bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal oral contraceptive pill use and the risk of atopic diseases in the offspring
Authors: Bai Xue-Feng , Wu Zheng-Xiang , Zhao Chun-Hong , Wu Yong , Fei Chang-Shun , Zhang Li-Qin , Chen Zhao-Hui 
Published: April 2020

Abstract
Studies of maternal oral contraceptive pill (OCP) exposure and the offspring's risk of atopic diseases are of current interest due to concerns about widespread use of OCP before or during pregnancy.
We evaluated whether maternal OCP exposure is associated with an increased risk of atopic diseases by reviewing the literature and performing a meta-analysis. The PubMed and Embase databases were searched to identify potential studies for inclusion. Three common atopic outcomes were included: asthma, eczema, and rhinitis.
We found 693 titles, abstracts, and citations, and 6 studies were included in this analysis. A meta-analysis revealed that maternal OCP exposure was associated with higher odds of asthma (odds ratio [OR] 1.1; 95% confidence interval [CI] 1.02–1.19; P = .014), rhinitis (OR 1.34; 95% CI 1.07–1.68; P = .011) during childhood, whereas there was no association with eczema (OR 1.17; 95% CI 0.81–1.68; P = .383). This analysis was limited by the small number of studies included and the limited adjustments for the possible confounders in the studies.
Current evidence suggests that maternal OCP exposure increases the risk for respiratory allergic diseases (asthma and rhinitis) in the offspring, but not for eczema. Given the few studies included, future larger, prospective studies that control for important confounders are needed to verify our findings.
The effect of exercise as an intervention for women with polycystic ovary syndrome
Authors: dos Santos Isis Kelly , Ashe Maureen C. , Cobucci Ricardo Ney , Soares Gustavo Mafaldo , de Oliveira Maranhão Tecia Maria , Dantas Paulo Moreira Silva 
Published: April 2020

Abstract

Background:
Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive implications, metabolic dysfunction, and cardiovascular risk. Physical activity offers several health benefits for women with PCOS. The aim of this systematic review was to synthesize evidence on the effect of different types of exercise on reproductive function and body composition for women with PCOS.

Methods:
This was a systematic review and meta-analysis of randomized controlled trials (RCTs) following recommended review methods. We searched 6 databases: Cumulative Index of Nursing and Allied Health Literature; Embase; MEDLINE (via Ovid); PubMed; Sport Discus; and Web of Science; and we developed search strategies using a combination of Medical Subject Headings terms and text words related to exercise interventions for women with PCOS. There was no restriction on language or publication year. The search was conducted on April 16, 2019 and updated on November 15, 2019. Two authors independently screened citations, determined risk of bias and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation. We conducted meta-analyses following recommended guidelines, and report results using standardized mean difference (SMD).

Results:
Ten RCTs (n = 533) were included in this review. Studies tested the following interventions: aerobic, resistance, and combined (aerobic/resistance) training programs. Most studies were small (average 32, range 15–124 participants), and of relatively short duration (8–32 weeks). There was high heterogeneity for outcomes of reproductive function (menstrual cycle, ovulation, and fertility). We noted low certainty evidence for little to no effect of exercise on reproductive hormones and moderate certainty evidence that aerobic exercise reduced body mass index (BMI) in women with PCOS: BMI SMD −0.35, 95% confidence interval −0.56 to −0.14, P = .001.

Conclusion:
For women with PCOS, evidence is limited to discern the effect of exercise on major health outcomes (e.g., reproductive function). There is moderate certainty evidence that aerobic exercise alone is beneficial for reducing BMI in women with PCOS. Future studies should be conducted with longer duration, larger sample sizes, and should provide detailed information on menstrual cycle and fertility outcomes.
PROSPERO Systematic review registration: 2017 CRD42017058869.
The efficacy of transcranial alternating current stimulation for treating post-stroke depression
Authors: Wang Hongxing , Zhang Wenrui , Zhao Wenfeng , Wang Kun , Wang Zu , Wang Li , Peng Mao , Xue Qing , Leng Haixia , Ding Weijun , Liu Yuan , Li Ning , Dong Kai , Zhang Qian , Huang Xiaoqin , Xie Yunyan , Chu Changbiao , Xue Sufang , Huang Liyuan , Yao Hui , Ding Jianping , Zhan Shuqin , Min Baoquan , Fan Chunqiu , Zhou Aihong , Sun Zhichao , Yin Lu , Ma Qingfeng , Baskys Andrius , Jorge Ricardo E. , Song Haiqing 
Published: April 2020

Abstract

Background:
The treatment of post-stroke depression (PSD) with anti-depressant drugs is partly practical. Transcranial alternating current stimulation (tACS) offers the potential for a novel treatment modality for adult patients with PSD. In this study, we will assess the efficacy and safety of tACS for treating PSD and explore its effect on gamma and beta-oscillations involving in emotional regulation.

Methods:
The prospective study is an 8-week, double-blind, randomized, placebo-controlled trial. Seventy eligible participants with mild to moderate PSD aged between 18 years and 70 years will be recruited and randomly assigned to either active tACS intervention group or sham group. Daily 40-minute, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), and an additional 4-week observational period (week 8) will be followed up. The primary outcome is the proportion of participants having an improvement at week 8 according to the Hamilton Depression Rating Scale 17-Item (HAMD-17) score, including the proportion of participants having a decrease of ≥ 50% in HAMD-17 score or clinical recovery (HAMD-17 score ≤ 7). Secondary outcomes include neurological function, independence level, activities of daily living, disease severity, anxiety, and cognitive function. The exploratory outcomes are gamma and beta-oscillations assessed at baseline, week 4, and week 8. Data will be analyzed by logistical regression analyses and mixed-effects models.

Discussion:
The study will be the first randomized controlled trial to evaluate the efficacy and safety of tACS at a 77.5-Hz frequency and 15-mA current in reducing depressive severity in patients with PSD. The results of the study will present a base for future studies on the tACS in PSD and its possible mechanism.
Trial registration number: NCT03903068, pre-results.
Contradictions between DAPT and PRECISE-DAPT scores with the severity of coronary lesion in acute coronary syndrome
Authors: Bi Sisi , Zhao Yue , Peng Qingling , Liu Wenxue , Zhang Guogang , Zhang Chenglong 
Published: April 2020

Abstract
This study aimed to identify the correlation of contradiction between DAPT score and PRECISE-DAPT score with the severity of coronary lesion in acute coronary syndromes (ACS).
In total, 458 patients with ACS after a percutaneous coronary intervention (PCI) who had tolerated 1-year uneventful dual antiplatelet therapy (DAPT) were enrolled and divided into groups based on the Gensini score, number of stenosed vessels, and left main (LM) disease. Both DAPT score and PRECISE-DAPT score were calculated and the proportion of patients receiving conflicting recommendations from each score was compared among the groups.
DAPT score as well as the proportion of patients with DAPT score ≥2 were associated with the Gensini score and the number of stenosed vessels. Similarly, PRECISE-DAPT score as well as the proportion of patients with PRECISE-DAPT score ≥25 were associated with the Gensini score and the number of stenosed vessels. The proportion of patients with DAPT score ≥2 along with PRECISE-DAPT score ≥25 were associated with Gensini score, but they had no significant association with the number of stenosed vessels (P = .006 and P = .075, respectively). None of those aforementioned items were associated with LM disease.
The inconsistencies of DAPT scores and PRECISE-DAPT scores are frequent and associated with the severity of coronary disease, represented by the Gensini score. Appropriate clinical decisions should be individualized.
Clinicopathological risk factors in the light of the revised 2018 International Federation of Gynecology and Obstetrics staging system for early cervical cancer with staging IB
Authors: Zeng Jing , Qu Pengpeng , Hu Yuanjing , Sun Peisong , Qi Ji , Zhao Guiling , Gao Yan 
Published: April 2020

Abstract
To validate the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer on the survival of patients who underwent radical hysterectomy for 2009 FIGO stage IB carcinomas.
We retrospectively identified and reviewed 251 patients treated with radical hysterectomy for 2009 FIGO stage IB cervical carcinomas from January 2011 to December 2016. The re-staged IB cohort consisted of 2018 FIGO stage IB1 (tumor size <2 cm), IB2 (2–3.9 cm), IB3 (≥4 cm), and IIIC1p (any pelvic nodal metastasis) cervical cancer. The univariate log-rank test and multivariate Cox regression models were performed for all potential clinic pathological risk factors based on cancer stage.
On re-staging the 251 patients with 2009 FIGO stage IB using the 2018 FIGO staging system, 96 patients (38.2%) had stage IB1, 109 patients (43.4%) had stage IB2, 28 patients (11.2%) had stage IB3, and 18 patients (7.2%) had stage IIIC1p. The 5-year overall survival (OS) rates of patients with 2018 FIGO stage IB1, IB2, IB3, and IIIC1p were 97.9%, 92.7%, 78.6%, and 61.1%, respectively. The 5-year progression-free survival rates were 97.9%, 92.7%,63.7%, and 20.8%, respectively. Factors significantly affecting OS and disease-free survival were 2018 FIGO stage≥IB3, histologic grade 2–3, and lymph node involvement.
The revised 2018 FIGO staging system seemed to accurately reflect the survival rate, with a distinct statistical tendency for poorer 5-year disease-free survival and OS rates with increasing stage. Women with positive lymph nodes in this classification were classified as having stage IIIC disease, which can achieve more realistic survival results than the previous staging system. The prognostic discrimination of histologic grade should be considered when revising the staging system in the future.
Changes in immune indicators and bacteriologic profile were associated with patients with ventilator-associated pneumonia
Authors: Yao Jie , Guan Shihe , Liu Zhou , Li Xin , Zhou Qiang 
Published: April 2020

AbstractThe aim of this study is to explore and identify ventilator-associated pneumonia (VAP)-related prognostic immune factors and further detect the drug-resistant pathogens to establish the theoretical guidance for clinical prevention and treatment strategies of VAP. A total of 478 patients using ventilator who were hospitalized in July 2014 to November 2016 in our hospital were enrolled in this study. About 103 patients with VAP (21.5%, 103/478) among 478 cases of patients using ventilator. Among the 103 patients with VAP, the distribution of pathogenic bacteria and drug resistance in patients with VAP were detected and analyzed. In the VAP group, 35 patients died and 43 patients had simultaneous sepsis. Compared with those of non-VAP group, the proportion of CD3+(P = .012), CD3+CD4+(P = .024) and CD8+CD28+(P = .017) T cells in VAP group increased significantly, which indicated more severe immune response. Multivariate regression model analysis revealed that tracheotomy of mechanical ventilation (P = .013), mechanical ventilation time ≥7 days (P = .02) and aspiration and reflux (P = .011) were independent risk factors associated with VAP. According to the results of bacterial culture and drug sensitivity test, rational selection of antibiotics and monitoring of patients within intensive care unit can effectively control the incidence of VAP and improve the prognosis of patients.
Predictive values of D-dimer for the long-term prognosis of acute ST-segment elevation infarction
Authors: Zhou Qi , Xue Yuzhou , Shen Jian , Zhou Wei , Wen Yi , Luo Suxin 
Published: April 2020

Abstract
D-dimer is a primary degradation product of cross-linked fibrin, and can be an effective diagnostic factor of venous thromboembolism. However, its prognostic role in patients with acute ST-segment elevation myocardial infarction (STEMI) remains controversial. This study aimed to investigate whether D-dimer has a predictive value for long-term prognosis in patients with STEMI.
We retrospectively enrolled 872 STEMI patients treated with primary percutaneous coronary intervention. Patients were divided into quartiles according to their admission D-dimer increased multiple, with the highest quartile (G4) (n = 219) defined as increased multiple ≧1.33, and the lowest quartile (G1) (n = 215) as increased multiple ≦0.33.
Compared with G1, higher in-hospital heart failure (40.2% vs 10.2%, P < .0001), malignant arrhythmia (14.2% vs 2.3%, P < .0001), and all-cause mortality (5.9% vs 0%, P < .0001) rates were observed in G4. After a follow-up period of 29 months, 84 patients had died. In the Cox multivariate analysis, a high admission D-dimer increased multiple (≧1.33) was found to be an independent predictor of all-cause mortality (hazards ratio: 2.53, 95% confidence interval: 1.02–6.26, P = .045).
Thus, there was an association between a high D-dimer level and the increase in in-hospital major adverse cardiovascular events, such as heart failure, malignant arrhythmias, and death. High D-dimer level was also an independent predictor of long-term all-cause mortality.
Discriminating malignant and benign clinical T1 renal masses on computed tomography
Authors: Uhlig Johannes , Biggemann Lorenz , Nietert Manuel M. , Beißbarth Tim , Lotz Joachim , Kim Hyun S. , Trojan Lutz , Uhlig Annemarie 
Published: April 2020

Abstract
The aim of this study was to discriminate malignant and benign clinical T1 renal masses on routinely acquired computed tomography (CT) images using radiomics and machine learning techniques.
Adult patients undergoing surgical resection and histopathological analysis of clinical T1 renal masses were included. Preoperative CT studies in venous phase from multiple referring centers were included, without restriction to specific CT scanners, slice thickness, or degrees of artifacts. Renal masses were segmented and 120 standardized radiomic features extracted. Machine learning algorithms were used to predict malignancy of renal masses using radiomics features and cross-validation. Diagnostic accuracy of machine learning models and assessment by independent blinded radiologists were compared based on the gold standard of histopathologic diagnosis.
A total of 94 patients met inclusion criteria (benign renal masses: n = 18; malignant: n = 76). CT studies from 18 different scanners were assessed with median slice thickness of 2.5 mm and artifacts in 15 cases (15.9%).
Area under the receiver-operating-characteristics curve (AUC) of random forest (random forest [RF], AUC = 0.83) was significantly higher compared to the radiologists (AUC = 0.68, P = .047). Sensitivity was significantly higher for RF versus radiologists (0.88 vs 0.80, P = .045), whereas specificity was numerically higher for RF (0.67 vs 0.50, P = .083).
Although limited by an overall small sample size and few benign renal tumors, a radiomic features and machine learning approach suggests a high diagnostic accuracy for discrimination of malignant and benign clinical T1 renal masses on venous phase CT. The presented algorithm robustly outperforms human readers in a real-life scenario with nonstandardized imaging studies from various referring centers.
Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy in a patient with multiple system atrophy
Authors: Heo Sung Jae , Kim Jung Soo , Lee Byung Joo , Park Donghwi 
Published: April 2020

Abstract

Rationale:
Multiple system atrophy (MSA) is a rare neurodegenerative disease characterized by Parkinsonism and autonomic dysfunction or cerebellar ataxia. MSA can be accompanied by stridor caused by laryngeal stenosis secondary to vocal cord dysfunction.

Patient concern:
A 60-year-old woman with MSA, complaining of difficulty in breathing during sleep. Her bed partner reported witnessing grunting-like sounds during sleep.

Diagnosis:
Isolated stridor without any other sleeping breathing disorder diagnosed using drug-induced sleep endoscopy (DISE) in a patient with MSA.

Interventions:
On polysomnography, there was no obstructive sleep apnea. Using DISE, abnormally adducted vocal cords during inspiratory respiration were identified, leading to a diagnosis of stridor. We prescribed positive airway pressure to resolve the stridor.

Outcome:
Our patient was also prescribed continuous positive airway pressure for the treatment of nocturnal stridor, and it is improved.

Lessons:
In summary, when MSA patients present with nocturnal stridor, it is important to evaluate the exact diagnosis and cause of stridor in patients by confirming the movement of vocal cords using DISE, as well as polysomnography.
Prevalence of osteoporosis in patients with type 2 diabetes mellitus in the Chinese mainland
Authors: Si Yuhao , Wang Cenyi , Guo Yang , Yin Heng , MA Yong 
Published: April 2020

Abstract

Background:
Osteoporosis, as a metabolic disease, has become one of the most rapidly growing complications of diabetes mellitus. Previously, we conducted a systematic review to report the estimated prevalence of osteoporosis among patients with type 2 diabetes mellitus (T2DM) from 2001 to 2016. However, some newer studies have been reported, and more potential risk factors for osteoporosis remain controversial and vague. Therefore, the presented review is tailored to synthesize available evidence regarding the pooled prevalence and related risk factors of osteoporosis among T2DM patients in mainland China.

Methods:
Both cross-sectional study and cohort study reporting on the prevalence of osteoporosis among patients with T2DM in mainland China, published in Chinese or English, will be considered for inclusion. Records from 4 English databases and 2 Chinese databases will be retrieved from their inceptions to March 2020. The process of study selection, data extraction, and methodologic quality assessment will be independently executed by 2 reviewers. The pooled prevalence of osteoporosis and the prevalence in the exposed and unexposed groups for each potential risk factor will be calculated by the software Stata version 12.0.

Results:
The current systematic review and meta-analysis will provide more precise prevalence rates and associated risk factors of osteoporosis among people with T2DM in mainland China.

Conclusion:
The study will offer high-quality and explicit evidence for assisting diabetic patients to prevent osteoporosis in mainland China.

OSF Registration:
DOI 10.17605/OSF.IO/5ZKJ6.
Efficacy and safety of the injection of the traditional Chinese medicine salviae miltiorrhizae and ligustrazine hydrochloride for the treatment of perioperative period of fracture
Authors: Xie Jialong , Chen Shichun , Ding Shaobo 
Published: April 2020

Abstract

Background:
The injection of the traditional Chinese patent medicine salviae miltiorrhizae and ligustrazine hydrochloride injection (SMLHI) has been widely used in treatment of various diseases such as angina pectoris or ischemic stroke in China. We aim to evaluate the efficacy and safety of SMLHI for the treatment of perioperative period of fracture.

Methods:
A systematic literature search was performed in seven medical databases from their inception until February 2019. 16 studies with randomized controlled trials, totaling 1589 patients, were included in this meta-analysis. The included studies were assessed by the cochrane risk of bias and analyzed by Review Manager 5.3 software.

Results:
The meta-analysis showed that SMLHI for the treatment of perioperative period of fracture was significantly better compared with the control group in terms of the total effective rate. The result showed that SMLHI could significantly reduce the risk of deep vein thrombosis and inflammatory cytokines. Furthermore, the result showed that SMLHI could significantly improve the coagulation function indexes such as prothrombin time, plasma fibrinogen and D-Dimer (P < .0001).

Conclusions:
This meta-analysis demonstrated that SMLHI may be more effective and safe for the treatment of perioperative period of fracture. However, further and higher quality randomized controlled trials are required to prove treatment outcome.
Evaluation of the development of the posterior fossa in normal Chinese fetuses by using magnetic resonance imaging
Authors: Ye Jintang , Rong Rong , Dou Yanbin , Jiang Jian , Wang Xiaoying 
Published: April 2020

Abstract
The posterior fossa is an important brain structure containing the cerebellum, cerebral ventricle, and cistern. Early evaluation of the cerebellar structure and function may be valuable for early detection of fetal deformities. At present, no normal value for the fetal posterior fossa has been established yet. This study is aimed to investigate the development of the posterior fossa in normal Chinese fetuses by using magnetic resonance imaging (MRI).
Pregnant women who need MRI scan were enrolled in our Hospital between January 2012 and December 2014. The fetal supero-inferior diameter (SID), anterio-posterior diameter (APD), cerebellar vermis area, cerebellar width (CW), cerebellar volume (CV), superior cerebellar cistern width, and cerebellomedullary cistern width were measured using MRI. Pearson's correlation analysis was used to detect the relationship between those parameters and gestational age. A regression analysis was performed for all parameters.
A total of 92 participants were retrospectively enrolled finally. The results indicated SID, APD, cerebellar vermis area, CW, and CV were positively associated with gestational age, while no significant correlation was found between the superior cerebellar cistern width and cerebellomedullary cistern width and gestational age. Each equation was established.
Our study demonstrated that MRI has the advantages over ultrasound imaging for prenatal evaluation of the fetal posterior fossa with multiple views. Normal value of the posterior fossa of Chinese fetuses was established in this study.