bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use and reporting of neonatal pain scales: a systematic review of randomized trials
Authors: Olsson Emma , Ahl Hanna , Bengtsson Kevin , Vejayaram Dhashini N. , Norman Elisabeth , Bruschettini Matteo , Eriksson Mats 
Published: August 2020

Abstract
The burden of pain in newborn infants has been investigated in numerous studies, but little is known about the appropriateness of the use of pain scales according to the specific type of pain or infant condition. This systematic review aimed to evaluate the reporting of neonatal pain scales in randomized trials. A systematic search up to March 2019 was performed in Embase, PubMed, PsycINFO, CINAHL, Cochrane Library, Scopus, and Luxid. Randomized and quasirandomized trials reporting neonatal pain scales were included. Screening of the studies for inclusion, data extraction, and quality assessment was performed independently by 2 researchers. Of 3718 trials found, 352 with 29,137 infants and 22 published pain scales were included. Most studies (92%) concerned procedural pain, where the most frequently used pain scales were the Premature Infant Pain Profile or Premature Infant Pain Profile—Revised (48%), followed by the Neonatal Infant Pain Scale (23%). Although the Neonatal Infant Pain Scale is validated only for acute pain, it was also the second most used scale for ongoing and postoperative pain (21%). Only in a third of the trials, blinding for those performing the pain assessment was described. In 55 studies (16%), pain scales that were used lacked validation for the specific neonatal population or type of pain. Six validated pain scales were used in 90% of all trials, although not always in the correct population or type of pain. Depending on the type of pain and population of infants included in a study, appropriate scales should be selected. The inappropriate use raises serious concerns about research ethics and use of resources.
Effects of dapagliflozin on blood pressure variability in patients with prediabetes and prehypertension without pharmacological treatment: a randomized trial
Authors: Díaz-Cruz Cristal , González-Ortiz Manuel , Rosales-Rivera Lizet Y. , Patiño-Laguna Anayeli de J. , Ramírez-Rodríguez Zaire G. , Díaz-Cruz Karina , Martínez-Abundis Esperanza 
Published: August 2020

Aim
The aim of the study was to evaluate the effect of dapagliflozin on blood pressure variability (BPV) in patients with prediabetes and prehypertension without pharmacological treatment.

Methods
A double-blind, randomized, placebo-controlled clinical study was performed in 30 patients (30–60 years) diagnosed with prediabetes and prehypertension. Study subjects were divided into two groups: a 10-mg dose of dapagliflozin was administered daily before breakfast for 12 weeks in 15 patients or placebo in the remaining 15 patients. At the beginning and end of the study, clinical and metabolic evaluations were performed, and the 24-h BPV was calculated.

Results
Dapagliflozin significantly decreased body weight (P = 0.010), BMI (P = 0.011), fasting plasma glucose (P = 0.002), glycated hemoglobin A1c (P = 0.004), office systolic blood pressure (SBP) (P = 0.001), office diastolic blood pressure (DBP) (P = 0.011), 24-h SBP (121 ± 8 vs. 117 ± 11 mmHg, P = 0.046), nighttime SBP (114 ± 11 vs. 108 ± 10 mmHg, P = 0.017), nocturnal mean arterial pressure (P = 0.043), and nocturnal hypertensive load (P = 0.015); and it significantly increased the percentage of the dipper circadian BP pattern (16.7 vs. 30.8%, P = 0.047). After the administration of dapagliflozin, some of the patients did not meet the diagnostic criteria for prediabetes (26.9%) or prehypertension (26.9%).

Conclusions
The administration of 10 mg dapagliflozin once daily for 90 days in patients with prediabetes and prehypertension decreased BPV by reducing 24-h and nighttime SBP, and increasing the dipper circadian BP pattern.
Comparison of plaque distribution and wire-free functional assessment in patients with stable angina and non-ST elevation myocardial infarction: an optical coherence tomography and quantitative flow ratio study
Authors: Dan Kazuhiro , Garcia-Garcia Hector M. , Yacob Omar , Kuku Kayode O. , Kolm Paul , Shah Nikunj , Bennett Martin R. , Curzen Nick , Waksman Ron , Mahmoudi Michael 
Published: August 2020

Background
Data comparing plaque characteristics and wire-free physiological assessment in the target vessel in patients with stable angina versus acute coronary syndrome are sparse. Therefore, we investigated the difference in plaque distribution between stable angina and non-ST-elevation myocardial infarction (NSTEMI) and explored the relationship between target vessel vulnerability by optical coherence tomography (OCT) and wire-free functional assessment with quantitative flow ratio (QFR).

Methods
Patients with stable angina (n = 25) and NSTEMI (n = 24) were in the final prospective study cohort from the DECODE study (ClinicalTrials.gov, NCT02335086). All 5480 OCT frames in the region of interest were analyzed to study plaque morphology in the target vessel. QFR was analyzed from baseline coronary angiography before percutaneous coronary intervention. Vulnerable vessel score (VVS) was calculated from each plaque, and vessel QFR was then compared.

Results
Out of all frames, thin-cap fibroatheroma was common with NSTEMI compared to stable angina (10.9 versus 6.3%, P < 0.01), while fibrous plaque was more commonly seen with stable angina compared to NSTEMI (19.7 versus 14.4%, P < 0.01). Calcified plaque was similar in both clinical settings (approximately 6%). Regression analysis showed that segments with normal vessel walls were located significantly farther from the other plaque types. Longitudinal distances for plaque-type in NSTEMI were numerically greater than those for stable angina; however, the mean difference was less than 10 mm. The VVS had a significant inverse linear correlation with QFR (r = −0.34, P = 0.009).

Conclusions
The plaque distribution by OCT between stable angina and NSTEMI was similar. Target vessel vulnerability was greater in patients with lower QFR value.
Development and evaluation of a computerized clinical outcome assessment tool for head and neck cancer patients
Authors: Lin Ching-Rong , Fan Kang-Hsing , Lin Chien-Yu , Hung Tsung-Min , Huang Bing-Shen , Chen Eric Yen-Chao , Kang Chung-Jan , Huang Shiang-Fu , Chang Joseph Tung-Chieh , Chang Chih-Hung 
Published: August 2020

Abstract
Paper-based clinical outcome data collection methods have practical limitations when used in clinical settings, as the data are often not summarized in time to facilitate patient–physician communications and therefore cannot be used in clinical decision making. This study aimed to develop a computerized clinical outcome assessment tool (COAT) and evaluate its acceptability, feasibility, and potential clinical applications during clinical encounters for patients with head and neck cancer (HNC).
The traditional Chinese (TChi) character version of the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire was first transcribed and implemented into a touch-screen computerized administration and reporting system (COAT-HNC for short). Each HNC patient was invited to complete the COAT-HNC during their scheduled clinic visits as part of their clinical care. Upon completion, a structured summary report was generated, and subsequently used for treatment evaluation and planning.
A cohort of 385 HNC patients were enrolled. Each scale of the computerized TChi FACT-H&N questionnaire demonstrated acceptable internal consistency, with Cronbach coefficient alpha ranging from 0.74 to 0.90. The touch-screen-based and audio-capable COAT-HNC was reported to be easy to use. Patients and physicians were able to utilize the summary report during their clinical encounters to discuss treatment progress and to plan care.
It is practically feasible to design, develop, and implement the COAT-HNC system in routine HNC care. The COAT-HNC has the potential to become a valuable tool for data collection and management of clinical outcomes, and appears useful for HNC patients. However, larger studies to demonstrate its clinical usefulness are still needed.
Ultrasound diagnosis and clinicopathological traits of female genital system malignant lymphomas
Authors: He Min , Hu Sha , Luo Hong 
Published: August 2020

Abstract
This study investigated the clinicopathological traits and ultrasound features (including 2-dimensional and color Doppler ultrasound) of female genital system malignant lymphomas and explored the diagnostic performance of ultrasonography in this disease.
Cases of female pelvic lymphoma diagnosed and treated at our hospital between July 2009 and July 2019 were included in this study. Pathological data and ultrasonic manifestations were assessed retrospectively to summarize the clinical traits and ultrasonic features of female genital system lymphoma (FGSL). Based on the results, recommendations for ultrasonography-based diagnosis of this disease are proposed.
During the 10-year study period, 20 female patients were diagnosed with malignant lymphomas in the pelvic cavity based on postoperative pathology tests. The age of the patients ranged from 11 to 83 years, and no patients demonstrated specific clinical traits; however, examination of tumor biomarkers revealed that certain patients had elevated levels of CA125. Twenty-eight lesions were identified in the 20 patients, including 24 involving the reproductive system. The primary ultrasonic manifestations were hypoechoic or extremely hypoechoic solid lesions that were relatively large in size, had a relatively regular shape, and had clear boundaries. Certain patients had concurrent ascites, and although some lesions lacked blood supply, most lesions had medium to abundant blood flow, which was largely characterized by low resistance. Almost none of the lesions were definitively diagnosed preoperatively.
Diagnosing malignant lymphomas in the female genital tract remains a considerable clinical challenge. Although certain clinical traits and ultrasonic features are associated with this disease and color Doppler ultrasonography might provide vital information indicating the presence of lymphoma, the final diagnosis depends on the clinical and pathological test results of the patients.
Efficacy of music-based cognitive behavior therapy on the management of test-taking behavior of children in basic science using a randomized trial group: Implication for community development
Authors: Agboeze Matthias U. , Ugwuanyi Christian S. , Okeke Chinedu I.O. , Ugwu Gloria C. , Obikwelu Chizoba L. , Obiozor Elizabeth E. , Oyigbo Dorida N. , Mbam David 
Published: August 2020

Abstract

Background:
This study sought the efficacy of cognitive-behavioral therapy-based music group (CBT-Music) intervention program on primary school children's test-taking behavior in Southeast Nigeria.

Methods:
A pretest, posttest randomized controlled trial experimental design was adopted for the study using a sample of 53 primary three (3) children. A test-taking behavior questionnaire was used for data collection. The instrument was face validated by test development experts. Construct validation of the instrument was done by subjecting the instrument to factor analysis after trial testing. Data were analyzed using independent samples t-test and paired samples t-test.

Results:
The findings of the study revealed that CBT-Music had a significant effect on the management of test-taking behavior of among children. Furthermore, the test-taking scores of children in the music-based CBT group were significantly lower than those in the control group at the follow-up measure. This implies that the test-taking behavior of the children can be better managed using the CBT-music intervention program to enable the children to grow better academically and contribute to the community they belong to.

Conclusion:
Music-based CBT demonstrated significant efficacy in the management of children's test-taking behavior. Thus, primary school teachers should be enlightened on how to make use of CBT-Music in the management of test-taking behavior among children.
Obstructive sleep apnea hypopnea syndrome
Authors: Wanyan Pingping , Wang Jianqin , Wang Wenge , Kong Yuke , Liang Yaojun , Liu Wei , Yu Qin 
Published: August 2020

Abstract

Background:
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common, chronic sleep disease. As the incidence of OSAHS increases, it has seriously threatened people's health. There have been an increasing number of clinical trials of OSAHS in recent years. However, the clinical trials of OSAHS have heterogeneous outcomes, surrogate outcomes, subjective outcomes, and composite outcomes, as well as the lack of endpoints or patient perspectives. The best method is to develop a core outcomes sets (COSs) for OSAHS's clinical trials.

Methods:
The development of COSs of OSAHS will include 5 stages:

Results:
The results of our study will be published in a peer-reviewed journal.

Discussion:
The development of the COSs of OSAHS will improve the design and operation of OSAHS clinical trials to conform to international standards and ensure the credibility of the outcomes. In addition, this study will involve different stakeholder groups to help ensure that the developed COSs will be suitable and well accepted.

Trial registration number:
1544.
Gene polymorphisms (rs324957, rs324981) in NPSR1 are associated with increased risk of primary insomnia
Authors: Xie Yuping , Zhao Yuan , Zhou Liya , Zhao Lijun , Wang Jinfeng , Ma Wei , Su Xiaoyan , Hui Peilin , Guo Bin , Liu Yu , Fan Jie , Zhang Shangli , Yang Jun , Chen Wenjuan , Wang Jing 
Published: August 2020

Abstract
Neuropeptide S and neuropeptide S receptor (NPSR1) are associated with sleep regulation. Herein, the possible contribution of 6 polymorphisms in NPSR1 on the chromosome to primary insomnia (PI) and objective sleep phenotypes was investigated.
The study included 157 patients with PI and 133 age- and sex-matched controls. All subjects were investigated by polysomnography for 3 consecutive nights. The genotyping of 6 polymorphisms was carried out by polymerase chain reaction-restriction fragment length polymorphism method.
A significant difference was detected for rs324957 and rs324981 between PI and controls. The PI patients had a higher frequency of AA than controls in rs324957 (P = .02) and rs324981 (P = .04). However, for other single nucleotide polymorphisms (rs323922, rs324377, rs324396, and rs324987), no significant differences were observed between PI patients and controls. There were 2 different allelic combinations that were associated with PI susceptibility (CATGTC, GCCAAT) and its risk factor. A significant difference in sleep latency was observed among 3 genotype carriers of NPSR1 gene polymorphism rs324957 in PI group (P = .04), with carriers of the A/A genotype having the longest sleep latency (mean ± SD: 114.80 ± 58.27), followed by the A/G genotype (112.77 ± 46.54) and the G/G genotype (92.12 ± 42.72).
This study provided the evidence that the NPSR1 gene polymorphisms (rs324957, rs324981) might be susceptibility loci for PI. Further studies are needed to explore the role of NPSR1 gene polymorphisms in molecular mechanisms of PI in a larger sample size.
Full-term pregnancy in a rudimentary horn with a live fetus
Authors: Zhang Yu , Pang Yingxin , Zhang Xue , Zhao Zhe , Liu Peishu 
Published: August 2020

Abstract

Introduction:
Rudimentary horns and unicornuate uteri, 2 types of Mullerian duct abnormalities, often lack obvious symptoms. Ultrasonography (US) and magnetic resonance imaging (MRI) are alternative examinations but have low accuracy. Full-term rudimentary horn pregnancies are rather rare but life-threatening.

Patient concerns:
A 30-year-old Chinese woman complained of lower abdominal pain one year after a full-term unicornate uterus pregnancy and a rudimentary horn pregnancy successively.

Diagnosis:
Uterine dysplasia (right rudimentary uterine horn and left unicornate uterus), hematometra and right fallopian tube effusion were diagnosed.

Interventions:
We performed laparoscopic hysterectomy (rudimentary horn), right salpingectomy, pelvic adhesion release and hysteroscopy.

Outcomes:
The patient has not complained of specific discomfort during the one-year follow-up so far.

Conclusion:
The reported case was a rare full-term rudimentary horn pregnancy. The degree of development of the rudimentary horn, such as the endometrial function, muscle layer thickness, and uterine shape and size, is closely related to pregnancy outcome. The rudimentary horn with a functional endometrium must be disposed of once it is definitely diagnosed. Pregnancy in the rudimentary horn with a weak muscular layer should be treated as soon as possible. Detailed and scientific prenatal examination is important.
Kimura's disease and ankylosing spondylitis
Authors: Chen Anping , Cui Beibei , Li Yanhong , Zhang Qiuping , Yuan Mingqi , Liu Yi 
Published: August 2020

Abstract

Rationale:
Ankylosing spondylitis (AS) and Kimura's disease (KD) which is quite rare are both chronic inflammatory diseases. Recently we encountered a patient who suffered from KD and AS, and some of his family members also suffer from AS. We, therefore, investigated this unique case and conducted the family-based whole exome sequencing to explore the possible genetic alterations.

Patient concerns:
Here, we reported a case of a 44-year-old Chinese man with multiple painless masses all over his body and a back pain for 32 years. His uncle and sister were diagnosed with AS.

Diagnosis:
The diagnosis of KD was based on the patient's clinical features and the biopsy of the neck masses. The diagnosis of AS was based on the patient's clinical features, HLA-B27(+) and the radiologic changes of sacroiliac joints. The genetic test showed that ARPC1B gene which was associated with recurrent infections, auto-inflammatory changes and elevated IgE levels was mutated in this patient.

Interventions:
Neck masses were removed by surgery. Systemic glucocorticoid, nonsteroidal anti-inflammatory agents, combined with cyclosporine were orally administered, and Etanercept was injected subcutaneously.

Outcomes:
The masses disappeared rapidly after surgery combined with systemic glucocorticoid, but relapsed shortly after the therapy was discontinued. Low dose glucocorticoid, cyclosporine and Etanercept could keep both KD and AS remained long-term remission.

Lessons:
Our experience suggests that low dose glucocorticoid, cyclosporine and Etanercept could be beneficial for the patient with KD and AS. The mutation of ARPC1B gene in this case, which is associated with immunologic disturbance, may increase the susceptibility of KD.
Association of patterns of multimorbidity with length of stay
Authors: Aubert Carole E. , Schnipper Jeffrey L. , Fankhauser Niklaus , Marques-Vidal Pedro , Stirnemann Jérôme , Auerbach Andrew D. , Zimlichman Eyal , Kripalani Sunil , Vasilevskis Eduard E. , Robinson Edmondo , Metlay Joshua , Fletcher Grant S. , Limacher Andreas , Donzé Jacques 
Published: August 2020

Abstract
The aim of this study was to identify the combinations of chronic comorbidities associated with length of stay (LOS) among multimorbid medical inpatients.
Multinational retrospective cohort of 126,828 medical inpatients with multimorbidity, defined as ≥2 chronic diseases (data collection: 2010–2011). We categorized the chronic diseases into comorbidities using the Clinical Classification Software. We described the 20 combinations of comorbidities with the strongest association with prolonged LOS, defined as longer than or equal to country-specific LOS, and reported the difference in median LOS for those combinations. We also assessed the association between the number of diseases or body systems involved and prolonged LOS.
The strongest association with prolonged LOS (odds ratio [OR] 7.25, 95% confidence interval [CI] 6.64–7.91, P < 0.001) and the highest difference in median LOS (13 days, 95% CI 12.8–13.2, P < 0.001) were found for the combination of diseases of white blood cells and hematological malignancy. Other comorbidities found in the 20 top combinations had ORs between 2.37 and 3.65 (all with P < 0.001) and a difference in median LOS of 2 to 5 days (all with P < 0.001), and included mostly neurological disorders and chronic ulcer of skin. Prolonged LOS was associated with the number of chronic diseases and particularly with the number of body systems involved (≥7 body systems: OR 21.50, 95% CI 19.94–23.18, P < 0.001).
LOS was strongly associated with specific combinations of comorbidities and particularly with the number of body systems involved. Describing patterns of multimorbidity associated with LOS may help hospitals anticipate resource utilization and judiciously allocate services to shorten LOS.
The efficacy and safety of multiple versus single doses dexamethasone in unicompartmental knee arthroplasty
Authors: Gao Dehong , Liu Xin , Zhang Fan , Ding Mingyan 
Published: August 2020

Abstract

Background:
Concerns exist regarding the analgesia effect and safety of multiple versus single doses dexamethasone in unicompartmental knee arthroplasty. There is an urgent need of studies that efficiently control for confounding, conduct comprehensive and consecutive observation of potential risks of the dexamethasone administration, and investigate its clinical applicability. We thus further designed a randomized controlled study to assess the different dose of dexamethasone on postoperative pain and complications in patients undergoing unicompartmental knee arthroplasty.

Methods:
This randomized, prospective, controlled study was carried out between January 2018 and August 2019. It was approved by the institutional review board in our hospital (HBRM2020013). A total of 80 patients were randomly assigned to each group: the study group (n = 40) and the control group (n = 40). All surgical procedures were performed by a similar orthopedic surgeon. In the study group, patients received intravenously 20 mg dexamethasone (4 mL, Tianjin Kingyork group Co., Ltd., China) just after the anesthesia, and repeated at 24 hours after the surgery. Patients in the control group received intravenously 10 mg dexamethasone solution (2 mL) just after the anesthesia, and repeated at 24 hours after the surgery. CRP, IL-6, VAS pain scores at rest and walking, the VAS scores of nausea, and the incidence of postoperative vomiting and nausea (POVN) were recorded at 24, 48, and 72 hours postoperatively.

Conclusion:
We hypothesized that patients receiving multiple doses of dexamethasone was associated with better outcomes compared with patients receiving single dose of dexamethasone.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5770).