bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feto-maternal Outcomes of Hypertensive Disorders of Pregnancy in Yekatit-12 Teaching Hospital: a Retrospective Study
Authors: Mengistu Mekoya Dabulo , Kuma Tilahun 
Published: August 2019

Abstract
Background

In resource poor countries, hypertensive disorders of pregnancy are common and form one of the deadly triad, along with hemorrhage and infection, which contribute greatly to maternal and fetal jeopardy.

Methods

The aim of this study was to assess the prevalence of hypertensive disorders of pregnancy, and determine the effects of hypertensive disorders of pregnancy on the feto-maternal outcomes. It was a descriptive, cross-sectional, retrospective study on 615 women who attended delivery at Yekatit-12 Teaching Hospital from July 2017 - Jan 2018. Data was analyzed using SPSS version 20 software. Descriptive statistics were used to calculate rates. Chi-square statistics were used to estimate the associations among selected predictor variables. A p-value < 0.05 was taken as statistically significant.

Results

Out of the 615 study population, the prevalence of hypertensive disorders of pregnancy was found to be 25.4%, of which the majority (54.5%) was severe pre-eclampsia. Eclampsia accounted for 2.6%, and superimposed pre-eclampsia was 2.6%. The rate of severe pre-eclampsia with HELLP syndrome was 7.1% of all mothers with the hypertensive disorders. The majority of mothers with hypertensive disorders (59.6%) had age range of 25-34 years. About 46% of mothers required interventions to terminate the pregnancy either by cesarean section (42.3%) or instrumental deliveries (3.7%). The rate of preterm, low birth weight, and low Apgar at 1st and 5thminutes accounted for 30%, 25%, 24.4% and 16.7% of neonates born to mothers with hypertensive disorders, respectively. Over 19% of neonates required resuscitation and 11.5% NICU referral. The rate of still birth was 2.6%.

Conclusion

The prevalence of hypertensive disorders of pregnancy is high in the study area and complicates maternal and fetal outcomes of the pregnancy. To deter its detrimental effects both on fetal and maternal outcomes of pregnancy, antenatal surveillance should be expanded to enable early detection, stringent follow-up and timely intervention in severely affected pregnancies.
Prognostic Significance of plasma albumin to fibrinogen ratio Associated Nomograms in Patients with breast invasive ductal carcinoma
Authors: Zheng Lihua , Liu Feng , Zhao Yaheng , Li Wei , Yang Yan , Zhang Hongsong , Liu Yunjiang 
Published: August 2019

Abstract
Background : In the context of breast invasive ductal carcinoma, this research aims to retrospectively evaluate by preoperative plasma albumin to fibrinogen ratio (AFR) and forecast oncological outcome and recurrence.
Methods : This reflective study included 230 patients who had surgical procedures at the Fourth Hospital of Hebei Medical University between January 2009 and April 2012 for the treatment of their non-metastatic breast invasive ductal carcinoma. We utilized an optimal value of preoperative plasma fibrinogen and albumin for the patient classification. Additionally, we used the Kaplan-Meier method to extensively evaluate progression-free and cancer-specific survival outcomes. The analysis of the linkages between the albumin to fibrinogen ratio and clinical outcomes was executed through the univariate and multivariate analyses. To construct nomograms and evaluate the survival outcomes, we used a variety of risk factors. We also verified the predictive accuracy through the Harrell's concordance index (C-index).
Results : The association of plasma AFR with diminished disease-free survival (DFS) and overall survival (OS) is statistically significant. An independent prognostic indicator is the plasma AFR, as reported by the multivariate analysis, for DFS (HR =1.346; 95% CI:1.107-1.636; p = 0.03) and overall survival (OS) (HR = 1.485; 95% CI: 1.106-1.993; p = 0.008). Two prediction model of OS and DFS based on the AFR was developed.
Conclusions : For patients with breast invasive ductal carcinoma, an independent prognostic factor for the outcomes of oncology patients is the elevated preoperative plasma AFR. For DFS and OS, the constructed nomogram demonstrated highly significant predictive accuracy.
Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations
Authors: Ruiz-Cordero Roberto , Ma Junsheng , Khanna Abha , Lyons Genevieve Ray , Rinsurongkawong Waree , Bassett Roland , Guo Ming , Routbort Mark J , Zhang Jianjun , Skoulidis Ferdinandos , Heymach John Victor , Roarty Emily B , Tang Zhenya , Medeiros L. Jeffrey , Patel Keyur P , Luthra Rajyalakshmi , Roy-Chowdhuri Sinchita 
Published: August 2019

Abstract
Introduction: Gene expression profiling has consistently identified three molecular subtypes of lung adenocarcinoma that have prognostic implications. To facilitate stratification of patients with this disease into similar molecular subtypes, we developed and validated a simple, mutually exclusive classification.
Methods: Mutational status of EGFR, KRAS, and TP53 was used to define six mutually exclusive molecular subtypes. A development cohort of 283 cytology specimens of lung adenocarcinoma was used to evaluate the associations between the proposed classification and clinicopathologic variables including demographic characteristics, smoking history, fluorescence in situ hybridization and molecular results. For validation and prognostic assessment, 63 of the 283 cytology specimens with available survival data were combined with a separate cohort of 428 surgical pathology specimens of lung adenocarcinoma.
Results: The proposed classification yielded significant associations between these molecular subtypes and clinical and prognostic features. We found better overall survival in patients who underwent surgery and had tumors enriched for EGFR mutations. Worse overall survival was associated with older age, stage IV disease, and tumors with co- mutations in KRAS and TP53. Interestingly, neither chemotherapy nor radiation therapy showed benefit to overall survival.
Conclusions: The mutational status of EGFR, KRAS, and TP53 can be used to easily classify lung adenocarcinoma patients into six subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously.
Association between PD-L1 expression and head and neck cancer prognosis: a meta-analysis
Authors: Shen Zhisen , Wu Linrong , Cai Xianlei , Ye Dong , Zhao Gangjun 
Published: August 2019

Abstract
Background: Programmed cell death ligand 1（PD-L1) plays an important role in tumor cell immune escape, and it has been extensively studied in head and neck cancer. However, its prognostic impact on patients with head and neck cancer remains controversial, so we sought to investigate this issue through a comprehensive meta-analysis. Methods: To assess the significance of PD-L1 on the survival of patients with head and neck cancer, we collected articles reported in PubMed, EMBASE, and Cochrane Library, until January 31, 2019. We also used the Newcastle Ottawa Scale (NOS) for literature quality evaluation. Results: The study included a total of 4551 patients affected by 6 different types of head and neck cancer reported in 26 articles. Our study found that the association between the expression of PD-L1 and the prognosis of head and neck tumors was highly heterogeneous (P < 0.00001, I2 = 80.0%); therefore, the random effects model was applied to combine the effect sizes. Based on the combined hazard ratios (HR)of 1.15 (95% CI: 0.88 to 1.50, P = 0.32), the expression of PD-L1 in head and neck tumors may not be a factor associated with poor prognosis. Conclusions: Our results suggest that PD-L1 expression cannot predict the overall survival of patients with oral, nasopharyngeal, or esophageal cancer. Through subgroup analysis, we found that the expression of PD-L1 may be a poor prognostic factor for some head and neck cancers.
Co-expression Network analysis of LncRNA associated with overexpression of DNMT1 in esophageal epithelial cells
Authors: Yin Dong , XU Yi , LI Xu-feng , CHEN Yan 
Published: August 2019

Abstract
Screening and preliminary identification of DNMT1 high expression related LncRNA, which is involved in various inter-related signaling pathways, has revealed a theoretical basis for various types of disease mechanisms. LncRNA and mRNA differential expression profiles were identified on a microarray. The 10 LncRNAs with high levels of variation were identified by qRT-PCR. KEGG and GO analyses were used to dissect out differentially expressed mRNAs. Six signal pathways were selected based on the KEGG results of the LncRNA-mRNAs expression network analysis.We found a total of 6987 differentially expressed LncRNAs and 7421 differentially expressed mRNAs were obtained from the microarrays in experimental and control groups (P<0.05; Fold Change >2.0x). GO analysis KEGG pathway analysis showed high expression of DNMT1 in esophageal epithelial cells. Nine pathways involved mRNA up-regulation including natural killer cell mediated cytotoxicity and many other prominent biochemical pathways. Forty six pathways were associated with down regulated mRNAs and ribosomes involving multiple biological pathways. Co-expression network analysis showed that the 8 mRNA and 16 LncRNA were linked to the P53 signaling pathway. Interactions occurred between 22 LncRNA and 11 mRNA in the ErbB signaling pathway, between 19 LncRNA and 8 mRNA in epithelial cell signal transduction of Helicobacter pylori infection. Interactions were present in 19 LncRNAs and 5 mRNAs in the sphingolipid signaling pathway along with 21 with LncRNA and 12 with mRNAs in the PI3K-Akt signaling pathway. Cytotoxicity interactions occurred with 22 LncRNAs and 9 mRNAs in natural killer cells.
Pretreatment platelet/lymphocyte ratio (PLR) is a significant predictive marker for EGFR targeted therapy in patients with non-small-cell lung cancer
Authors: Liu Kejun , Zhang Weiwei , Tan Qinquan , Jiang Guanming , Jia Jun 
Published: August 2019

Abstract
Non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) gene mutation is benefited from targeted therapy. There is no other superior predictive factor for targeted therapy except EGFR in the clinical. In this study, we analyzed the effect of pretreatment platelet/lymphocyte ratio (PLR) in NSCLC patients. In the present study, a total of 96 patients with EGFR mutations were included in this study. All patients received EGFR targeted therapy, until disease progression, unacceptable toxicity or other factors. The following evaluation was conducted about 3 days before initial treatment: detailed clinical history, physical examination, radiographic results, pathological diagnosis and laboratory parameters including complete blood cell counts and albumin levels. We found that pretreatment PLR is significantly associated to the PFS of NSCLC patients with EGFR targeted therapy. Patients in the PLR ≥190 group had shorter PFS than those in the PLR <190 group (P= 0.009). Furthermore, the 1-year PFS rate in the PLR ≥190 group were inferior to the low value group (P= 0.016). Multivariate analysis confirmed the role of PLR on predicting the efficacy of targeted therapy for advanced NSCLC. In addition, we found that PLR was also an predictive biomarker for grade 3/4 adverse events of diarrhea. In conclusion, high pretreatment PLR was an independent indicator for predicting a poor PFS for NSCLC patients receiving EGFR-TKIs treatment. Further studies are needed to identify the impact of PLR on results of EGFR-TKIs treatment.
Experiences of Selected Students in the Scientific Olympiad for Medical Students – A Qualitative Study
Authors: Vahedi Leila , Ghorbanian Naser , Zabihi Atefeh , hazrati hakimeh 
Published: August 2019

Abstract
Objective: It is of great importance to identify the talent students in the Scientific Olympiad and pay attention to the upgrade of quality of these competitions. The aim of this study was to explain the Students' experiences about the Scientific Olympiad. This research was a phenomenological qualitative study. Data were collected based on questionnaires (27 students) and semi-structured interviews (13 students) who were selected in the Medical Students' Scientific Olympiad. The analyzing of information was performed using clayze method.
Results: Students' experiences were divided into two main themes, including motivating and restrictive factors. Scientific level, planning and implementation and welfare issues were obtained as the three main categories by analyzing data. The participants suggested four holding suggestions, side plans, facilities and the notification results. In conclusions, students' experiences stated that the Medical Students' Scientific Olympiad in Iran is still at an early stage that challenges further the knowledge level. Therefore, it is necessary to design questions with high taxonomy by trained academic facilities. Also, the attention to the side programs, welfare amenities and recreational programs as the motivating factors for participating in these competitions recommend.
Neurofeedback for tinnitus: Study protocol for a double-blind randomized controlled trial assessing the specificity of an alpha/delta neurofeedback training protocol in alleviating both the sound perception and the psychological distress, in a cohort of chronic tinnitus sufferers
Authors: Jensen Martin , Hüttenrauch Eva , Schmidt Jennifer , Andersson Gerhard , Chavanon Mira-Lynn , Weise Cornelia 
Published: August 2019

Abstract
Background Tinnitus is a very common condition, which for some can have debilitating psychological consequences. Although some interventions are helpful in learning how to cope better with the tinnitus, at present there is no cure. Neurofeedback is an emerging treatment modality in tinnitus. Previous studies, utilizing an alpha/delta training protocol have shown promise. However, they were characterized by small sample sizes and lack of neurofeedback control conditions. Therefore, the aim of this study is to investigate, if an alpha/delta neurofeedback training protocol, compared to beta/theta neurofeedback or a diary control group, is effective in reducing, not only the tinnitus sound perception, but also the psychological symptoms associated with the condition. Methods The study is designed as a three-armed, single-blinded randomized controlled trial. Participants are randomly assigned to either an established neurofeedback protocol for tinnitus (alpha/delta training), another neurofeedback protocol as active comparator (beta/theta training) or diary control group. In the four-week intervention period, participants in both neurofeedback groups undergo ten sessions, whereas participants in the diary control group complete a diary bi-weekly. The primary outcomes are between group differences in tinnitus sound percept change, as measured with the Tinnitus Magnitude Index (TMI) and changes in tinnitus distress, measured with the Tinnitus Handicap Inventory (THI), four weeks post baseline. Secondary outcome measures include changes in tinnitus distress, sleep quality, depressive symptoms and whether neurofeedback leads to specific power changes in the trained frequency bands. Discussion This is the first double-blind, randomized controlled trial examining the efficacy of an alpha/delta neurofeedback training protocol in reducing the tinnitus sound percept and the distress associated with the condition. Compared to former studies, the present study is designed to assess both the specificity of an alpha/delta neurofeedback training protocol by including an active comparator, beta/theta neurofeedback training, and in addition to control for placebo effects by inclusion of a diary control group. We hope this study contributes not only to our understanding of the neurological underpinnings of tinnitus, but also to the potentiality of neurofeedback as a therapeutic agent.
Scaling Up Quality Improvement for Surgical Teams (QIST) - avoiding surgical site infection and anaemia at the time of surgery: protocol for a cluster randomised controlled trial
Authors: Scrimshire Ashley B , Booth Alison , Fairhurst Caroline , Tadd Win , Laverty Annie , Corbacho Belen , Torgerson David , McDaid Catriona , Reed Mike 
Published: August 2019

Abstract
Background:Measures shown to improve outcomes for patients often fail to be adopted into routine practice in the NHS. The Institute for Health Improvement Breakthrough Series Collaborative (BSC) model is designed to support implementation at scale. This trial aims to assess the effectiveness and cost-effectivenessof quality improvement collaboratives based on the BSC method for introducing service improvements at scale in the NHS.
Methods:Forty Trusts will be randomised (1:1) to introduce one of two protocols already shown to improve outcomes in patients undergoing elective total hip and knee replacement surgery.

The intervention is improvement collaboratives based on the BSC model, a learning system that brings together a large number of teams to seek improvement focused on a proven intervention. Collaboratives aim to deliver at scale, maximise local engagement and leadership and are designed to build capacity, enable learning and prepare for sustainability. Collaboratives involve learning sessions, action periods, and a summative congress.

Trusts will be supported to introduce either: decolonisation for MSSA to reduce post-operative infection (QIST:Infection), or an anaemia optimisation programme to reduce peri-operative blood transfusions (QIST:Anaemia). Trusts will continue with their usual practice for whichever protocol they are not introducing. Anonymised data related to both infection and anaemia outcomes for patients undergoing hip or knee arthroplasty at all sites will mean the two groups act as controls for each other.

The primary outcome for the QIST: Infection collaborative is deep MSSA surgical site infection within 90 days of surgery, and for the QIST: Anaemia collaborative is blood transfusion within 7 days of surgery. Patient-level secondary outcomes include length of hospital stay and re-admission, which will also inform the economic costings. Qualitative interviews will evaluate the support provided to teams.

Discussion: The scale of this trial brings considerable challenges and potential barriers to delivery. Anticipated challenges relate to recruiting and sustaining up to 40 organisations, each with their own culture and context. This complex project with multiple stakeholders across a large geography will be managed by experienced senior-level project leaders with a proven track record in advanced project management. The team will ensure effective project governance and communications.

Trial registration: ISRCTN, ISRCTN11085475. Pprospectively registered 15thFebruary 2018, https://www.isrctn.com/ISRCTN11085475?q=qist&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search
Mass screening for hepatitis B and C in the Southern Upper Egypt
Authors: Soliman Gamal , Elzalabany Mahmoud S. , Hassanein Tarek , Miller F. DeWolfe 
Published: August 2019

Abstract
Background : It is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. The recent development of fast acting, highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on large scale.
Methods : A screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibody (anti-HCV) and hepatitis B virus surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI).
Results: There was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2106. 31,965 males (47.7%) and 35,077 females (52.3%) were screened with a mean age of 43.6±14.3 years. 9,701 patients (14.5%) were positive for anti-HCV and 2,950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR=2.27; CI 2.2 to 2.4; p<0.001) and the same for HBsAg (6.2% vs. 2.8% OR=2.3; CI 2.2 to 2.5; p<0.001). The prevalence of anti-HCV was significantly associated with age (p<0.001), ranging from between 1-4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence.
Conclusions: The results showed unanticipated patterns of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the results provide essential information for effective planning, design, and evaluation for future Egyptian national mass screen and treatment programs.
Revealing QTLs Associated with Fatty Acid Composition and Compactness on an Integrated Linkage Map Of Oil Palm Interspecific Backcross 2 (BC2)
Authors: Yaakub Zulkifli , Kamaruddin Katialisa , Singh Rajinder , Mustafa Suzana , Marjuni Marhalil , Ting Ngoot-Chin , Amiruddin Mohd Din , Leslie Low Eng-Ti , Cheng-Li Ooi Leslie , Sritha Kandha , Nookiah Rajanaidu , Jansen Johannes , Abdullah Meilina Ong 
Published: August 2019

Abstract
Background
Molecular breeding has opened new avenues for crop improvement with the potential for faster progress. As oil palm is the major producer of vegetable oil in the world, its improvement, such as developing compact planting materials and improving its oil’s fatty acid composition, is important.

Results
This study sought to identify the QTLs associated with fatty acid composition and vegetative traits for compactness in the crop. It integrated two separate interspecific backcross two (BC2) mapping populations to improve the genetic resolution and evaluate the consistency of the QTLs identified. A total of 1,963 markers (1,814 SNPs and 149 SSRs) spanning a total map length of 1793 cM was integrated into a consensus map. The QTL analysis observed 19 and 10 significant genomic loci associated with FAC and compactness, respectively.

Conclusions
A few genomic regions were revealed to be major loci influencing FAC and compactness. It is hoped that the QTLs identified will be useful tools for marker-assisted selection, accelerate the process of identifying desirable genotypes for breeding.