bluuebunny/crossref_metadata_2025_split huggingface dataset:
Six-Month Clinical Outcomes for Bone-Anchored Hearing Implants: Comparison Between Minimally Invasive Ponto Surgery and the Linear Incision Technique With Tissue Preservation
Authors: Caspers Coosje J. I. , Kruyt Ivo J. , Mylanus Emmanuel A. M. , Hol Myrthe K. S. 
Published: January 2020

Objectives:
The aim of this study is to investigate and compare the clinical outcomes of minimally invasive ponto surgery (MIPS) to the linear incision technique with soft tissue preservation (LIT-TP) for percutaneous bone-anchored hearing implants (BAHI).

Study Design:
Prospective cohort study with a historical control group.

Setting:
Tertiary referral center.

Patients:
Twenty-five patients were prospectively included in the test group. The control group consisted of 25 patients who previously participated in another clinical trial and already underwent BAHI surgery.

Intervention:
All patients were implanted with a 4.5-mm-wide implant, using MIPS in the test group and the LIT-TP in the control group. Follow-up visits were scheduled 7 days, 21 days (sound processor fitting), 12 weeks and 6 months after surgery.

Main Outcome Measures:
The primary outcome measure was skin sensibility around the abutment 6 months after surgery. Secondary outcomes were subjective numbness, surgery time, wound healing, adverse soft tissue reactions, cosmetic outcomes, implant stability quotient (ISQ), implant survival, and sound processor use.

Results:
Skin sensibility, adverse soft tissue reactions, and sound processor use were comparable between groups. The test group had a shorter surgery time and better cosmetic outcomes. More skin dehiscences and a statistically nonsignificant higher implant loss rate (12% vs 0%, p = 0.079) were observed in the test group.

Conclusion:
MIPS is comparable to the LIT-TP regarding skin sensibility at 6 months and soft tissue tolerability. With MIPS, surgery time is further reduced and better cosmetic outcomes are reported. More research into MIPS, exact drill protocol, used instruments, and associated implant loss is warranted.
Psychological effects of cognitive behavioral therapy on internet addiction in adolescents
Authors: Zhang Ying-ying , Chen Jian-ji , Ye Hai , Volantin Lupe 
Published: January 2020

Abstract

Background:
In this study, we aim to assess the psychological effects of cognitive behavioral therapy (CBT) on internet addiction (IA) in adolescents.

Methods:
This study will search the following databases of Cochrane Library, PUBMED, EMBASE, Scopus, Web of Science, PsycINFO, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All these electronic databases will be searched from inception to the September 30, 2019 without any language limitation. Two authors will conduct study selection, data extraction, and study quality assessment, respectively. Any disagreements between 2 authors will be solved by a third author through discussion. Statistical analysis will be performed using RevMan 5.3 software.

Results:
This study will investigate the psychological effects of CBT on IA in adolescents by measuring psychopathological symptoms, depression, anxiety, time spent on the internet (hours/day), and health-related quality of life.

Conclusion:
This study summarizes current evidence of CBT on IA in adolescents and may provide guidance for both intervention and future researches.

PROSPERO registration number: PROSPERO CRD42019153290.
Danggui-Shaoyao-San for dementia
Authors: Kim Yunna , Cho Seung-Hun 
Published: January 2020

Abstract

Background:
Although memory loss and other symptoms of dementia pose tremendous burdens on patients and societies, there is currently no cure for dementia.

Methods:
We conducted a systematic review and meta-analysis of the anti-dementia effects of Danggui-Shaoyao-San (DSS), which is derived from natural resources. We searched for randomized controlled trials (RCTs) from inception to June 2019. We searched PubMed, Embase, Korean databases (Research Information Service System and Oriental Medicine Advanced Searching Integrated System), Chinese databases (China Knowledge Resource Integrated Database and Wanfang Database), and Japanese databases (CiNii and J-STAGE). Studies were included if they were a RCT, investigated the efficacy of DSS or its modified form, and included participants with dementia. Use of DSS with other treatment (eg, acupuncture, anti-dementia drugs, etc) was included. Items of each trial were evaluated by 2 independent reviewers. Data were pooled by using random-effect models.

Results:
A total of 482 studies were identified, and 5 eligible studies for Alzheimer disease (AD) and 4 studies for vascular dementia (VD) were included in the final analysis, representing a total of 567 participants. As for AD, pooled results of the Mini-Mental State Examination (MMSE) (mean differences [MD] 4.60; 95% confidence interval [CI] 4.29, 4.91) and activities of daily living (MD 11.40; 95% CI 10.94, 11.86) favored DSS. DSS had synergistic effect with acupuncture over acupuncture alone in MMSE (MD 1.69; 95% CI 1.05, 2.34), Hasegawa Dementia Scale (MD.62; 95% CI –0.20, 1.44), and activities of daily living (MD 2.38; 95% CI 1.92, 2.85). In VD, pooled results showed a significant difference in the score of dementia scales such as MMSE and Hasegawa Dementia Scale compared with nootropic drugs. DSS significantly reduced symptoms (odds ratio 5.02, 95%, CI 2.76–9.11) in patients with VD. The respective size of each RCTs was small and some included studies were of low quality due to their limited description on methodological issues.

Conclusion:
These estimates suggest that DSS provides clinically important reductions in symptoms of AD and VD and can be a promising anti-dementia drug candidate.
Impact of a systematic evaluation of connective tissue disease on diagnosis approach in patients with interstitial lung diseases
Authors: Hernandez-Gonzalez Fernanda , Prieto-González Sergio , Brito-Zeron Pilar , Cuerpo Sandra , Sanchez Marcelo , Ramirez Jose , Agustí Carlos , Lucena Carmen María , Paradela Marina , Grafia Ignacio , Espinosa Gerard , Sellares Jacobo 
Published: January 2020

Abstract
To date, there is no clear agreement regarding which is the best method to detect a connective tissue disease (CTD) during the initial diagnosis of interstitial lung diseases (ILD). The aim of our study was to explore the impact of a systematic diagnostic strategy to detect CTD-associated ILD (CTD-ILD) in clinical practice, and to clarify the significance of interstitial pneumonia with autoimmune features (IPAF) diagnosis in ILD patients.
Consecutive patients evaluated in an ILD Diagnostic Program were divided in 3 groups: IPAF, CTD-ILD, and other ILD forms. Clinical characteristics, exhaustive serologic testing, high resolution computed tomography (HRCT) images, lung biopsy specimens, and follow-up were prospectively collected and analyzed.
Among 139 patients with ILD, CTD was present in 21 (15.1%), 24 (17.3%) fulfilled IPAF criteria, and 94 (67.6%) were classified as other ILD forms. Specific systemic autoimmune symptoms such as Raynaud phenomenon (19%), inflammatory arthropathy (66.7%), and skin manifestations (38.1%) were more frequent in CTD-ILD patients than in the other groups (all P < .001). Among autoantibodies, antinuclear antibody was the most frequently found in IPAF (42%), and CTD-ILD (40%) (P = .04). Nonspecific interstitial pneumonia, detected by HRCT scan, was the most frequently seen pattern in patients with IPAF (63.5%), or CTD-ILD (57.1%) (P < .001). In multivariate analysis, a suggestive radiological pattern by HRCT scan (odds ratio [OR] 15.1, 95% confidence interval [CI] 4.7–48.3, P < .001) was the strongest independent predictor of CTD-ILD or IPAF, followed by the presence of clinical features (OR 14.6, 95% CI 4.3–49.5, P < .001), and serological features (OR 12.4, 95% CI 3.5–44.0, P < .001).
This systematic diagnostic strategy was useful in discriminating an underlying CTD in patients with ILD. The defined criteria for IPAF are fulfilled by a considerable proportion of patients referred for ILD.
Association of rs2230806 in ABCA1 with coronary artery disease
Authors: Fan Qian , Zhu Yanfang , Zhao Fang 
Published: January 2020

Abstract

Background:
As a key gene in the reverse transport pathway of cholesterol, ABCA1 (ATP-binding cassette transporter A1) plays an important role in the pathogenesis of coronary artery disease (CAD). In the ABCA1, rs2230806 is the most widely studied polymorphism and its role has been controversial.

Methods:
We performed an updated meta-analysis by searching online electronic databases using the PubMed, Web of Science, Embase, Cochrane Library, EMBASE, Google Scholar, China National Knowledge Infrastructure, and Wan Fang databases before June 28, 2019. STATA12.0 software was used to perform a series of analyses on the data, including genetic effect model, heterogeneity, sensitivity, and publication bias analysis.

Results:
Based on our inclusion and exclusion criteria, finally 43 articles including a total of 34,348 subjects (14,085 CAD cases and 20,263 healthy controls) were investigated. Results showed that carrying the K allele in rs223086 in the overall population significantly reduced the risk of CAD (OR = 0.745, 95% CI = 0.687–0.809, P < .001). After the ethnicity stratification analysis, the above phenomenon was found to be significant in Asian populations (OR = 0.686, 95% CI = 0.633–0.744, P < .001), marginally significant in Caucasians (OR = 0.887, 95% CI = 0.786–1.001, P = .051), and not significant in other populations (OR = 0.851, 95% CI = 0.558–1.297, P = .452). Further stratified according to the sample size in the Asian and Caucasian populations, in the Asian the K allele is more protective in small samples than large samples; however, in the Caucasian small samples carrying the K allele play a protective role while large samples are negative. In addition, according to the source of the control population and the geographical location in China, the results showed that rs2230806 was significantly associated with CAD in any group. Five genetic models (allelic, recessive, dominant, homozygote, and heterozygote) were analyzed in the above analysis.

Conclusion:
The K allele of rs2230806 was significantly associated with decreased risk of CAD, especially in Asian populations and small sample Caucasians.
Ecchymosis combined with postinflammatory hyperpigmentation associated with acupuncture therapy
Authors: Zhao Yuwei , Yu Jinna , Liu Sixing , Zhou Jing , Wang Jing , Wang ZhaoBo , Liu Zhishun 
Published: January 2020

Abstract
To evaluate the incidence of ecchymosis combined with postinflammatory hyperpigmentation (ECPH) over the course of 10 sessions of acupuncture therapy and to examine associated factors.
An observational study was conducted from March 7, 2017 through March 6, 2018. This study included a total of 167 subjects and 326 bodily locations where acupuncture needles had been inserted. A 1-page questionnaire that included 14 items was used to collect patient data. The information collected was used to determine the incidence of ECPH. Chi-square tests were used to observe the associations between ECPH and demographic characteristics, dermatologic features, acupuncture-related factors, and other associated factors. Cox proportional hazards regression models were applied to calculate hazard ratios for ECPH among subjects treated with various frequencies of acupuncture and needles that differed in diameter.
Although 186 subjects were initially enrolled, the study ultimately included 167 subjects and 326 bodily locations at which acupuncture needles were inserted. Over 10 sessions of acupuncture, ECPH was observed in 117 (70.06%, 117/167) subjects and 221 (67.79%, 221/326) bodily locations. Factors found to be associated with ECPH included: frequency of acupuncture, diameter of acupuncture needle, total number of acupuncture sessions, and bodily location at which acupuncture was administered (P < .05). Among subjects who received >2 acupuncture sessions per week, a higher frequency of acupuncture was associated with increased incidence of ECPH. Thicker acupuncture needle diameter was associated with a higher incidence of ECPH.
The incidence of acupuncture-associated ECPH among the subjects included in the study was high. There were significant associations between ECPH and higher frequency of acupuncture as well as thicker diameter of acupuncture needles. Additional studies are required to confirm the findings.
Trial registration number: AMCTR-OOC-17000109.
d-dimer and diffusion-weighted imaging pattern as two diagnostic indicators for cancer-related stroke
Authors: Shen Yijun , Li Yuxia , Chen Chengming , Wang Wenan , Li Tian 
Published: January 2020

Abstract
The aim of this study was to evaluate the risk factors and elucidate the clinical characteristics of cancer-associated ischemic stroke to differentiate it from conventional ischemic stroke in China and East Asia. Between June 2012 and June 2016, a retrospective analysis was performed on 609 stroke patients with cancer. They were divided into 3 groups: cancer-stroke group (CSG, 203 cases), stroke group (SG, 203 cases), and cancer group (CG, 203 cases). The d-dimer levels and diffusion-weighted imaging lesion (DWI) pattern were compared to an age- and sex-matched control group. The most common cancer types were colorectal cancer (20.2%) and lung cancer (18.72%). The average d-dimer level in stroke patients and cancer patients were 0.34 and 1.50 mg/L, respectively. The descending levels of d-dimer from cancer types were lung cancer (2.06 mg/L), pancreas (1.74 mg/L), gastric (1.61 mg/L), among others. Univariate analysis of the CSG and the others shows there were significant differences in the prevalence of the levels of d-dimer and DWI pattern, hypertension, diabetes mellitus, and thrombus. CSG has a unique pathological characteristic including high plasma d-dimer levels and multiple vascular lesions. The results show that d-dimer and DWI can be used as diagnostic index in clinical practice.
Effect of alkaline phosphatase on sepsis-associated acute kidney injury patients
Authors: Tang Wenting , Huang Junlin , Huang Xiaowen , Han Xiao , Tang Wenyi , Ke Guibao , Xu Qingqing 
Published: January 2020

Abstract

Background:
This systematic review and meta-analysis were performed to evaluate kidney function in patients with sepsis-associated acute kidney injury (SA-AKI) on alkaline phosphatase (AP) therapy.

Methods:
PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched electronically from inception until May 4, 2019 and randomized controlled studies assessing AP treatment in patients with SA-AKI were included. Pool analyses with fixed effects or random effects models calculated pooled mean, standard deviation, and odds ratio (OR) with 95% confidence interval (CI).

Results:
Four randomized controlled trials involving AP therapy for 392 patients with SA-AKI were included. AP had a positive effect on endogenous creatinine clearance (ECC) in patients with SA-AKI at day 14 (random effects: mean difference = 10.56, 95% CI = 2.27–18.84, P = .01) and day 28 (random effects: mean difference = 14.30, 95% CI = 6.27–22.33, P = .0005). All-cause mortality at day 28 (fixed effects: OR = 0.62, 95% CI = 0.40–0.97, P = .04) and day 90 (fixed effects: OR = 0.61, 95% CI = 0.39–0.96, P = .03) improved. Plasma creatinine level (fixed effects: mean difference = −76.83, 95% CI = −146.92 to −6.74, P = .03) and biomarkers level (random effects: mean difference = −6.57, 95% CI = −10.74 to −2.40, P < .00001) also improved in the therapy group compared with placebo.

Conclusion:
In patients with SA-AKI, AP showed a relatively late protective effect by improving ECC at days 7, 14, and 28. ECC level improved when patients received AP dose of 0.212 mg/kg. Mortality improved at days 28 and 90, respectively, when patients received AP dose of 1.6 mg/kg. Levels of overall AKI biomarkers were improved in short term.
Anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom
Authors: Zhao Teng , Deng Yuyan , Ding Ying , Zhang Rensheng , Zhou Chunkui , Lin Weihong 
Published: January 2020

Abstract

Rationale:
Anti-GQ1b antibody syndrome refers to a distinct variant of Guillain– Barré syndrome. Involvement of the optic nerve in anti-GQ1b antibody syndrome is extremely rare.

Patient concerns:
Here, we report a case of anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom. A 73-year-old man presented with a 5-day history of bilateral blurred vision and ptosis. He had a previous history of diarrhea starting 10 days before admission. Physical examination showed visual deterioration, ophthalmoplegia, and peripheral facial paralysis. Testing of both serum and cerebrospinal fluid was positive for anti-GQ1b immunoglobulin G antibodies and negative for anti-aquaporin 4antibodies.

Diagnosis:
Anti-GQ1b antibody syndrome.

Interventions:
The patient was treated with intravenous methylprednisolone and human immunoglobulin.

Outcomes:
After a 20-day follow-up, the patient's condition took a favorable turn.

Lessons:
This case reminds us that anti-GQ1b antibody syndrome should be suspected in patients with visual deterioration and preceding infection.
Adjuvant chemotherapy for locally advanced rectal cancer in elderly patients after neoadjuvant chemoradiotherapy and surgery
Authors: Sun Quanquan , Liu Tongxin , Liu Peng , Lu Ke , Zhang Na , Liu Luying , Zhu Yuan 
Published: January 2020

Abstract
The treatment strategy for elderly patients with locally advanced rectal cancer (LARC) remains controversial. The aim of this study was to identify the significance of adjuvant chemotherapy (AC) for elderly patients with LARC after neoadjuvant chemoradiotherapy (nCRT) and surgical resection. Between February 2002 and December 2012, a total of 43 patients aged ≥70 years with LARC following nCRT and surgery were retrospectively reviewed. The median follow-up time was 51 months (range 15–161 months). All patients completed the programmed chemoradiotherapy, of which 20 patients (46.5%) received 5-fluorouracil-based AC, and other 23 patients (53.5%) received no adjuvant chemotherapy. The 5-year overall survival and disease-free survival rates for AC group and non-adjuvant chemotherapy (NAC) group were 74.7% vs 63.4% (P = .562) and 73.4% vs 66.3% (P = .445), respectively. More patients in AC group suffered from severe leucopenia than that in NAC group (60% vs 17.4%, P = .004). For elderly patients with LARC following nCRT and surgery, AC may not benefit for survival, but increase treatment related leucopenia.
Effectiveness of supervised early exercise program in patients with arthroscopic rotator cuff repair
Authors: Gutiérrez-Espinoza Héctor , Araya-Quintanilla Felipe , Pinto-Concha Sebastian , Zavala-González Jonathan , Gana-Hervias Gonzalo , Cavero-Redondo Iván , Álvarez-Bueno Celia 
Published: January 2020

Abstract

Background:
Based on the available evidence, it is difficult to make a clinical decision about the best exercise program and to establish the most favorable time to start postoperative treatment after rotator cuff (RC) repair. The aim of this trial is to evaluate the effects of adding a supervised early exercise program to standard treatment for functional improvement and pain relief compared with standard treatment alone in patients with arthroscopic RC repair.

Method/design:
A total of 118 patients between the ages of 18 and 50 years with arthroscopic RC repair will be randomized to 2 treatment arms. The control group will receive a standard exercise program based on a consensus statement on shoulder rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The intervention group will receive a supervised early exercise program in combination with standard treatment. This supervised exercise program will be based on electromyographic evidence. Three evaluations will be performed: before surgery, at 6 weeks, and at 12 weeks. The primary outcome measure will be the shoulder function by the Constant–Murley questionnaire, and the secondary outcome measures will be the upper limb function by the disabilities of the arm, shoulder, and hand questionnaire; pain by the visual analog scale; and the shoulder range of motion by a goniometer.

Discussion:
We hypothesize that patients who receive a supervised early exercise program in combination with standard treatment will benefit more in respect to shoulder function, pain reduction, and range of motion than those who receive a standard exercise program. If this is confirmed, our study can be used clinically to enhance the recovery of patients with arthroscopic RC repair.

Trial registration:
Brazilian registry of clinical trials UTN number U1111-1224-4143. Registered December 18, 2018.
The prevalence of stroke according to indoor radon concentration in South Koreans
Authors: Kim Soo Han , Park Jeong Mee , Kim Hee 
Published: January 2020

Abstract
To investigate the relationship between indoor radon level and stroke, which is a major factor for background radiation.
This study combines 2 nationwide studies. Demographic characteristics and medical history of participants were obtained from Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2012. Participants over 40 years old and who completed the questionnaire were included in the study. Indoor radon concentration was analyzed using the mean value of winter housing radon concentration from 2012 to 2016 published by the National Institute of Environmental Research. The average values of each metropolitan city and province were assigned to the residence of the participant. To eliminate the potential confounding factors, participants’ age, sex, hypertension, diabetes, dyslipidemia, ischemic heart disease, education level, occupation, smoking, drinking, exercise, and dietary intake were adjusted in multivariable logistic regression.
Total of 28,557 participants were included in this study. Indoor radon levels were significantly higher in the participants with stroke, and the prevalence of stroke increased as indoor radon levels increased (P < .001, P for linear trend <.001). Indoor radon level was associated with stroke even after adjusting potential confounding factors (OR: 1.004 [95CI: 1.001–1.007], P = .010) and high radon exposure (indoor radon over 100Bq/m3) was also associated with stroke (OR: 1.242 [95CI: 1.069–1.444], P = .005). Trend analysis showed linear correlation of increased odds between radon quartile and stroke (P for linear trend < .001). In subgroup analysis, elevated indoor radon was most strongly associated in participants with age over 76(OR: 1.872[95%CI:1.320–2.654], P < .001).
High indoor radon concentration may be associated with stroke. Specifically, elevated radon was associated with stroke in participants over 76 years old. In high-risk population, home modification to reduce indoor radon may help decreasing the risk of stroke.