bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.
Authors: Wang Long , Xie Lin , Ruan Weiqiang , Li Tao , Gan Changping , Lin Ke 
Published: October 2019

Abstract
Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There are totally 54 patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5 years follow-up. Results: Closure was successful in 53 patients (98.1%). There was no mortality, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient who developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2±0.6 days (range, 3.0 to 6.0 days), one unsuccessful cases needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be efficacious. Close monitoring for bleeding is very necessary postoperatively especially in younger patients. This technique is generally safe in selected group of patients with acceptable mid-term outcomes. Keywords: Ventricular septal defect; Device closure; Minimally invasive surgery
Declining prevalence of Methicillin-resistant Staphylococcus aureus septic arthritis and osteomyelitis in children: implications for treatment
Authors: Weiss Lindsay , Lansell Amanda , Figueroa Janet , Suchdev Parminder , Kirpalani Anjali 
Published: October 2019

Abstract

OBJECTIVES To assess clinical characteristics and differences in outcomes between children with Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) osteomyelitis or septic arthritis and whether initial antibiotic regimen affects patient outcomes.STUDY DESIGN We analyzed records of children ages 15 days to 18 years admitted between 2009 and 2016 to two tertiary children’s hospitals who were diagnosed with an osteoarticular infection and had a microorganism identified. We compared the relationship of MRSA versus MSSA and initial antibiotic selection on patient outcomes including length of hospitalization and requiring a PICU transfer.RESULTS A total of 584 patients met inclusion criteria of which 365 (62.5%) had a microbiological diagnosis. MSSA was the most common pathogen identified (45.5%) followed by MRSA (31.2%). The percentage of MRSA cases decreased by 25.4% between 2009 and 2016, whereas MSSA infections increased by 18.6%. Compared to MSSA, patients with MRSA had a higher initial C-reactive protein (median 17.3 mg/dL vs 7.8 mg/dL, p<0.05) and a longer hospitalization (median 8.3 days vs 6.1 days, p<0.05). Patients whose initial antibiotic regimens included vancomycin were more likely to require a PICU transfer (15.0% vs 2.2%, p<0.05) and had a longer hospitalization (median 6.7 days vs 5.5 days, p<0.05) compared to those initiated on clindamycin without vancomycin.CONCLUSIONS While MRSA was associated with increased severity of osteoarticular infections compared to MSSA, the incidence of MRSA has been declining at our institution. Patients with longer lengths of stay and those requiring a PICU transfer were more likely to be on vancomycin. Clindamycin should be considered in the initial antibiotic regimen for osteomyelitis and septic arthritis with ongoing surveillance of local microbiology and outcomes.
Characteristics of babies referred for Retinopathy of prematurity screening and management to a tertiary eye hospital of Bangladesh, a database analysis
Authors: Niyonzima Jean Claude , Nahar Nazmun , Chowdhury Mahjabeen , Das Sanjoy Kumar , Rahman Mostafizur 
Published: October 2019

Abstract
Background: Ispahani Islamia Eye Institute and Hospital (IIEIH) is a leading ROP screening center in Bangladesh. The study had an aim to analyze the characteristics of referred babies and identify possible bottlenecks. Methods : Electronic records of babies referred to IIEIH for a period of three years (2016-2918) were analyzed retrospectively. All the babies registered in the electronic file were screened by any of the three consultants with keen interest in ROP. Variables of interest were ROP stage, gestational age, birth weight, time to screening, referring institution and treatment modalities (laser, Anti-VEGF, retina surgery or combination). Data were exported to SPSS version 23 for Mac for descriptive and correlation analysis. P-value less than 0.05 was considered statistically significant. Results: 887 babies with ROP stage 1 or above were registered, a large majority were referred by private institutions (75%), 60% of babies were moderate pre-terms according to WHO classification, the mean birth weight was 1563±397.1 grams. ROP was largely stage 2 (37%) and 61% of babies had at least one treatment modality. The younger the gestational age and the lower the birth weight, the higher the risk of presenting with ROP with advanced stage. Conclusion : The majority of babies with ROP came from private institutions and more than half of them needed at least one treatment modality. We recommend a large study to analyze the incidence and availability of ROP services in public hospitals. Key words : Retinopathy of prematurity, screening, treatment options, Referrals
Clinical study of 24-hour intraocular pressure curve measurement strategy
Authors: Qin Jiayin , Wang Xijuan , Li Mingwu , Ren Zeqin 
Published: October 2019

Abstract
Background To investigate the measurement time of 24-hour intraocular pressure(IOP) curve: the representativeness of 4 and 6 times IOP to the fluctuation of IOP at night and day. Methods From September 2018 to January 2019, 41 patients with suspected primary open angle glaucoma(POAG), who were admitted to the Department of Ophthalmology, Peking University International Hospital, underwent 24-hour IOP monitoring. The measuring time points were set as: 0:00, 2:00, 5:00, 7:00, 8:00, 10:00, 11:00, 14:00, 16:00, 18:00, 20:00 and 22:00, of which 8:00, 11:00, 14:00, 16:00 were the customary measuring time of IOP daily curve for 4 times; 5:00, 7:00, 10:00, 14:00, 18:00, 22:00 were the conventional measuring time points for IOP curve for 6 times. The time points of the two groups was increased by 0:00, 2:00 and 20:00 to 12 times IOP measurements. Goldmann tonometer was used to measure IOP . Oxybuprocainehydrochloride eye drops were anesthetized by the same ophthalmologist. The sensitivity of the two methods to detect 24-hour intraocular pressure fluctuations was calculated according to whether the peak values of 12 times IOP measurements could be included by 4 or 6 times IOP measurements. Results A total of 41 patients (82 eyes) were enrolled, including 21 males (42 eyes) and 20 females (40 eyes). The age ranged from 23 to 77（44.60±14.67）. The peak IOP measured by 4 times, 6 times and 12 times IOP measurements were 19.91±4.38mmHg、 20.54±4.10 mmHg and 21.09±4.15 mmHg respectively, and there were significant differences between the two methods (P < 0.05); the trough values of IOP were 15.46±3.63 mmHg 、14.63±3.49 mmHg and 13.93±3.38 mmHg respectively, with statistical significance (P < 0.05). The peak IOP co-occurrence is 74.39% between 6 times and 12 times IOP measurements. The peak IOP co-occurrence is 43.90% between 4 times and 12 times IOP measurements. The sensitivity of 4 and 6 times IOP measurements to detect 24-hour IOP fluctuations were 36.11% and 55.56%, respectively. Conclusion For suspected glaucoma patients, neither 4 times IOP measurements nor 6 times IOP measurements during a day can accurately reflect the range of IOP fluctuations, which may easily lead to missed diagnosis.
Correction of Madelung deformity by monorail external fixator in young adults
Authors: Shi Li , Wang Meng-wei , Cheng Dong-dong , Xu Jia , Chai Yimin , Kang Qinglin 
Published: October 2019

Abstract
Aims: Many surgical techniques are proposed to address Madelung deformity, but the most suitable surgical treatment still remains unknown for symptomatic cases. We introduced a modified management by radius osteotomy and Sauvé-Kapandji’s procedure using the monorail external fixator to provide a supplement to the treatment of Madelung deformity. Methods : From January 2013 to October 2018, 12 patients (9 right and 6 left wrists) with a mean age of 18 (16 to 24) years complained of pain, deformities and limited function of effected wrists. These 12 patients received operation for subsequent acute correction by monorail external fixator. The Vas Score, ulnar tilt of the radial articular surface angle, radiopalmar tilt angle, lunate subsidence, volar translation and range of wrist movement were evaluated pre- and postoperatively. Results : Consolidation cost an average time of 87 (66 to 122) days. All patients were followed up for an average time of 24 (8 to 65) months. The Vas score for all patients decreased from 4 (2 to 7) to 0 (p<0.001). The ulnar tilt and radiopalmar tilt were decreased by a mean of 21° (mean changed from 50 to 29) and 21° (from 38 to 17), respectively (both p<0.001). The length of lunate subsidence and volar translation was reduced by a mean of 6 (from 7 to 1) mm and 8 (from 25 to 17) mm, respectively (both p<0.001). Five patients received radius lengthening for an average of 22 (18 to 29) mm. Wrist extension improved by a mean of 8° (from 50 to 58), while flexion decreased by 40° (from 100 to 40). Conclusion : Acute correction by radius osteotomy and Sauvé-Kapandji’s procedure and gradual lengthening with the extendable monorail external fixator can be used for Madelung deformity with little surgical trauma. The radiographic parameters and wrist pain are improved after surgery and postoperative therapy.
Mid-upper arm circumference, central obesity and metabolic syndrome in middle-aged and elderly Chinese: the REACTION study
Authors: Shi Jie , Yang Zhen , Niu Yixin , Zhang Weiwei , Li Xiaoyong , Zhang Hongmei , Lin Ning , Gu Hongxia , Wen Jie , Ning Guang , Qin Li , Su Qing 
Published: October 2019

Abstract
Background The mid-upper arm circumference (MUAC) is a proxy for upper body subcutaneous fat and a reliable screening measure for identification of individuals with abnormal local fat distribution. The purpose of present study was to evaluate the association between MUAC and metabolic syndrome (MetS) as well as other metabolic phenotype in the middle-aged and elderly population. Methods We measured the MUAC in a cross-sectional sample with a total of 9787 subjects aged 40 years and older in Shanghai, China. The measurement of MUAC is performed on the right arm using a non‐elastic tape held midway between the acromion and the olecranon processes in duplicate, with arm hanging loosely at the side of the body. The MetS was defined according to the Joint Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. The association of MUAC with MetS was tested in logistic regression analyses and reported as odds ratio (OR) with 95% confidence interval (CI). Results T he prevalence of MetS, overweight, and central obesity raised sharply from the smaller MUAC groups to the larger MUAC groups both in men and women. MUAC was positively correlated with waist circumference, BMI, fasting insulin, HOMA-IR, triglycerides, systolic and diastolic blood pressure, and inversely correlated with adiponectin and HDL-cholesterol after adjusting for age and gender. As the MetS components accumulated, the MUAC increased concomitantly. The risk of MetS in the highest MUAC quartile was significant higher (odds ratio 1.77; 95% confidence interval 1.51-2.09) than the lowest quartile after adjustment of potential confounders. Conclusion Our results indicated that large MUAC is an independent risk factor of MetS in Chinese individuals.
Pentraxin 3 as a promising biomarker for cancer detection: a systematic review and meta-analysis
Authors: Liang Qindong , Zhang Guangjie , Huang Huaan , Xing Nai , Sheng Shangchun , Gu Changguo 
Published: October 2019

Abstract
Background Mounting studies reported that circulating pentraxin 3 (PTX3) expression level was significantly different between cancer patients and healthy groups, suggesting that PTX3 may be a potential biomarker for cancer detection. However, the results were inconsistent. In this paper, a systematic review and meta-analysis was performed to quantitatively assess the diagnostic value of PTX3 in cancer detection.Methods A comprehensive computerized literature search was conducted in Embase, PubMed, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI) from inception to July 31, 2019. Eligible studies were identified and raw data were extracted. Diagnostic estimates were synthesized using STATA (version 12.0) and MetaDisc (version 1.4) statistical software.Results Overall, 9 studies from 8 citations with a total of 1408 cancer patiens and 3116 controls were included in this meta-analysis. The global sensitivity was 0.70 (95% confidence interval (CI): 0.67 – 0.72), and the specificity was 0.77 (95% CI: 0.75 – 0.78). The pooled positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the diagnostic odds ratio (DOR) were 2.86 (95% CI: 2.29 – 3.56), 0.40 (95% CI: 0.32 – 0.50) and 7.38 (95% CI: 5.05 – 10.78), respectively. The merged AUC was 0.80 (95% CI: 0.76 – 0.83).Conclusion The serum PTX3 appears to be a reliable biomarker for cancer detection though large-scale multicenter studies are needed.
Correlation between SES and BMI and gender-disparity of mediation of lifestyle among Chinese people aged 45 and over&nbsp;
Authors: Xue Li , ren xiaohui 
Published: October 2019

Abstract
Background: Previous studies suggested the relationship between SES and BMI is different in developing countries and developed countries and lifestyle is medication between SES and BMI. Little research focused on relationship between SES and BMI among the middle and the elderly and gender-disparity of mediation of lifestyle. Methods: The data for this study were obtained from the 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). Structural equation model (SEM) was used to explore the relationships among SES, lifestyles and BMI. Results: Among men, the effect of SES on sleeping time and smoking were not statistically significant. SES had a direct positive effect on BMI (b=0.306, P<0.001). Smoking had a direct positive effect on BMI (b=0.180, P<0.001). Among women, SES had a direct negative effect on physical activity (b=-0.048, p<0.05), a direct positive on sleeping time (b=0.048, P<0.05), smoking (b=0.098, P<0.001) and BMI (b=0.168, P<0.001). Physical activity had a direct negative effect on BMI (b=-0.050, P<0.01). Sleeping time (b=0.066, p<0.001) and smoking (b=0.088, p<0.001) both had a direct positive effect on BMI. Conclusion: A positive relationship was found between SES and BMI both among middle and old men and women. The gender-disparity of mediation of lifestyle was existed.
Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care
Authors: Haukland Ellinor Christin , von Plessen Christian , Nieder Carsten , Vonen Barthold 
Published: October 2019

Abstract
Background: Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and see if adverse events can be used as a measure of quality and safety in end-of-life cancer care
Methods: Retrospective cohort study of deceased hospitalised cancer patients using the Global Trigger Tool to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life.
Results: 30 % of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62 % more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1 000 patient days (p<0.001, OR 1.62 (1.23 – 2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18 % (p=0.03, OR 2.10 (1.09 – 4.01).
Conclusions: Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Identifying these adverse events is clearly warranted to improve clinical practice and avoid overtreatment in end-of life cancer care.
Challenges when caring for end-of-life patients with advanced dementia and pain: A qualitative study in Swedish nursing homes
Authors: Godskesen Tove , Lundin Emma 
Published: October 2019

Abstract
Background Of Swedish people with advanced dementia, the majority dies in nursing homes. Pain is a common symptom in patients at the end-of-life, and patients with advanced dementia often experience suboptimal and inadequate pain management. Compared to cancer patients, they receive fewer palliative care interventions. Although being largely responsible for the care of these patients, few studies address the experiences of registered nurses. Therefore, this study aimed to describe nurses' experiences of caring for end-of-life patients with advanced dementia and pain. Methods This study had a descriptive and explorative design. Individual interviews with thirteen nurses from twelve nursing homes in Sweden were qualitative and semi-structured. The content was analysed through inductive content analysis. Results Nurses described communicative, relational and organisational challenges. A major issue was difficulties to communicate with the patient, resulting in uncertain pain assessments. Other difficulties were to separate pain from anxiety, to balance benefits and risks in morphine administration, and to create good relationships with health care personnel and relatives. Relatives could greatly influence the assessment and management of pain, both as interpreters of pain behaviour and by questioning the care given. Facilitators of good pain management were good communication and relations with health care staff and relatives, having extensive professional experience, and knowing the patient.Conclusions This study highlights the need for nursing homes to employ specialist-trained nurses, who have the appropriate knowledge and skills to deal with the challenges in caring for end-of-life patients with dementia and pain. Additionally, there should be resources and strategies available for providing information to patients’ family members and for involving them in the decisional process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administrative morphine or not.
Radiotherapy versus radiotherapy combined with temozolomide in high-risk low-grade gliomas after surgery:Study protocol for a randomized controlled clinical trial
Authors: Wang Jingjing , Wang Ying , He Yan , Guan Hui , He Ling , Mu Xiaoli , Peng Xingchen 
Published: October 2019

Abstract
Background

It has been reported that radiation therapy followed by PCV chemotherapy (procarbazine, lomustine and vincristine) could improve progression-free survival (PFS) and overall survival (OS) in patients with high-risk WHO grade 2 gliomas after surgery. However, procarbazine is not available in China. In clinical practice, Chinese doctors often use radiotherapy combined with temozolomide to treat these patients, though large-scale prospective studies are lacking. This trial aims to confirm whether RT combined with temozolomide (TMZ) can improve PFS and OS in patients with high-risk low-grade gliomas (LGGs). Methods/design

This is a two-group, randomized controlled trial (RCT) enrolling patients who have low-grade (WHO grade 2) gliomas aged 40 years or older without regard to the extent of resection or younger than 40 years old with subtotal resection or biopsy. An estimated 250 patients will be enrolled. Eligible participants will be randomly assigned to receive radiation therapy (RT) alone or RT plus temozolomide chemotherapy in a 1:1 ratio. The same RT will be given to all eligible participants regardless of whether they are randomly assigned to RT group or chemoradiotherapy (CRT) group. While in the CRT group, patients will receive adjuvant TMZ with or without concurrent radiochemotherapy. The primary outcome of this trial is progression-free survival and it will be analyzed by intention-to-treat (ITT). Secondary outcomes include OS, adverse events and cognitive function (CF). Discussion

The objective of our research is to assess the effect of radiotherapy coupled with temozolomide in high-risk LGGs after surgery, compared with RT alone. Different histological types and molecular subtypes will be examined and subgroup analysis will be conducted based on them. Our data can provide evidence for postoperative adjuvant therapy in Chinese high-risk LGGs.
Coagulation/flocculation of textile effluent using a natural coagulant extracted from Dillenia indica
Authors: Manholer Daniele Domingos , de Souza Maísa Tatiane Ferreira , Ambrosio Elizângela , Freitas Thábata Karoliny Fornicoly de Souza , Geraldino Henrique César Lopes , Garcia Juliana Carla 
Published: October 2019

Abstract
The aim of this study was to assess the efficiency of mucilage extracted from the fruit of Dillenia indica for enhancing coagulation in the treatment of textile effluent. The mucilage extraction was carried out in water at room temperature. The pH, concentration of coagulant FeCl3.6H2O, and concentration of mucilage solution were optimized with star-type central composite design (CCD). We were able to analyze the synergistic effects between the FeCl3.6H2O and mucilage concentrations: the process of coagulation/flocculation (CF) for chemical oxygen demand (COD) removal was more efficient at a low chemical coagulant concentration (8.00 mg L−1) and a higher natural coagulant (NC) concentration (15.00 mg L−1). This demonstrated the potential of this mucilage to treat textile effluents, with 67.66%% COD removal, 96.86% turbidity removal and 91.12% apparent color reduction. The characterization of the mucilage of Dillenia indica was done using Fourier transform infrared spectroscopy (FTIR) and solid-state cross-polarization magic angle spinning carbon-13 nuclear magnetic resonance (CP/MAS 13C NMR), and the signals obtained indicated the presence of polysaccharides, which are responsible for enhancing the CF process.