at least 5 Gy (V5), 10 Gy (V10), 20 Gy (V20), 30 Gy (V30), 40 Gy, and 50 Gy. Patients at high risk of developing radiation-induced liver disease (RILD) were those with MLD and V30 of >23 Gy and >28%, respectively.
Results. The V5, V10, V20, and MLD were significantly lower in patients who received 60 Gy (RBE) of C-ion RT than in those who received 60 Gy of IMRT, although the D95 values were not significantly different. The V5, V10, and V20 were also significantly lower in patients who received 60 Gy (RBE) of C-ion RT than in those who received 50 Gy of IMRT; moreover the D95 was significantly superior in the former group. The numbers of high-risk patients who developed RILD when administered 60 Gy (RBE) of C-ion RT, 60 Gy of IMRT, and 50 Gy of IMRT were 1, 7, and 6, respectively.
Conclusions. C-ion RT exhibits a better dose distribution to the liver than does IMRT when treating patients with LAHCC. C-ion RT made it possible to treat patients with LAHCC who otherwise could not be treated using IMRT because of the high risk of RILD.
Association Of Diabetes With Sleep Duration and Quality in Urban and Rural Cameroonian Community Dwellers
Authors: LELE Elysée Claude BIKA , DOUMBE Jacques Narcisse , BORNE Philippe VAN DE , MESSOMO Thierry , MBANGO EDISARI , HERMANS Michel , DEGAUTE Jean Paul , LEEMAN Marc , MBATCHOU Hugo Bertrand , NGATCHOU William , LEMOGOUM Daniel 
Published: September 2019

Abstract
Background Sleep disorders are known to be linked with numerous cardiovascular co-morbidities like diabetes. The prevalence and impact of sleep quality and duration on diabetes in the Cameroonian population is not well established. The aim of our study was to evaluate the separate and combined roles of sleep duration and quality on diabetes mellitus in the urban and rural Cameroonian population.Methods This was a cross-sectional prospective survey conducted in 249 rural and 250 urban community dwellers in Cameroon aged 18 years and older. Sleep duration (SD) and quality were self-reported using the Pittsburg Sleep Quality Index (PSQI). Poor sleep quality was considered for PSQI score>5 and short SD was considered ≤6h. Diabetes mellitus was considered for fasting blood glucose≥126mg/dL and/or being on glucose-lowering medication(s). Multivariable logistic regression was used to determine the association of sleep duration and quality with diabetes.Results mean age was 36±12years with 39.1% male participants. Frequency of diabetes was 8.2% and was similar between urban and rural participants (10% vs 6.4% respectively; p=0.188). Frequency of poor sleep quality was 50.3% and was similar in urban and rural groups (48.2% vs 52.4% respectively, p=0.395). Short SD represented 30.5% of the sample and was more frequent in the urban than rural group (36.1% vs 24.8% respectively, p=0.006). Short SD was significantly associated with diabetes (OR 2.62, 95%CI 1.38 – 5.00) while poor sleep quality was not significantly associated with diabetes. Poor sleep quality combined with short SD was strongly associated with diabetes (OR 2.67, 95%CI 1.23- 5.79).Conclusion there is a necessity to take into account sleep duration and quality in the management of diabetes
Burnout level and associated factors in a Sub-Saharan African medical setting: prospective cross-sectional survey.
Authors: MACKANGA Jean-Rodolphe , MOULOUNGUI Emeline Gracia MOUENDOU , IBA-BA Josaphat , POTTIER Pierre , KOMBILA Jean-Baptiste MOUSSAVOU , BOGUIKOUMA Jean Bruno 
Published: September 2019

Abstract
Background Burnout, a real barrier to care, whose knowledge has often been established in the high-income medical context. However, in low and middle-income countries, such as sub-Saharan Africa, which is characterized by a precarious hospital situation and a high stakes linked to the Millennium Development Goals, burnout is poorly studied. The objective of our study was to evaluate, in the medical context of one sub-Saharan African country, the burnout level and associated factors.Methods a prospective cross-sectional study concerning doctors and doctoral student in medicine practicing clinical activity in Gabon. According to the Maslach Burnout Inventory Scale, the burnout symptom was defined by high level in at least one of the 3 dimensions and the severe burnout by high level in all 3 dimensions. Potential factors explored: demographic, socio-professional and psychometric. Multiple logistic regression, by backward method, established the model of factors associated with burnout symptom.Results out of 104 participants, severe burnout prevailed at 1.9% (95% CI: 0.2% -6.8%) and burnout symptom at 34.6% (95% CI: 25, 6% -44.6%). Model of factors associated with burnout symptoms: age (OR = 0.86, p = 0.004), clinical activity in a university hospital center (OR = 5.19, p = 0.006), the feeling of ease of access to the hospital (OR = 0.59, p = 0.012), the number of elderly dependents living with the practitioner (OR = 0.54, p = 0.012), living in a different borough from that of the hospital (OR = 0.24, p = 0.039) and the opinion score favorable to traditional medicine (OR = 1.82, p = 0.087).Conclusion in the Gabonese medical settings, almost one out of two practitioners is symptomatic of burnout. The young age, the university hospital center, the perceived difficulty to access the workplace and paradoxically the proximity to the hospital seems be at risk of burnout. The link between burnout and the perception of traditional medicine questions cultural issues in the doctor-patient relationship in this context.
Inhibition of Type I Interferon Signaling abrogates Early Mycobacterium bovis Infection
Authors: Wang Jie , Hussain Tariq , Zhang Kai , Liao Yi , Yao Jiao , Song Yinjuan , Sbair Naveed , Cheng Guangyu , Dong Haodi , Li Miaoxuan , Ni Jiamin , Mangi Mazhar Hussain , Zhao Deming , Zhou Xiangmei 
Published: September 2019

Abstract
Background: Mycobacterium bovis (M. bovis) is the central causative agent of bovine tuberculosis; however, it also caused serious infection in human beings. Type I IFNs is a key factor in reducing viral multiplication and modulate host immune defense against viral infection. However, the regulatory pathways of type I IFN signaling during Mycobactrium bovis (M. bovis) infection are not yet fully explored. Here, we investigate the role of type I IFN signaling on the pathogenesis of M. bovis infection in mice. Methods: C57BL/6 mice were treated with IFNAR1-blocking antibody or Isotype control 24 hour before M. bovis infection. After 21 and 84 days of infection mice were sacrificed, for analysis of type I IFN signaling on the pathogenesis of M. bovis. qRT-PCR and ELISA was performed to detect the expression of type I IFNs and relative gene. M. bovis induced lung lesions and viable bacterial count was assessed by conducting histopathology and CFU assay. Results: We observed an abundant expression of type I IFNs in the blood serum and lung tissues of M. bovis infected mice. In vivo blockade of type I IFN signaling reduced the recruitment of neutrophils to the lung tissue, mediate the activation of macrophages toward a pro-inflammatory profile and regulate the inflammatory cytokine production; however, no impact on T cell recruitment and activation in the early acute phase of infection was observed. Additionally, blocking of type I IFN signaling reduces bacterial burden in infected mice than untreated infected mice. Conclusions: Altogether, our results reveal that type I IFN mediates a balance between infection-mediated inflammatory reactions and pathogen’s control mechanism of the host during M. bovis infection. Thus, modulating type I IFN signaling could be exploited as therapeutic strategies against a large repertoire of inflammatory disorders, including tuberculosis.
Severe acute malnutrition and its associated factors among under-five children in two districts of Nepal
Authors: Ghimire Umesh , Aryal Binod Kumar , Gupta Ankush Kumar , Sapkota Suman Sapkota 
Published: September 2019

Abstract
Background : The main objective of this study was to identify the risk factors of severe acute malnutrition in under-five children in the two districts of Nepal. Methods: Using a mid-upper arm circumference measure, nutritional status along with the associated factors underlying determinants of undernutrition of 404 children who visited the Outpatient Therapeutic Centres were assessed using a validated structured questionnaire. Multivariate logistic regression was used to determine the factors associated with severe acute malnutrition (SAM) and associated variables. Results: The odds of a child being in the SAM category increased significantly if the family have five or more children and if the household yearly income is below an average. The children in the Madhesi family were 3.6 times more likely to be malnourished. Toilet facility (Adjusted Odds Ratio [AOR]: 4.45; 95% Confidence Interval [CI]: 1.88-10.53) and family with no kitchen garden (AOR: 3.16; 95% CI: 1.28-7.89) were significantly associated with SAM among under five children. Children from moderate food insecure and severe food insecure households were 3.2 and 5.5 times more likely to be malnourished respectively. Compared to the mothers with no job, mother with some sort of paid job had more than six times higher odds of having severely acute malnourished children.Conclusions: These findings suggest that the nutrition interventions as well as awareness on child feeding practices are crucial to improve the nutritional status of children especially among Madhesi community, poorer households and among illiterate mothers.
Occult hepatitis B virus infection in maintenance hemodialysis patients: prevalence and mutations in “a” determinant
Authors: Tang Yun , Liu Xiangqin , Hong Daqing , Lu Xiangheng , He Qiang , Li Guisen , Zou Yang 
Published: September 2019

Abstract
Background：Occult hepatitis B virus infection (OBI) is rare and its diagnosis is often overlooked, but there is still a risk of HBV transmission. To analysis the prevalence of OBI among maintenance hemodialysis (MHD) patients in Sichuan Provincial People’s Hospital, the molecular biological characteristics of OBI and the mutation of “a” determinant were investigated. Method: A total of 330 patients undergoing hemodialysis at Sichuan Provincial People’s Hospital and its satellite dialysis units were tested for HBV markers by ELISA. HBV-DNA was detected by real-time PCR in patients with HBsAg negative/ HBcAb positive to investigate the prevalence of OBI. For plasma samples with persistent HBV DNA positive, the S gene was determined by nested PCR, and the sequence of gene mutation was compared with the standard sequence. Result: Among 330 patients, ages range from 27 to 95 with a mean of 60.66 years old and majority of patients (57.6%) > 60 years old. Serum from 165 of 180 HBsAg negative/HBcAb positive individuals were tested for HBV DNA by real-time PCR. 7 of 165 patients had low level of HBV DNA. Of those, 5 individuals were both HBcAb and HBsAb positive, and 2 individuals were HBcAb positive alone. After 2 years follow-up, 2 individuals with HBcAb positive alone were both tested HBV DNA again, but the other patients were not. Serum from the 2 patients were used nested PCR to confirm the genotype and the mutation of S gene. We found they both were genotype B. Amino acid sequencing confirmed that one had no mutations and the other one had Q128R, T131N, M133S, F134L and D144E mutants in “a” determinant. Conclusion: Chronic HBV infection was 7.3% (24/330) and OBI was 2.1% (7/330) in our hospital hemodialysis center. The genotype of patients with OBI were genotype B. Mutations of Q128R，T131N，M133S，F134L and D144E might be the potential sites associated with OBI.
Debridement, Antibiotics and Implant Retention (DAIR) Has High Success Rate for Acute Periprosthetic Joint Infection
Authors: Zhang Chaofan , He Long , Fang Xinyu , Huang Zida , Bai Guochang , Li Wenbo , Zhang Wenming 
Published: September 2019

Abstract
Background: The efficacy of debridement, antibiotics and implant retention (DAIR) for acute periprosthetic joint infection (PJI) has been debated. The purpose of this study was to report our clinical outcome and experience of managing acute PJI with DAIR. Methods: A retrospective review of all patients diagnosed with acute PJI after hip or knee replacement surgery and managed with DAIR in our prospective joint replacement register from 2008 to 2019 was performed. Patients’ symptom onset duration, inflammatory marker levels, bacteriology, and surgical outcome were tracked and recorded. Results: A total of 24 patients with 7 after hip replacement and 17 after knee replacement were included. Twenty-one were early post-operative infection and 3 were late acute haematogenous infection. During a mean follow-up time of 29.2±15.1 months, twenty-two were successfully treated while 2 failed who required repeated DAIR. The overall success rate of DAIR was 91.7%. For staphylococcal infection, DAIR has 100% success rate. Five patients presented with symptoms between 4 to 8 weeks also achieved 100% success rate. Conclusions: DAIR has a high success rate for acute PJI, and can be performed in selected patients whose symptoms have sustained for over 4 weeks. DAIR has high rate of success for staphylococcal infection. Metagenomic next-generation sequencing (mNGS) test can be used as a potential tool to identify pathogens in acute PJI. Key Words: Debridement, antibiotics and implant retention (DAIR); acute periprosthetic joint infection, debridement, total knee replacement, total hip replacement
Musculoskeletal Symptoms among Radiologists in Saudi Arabia: A Multi-Center Cross-Sectional Study
Authors: Shammari Malak Al , Hassan Ali , Dandan Omran Al , Qadeeb Mohammed Al , Bubshait Dalal 
Published: September 2019

Abstract
Background : Musculoskeletal disorders account for the majority of work-related illnesses resulting in a significant economic burden on society. Computer users are subject to unique repetitive strains, predisposing them to musculoskeletal symptoms. In the digitalized field of radiology, radiologists tend to spend long hours interpreting medical images on computers. This study aimed to determine the prevalence of musculoskeletal symptoms among radiologists in Saudi Arabia and to the factors that contribute to these symptoms. Methods : An online survey was sent to radiologists practicing in hospitals in the Eastern Province of Saudi Arabia. The survey addressed demographic characteristics, workload, and workstation environments, and included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. Results were analyzed descriptively using the Chi-square test and logistic regression analysis. Results : The survey was completed by 198 participants (111 men and 87 women). Most participants were aged below 40 years. The proportions of radiology residents, specialists, and consultants who completed the survey were 40.9%, 27.3%, and 27.3%, respectively. Most participants spent 7-9 hours per day reviewing medical images. In total, 140 (70.7%) participants had experienced musculoskeletal symptoms in the week preceding the survey, whereas 176 (88.9%) participants reported having symptoms in the last 12 months preceding the survey. The normal daily activities of 15.2%, 14.6%, and 14.6% of survey participants were restricted in the last 12 months, due to neck, lower back, and shoulder pain respectively. Significant contributing factors for musculoskeletal symptoms included age, sex, number of hours spent reviewing medical images, and the type of medical images predominantly reviewed. A multivariable logistic regression analysis revealed that radiologists who spent most of their time performing ultrasound scanning or reviewing computed tomography images were at higher risk of developing musculoskeletal symptoms. Conclusions : Musculoskeletal symptoms are common among radiologists. The high prevalence rate among our study participants indicates the need for preventive actions, such as increasing awareness of this issue among practicing radiologists, educating practitioners about the adverse effects of prolonged sitting, and providing training to ensure proper ergonomic practices.
Association of Backpack Loads and Wearing Time with Musculoskeletal Disorders in School Children of Wah Cant Pakistan: Correlational study
Authors: Sundas Rabia , Ghous Misbah , Sehar Shadab 
Published: September 2019

Abstract
Background: Young children are carrying heavy bags to and from their schools. The use of backpacks increases recently because of several factors, including decreased availability of school lockers, increased homework, text books & other belongings being carried to school. All these factors amplify backpack weight which have drastic effects on young students’ musculoskeletal system.Methods: This was a correlational study. Data collection was done between Septembers to December 2018. The inclusion criteria were healthy young boys and girls of school children, with no known history of any musculoskeletal disorder or any other deformity or pathology. Survey was done through self-structured questionnaire and Nordic Musculoskeletal questionnaire. SPSS 21.0 was used for data analysis.Results: A total of 1104 students were included in the study, mean age of the students was 11.90 ± 2.2 (range 8-15) years. There were 48.4% males while 51.6% were females. Frequency of fatigue due to heavy backpack was 61.6%.Neck pain was common in 40.2% students, shoulder pain in 47.4% and the frequency of low back pain was 46.6% .According to BMI 33.2% students had normal BMI and 32.6% students were very severely underweight which is an alarming situation. The correlation of bag pack weight with students BMI was weak positive(r=0.25, p<0.05) Conclusion: This study concluded that the frequency of musculoskeletal pain was high due to carrying heavy backpacks. Upper and low back pain were the most common type. Maximum students carry >16% ratio of backpacks load. Wearing time of backpack was more than 10 minutes. Keywords: Backpacks, load, wearing time, School children, Pain, Dysfunction, musculoskeletal
A simple and cost-effective approach for technical validation of next generation methylation sequencing data
Authors: Javadmanesh Ali , Shariatpanahi Afsaneh Mojtabanezhad , Davodly Ehsan Shams , Azghandi Marjan , Yassi Maryam , Heidari Mehdi , Kerachian Matin , Kerachian Mohammad Amin 
Published: September 2019

Abstract
Background DNA methylation is a fundamental epigenetic process that, in most cases, modulates genetic expression levels. Changes in DNA methylation, either hypo- or hypermethylation, have a key role in many biological processes and several human diseases such as cancer. In the current study, we offered an approach to validate the next generation methylation sequencing data.Methods Genomic DNA was extracted from target and control samples (6 in each group), followed by bisulfite conversion. Next generation methylation sequencing and methylation sensitive high-resolution melting assay were carried out. The primers for methylation sequencing validation were designed by R programming language.Results In the current study, two groups, case and control, were discriminated based on methylation sequencing results and the real time PCR-based results were in accordance with the next generation methylation sequencing.Discussion Methylation sensitive high-resolution melting validation assay is a simple and cost-effective method, which confirmed next generation methylation sequencing results.
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease
Authors: Hong Wanzi , Wang Yu , Wei Xuebiao , Yu Danqing , Zhang Chunxiang , Tan Ning , Jiang Lei 
Published: September 2019

Abstract
Background: Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart disease (RHD) undergoing valve replacement surgery (VRS).
Methods: We identified 1395 non-diabetic patients who diagnosed with having RHD, and underwent preoperative coronary angiography and at least one valve replacement. BG was measured at admission to the intensive care unit (ICU) after surgery. The association of postoperative BG level with in-hospital and one-year mortality was accordingly analyzed.
Results: Included patients were stratified into four groups according to postoperative BG level’s (mmol/L) quartiles: Q1 (< 9.3 mmol/L, n=348), Q2 (9.3-10.9 mmol/L, n=354), Q3 (10.9-13.2 mmol/L, n=341), and Q4 (≥ 13.2 mmol/L, n=352). The in-hospital death (1.1% vs. 2.3% vs. 1.8% vs. 8.2%, P<0.001) and MACEs (2.0% vs. 3.1% vs. 2.6% vs. 9.7%, P<0.001) were significantly higher in the upper quartiles. Postoperative BG > 13.0 mmol/L was the best threshold for predicting in-hospital death (area under the curve (AUC) = 0.707, 95% confidence interval (CI): 0.634-0.780, P<0.001). Multivariate logistic regression analysis indicated that postoperative BG > 13.0 mmol/L was an independent predictor of in-hospital mortality (adjusted odds ratio (OR) = 3.418, 95% CI: 1.713–6.821, P<0.001). In addition, Kaplan–Meier curve analysis showed that the risk of one-year death was increased for a postoperative BG > 13.2 (log-rank = 32.762, P<0.001).
Conclusion: Postoperative BG, as a routine test, could be served as a risk-stratified measure for non-diabetic patients with RHD.