bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indications for adjuvant chemotherapy in patients with AJCC stage IIa T3N0M0 and T1N2M0 gastric cancer—an east and west multicenter study
Authors: Huang Ze-Ning , Desiderio Jacopo , Chen Qi-Yue , Zheng Chao-Hui , Li Ping , Xie Jian-Wei , Wang Jia-Bin , Lin Jian-Xian , Lu Jun , Cao Long-Long , Lin Mi , Tu Ru-Hong , Lin Ju-Li , Zheng Hua-Long , Huang Chang-Ming 
Published: October 2019

Abstract
Abstract
Purpose To determine the indications for adjuvant chemotherapy (AC) in patients with stage IIa gastric cancer (T3N0M0 and T1N2M0) according to the 7th American Joint Committee on Cancer (AJCC)
Methods A total of 1593 patients with T3N0M0 or T1N2M0 stage gastric cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database for the period 1988.1-2012.12. Cox multiple regression, nomogram and decision curve analyses were performed. External validation was performed using databases of the Fujian Medical University Union Hospital (FJUUH) (n = 241) and Italy IMIGASTRIC center (n = 45).
Results Cox multiple regression analysis showed that the risk factors that affected OS in patients receiving AC were age > 65 years old, T1N2M0, LN dissection number ≤ 15, tumor size > 20 mm, and nonadenocarcinoma. A nomogram was constructed to predict 5-year OS, and the patients were divided into those predicted to receive a high benefit (points ≤ 188) or a low benefit from AC (points > 188) according to a recursive partitioning analysis. OS was significantly higher for the high-benefit patients in the SEER database and the FJUUH dataset than in the non-AC patients (Log-rank < 0.05), and there was no significant difference in OS between the low-benefit patients and non-AC patients in any of the three centers (Log-rank = 0.154, 0.470, and 0.434, respectively). The decision curve indicated that the best clinical effect can be obtained when the threshold probability is 0-92%.
Conclusion Regarding the controversy over whether T3N0M0 and T1N2M0 gastric cancer patients should be treated with AC, this study presents a predictive model that provides concise and accurate indications. These data show that high-benefit patients should receive AC.
Effect of Prenatal EPA and DHA on Maternal and Cord Blood Insulin Sensitivity: A secondary analysis of the mothers, omega 3, and mental health study
Authors: England Joey A. , Jain Joses , Holbrook Bradley D. , Schrader Ronald , Qualls Clifford , Mozurkewich Ellen 
Published: October 2019

Abstract
Abstract

Background

We sought to determine whether prenatal supplementation with the omega-3 fatty acids eicosapentaenoic acid (EPA) or docosahexanoic acid (DHA) would increase markers of insulin sensitivity in maternal or cord blood compared with placebo supplementation. A secondary aim was to evaluate the association of serum EPA and DHA fractions with adiponectin, leptin and the adiponectin:leptin ratio (ALR). We hypothesized that omega-3 fatty acid supplementation would increase markers of insulin sensitivity in maternal and umbilical cord plasma.Methods

We analyzed stored plasma samples collected from a prior 3-arm prospective, double-blinded, randomized controlled trial in which 126 women with singleton pregnancies between 12- and 20-weeks’ gestation were randomized to receive: 1) an EPA-rich fish oil supplement, 2) a DHA-rich fish oil supplement, or 3) a soy oil placebo. Maternal venous blood samples were collected at 12-20 weeks gestation (before supplementation) and at 34-36 weeks gestation. At delivery, cord blood was collected. Samples were analyzed using sandwich enzyme-linked immunosorbent assay kits to quantify leptin and adiponectin levels which were utilized to calculate the ALR, a proxy measure for insulin sensitivity.Results

We found no difference in adiponectin, leptin, and the ALR between the treatment and placebo groups at baseline, after supplementation, or in umbilical cord blood. In regression analyses, higher maternal serum DHA fraction was associated with increased ALR before (p = 0.01) and after (p = 0.04) DHA supplementation. There was no association of EPA fraction with any measure of insulin sensitivity. Cord blood DHA fraction was significantly associated with cord plasma leptin (p = 0.02).
Early pregnancy BMI was significantly associated with maternal leptin levels at baseline and in late pregnancy (p < 0.001) and was inversely associated with the ALR (p < 0.001). The ALR decreased significantly between the early and late pregnancy visits (p < 0.001). Pregnancy weight gain was inversely associated with the ALR (P. <0.02). Conclusions

EPA- and DHA- rich fish oil supplementation had no effect on plasma markers of insulin sensitivity. However, maternal serum DHA fraction was significantly associated with markers of insulin sensitivity.
The clinical features and prognosis of infective endocarditis in the elderly from 2007-2016 in a tertiary hospital in China
Authors: Wu Zhenzhu , Chen Yi , Xiao Tingting , Niu Tianshui , Shi Qingyi , xiao Yonghong 
Published: October 2019

Abstract
Background Infective endocarditis (IE) especially in the elderly is a serious disease, with a worse prognosis.
Methods A retrospective cohort study was conducted. A total of 405 patients with definite IE were divided into three groups: 205 patients under 50 years old, 141 patients between 50 and 64 years old and 59 patients over 65 years old.
Results For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as the younger patients. IE in old patients had more frequent nosocomial origin (P=0.007) and tended to be more frequent with bad oral hygiene (p=0.008). The most frequent isolated pathogens in the old groups was streptococci and coagulase-negative staphylococci. The old patients had a lower operation rate (40.7% vs 58.9% vs 62.4%, P=0.012) and higher in-hospital mortality (20.3% vs 10.6% vs 8.8%, P=0.044) compared with the younger patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR=2.45, 95% CI 1.027-10.598, P=0.009).The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P=0.007).
Conclusions Older patients with IE presented with more comorbidities, bad oral hygiene, more nosocomial origin and a more severe prognosis than younger patients. Streptococci was the most frequent micro-organisms in this group. Surgery were underused in old patients and those with surgical treatment had better prognosis.
Keywords: Infective endocarditis; older patients; risk factors; surgical
A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic.
Authors: Levola Jonna , Sailas Eila , Säämänen Timo , Turunen Leena , Thomson Annika 
Published: October 2019

Abstract
Abstract
Background: The focus of emergency room (ER) treatment is on acute medical crises, but frequent users of ER services often present with various needs. The objectives of this study were to obtain information on persistent frequent ER service users and to determine reasons for their ER service use. We also sought to determine whether psychiatric diagnoses or ongoing use of psychiatric or substance use disorder treatment services were associated with persistent frequent ER visits.
Methods: A cohort (n=138) of persistent frequent ER service users with a total of 2585 ER visits during a two-year-period was identified. A content analysis was performed for 10% of these visits. Register data including International Classification of Primary Care 2 (ICPC-2) –codes and diagnoses were analyzed and multivariable models were created in order to determine whether psychiatric diagnoses and psychosocial reasons for ER service use were associated with the number of ER visits after adjusting for covariates.
Results: Patients who were younger, had a psychiatric diagnosis and engaged in ongoing psychiatric and other health services, had more ER visits than those who were not. Having a psychiatric diagnosis was associated with the frequency of ER visits in the multivariable models after adjusting for age, gender and ongoing use of psychiatric or substance use disorder treatment services. Reasons for ER-service use according to ICPC-2 –codes were inadequately documented.
Conclusions: Patients with psychiatric diagnoses are overrepresented in this cohort of persistent frequent ER service users. More efficient treatments paths are needed for patients to have their medical needs met through regular appointments.
ROS as a Novel Indicator to Predict Anticancer Drug Efficacy
Authors: Zaidieh Tarek , Smith James , Ball Karen , An Qian 
Published: October 2019

Abstract
Background
Mitochondria are considered a primary intracellular site of reactive oxygen species (ROS) generation. Generally, cancer cells with mitochondrial genetic abnormalities (copy number change and mutations) have escalated ROS levels compared to normal cells. Since high levels of ROS can trigger apoptosis, treating cancer cells with low doses of mitochondria-targeting / ROS-stimulating agents may offer cancer-specific therapy. This study aimed to investigate how baseline ROS levels might influence cancer cells’ response to ROS-stimulating therapy.
Methods
Four cancer and one normal cell lines were treated with a conventional drug (cisplatin) and a mitochondria-targeting agent (dequalinium chloride hydrate) separately and jointly. Cell viability was assessed and drug combination synergisms were indicated by the combination index (CI). Mitochondrial DNA copy number (MtDNAcn), ROS and mitochondrial membrane potential (MMP) were measured, and the relative expression levels of the genes and proteins involved in ROS-mediated apoptosis pathways were also investigated.
Results
Our data showed a correlation between the baseline ROS level, mtDNAcn and drug sensitivity in the tested cells. Synergistic effect of both drugs was also observed with ROS being the key contributor in cell death.
Conclusions
Our findings suggest that mitochondria-targeting therapy could be more effective compared to conventional treatments. In addition, cancer cells with low levels of ROS may be more sensitive to the treatment, while cells with high levels of ROS may be more resistant. This study provides an insight into understanding the influence of intracellular ROS on drug sensitivity, and may lead to the development of new therapeutic strategies to improve efficacy of anticancer therapy.
Sex inequality for hospital readmissions due to pulmonary diseases: a sex perspective in management is warrant
Authors: Buja Alessandra , De Polo Anna , De Battisti Elisa , Sperotto Milena , Baldovin Tatjana , Cocchio Silvia , Furlan Patrizia , Saia Mario , Scapellato Maria Luisa , Viel Guido , Baldo Vincenzo , Bertoncello Chiara , Ebell Mark 
Published: October 2019

Abstract
Background
Pulmonary diseases are a common and costly cause of 30-day readmissions. Few studies have focused on the difference in risk for rehospitalization between men and women in older patients. In this study we analyzed the association between sex and the risk of readmission in a cohort of patients admitted to the hospital for chronic obstructive pulmonary disease (COPD) exacerbation and other major pulmonary diseases.
Methods
This was a retrospective cohort study based on administrative data collected in the Veneto Region in 2016. We included 14,869 hospital admissions among residents aged ≥ 65 years for diagnosis related groups (DRGs) of the most common disorders of the respiratory system: bronchitis and asthma, pneumonia, pulmonary edema, respiratory failure, and COPD. Multilevel logistic regressions were performed to test the association between 30-day hospital readmission and sex, adjusting for confounding factors.
Results
For bronchitis and asthma, male patients had significantly higher odds of 30-day readmission than female patients (aOR, 2.07; 95% CI, 1.11-3.87). The odds of readmission for men were also significantly higher for pneumonia (aOR, 1.40; 95% CI, 1.13-1.72), for pulmonary edema and respiratory failure (aOR, 1.28; 95% CI, 1.05-1.55), and for COPD (aOR, 1.34; 95% CI, 1.00-1.81).

Conclusions
This study found that male sex is a major risk factors for readmission in patients aged more than 65 years with a primary pulmonary diagnosis. More studies are needed to understand the underlying determinants of this phenomena and to provide targets for future interventions
Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age
Authors: Diena Davide , Messina Maria , De Biase Consuelo , Fop Fabrizio , Scardino Edoardo , Rossetti Maura Maria , Barreca Antonella , Verri Aldo , Biancone Luigi 
Published: October 2019

Abstract
Background
Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored.
Methods
This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day.
Results
Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (HR 2.77 vs HR 2.46). Low-grade proteinuria (0.2-0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥ 0.5 effect was more significant with donors >50 years old (OR 2.3).
Conclusions
Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥ 0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).
Autotransplantation of mature impacted tooth to a fresh molar socket using a 3D replica and guided bone regeneration: two years retrospective case series
Authors: Wu Ye , Chen Jiaming , Xie Fuping , Liu Huanhuan , Niu Gang , Zhou Lin 
Published: October 2019

Abstract
Objective : The aim of this study was to evaluate the clinical outcome of autotransplantation of mature third molars to fresh molar extraction sockets using 3D replicas.
Materials and Methods : Ten patients underwent teeth autotransplantation. We observed the mobility, percussion, radiography examination, the probing depth and the masticatory function of the transplanted teeth duringtwo yearsfollowing up, which were transplanted into fresh molar sockets by using 3D replicas, and GBR when it is necessary.
Results : The average extra-oral time of donor tooth had been shortened to 1.65 min when used the 3D replica. Some probing depth of the transplanted tooth were deeper than 3 mm at 4 or 5 weeks temporarily. And one patient felt slight sensitive when chewing with soft food at 4 weeks, then disappeared. The clinical examination of the autotransplantation teeth during one year follow-up showed no sign of failure.
Conclusions : The tooth autotransplantationusing 3D replica is an effective method which can reduce the extra-oral time of the donor teeth and may result in less failure.
Clinical Relevance : The new 3D replica of donor tooth can make the surgery of tooth autotransplantation much easier, and improve it success rate.
Awareness of Complications of Diabetes Mellitus and its Associated Factors among Type 2 Diabetic Patients at Addis Zemen District Hospital, Northwest Ethiopia
Authors: Belsti Yitayeh , Akalu Yonas , Fekadu Haileab , Animut Yaregal 
Published: October 2019

Abstract
Objectives: Awareness about complications is important to reduce diabetes related morbidity and mortality. This study aimed to assess awareness of diabetes complications and associated factors among type 2 diabetic patients. Institution based cross sectional study was conducted from April to June, 2018, using simple random sampling technique, and interviewer administered questionnaires.
Results: The mean age was 41± 1.46 years and 56 % were females. Awareness regarding diabetic complications was 48.5% with 95% CI (43.3, 52.7%). Male sex (AOR: 4.67, 95% CI (2.53, 8.61)), age of 31-45years (AOR: 7.30, 95% CI (3.10, 17.17)), 46- 70 years old (AOR: 15.02, 95% CI (6.11, 36.92)), read and write (AOR: 3.79, 95% CI (1.78, 8.06)), primary school (AOR: 9.58, 95% CI (3.26, 28.18)),high school and above (AOR: 7.46, 95%CI (3.02, 18.44)), NGO employee (AOR: 7.24, 95% CI (2.68,19.53)), having a family history of DM (AOR: 5.55, 95% CI (2.53,12.20)); income of 1001-1500 (AOR: 3.22, 95% CI (1.28,8.10)), 1501-2500(AOR: 11.73, 95% CI (4.32, 31.81)) and >2500 Ethiopian birr (AOR: 7.18, 95% CI (1.70,30.28)) ≥ 2500 ETB (AOR: 7.18, 95%CI (1.70, 30.28)) were significantly associated with good awareness. To improve patient’s awareness on DM complications providing health education for type 2 diabetic patients is crucial.
A multicentre parallel-group randomised trial assessing multiparametric MRI characterisation and image-guided biopsy of prostate in men suspected of having prostate cancer: MULTIPROS study protocol
Authors: Szewczyk-Bieda Magdalena , Wei Cheng , Coll Katherine , Gandy Stephen , Donnan Peter , Ragupathy Senthil Kumar Arcot , Singh Paras , Wilson Jennifer , Nabi Ghulam 
Published: October 2019

Abstract
Background There is growing evidence suggesting that multiparametric magnetic resonance imaging (mpMRI) is a marker for prostate cancer (PCa) aggressiveness and could be used to plan treatment. Improving early detection of clinically significant PCa with pre-biopsy mpMRI would very likely have advantages including optimising the diagnosis and treatment of diseases and diminishing patient anxiety. Methods and materials This is a prospective multicentre study of pre-biopsy mpMRI diagnostic test accuracy with subgroup randomisation at a 1:1 ratio with respect to transrectal ultrasound (TRUS) and MRI/US fusion-guided biopsy or TRUS-only biopsy. It is designed as a single-gate study with a single set of inclusion criteria. The total duration of the recruitment phase was 48 months; however, this has now been extended to 66 months. A sample size of 600 participants is required. Discussion The primary objective is to determine whether mpMRI can improve PCa detection and characterisation. The key secondary objective is to determine whether MRI/US fusion-guided biopsy can reduce the number of false-negative biopsies. Ethical approval was obtained from the East of Scotland Research Ethics Committee 1 (14/ES/1070) on 20 November 2014. The results of this study will be used for publication and presentation in national and international journals and scientific conferences.
Room 4 Birth - The effect of an adaptable birthing room on labour and birth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden
Authors: Berg Marie , Goldkuhl Lisa , Nilsson Christina , Wijk Helle , Gyllensten Hanna , Lindahl Göran , Moberg Kerstin Uvnäs , Begley Cecily 
Published: October 2019

Abstract
Background: An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences, and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden.
Methods/Design: Following ethical approval, a study design was developed and tested for feasibility in a pilot study which led to some important improvements for the conduction of the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour, who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centered approach and physical aspects (such as: light, silencer, media installator offering programmed nature scenes with sound, bath tub, birth support tools) that are adaptable as a woman wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding <1000 ml.); and a positive overall childbirth experience (7-10 on a scale 1-10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome, other physical outcomes of labour and birth; women´s selfreported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life), and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms.
Discussion: The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care.
Trial registration: ClinicalTrials.gov. Identifier NCT03948815. Registered 13 May 2019 - retrospectively registrered. https://clinicaltrials.gov/ct2/results?cond=Room+4+Birth&draw=1&rank=1#rowId0.
Keywords: Birth environment, Birthing room, Person-Centered Care, Labour, Randomised Controlled Trial