bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations
Authors: Thibaudeau Élisabeth , Cellard Caroline , Turcotte Mélissa , Achim Amélie M
Published: November 2020

Schizophrenia is associated with major functioning difficulties. Theory of mind (ToM), the ability to infer the mental states of others, is an important determinant of functioning. However, the contribution of ToM to each specific domain of functioning remains to be better understood. The objectives of this meta-analysis were to document and compare the magnitude of the associations between ToM and (1) different domains of functioning (social functioning, productive activities, and instrumental activities of daily living), each assessed separately for functional performance and functional outcome and (2) different aspects of functioning (functional performance and functional outcome) in schizophrenia. Fifty-nine studies (N = 4369) published between 1980 and May 2019 targeting patients with schizophrenia or schizoaffective disorder aged between 18 and 65 years old were included. Studies were retrieved from seven databases. Correlations were extracted from the articles, transformed into effect sizes Zr and combined as weighted and unweighted means. The strength of the associations between the domains and aspects of functioning were compared using focused tests. A moderate association was observed between ToM and all domains of functioning, with a stronger association between ToM and productive activities compared with social functioning (only for functional outcome [χ2(2) = 6.43, P = 0.040]). Regarding the different aspects of functioning, a stronger association was observed between ToM and functional performance, compared with functional outcome, for overall functioning (χ2(1) = 13.77, P < 0.001) and social functioning (χ2(1) = 18.21, P < 0.001). The results highlight a stronger association of ToM with productive activities and with functional performance, which should be considered in future studies to improve functional recovery in schizophrenia.
Altered heart rate variability during sleep in mild cognitive impairment
Authors: Kong Shawn D X , Hoyos Camilla M , Phillips Craig L , McKinnon Andrew C , Lin Pinghsiu , Duffy Shantel L , Mowszowski Loren , LaMonica Haley M , Grunstein Ronald R , Naismith Sharon L , Gordon Christopher J
Published: November 2020

Study Objectives

Cardiovascular autonomic dysfunction, as measured by short-term diurnal heart rate variability (HRV), has been reported in older adults with mild cognitive impairment (MCI). However, it is unclear whether this impairment also exists during sleep in this group. We, therefore, compared overnight HRV during sleep in older adults with MCI and those with subjective cognitive impairment (SCI).

Methods

Older adults (n = 210) underwent overnight polysomnography. Eligible participants were characterized as multi-domain MCI or SCI. The multi-domain MCI group was comprised of amnestic and non-amnestic subtypes. Power spectral analysis of HRV was conducted on the overnight electrocardiogram during non-rapid eye movement (NREM), rapid eye movement (REM), N1, N2, N3 sleep stages, and wake periods. High-frequency HRV (HF-HRV) was employed as the primary measure to estimate parasympathetic function.

Results

The MCI group showed reduced HF-HRV during NREM sleep (p = 0.018), but not during wake or REM sleep (p > 0.05) compared to the SCI group. Participants with aMCI compared to SCI had the most pronounced reduction in HF-HRV across all NREM sleep stages—N1, N2, and N3, but not during wake or REM sleep. The naMCI sub-group did not show any significant differences in HF-HRV during any sleep stage compared to SCI.

Conclusions

Our study showed that amnestic MCI participants had greater reductions in HF-HRV during NREM sleep, relative to those with SCI, suggesting potential vulnerability to sleep-related parasympathetic dysfunction. HF-HRV, especially during NREM sleep, may be an early biomarker for dementia detection.
A Nod factor- and type III secretion system-dependent manner for Robinia pseudoacacia to establish symbiosis with Mesorhizobium amorphae CCNWGS0123
Authors: Huo Haibo , Wang Xinye , Liu Yao , Chen Juan , Wei Gehong
Published: November 2020

Under nitrogen-limiting conditions, symbiotic nodulation promotes the growth of legume plants via the fixation of atmospheric nitrogen to ammonia by rhizobia in root nodules. The rhizobial Nod factor (NF) and type III secretion system (T3SS) are two key signaling pathways for establishing the legume–rhizobium symbiosis. However, whether NF signaling is involved in the nodulation of Robinia pseudoacacia and Mesorhizobium amorphae CCNWGS0123, and its symbiotic differences compared with T3SS signaling remain unclear. Therefore, to elucidate the function of NF signaling in nodulation, we mutated nodC in M. amorphae CCNWGS0123, which aborted NF synthesis. Compared with the plants inoculated with the wild type strain, the plants inoculated with the NF-deficient strain exhibited shorter shoots with etiolated leaves. These phenotypic characteristics were similar to those of the plants inoculated with the T3SS-deficient strain, which served as a Nod− (non-effective nodulation) control. The plants inoculated with both the NF- and T3SS-deficient strains formed massive root hair swellings, but no normal infection threads were detected. Sections of the nodules showed that inoculation with the NF- and T3SS-deficient strains induced small, white bumps without any rhizobia inside. Analyzing the accumulation of 6 plant hormones and the expression of 10 plant genes indicated that the NF- and T3SS-deficient strains activated plant defense reactions while suppressing plant symbiotic signaling during the perception and nodulation processes. The requirement for NF signaling appeared to be conserved in two other leguminous trees that can establish symbiosis with M. amorphae CCNWGS0123. In contrast, the function of the T3SS might differ among species, even within the same subfamily (Faboideae). Overall, this work demonstrated that nodulation of R. pseudoacacia and M. amorphae CCNWGS0123 was both NF and T3SS dependent.
Monoterpene synthases responsible for the terpene profile of anther glands in Eucalyptus polybractea R.T. Baker (Myrtaceae)
Authors: Goodger Jason Q D , Sargent Demi , Humphries John , Woodrow Ian E
Published: November 2020

Research on terpene biosynthesis in the genus Eucalyptus (Myrtaceae) is poorly developed, but recently large numbers of terpene synthase (TPS) genes have been identified. Few of these have been characterized or their expression localized to specific tissues. A prime candidate for detailed examination of TPS gene expression is the bisexual eucalypt flower—composed of male and female reproductive organs, and vegetative tissues that may express different TPS genes. We aimed to characterize and compare the terpene profile and TPS genes expressed in anthers and gynoecia in the high oil-yielding Eucalyptus polybractea R.T. Baker. We hypothesized that gynoecia will produce greater amounts of defensive terpenes, whereas anthers will have a terpene profile that is biased towards a role in pollination. Microscopy of isolated anthers showed them to possess a single, prominent oil gland. Chemical analysis of whole floral structures at different stages of development showed total oil per unit dry mass increased as flower buds expanded, with highest concentrations in mature flower buds just prior to flower opening. The oil profile of gynoecia was dominated by the monoterpene 1,8-cineole, whereas that of isolated anthers were enriched with the monoterpene α-pinene. Through transcriptomic analysis and recombinant protein expression, we were able to identify monoterpene synthases responsible for the different profiles. Synthases for α-pinene and 1,8-cineole were expressed in each tissue type, but the relative expression of the former was higher in anthers. Sequence comparison and site-directed mutagenesis of the α-pinene synthase allowed us to identify amino acids that influence the α-pinene to β-pinene ratio of the product profile. We suggest the terpene constituents of anthers may have multiple roles including attracting pollinators through emission of volatile α-pinene, deterrence of palynivores through emission of volatile 1,8-cineole and adhesion of pollen to pollinators via the release of sticky α-pinene onto the anther surface.
Real-Time PCR and Droplet Digital PCR Are Accurate and Reliable Methods To QuantifyPseudomonas syringaepv.actinidiaeBiovar 3 in Kiwifruit Infected Plantlets
Authors: Barrett-Manako Kelvina , Andersen Mark , Martínez-Sánchez Marcela , Jenkins Heather , Hunter Shannon , Reese-George Jonathan , Montefiori Mirco , Wohlers Mark , Rikkerink Erik , Templeton Matt , Nardozza Simona
Published: November 2020

Pseudomonas syringae pv. actinidiae is the etiological agent of kiwifruit canker disease, causing severe economic losses in kiwifruit production areas around the world. Rapid diagnosis, understanding of bacterial virulence, and rate of infection in kiwifruit cultivars are important in applying effective measures of disease control. P. syringae pv. actinidiae load in kiwifruit is currently determined by a labor-intense colony counting method with no high-throughput and specific quantification method being validated. In this work, we used three alternative P. syringae pv. actinidiae quantification methods in two infected kiwifruit cultivars: start of growth time, quantitative PCR (qPCR), and droplet digital PCR (ddPCR). Method performance in each case was compared with the colony counting method. Methods were validated using calibration curves obtained with serial dilutions of P. syringae pv. actinidiae biovar 3 (Psa3) inoculum and standard growth curves obtained from kiwifruit samples infected with Psa3 inoculum. All three alternative methods showed high correlation (r > 0.85) with the colony counting method. qPCR and ddPCR were very specific, sensitive (5 × 102CFU/cm2), highly correlated to each other (r = 0.955), and flexible, allowing for sample storage. The inclusion of a kiwifruit biomass marker increased the methods’ accuracy. The qPCR method was efficient and allowed for high-throughput processing, and the ddPCR method showed highly accurate results but was more expensive and time consuming. While not ideal for high-throughput processing, ddPCR was useful in developing accurate standard curves for the qPCR method. The combination of the two methods is high-throughput, specific for Psa3 quantification, and useful for research studies (e.g., disease phenotyping and host–pathogen interactions).
Coronavirus Disease 2019 (COVID-19) and Pregnancy: Combating Isolation to Improve Outcomes
Authors: Jago C.A. , Singh S.S. , Moretti F.
Published: November 2020

(Obstet Gynecol. 2020;00:1–4)

Due to the current coronavirus disease 2019 (COVID-19) pandemic, many obstetric units across North America have implemented social distancing policies, including modified visitation, to minimize exposure to the virus. Unfortunately, these policies may have unintended consequences stemming from reduced labor support and increased maternal stress. This commentary offers recommendations to combat isolation and improve birth outcomes while continuing to mitigate the risk of infection posed by COVID-19.
Effects of Long Working Hours and Shift Work During Pregnancy on Obstetric and Perinatal Outcomes: A Large Prospective Cohort Study—Japan Environment and Children’s Study
Authors: Suzumori N. , Ebara T. , Matsuki T. , Yamada Y. , Kato S. , Omori T. , Saitoh S. , Kamijima M. , Sugiura-Ogasawara M.
Published: November 2020

(Birth. 2020;47:67–79)

Previous evidence suggests that working during pregnancy is not associated with adverse outcomes; however, standing, heavy lifting, or unusual workloads may increase risks of complications. In Japan, the number of pregnant workers has increased, and time working is ∼20% longer than in some European countries. There is conflicting evidence as to whether or not shift work increases rates of adverse pregnancy outcomes. This study aimed to assess the relationship between working hours during pregnancy and pregnancy outcomes in Japan.
Trichilemmal Cysts With Divergent Ductal Differentiation: A Series of 4 Cases
Authors: Khan Irfan , Fraga Garth R. , Dai Hongyan
Published: November 2020

Trichilemmal cysts are common clonal tumors with a predilection for the scalp. They are composed of an outer epithelial wall resembling the outer root sheath in the isthmus of the hair follicle and a central core of compact keratin. Sweat duct differentiation is exceptional with only one convincing case reported to date. Here, we sought to characterize the clinicopathological characteristics of sweat duct differentiation in trichilemmal cysts. We reviewed all cases of trichilemmal cyst diagnosed at our institution between 2008 and 2019. Ductal structures were found in 4 of 411 cases (0.97%). Subjects included 2 male and 2 female patients with a median age of 37.5 years (range 34–55). The ducts were lined by attenuated epithelial cells and immunoreactive for polyclonal carcinoembryonic antigen and cytokeratin 7. Ductal differentiation involved a median of 7.5% (range 1%–50%) of the cyst wall. All 4 cases were from the scalp and treated with local excision. No recurrence was identified with a median follow-up period of 1.5 years (range 1–12 years). In summary, sweat duct differentiation in trichilemmal cysts is rare but likely under recognized. Conceptually, we suggest it represents a type of divergent cellular differentiation within a clonal neoplasm rather than a retention cyst or hybrid cyst.
A prospective observational cohort study to evaluate patients’ experience during sequential cataract surgery under monitored anesthesia care and topical anesthesia
Authors: Heard Jarrett A. , Zacarias Alicia A. Gonzalez , Lawrence Alec T. , Stoicea Nicoleta , Palettas Marilly , Fiorda-Diaz Juan , Guertin Michael G. , Tandon Amit , Lowery Deborah S.
Published: November 2020

Cataract surgery is the most common ambulatory surgery at our outpatient surgery center. Several studies have shown that patients with bilateral cataracts may experience different levels of anxiety, pain, and awareness during the first and second cataract extraction.

A prospective observational cohort study was conducted at The Ohio State University Wexner Medical Center Eye and Ear Institute in order to compare anxiety, general comfort, awareness, and pain levels in patients undergoing sequential cataract surgeries. Likert and numerical rating scale were used to assess the outcomes. Patients receiving monitored anesthesia care and topical anesthesia were included.

A total of 198 patients were enrolled in this study, 116 patients (59%) were female and 157 patients (78%) were Caucasians with a median age of 67 years among participants. Patients with rating “no anxiety” or feeling “somewhat anxious” were significantly higher during surgery 2 (P =< .001). Most of the patients felt “extremely comfortable” during surgery 1 when compared to surgery 2 (54% vs 42.9%; P = .08). No significant differences were found between surgeries regarding intraoperative awareness (P = .16). Overall, patients experienced mild pain during both procedures (92.4% in surgery 1 compared to 90.4% in surgery 2; P = .55). During the postoperative visit, 54% of the patients associated surgery 2 with less anxiety levels, 53% with no differences in general comfort, 60% felt more aware, and 59% had no differences in pain levels.

Previous exposure to surgery could have been associated with a significant reduction in anxiety levels reported during surgery 2. Non-pharmacological strategies aiming to reduce perioperative anxiety may be considered an alternative or additional approach to premedication in patients undergoing consecutive cataract surgeries.
Evaluation of walking exercise on glycemic control in patients with type 2 diabetes mellitus
Authors: Hu Hengchang , Lei Yuanhong , Yin Liping , Luo Xiaoqiong
Published: November 2020

Introduction:

Hyperglycemia is closely associated with the occurrence of diabetic complications, especially for patients with type 2 diabetes mellitus. Clinical trials indicated that walking exercise could improve glycemic control in patients with type 2 diabetes mellitus, but it is difficult to draw definitive and reliable conclusions due to the small sample size and possible exaggerated efficacy of various individual clinical trials. Therefore, we will conduct systematic review and meta-analysis to assess the current evidence for the efficacy of walking on glycemic control.

Methods and analysis:

The databases of PubMed, EMBASE, Web of Science and Cochrane Library will be searched for this review. Cochrane risk-of-bias assessment tool will be applied to assess the risk of bias of included studies. A meta-analysis will be performed according to the Cochrane Handbook for Systematic Reviews of Interventions by using RevMan 5.3 and STATA/SE 14.0 software. Subgroup analysis will be conducted to investigate the sources of heterogeneity. Sensitivity analysis will be performed to assess the reliability and stability of the meta-analysis. Publication bias and small-study effects will be evaluated by a funnel plot and Eggers test if there are at least 10 studies. Additionally, the quality of evidence for this review will be assessed by Grades of Recommendations Assessment, Development and Evaluation (GRADE).

Results:

This systematic review and meta-analysis will be to assess the efficacy of walking exercise on glycemic control.

Conclusion:

We will provide strong evidence to determine whether walking can improve glycemic control in patients with type 2 diabetes mellitus. This study is supposed to provide references for clinical trials and patients with type 2 diabetes mellitus.

Ethics and dissemination:

This study does not require ethical approval. The results of this review will be published in a peer reviewed journal.

INPLASY registration number:

INPLASY202090046.
Study on association between shear wave elastography parameters and clinicopathological characteristics in breast cancer
Authors: Xue Hong-hong , Wang Yuan-yuan
Published: November 2020

Background:

This study aims to explore the association between shear wave elastography parameters (SWEPs) and clinicopathological characteristics (CPCs) in breast cancer (BC).

Methods:

The electronic databases of Cochrane Library, MEDLINE, EMBASE, Allied and Complementary Medicine Database, WANGFANG, VIP, and China National Knowledge Infrastructure will be used to search for studies dated from database inception to the present. No limitations of language and publication status will be applied in this study. Only case-controlled study and randomized controlled trials investigating the association between SWEP and CPC in BC will be included. Cochrane risk of bias will be used to assess study quality for each included study. RevMan 5.3 software will be utilized for statistical analysis.

Results:

This study will provide accurate data to appraise the association between SWEP and CPC in BC.

Conclusion:

This study will summarize the most recent evidence to improve our understanding of the association between SWEP and CPC in BC.

OSF registration number:

osf.io/vmkwu.
Effect of home-based high-intensity interval training using telerehabilitation among coronary heart disease patients
Authors: Dosbaba Filip , Hartman Martin , Hnatiak Jakub , Batalik Ladislav , Ludka Ondrej
Published: November 2020

Introduction:

Cardiovascular diseases are the world's most common causes of morbidity and mortality in the population, including Central Europe. Cardiac rehabilitation (CR) is an effective preventive approach that includes several core components. Physical training is identified as an integral and essential part of CR. Training can positively influence several cardiovascular risk factors in people diagnosed with coronary heart disease and prevent them from clinical events. Our study aims to research the method of high-intensity interval training (HIIT) in a home environment using telerehabilitation. We assume that the HIIT form of telerehabilitation, using a heart rate monitor as a tool for backing up training data, can improve cardiorespiratory fitness and lead to higher peak oxygen uptake than the traditional moderate-intensity continuous training (MICT).

Methods:

This study is designed as a monocentral randomized controlled trial at University Hospital Brno in the Czech Republic. After the coronary heart event, the suitable patients will be randomized (1:1 ratio) and separated into 2 groups: the experimental HIIT group and the control MICT group. Both groups undergo a 12-week telerehabilitation with a 1-year follow-up period. Study participants will be telemonitored during physical training in their home environment via a heart rate monitor and a web platform. Once a week, the patients will give their feedback and motivation by a telephone call.

The primary outcome observed will be the effect of intervention expressed by changes in cardiorespiratory fitness. Secondary outcomes will be the health-related quality of life, anxiety, training adherence, body composition, safety, and satisfaction.

Discussion:

The HIIT is widely researched predominantly in a center-based supervised form. Our study differs from others by the use of telemedicine and smart technologies in home-based settings. Previous home-based cardiac telerehabilitation studies have focused primarily on MICT, which has demonstrated feasibility, and results have shown similar improvements as center-based CR. There is a presumption that HIIT may be superior to MICT. However, it can be complicated to self-dose the method in the home environment. Investigators expect that HIIT research will provide insight into the possibilities of telemedicine feasibility, effect, and limitations of coronary heart disease patients’ use at low to moderate cardiovascular risk.
Factors associated with willingness to enter care homes for the elderly and pre-elderly in west of China
Authors: Dong Xiaoyang , Wong Bonnie O. , Yang Chunsong , Zhang Fengying , Xu Fei , Zhao Li , Liu Yi
Published: November 2020

The research describes willingness of urban and rural residents over age 40 to enter care homes and examines personal factors which impact their willingness. Trained investigators gathered survey responses on sociodemographic information, physical health status, lifestyle behaviors, willingness to enter care homes, and specific service needs. 34.8% of the 1186 survey participants expressed willingness to enter care homes, with lower percentage of rural residents (25.8%) expressing willingness compared to urban residents (41.6%). The decision to enter care homes is impacted by occupation for urban residents and education status for rural residents. Healthcare remains the top consideration when considering care homes.
Validation of digital tourniquet pressures
Authors: Kim Hyeonwoo , Joo Yoon Ha , Yu Na Hee , Kwon Sung Tack , Lee Jung Chan , Kim Byung Jun
Published: November 2020

Digital tourniquets are widely used for the management of digital injuries in emergency departments or outpatient clinics. This study is focused on the pressure analysis of digital tourniquets on some points not covered in the existing literature.

A total of thirty volunteers were enrolled in this study. Instantaneous surface pressure was measured at the thumbs, index fingers, and little fingers. We investigated the pressure according to the circumference of digits, tourniquet types, and measurement sites (dorsal and mid lateral volar sides) above the digital vessels. Continuous pressure was measured in artificial silicone models to determine the change of pressure over 2 hours.

The average pressure measured on the mid lateral volar side of volunteers fingers were 154.3 ± 54.9 mm Hg by T-RingTM and 162.6 ± 61.0 mm Hg by surgical glove. The pressure on the dorsal side were 224.7 ± 57.7 mm Hg by T-RingTM and 228.8 ± 66.0 mm Hg by surgical glove, each significantly higher than the mid lateral volar side. The circumference of digits did not significantly affect the surface pressure. The pressure pattern did not change significantly over 2 hours in both tourniquet types.

The surface pressure of the mid lateral volar side was significantly lower than that of the dorsal side. However, there was no significant pressure difference according to the circumference of digits. Time dependent pressure change were not significantly different between 2 tourniquets.
Dexamethasone prevents TACE-induced adverse events
Authors: Chang Lei , Wang Wei , Jiang Nanhui , Rao Fengying , Gong Cheng , Wu Ping , Yang Jian , Liu Zhisu , Guo Tao
Published: November 2020

Background:

While dexamethasone has been applied following transcatheter arterial chemoembolization (TACE) for years, its clinical effects have not been determined. In the current study, we aimed to evaluate the efficacy of dexamethasone in preventing adverse events induced by TACE.

Methods:

Literature retrieval was conducted using globally recognized online databases, namely MEDLINE, EMBASE, and Cochrane Central, to identify randomized controlled trials (RCTs) of dexamethasone application in patients undergoing TACE. The relative odds ratios (ORs) of incidence rates of three adverse events, namely, fever, abdominal pain and nausea/vomiting, were calculated. The value of I2 was applied to evaluate the heterogeneity of the trials, and the overall publication bias was assessed with Egger test.

Results:

Four RCTs containing 350 subjects were included for the pooled estimation. Dexamethasone significantly reduced the incidence rate of TACE-induced adverse events (OR = 1.237, 95% CI: 1.170–1.308, P < .001) with moderate heterogeneity (I2 = 46.0%). The result of Egger test revealed a publication bias for the included studies.

Conclusion:

The current meta-analysis confirmed the efficacy of dexamethasone in preventing TACE-induced adverse events. To confirm the practicality of dexamethasone use with TACE, further studies with large sample sizes are warranted to update the evidence-based analyses.
Differences in midazolam premedication effects on recovery after short-duration ambulatory anesthesia with propofol or sevoflurane for gynecologic surgery in young patients
Authors: Kim Hyunjee , Park Sung-Sik , Shim Jihye
Published: November 2020

Background:

Anxiolytic premedication requires careful consideration owing to potential side effects including delayed recovery after ambulatory anesthesia. We aimed to compare the effect of midazolam on recovery profiles postoperatively, depending on whether propofol or sevoflurane was the primary anesthetic.

Methods:

We enrolled 226 patients (age, 18–50 years) undergoing ambulatory gynecologic laparoscopic surgery. Patients were categorized into propofol without midazolam (P), propofol with midazolam (MP), sevoflurane without midazolam (S), and sevoflurane with midazolam (MS) groups. As premedication, placebo or 0.02 mg/kg intravenous midazolam was used. The primary outcome was the difference in the time from anesthetic discontinuation to eye opening in response to verbal command. Secondary outcomes included postoperative nausea and pain occurrence and time to reach the discharge score.

Results:

The time from anesthetic discontinuation to eye opening was longer in the MP group (n = 49) than in the P group (n = 50; P < .001) but was not significantly different between the MS (n = 50) and S groups (n = 49; P = .1). Midazolam premedication did not significantly affect postoperative nausea in the MP group compared with that in the P group (P = .3) but had a nausea prevention effect in the MS group compared with that in the S group (P < .001). The time to reach the discharge score was similar in all patients regardless of midazolam administration.

Conclusion:

In the recovery from short-duration ambulatory gynecologic surgery in young patients, intravenous midazolam premedication showed positive effects on postoperative nausea without affecting the time from anesthetic discontinuation to eye opening with sevoflurane-based anesthesia but prolonged the time from anesthetic discontinuation to eye opening with propofol-based anesthesia. Because this difference between the propofol groups is not clinically significant, the results support midazolam premedication in young women. Further studies assessing larger populations are needed.
Comparative efficacy and acceptability of traditional Chinese medicine for adult major depression
Authors: Shao Yuze , Wang Kai , Jiang Zhenyuan , Yu Xiaowen , An Wenrong , Han Yue , Wang Zhonglin
Published: November 2020

Background:

Major depression disorder (MDD) is a severe health threat characterized by persistent depression, loss of interests, lack of initiative, and even suicidal tendencies. Traditional Chinese medicine (TCM) is well tolerated and effective in treating adult MDD. However, research on the evaluation of efficacy and acceptability of different TCM strategies for adult MDD is insufficient. Consequently, it is high time to evaluate the efficacy of TCM strategies for adult MDD. Meanwhile, the acceptability of different TCM strategies is worth exploring.

Methods:

Comprehensively and systematically retrieve the literature in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and Chinese BioMedical Literature Database (CBM). The literature search will focus on randomized controlled trials (RCTs) with TCM in adult MDD. Two reviewers will search the literature and extract relevant data back-to-back. Once mismatched outcomes appear, arbitration will be conducted by a third reviewer. Based on the Bayesian framework, data analysis is carried out with STATA and WinBUGS software. Heterogeneity, transitivity, consistency test, bias risk assessment, subgroup and sensitivity analysis, evidence quality evaluation will be performed accordingly.

Results:

The efficacy and acceptability of different TCM strategies for adults with MDD will be compared and sorted.

Conclusion:

The study will facilitate the treatment options of adults MDD according to the supporting evidence.

INPLASY registration number:

INPLASY2020100028.
Comparison of the intraoperative analgesic efficacy between ultrasound-guided deep and superficial serratus anterior plane block during video-assisted thoracoscopic lobectomy
Authors: Moon Suyoung , Lee Jungwon , Kim Hyuckgoo , Kim Jeongeun , Kim Jiseob , Kim Saeyoung
Published: November 2020

Background:

The serratus anterior plane block (SAPB) is a novel method that provides lateral chest wall analgesia. There are 2 methods of SAPB; deep and superficial SAPB. Each of these methods has been demonstrated to provide effective perioperative analgesia in thoracic surgery. The aim of this study was to compare the intraoperative hemodynamic and analgesic benefits of deep versus superficial SAPB during video-assisted thoracic surgery (VATS) lobectomy.

Methods:

We performed a prospective, randomized, patient/assessor-blinded trial. We included patients who were 20 to 75 years of age and scheduled to undergo VATS lobectomy with American Society of Anesthesiologists physical status 1 or 2. Patients were randomly allocated to receive either ultrasound-guided deep SAPB (Group D) or superficial SAPB (Group S). The primary outcome was intraoperative remifentanil consumption. We also recorded intraoperative systolic blood pressure (SBP), heart rate (HR), emergence time, and doses of rescue drugs used to manage hemodynamic instability.

Results:

Data for 50 patients undergoing 3-port VATS lobectomy were analyzed. Intraoperative remifentanil consumption did not differ significantly between Group D (n = 25, 715.62 ± 320.36 μg) and group S (n = 25, 721.08 ± 294.48 μg) (P = .97). Additionally, there were no significant differences between the 2 groups in SBP and HR at any time point, emergence time, or amount of rescue drugs used.

Conclusion:

Our study suggests that the intraoperative analgesic efficacy is similar for deep and superficial SAPB during VATS lobectomy.
A protocol of randomized controlled trial for Modified Xiaoyao Powder in the treatment of chronic obstructive pulmonary disease combined mild to moderate depression
Authors: Chen Keling , Zhao Keni , Wang Wujun , Xiao Wei , Xiao Jing , Yang Yang , Liu Yufei , Xie Xiaohong
Published: November 2020

Introduction:

Depression is an important complication of chronic obstructive pulmonary disease (COPD), occurring in more than one-third of individuals with COPD, and its severity is closely related to the severity and acute exacerbation of COPD, significantly contributing to the risk of death from COPD. Comorbid depression in COPD can be a burden on COPD-related diseases by reducing quality of life and compliance with treatment. Unfortunately, symptoms of COPD combined anxiety and depression are not properly diagnosed and treated in clinical practice, especially in the early stages of mood changes in patients with COPD, as the symptoms are mild and monotonous, and are overlooked.

Methods:

In this prospective, randomized, placebo-controlled trial, we will assigned 280 eligible patients who had COPD combined depression to receive either Modified Xiaoyao Powder (MXP) or placebo. The primary end point is the change in the Hamilton Depression Scale (17 items) (HAMD-17) score from baseline on weeks 4, 12, and 24.

Discussion:

Six months of MXP for COPD combined mild to moderate depression may alleviate the symptoms of depression, reduce the frequency of hospitalizations, the number of exacerbations, and improve the compliance of treatment.

Trial registration:

ChiCTR2000038741.
The effectiveness and safety of acupoint catgut embedding for the treatment of primary dysmenorrhea
Authors: Wang Xue , Wang Nan , Liang Junquan , Xu Yunxiang , Chen Guizhen
Published: November 2020

Background:

Primary dysmenorrhea (PD), also regarded as functional dysmenorrhea, refers to dysmenorrhea without obvious organic lesions in the reproductive system. It accounts for more than 90% of dysmenorrhea and seriously affects womens life and work. Previous studies have proved that acupoint catgut embedding therapy is effective and safe for PD patients. It could relieve the pain rapidly and work for a long time in multiple mechanisms. This protocol aims to evaluate the effectiveness and safety of acupoint catgut embedding therapy on PD systematically. With the latest published evidence, a systematic review and meta-analysis of catgut embedding for patients with PD would be carried out in this study.

Methods:

All randomized controlled trials (RCTs) related to acupoint catgut embedding therapy on PD will be searched in the following electronic databases: PubMed, Cochrane Library, EMBASE, Wed of Science, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Database, Wanfang Database, and Chinese Biomedical Literatures Database (CBM), from inception to September 2020. The primary outcomes contain visual analog scale (VAS), dysmenorrhea symptom score, and clinical effectiveness rate, while the secondary outcomes consist of adverse events and the recurrence rate. Two reviewers will independently perform data selection, data synthesis, and quality assessment. Assessment of risk of bias and data synthesis would be performed with Review Manager 5.3 software.

Result:

This systematic review will summarize the current and high-quality evidence of acupoint catgut embedding therapy on PD.

Conclusion:

This systematic review aims to offer the latest persuasive evidence for clinical practitioners that using acupoint catgut embedding therapy on PD is effective and safe.

PROSPERO registration number:

CRD42020156362.
Assessment of clinical efficacy of traditional Chinese medicine for the management of primary dysmenorrhea in the UK
Authors: Fu Ming-ming , Meng Xiang-dong
Published: November 2020

Background:

This study aims to appraise the clinical efficacy of traditional Chinese medicine (TCM) for the management of patients with primary dysmenorrhea (PD) in the UK.

Methods:

We will comprehensively search electronic databases (Cochrane Library, PUBMED/MEDLINE, EMBASE, PsycINFO, AMED, Web of Science, and CNKI) and additional resources for original articles on randomized controlled trials published in English, Chinese, German, Spanish, Korean and Japanese. Outcomes will be the pain intensity, pain duration, menstrual cramps, amount of bleeding, and severity of dysmenorrhea symptoms, quality of life, and adverse events. Two authors will independently check all citations, extract data, and assess study quality. All potential conflicts will be solved through discussion by consulting another experienced author. A narrative synthesis will summarize the characteristics and findings of eligible trials. If it is possible, we will also pool the data and carry out meta-analysis.

Results:

The available evidence of the clinical efficacy of TCM for the treatment of PD in UK will be assessed through outcome measurements.

Conclusion:

The findings of this study will determine whether or not TCM is effective and safe for the treatment of PD in UK.

OSF registration number:

osf.io/jyc95.
Correlation between serum circRNA and thyroid micropapillary carcinoma with cervical lymph node metastasis
Authors: Yang Wenwen , Bai Chao , Zhang Li , Li Zongbao , Tian Ye , Yang Zhenwei , Wang Liang , Wu Wennian
Published: November 2020

The study aims to characterize the circular RNA (circRNA) expression profile that is functionally related with the invasiveness of papillary thyroid microcarcinoma (PTMC).

A total of 13 pairs of female patients with non-invasive PTMC or lymph node metastasis PTMC (PTMC (L)) were included and the serum RNA was obtained. CircRNA microarray was performed to identify the circRNA expression profile. Real time-PCR was used to verify circRNA expression. Bioinformatic approaches were adopted to annotate the function of differentially expressed circRNAs and construct the circRNA-miRNA-mRNA network.

In total, 400 significantly upregulated and 290 significantly downregulated circRNAs were identified in PTMC (L) compared with PTMC. Among them, 10 circRNAs were selected and validated by real time-PCR. Putative microRNAs (miRNAs) that could bind to the differentially expressed circRNAs were predicted. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of target genes of the differentially expressed circRNAs revealed that these circRNAs may play an important role in lymph node metastasis. Finally, circRNA targeted miRNAs were predicted and a circRNA-miRNA-mRNA network was constructed for hsa_circRNA_404686.

Our results showed that several circRNAs, such as hsa_circRNA_404686, may serve as promising diagnostic marker for PTMC (L) in female.
Medical cost and healthcare utilization of amyotrophic lateral sclerosis in China
Authors: Song Han , Liu Jian-Chao , Cao Zi-Peng , Luo Wen-Jing , Chen Jing-Yuan
Published: November 2020

Amyotrophic lateral sclerosis (ALS), a specific neurodegenerative disease, imposed increased economic and utilizations burden on the healthcare system, especially with the progress of the diseases severity. However, the economic burden on Chinese ALS patients remained unclear. This study therefore was aimed to investigate medical cost and healthcare utilization for Chinese ALS patients.

Longitudinal health data of over 20 million individuals, including military personnel and civilians, was collected from all Chinese military hospitals. We identified 480 patients with a first major diagnosis for ALS from 2015 to 2018, while matched 400 controlled patients on age, gender, ethnic group, geographic region, length of stay, year of diagnosis and comorbidity. Their medical cost and healthcare utilizations were then measured 1 year before, and 1 year after ALS diagnosis.

The median annual medical cost of ALS patients was about 2-fold higher, 17,087 CNY during the index year than 1 year before, 7859 CNY. The highest increase in utilizations may account for medical costs on ALS patients, which was represented by hospitalizations (Odd Ratio (OR) = 4.26, 95% confidence interval (CI) 3.52, 5.15), electromyography (OR = 4.14, 95% CI 2.37, 7.22), nerve conduction velocity (OR = 3.26, 95% CI 2.23, 4.77).

This study is the first one reporting direct economic burden on Chinese ALS patients. Efforts should be made to develop cost-effective diagnostic tools in order that sources of medical cost were more effectively allocated, and this disease was detected earlier.
Nursing intervention reduces depression for patients with rheumatoid arthritis
Authors: Liu Moying , Shi Baoxin
Published: November 2020

Background:

Rheumatoid arthritis (RA) is a kind of chronic disease of inflammatory joint, which can lead to the damage and disability of bone and cartilage. Psychiatric comorbidity is related to the adverse results of RA. Symptoms of depression is associated with the increased disease activity and decreased response to the treatments. Therefore, the depression may be an effective intervention target to improve the life quality and subjective health of the patients with RA. The objective of this experiment is to evaluate the effectiveness of nursing intervention for reducing depression for patients with RA.

Method:

It is a single-center randomized controlled study to be conducted from January 2021 to December 2021. It was admitted via the Ethics Committee of Tianjin Medical University (202018384). One hundred patients are included in the study. The inclusion criteria contains:

The exclusion criteria contains:

All the patients participating in this study are randomly divided into control group and study group, with 50 patients in each group. The primary result is the severity of depression in the patients with RA, based on the generally utilized questionnaires (Hospital Anxiety and Depression Scale). The secondary outcome is the patients life quality, which is evaluated with the short form 36 questionnaire. The analysis of all the data are conducted with the software of IBM SPSS Statistics for Windows, version 20.

Results:

Table will show the clinical outcomes after various interventions.

Conclusion:

This paper instructs the nurses to develop protocol based on evidence to improve the clinical efficacy for the RA patients.

Trial registration number: researchregistry6114.
Effects of medial meniscal slope and medial posterior tibial slope on the locations of meniscal tears
Authors: Wang Xiaotan , Jing Lizhong , Wang Xiaole , Li Zhen , Li Zhuang , Zhang Zhiwei , Yang Jiushan
Published: November 2020

The aim of this study was to analyze the relationship between medial posterior tibial slope (MPTS) and medial meniscus slope (MMS) with the location of meniscal lesions. We hypothesize that meniscuses with greater MPTS and MMS are more likely to have lesions in posterior horn.

A total of 292 patients underwent arthroscopic surgery between January 2014 to September 2019 due to knee osteoarthritis (OA) and meniscal lesions were reviewed. Based upon the location of meniscal tears, patients were categorized as group B (tears in posterior horn) and group A (other sites). MPTS and MMS were measured from magnetic resonance imaging (MRI) slices. Osteoarthritis grade was evaluated in anteroposterior radiographs by the criteria defined by Kellgeren and Lawrence. Demographic data, OA grade, MPTS, and MMS for the 2 groups were compared and analyzed.

The group A had 29 (39%) male and 45 (61%) female subjects with a mean age of 57.07 ± 6.79 years. Group B consists of 74 (34%) male and 144 (66%) female subjects with a mean age of 58.90 ± 7.594 years. (P = .067 and P = .458 for age and sex, respectively). In group A, 31 knees (42%) were determined to be Kellgren–Lawrence grade one, 32 knees (43%) grade two, and 11 knees (15%) grade three. In group B, 86 knees (39%) were categorized in grade one, 85 knees (39%) in grade two, and 47 knees (26%) in grade three (P = .085). The mean MPTS was 5.06 ± 2.11 degree for group A and 6.15 ± 2.37 degree for group B (P = .001). The mean MMS for group A was lower than group B (1.38 ± 2.12 degree vs 3.14 ± 2.92 degree; P < .000)

This study demonstrated that increased MPTS and MMS may be considered as the risk factors for medial meniscal posterior horn tears.
The haemostatic profile in critically ill COVID-19 patients receiving therapeutic anticoagulant therapy
Authors: Tsantes Argirios E. , Frantzeskaki Frantzeska , Tsantes Andreas G. , Rapti Evdoxia , Rizos Michalis , Kokoris Styliani I. , Paramythiotou Elizabeth , Katsadiotis Georgios , Karali Vassiliki , Flevari Aikaterini , Chrysanthopoulou Evangelia , Maratou Eirini , Kyriakou Elias , Gialeraki Argyri , Bonovas Stefanos , Dimopoulos George , Tsangaris Iraklis , Armaganidis Apostolos
Published: November 2020

Hypercoagulability and thrombosis remain a challenge in severe coronavirus disease 2019 (COVID-19) infections. Our aim is to investigate the hemostatic profile of critically ill COVID-19 patients on therapeutic anticoagulant treatment.

Forty one patients were enrolled into the study. We recruited 11 consecutive, COVID-19, patients who received therapeutic anticoagulant treatment on intensive care unit (ICU) admission. Disease severity indexes, biochemical, hematological and haemostatic parameters, endogenous thrombin potential (ETP), plasminogen activator inhibitor-1 (PAI-1) activity and extrinsically activated rotational thromboelastometry assay (EXTEM) were recorded on days 1, 3, 7. We also enrolled 9 ICU non-COVID-19, 21 non-ICU COVID-19 patients and 20 healthy blood donors as control populations.

Critically ill COVID-19 patients demonstrated a more hypercoagulable and hypofibrinolytic profile related to those with COVID-19 mild illness, based on EXTEM amplitude at 10 min (A10), maximum clot firmness (MCF) and lysis index at 60 min (LI60) variables (p = 0.020, 0.046 and 0.001, respectively). Similarly, a more hypercoagulable state was detected in COVID-19 ICU patients related to non-COVID-19 ICU patients based on A10 and MCF parameters (p = 0.03 and 0.04, respectively). On the contrary, ETP and EXTEM (clotting time) CT values were similar between patients with severe and mild form of the COVID-19 infection, probably due to anticoagulant treatment given.

Critically ill COVID-19 patients showed a hypercoagulable profile despite the therapeutic anticoagulant doses given. Due to the small sample size and the study design, the prognostic role of the hypercoagulability in this clinical setting remains unknown and further research is required in order to be assessed.
Association of glycosylated hemoglobin and outcomes in patients with COVID-19 and pre-existing type 2 diabetes
Authors: Zhang Nie , Yun Ruiyuan , Liu Lin , Yang Liu
Published: November 2020

Background:

The impact of glycosylated hemoglobin on mortality in patients with coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) remains uncertain. In this study, we aim to assess the effect of pre-hospital blood glucose regulation on patients with COVID-19 and pre-existing T2D.

Methods:

All randomized controlled trials (RCTs) and cohort studies of association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be included in this review. PubMed, Embase, and CNKI will be searched for relevant literature, up to August 20, 2020 in English and Chinese language. Two reviewers will select trials independently for inclusion and assess trial quality. Two pairs of authors will independently extract information for each included trials. Primary outcomes are death and composite adverse outcomes: the number of participants who died or remained severely disabled. Revman 5.3 will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysisa and generating funnel-plots.

Results:

We will provide practical results about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D.

Conclusion:

The stronger evidence about the association of glycosylated hemoglobin and outcomes in patients with COVID-19 and T2D will be provided for clinical practice.

Systematic review registration:

PROSPERO CRD42020200574.

Ethics and dissemination:

There is no need for ethical approval, and the review will be reported in a peer-reviewed journal.