bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suvorexant for the prevention of delirium
Authors: Xu Shu , Cui Yuanyuan , Shen Jinhua , Wang Peili 
Published: July 2020

Abstract

Background:
Delirium is a frequently encountered complication, which is associated with increased mortality. Suvorexant, an approved agent for the treatment of insomnia, is recently suggested to be also effective for prevention of delirium by some authors. However, a consensus has yet to be reached. The goal of this study was to perform a meta-analysis to overall estimate the effectiveness of suvorexant in preventing delirium and its related consequences.

Methods:
Eligible studies were identified by searching online databases of PubMed, EMBASE, and Cochrane Library. The pooled OR was calculated for binary outcomes (e.g., the incidence of delirium, mortality, or adverse events), while standardized mean difference (SMD) were expressed for continuous outcomes (e.g., time to delirium onset, length of stay in hospital and ICU, time on ventilation).

Results:
Seven studies which comprised 402 suvorexant treatment patients and 487 patients with control treatment were included in this meta-analysis. Overall, pooled analysis indicated the incidence of delirium could be significantly reduced (OR, 0.30; P < .001) and time to delirium onset was significantly lengthened (SMD, 0.44; P = .006) in patients undergoing suvorexant treatment compared with controls. Suvorexant had no beneficial effects on the secondary outcomes [length of stay in hospital (SMD, −0.65; P = .161) and ICU (SMD, 0.34; P = .297), time on ventilation (SMD, 1.09; P = .318), drug-related adverse events (OR, drug-related adverse events (OR, 1.66; P = .319) and mortality (OR, 2.21; P = .261)]. Subgroup analysis also confirmed the benefit of suvorexant on the development of delirium, which was significant in any subgroup.

Conclusion:
Suvorexant should be recommended for the prevention of delirium in clinic.
Effectiveness of electroacupuncture (EA) for the treatment of urinary incontinence (UI) in patients with spinal cord injury (SCI)
Authors: Wang Tian-Shu , Wang Zeng-Mian , Zhao Yu , Tang Zhao-Chen , Song Wei-Dong , Wang Guan-Kai 
Published: July 2020

Abstract

Background:
The objective of this study is to examine the effectiveness and safety of electroacupuncture (EA) in the treatment of urinary incontinence (UI) in patients with spinal cord injury (SCI).

Methods:
All potential studies will be retrieved from the electronic databases of MEDLINE, EMBASE, Cochrane Library, PsycINFO, Web of Science, CBM, and China National Knowledge Infrastructure from origin of each database up to January 31, 2020. Additionally, we will check other resources, such as Google scholar, dissertations, conference proceedings, and reference lists of included studies. No language and publication date limitations will be considered in the literature resources search. All randomized controlled trials using EA for the treatment of UI in patients with SCI will be included. Two independent investigators will perform study selection, data extraction and study quality assessment. If any conflicts occur, we will invite a third investigator to solve them. Cochrane risk of bias will be used for study quality assessment, and RevMan 5.3 software will be employed for statistical analysis.

Results:
This study will summarize the most recent evidence to assess the effectiveness and safety of EA for the treatment of UI in patients with SCI.

Conclusion:
The results of this study will provide helpful evidence to determine whether EA is effective and safety for the treatment of UI in patients with SCI or not.

PROSPERO registration number:
PROSPERO CRD42020165562.
Small bowel perforation caused by pancreaticojejunal anastomotic stent migration after pancreaticoduodenectomy
Authors: Bao Li , Chen Zhi-Tao , Huang Jia-Cheng , Li Meng-Xia , Zhang Le-Le , Wan Da-Long , Lin Sheng-Zhang 
Published: July 2020

Abstract

Introduction:
Pancreaticoduodenectomy (PD) has been widely applied as a standard surgical procedure to treat periampullary diseases. The placement of a pancreaticojejunal anastomotic stent is considered an effective and safe method for preventing pancreatic fistula after PD. Recently, the role of pancreaticojejunal anastomotic stents has been challenged, as gradually increasing complications have been observed. Stent-related small bowel perforation has only occurred in 2 cases as long-term complications but has not been reported to occur within 1 week after surgery.

Patient concerns:
Here, we report the case of a 71-year-old female patient complaining of painless jaundice who underwent PD with a pancreaticojejunal anastomotic stent for a duodenal papillary adenocarcinoma (T4N1M0). Four days after surgery, she had a sudden rise in temperature, high white blood cell count, significantly elevated C-reactive protein and 400 ml green-brown drainage fluid. Enhanced computed tomography showed hydrops abdominis.

Diagnosis:
Small bowel perforation caused by stent migration was considered first.

Interventions:
An emergency exploratory laparotomy was performed. We located the pancreaticojejunal anastomotic stent, which extended 2 cm from the small bowel, and sutured the jejunum hole after cutting away the protruding part of the stent.

Outcomes:
The patient recovered smoothly and was discharged on the 7th day after the second surgery. After more than 12 months of follow-up, the patient is doing well and is free of any symptoms related to the procedure.

Conclusion:
We caution that stent-related complications can occur when perioperative patients suffer from unexplained or sudden changes in vital signs after PD. In addition, the function of the pancreaticojejunal anastomotic stent needs to be reevaluated by future studies.
Economic and health impacts of infectious diseases in China
Authors: Li Meiyue , Fan Danxue , Wang Xiaowen 
Published: July 2020

Abstract

Background:
A worldwide concern has been raised that novel infectious diseases may outbreak rapidly with a limited response time due to globalization. Severe Acute Respiratory Syndrome, influenza A, Avian Influenza Virus, and Corona Virus Disease 2019 are acute respiratory diseases that have been affected by the movements of people, and globalization accelerates these movements. These infectious diseases not only have an overwhelming health impact but also impact the worldwide economy.

Methods:
We will conduct a systematic review and meta-analysis in Chinese National Knowledge Infrastructure, WANFANG Database, and the VIP Database for Chinese Technical Periodicals, Web of Science, PubMed, EMBASE, the Cochrane Library, EBSCO host, ProQuest, ProQuest Dissertations & Theses A&I, SAGE Journals, ScienceDirect, JSTOR, and Scopus. We will evaluate the risk of bias of included RCTs according to the criteria and technique proposed in the Cochrane Handbook V.5.1.0 and use ROBINS-I to assess risk of bias in nonrandomized studies. We will use GRADE to evaluate the quality of evidence.

Results:
Results of this review will be submitted to a peer-reviewed journal.

Conclusion:
To the best of our knowledge, this study will firstly evaluate both health and economic impact of infectious diseases in china and may provide strategy development ideas for future resistance.
Atopic dermatitis in Taiwanese children
Authors: Kuo Ho-Chang , Chu Chi-Hsiang , Su Yu-Jih , Lee Chih-Hung 
Published: July 2020

Abstract
Atopic dermatitis (AD) is a common chronic relapsing inflammatory skin disease associated with a personal or family history of atopic diseases. Determining the objective severity scoring of AD index (SCORAD) and total immunoglobulin E (IgE) to help to stage the severity (lesions extent and intensity of the lesions and then the itch and sleep disturbance they may cause) of AD in children.
In this study, we adopted the SCORAD index, which consists of severity, area, and sleep disturbance, to evaluate the AD status of children up to 18 years old. We examined the blood levels of total serum IgE, white blood cell count/differential count (WBC/DC), eosinophil counts (EC), eosinophil cationic protein (ECP) and specific IgE.
A total of 208 children with AD were enrolled in this study. Serum IgE values and a number of specific IgE that are positive significantly different SCORAD index through simple linear regression; however, after multiple linear regression, only IgE values (95% CI: 0.001–0.004, P < .001), total WBC count (95% CI: 0.112–1.736, P = .026), EC (95% CI: 0.045–6.706, P = .047), and specific IgE to Cheddar cheese (95% CI: 1.814–16.731, P = .015) remain different. After applying the Phi coefficient, we found that specific IgE to tuna (r = 0.632), codfish (r = 0.613), and clam (r = 0.613) each had a moderate correlation with specific IgE to Cheddar cheese. The 6 most common allergens were found to be mite (D. Farinae: 65.9%), mite (D. Pterony: 64.9%), house dust (47.6%), cockroach mix (37.0%), shrimp (30.8%), and crab (22.6%). Covariates of SCORAD index, severity, area, and sleep disturbance differed.
In this study, we found that total IgE values, specific IgE values, WBC, EC, and specific IgE to Cheddar cheese have significant correlations with SCORAD index in AD of Taiwanese children.
Comparing efficacy of drug-coated balloon-only approach and stent approach in treating de novo coronary artery lesions
Authors: Yu Deshuai , Cai Junjun , Wang Kai , Li Tianli , Liu Leilei , Shi Lei , Wang Xian 
Published: July 2020

Abstract

Background:
Drug-coated balloons (DCB) have been a novel alternative therapeutic strategy in de novo coronary artery diseases. However, the clinical feasibility of the DCB-only approach in treating small vessel disease remains controversial, while study aimed to assess the efficacy and safety of the DCB-only approach versus stent approaches in treating large vessel disease is limited.

Methods:
From February 2020 to May 2020, we will search Cochrane Library, PubMed, EMBASE, ScienceDirect, Scopus, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, and Chongqing VIP Database for eligible trials comparing DCB with drug-eluting stents for treatment of de novo lesions in both small vessel disease and large vessel disease. The primary endpoint is major adverse cardiac events (MACE); the secondary endpoints include in-lesion late lumen loss, binary restenosis, myocardial infarction, target lesion revascularization (TLR), mortality and target vessel thrombosis. Meta-analysis will be conducted using Review Manager software (V.5.3).

Results:
The results will be presented as risk ratios for dichotomous data, and weighted mean differences for continuous data.

Conclusion:
We will assess outcomes of the DCB-only approach in the treatment of de novo lesions compared with the stent approach.

PROSPERO registration number:
CRD42020164484.
Difference in the metabolic characteristics of chronic obstructive pulmonary disease patients and healthy adults
Authors: Jiang Yongliang , Hu Hantong , Li Xiaoyu , He Xiaofen , Shao Xiaomei , Lou Jiali , Zhang Yajun , Wu Yuanyuan , Fang Jianqiao 
Published: July 2020

AbstractIntroduction:By detecting the metabolic difference of the Heart and Lung meridians, the present study aims to investigate the specificity of different meridians and verify whether functional near infrared spectroscopy is validated as an add-on technique to assist diagnosis of chronic obstructive pulmonary disease (COPD).Methods and analysis:The Lung and Heart meridians are chosen as the target for comparison; accordingly, 120 eligible participants will be included and divided into the COPD group, healthy control group, and healthy intervention group. Functional near infrared spectroscopy will be adopted to measure the metabolic characteristics of the Heart and Lung meridians. On one hand, the specificity of the meridian-visceral association will be investigated by comparing the metabolic difference in the Heart and Lung meridians between the healthy control group and COPD group. On the other hand, the specificity of site-to-site association will be determined by comparing the metabolic change between the 2 meridians that induced by moxibustion in the Heart meridian and Lung meridian, respectively, in the healthy control group. The primary outcome will be regional oxygen saturation of corresponding regions along the Heart and Lung meridians.Trial registration:ClinicalTrials.gov NCT04046666.
Effect of depth of anesthesia on the phase lag entropy in patients undergoing general anesthesia by propofol
Authors: Park Jae Hong , Lee Sang Eun , Kang Eunsu , Park Yei Heum , Lee Hyun-seong , Lee Soo Jee , Shin Dongju , Noh Gyu-Jeong , Lee Il Hyun , Lee Ki Hwa 
Published: July 2020

Abstract
The PLEM100 (Inbody Co., Ltd., Seoul, Korea) is a device for measuring phase lag entropy (PLE), a recently developed index for the quantification of consciousness during sedation and general anesthesia. In the present study, we assessed changes in PLE along with the level of consciousness during the induction of general anesthesia using propofol. PLE was compared with the bispectral index (BIS), which is currently the most commonly used index of consciousness.
After obtaining Institutional Review Board approval and written informed consent, we enrolled 15 patients (8 men, 7 women; mean age: 37 ± 9 years; mean height: 168 ± 8 cm; mean weight; 68 ± 11 kg) undergoing nasal bone reduction. PLE and BIS sensors were attached simultaneously, and general anesthesia was induced via target-controlled infusion (TCI) of propofol. PLE and BIS scores were recorded when the calculated effect site concentration shown on the TCI pump was equal to the target concentrations of 1.5, 2.0, 2.5, 2.8, 3.0, 3.2, 3.4, and 3.5 μg/mL (and at each 0.1 μg/mL increase, thereafter). Observer's Assessment of Alertness/Sedation (OAA/S) scores were also recorded until unconsciousness was achieved. Throughout the anesthesia period, all pairs of PLE and BIS data were collected using data acquisition software.
The partial correlation coefficients between OAA/S scores and PLE, and between OAA/S scores and BIS were 0.778 (P < .001) and 0.846 (P < .001), respectively. Throughout the period of anesthesia, PLE and BIS exhibited a significant positive correlation. The partial correlation coefficient prior to the loss of consciousness was 0.838 (P < .001), and 0.669 (P < .001) following the loss of consciousness. Intra-class correlation between the 2 indices was 0.889 (P < .001) and 0.791 (P < .001) prior and following the loss of consciousness, respectively.
PLE exhibited a strong and predictable correlation with both BIS and OAA/S scores. These results suggest that PLE is reliable for assessing the level of consciousness during sedation and general anesthesia.
Acupuncture and related interventions for anxiety in coronavirus disease 2019
Authors: Jia Haowen , Han Zhenzhen , Zhang Kai , Tang Qilin , Sun Kaihang , Huang Hongwen , Qi Feng 
Published: July 2020

Abstract

Background:
Traditional Chinese medicine plays an irreplaceable role in the treatment and prevention of epidemic diseases in China. Acupuncture is an important part of Chinese medicine. During the coronavirus disease 2019 (COVID-19) epidemic, acupuncture and related interventions are used to treat COVID-19 patients in China. The systematic review aims to evaluate the efficacy and safety of acupuncture and relevant interventions for anxiety in COVID-19.

Methods:
We will search for randomized control and observational studies of acupuncture and related interventions for anxiety in COVID-19 in the 6 databases from inception to 31 October 2020. There is no language restriction. Two independent reviewers will screen and collect all trials, data extraction and evaluate the risk of bias of the researches. We will perform a meta-analysis if appropriate.

Results:
Our findings will evaluate the feasibility of acupuncture and related interventions as adjunctive therapy for anxiety in COVID-19 patients, which will be disseminated in a relevant conference and published in a peer-reviewed publication.

Conclusion:
Our research will appraise the overall quality and evidence of whether acupuncture and related interventions are effective therapies for anxiety in COVID-19.
Analysis of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma
Authors: Wu Shihai , Quan Rencui , Han Ling , Zhang Huaqing , Zhang Baozhu , Xu Gang , Li Xianming 
Published: July 2020

Abstract
The present study aimed to retrospectively analyze the survival outcomes and prognostic factors for patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT).
Clinical data was collected from 691 patients with NPC receiving IMRT from January 2009 to August 2015. A survival analysis was performed and prognostic factors were analyzed using the Kaplan–Meier method, the Cox proportional hazards regression model, and the log-rank test.
The median follow-up time was 62.8 months. Sixty-three patients experienced relapse, 44 cases (70%) of which occurred within 3 years. Six cases (9.5%) remained in remission for over 5 years. Seventy-two patients developed metastasis, 63 cases (87.5%) of which occurred within 3 years and only 1 case occurred after 5 years (1.3%). Five-year disease special survival (DSS), progression free survival, locoregional recurrence free survival, and distant metastasis free survival were 86.5%, 82.5%, 90.7%, and 89.4%, respectively in patients with NPC. Patients with stage III NPC with and without induction chemotherapy had 5-year DSS rates of 95.8% and 89.3%, respectively (P = .00). Patients with stage IVa NPC with and without induction chemotherapy had 5-year DSS rates of 73.1% and 68.9%, respectively (P = .04). The 5-year DSS rates of patients with stage III with or without concurrent chemotherapy were 92.8% and 85.5%, respectively (P = .04). The 5-year DSS rates of patients with stage IV with or without concurrent chemotherapy were 72.7% and 53.0% (P = .02).
IMRT improves the survival rate of patients with NPC. Recurrence and metastasis mainly occur within 2 to 3 years after radiotherapy. Induction and concurrent chemotherapy improve the 5-year DSS of patients with locally advanced NPC.
Migration inhibitory factor in spinal tuberculosis: -173G/C polymorphisms, and transcript and protein levels in a northern province of China
Authors: Wang Jun , Sheng Bin , Li XiaoPeng , Sun JianMin , Shi Lin , Wei WenTao , Wang GuoWei , Cao XueJun 
Published: July 2020

Abstract
The aim of this study was to elucidate the possible association between migration inhibitory factor (MIF)-173G/C gene polymorphisms and transcript and plasma levels of MIF in spinal tuberculosis (TB) patients. Clinical data were collected from 254 spinal TB patients and 262 healthy controls participating in the study. The genotype of the MIF-173G/C gene was amplified by polymerase chain reaction and genotyped by DNA sequencing technology. The level of mRNA expression was determined by real-time polymerase chain reaction and MIF plasma levels were measured by a solid-phase enzyme-linked immunosorbent assay. The frequency of the C allele and GC+CC genotype in MIF-173G/C was over-represented in spinal TB patients. The mean MIF mRNA level in spinal TB patients and patients with the GG and GC+CC genotype were significantly lower than controls; however, our study also indicated that the MIF concentration in spinal TB patients and patients with the GG and GC+CC genotypes were significantly higher than controls. Spinal TB patients with the GG genotype had higher MIF plasma levels than patients with the GC+CC genotype. The C-reactive protein level and erythrocyte sedimentation rate was correlated with the MIF plasma level. In summary, the association between the MIF-173G/C genetic polymorphism, reduced transcript and increased plasma levels of MIF in spinal TB patients, and MIF may play an important role in the occurrence, development, and damage of spinal TB in the northern Province population of China.
Concomitant fulvestrant with reirradiation for unresectable locoregional recurrent estrogen receptor positive (ER+) breast cancer
Authors: Ding Jingxian , Guo Yonghong , Jiang Xiaoliu , Li Kai , Fu Wenbing , Cao Yali 
Published: July 2020

Abstract

Rationale:
Locoregional recurrence of breast cancer is a challenging issue for clinicians. Treatment options for unresectable recurrent estrogen receptor positive (ER+) breast cancer in previously irradiated area are limited. Some studies showed concomitant fulvestrant with radiation therapy might increase radiosensitivity compared with radiation alone in vitro, no in vivo reports yet.

Patient concern:
Here, we present a case report and make a narrative review of concomitant fulvestrant with radiation therapy for unresectable locoregional recurrent ER+ breast cancer. The patient was treated with modified radical mastectomy in 2015, adjuvant chemotherapy, radiotherapy, followed by exemestane until November 2018, relapsed in internal mammary lymph nodes with sternum involved.

Diagnosis:
The final diagnosis was breast cancer internal mammary lymph nodes metastasis with sternum involved.

Interventions:
After diagnosis was made, concurrent fulvestrant with reirradiation as a palliative treatment were proposed under multiple disciplinary team.

Outcomes:
There was a good clinical response, enabling curative chance with radiation therapy to a total dose of 60 Gy. Computed tomography scan revealed no evidence of residual tumor.

Lessons:
As far as we know, this is the first report concerning concomitant fulvestrant with reirradiation for unresectable locoregional recurrent ER+ breast cancer. Since no severe adverse events were observed, this strategy could be a suitable “loco-regional rescue therapy” to further reduce tumor progression or even reach a curative effect. Studies of this treatment strategy in randomized clinical trials are warranted to further assess its safety and effectiveness.
Analysis of user behavior on the website of a university eye hospital in Germany
Authors: Lang Stefan J. , Böhringer Daniel , Bach Michael , Reinhard Thomas 
Published: July 2020

Abstract
Medical information websites are usually targeted toward patients, physicians, and medical students. Most of the latest studies researched the usability of such websites. However, reports on user numbers and behavior are rare.
The goal of our study is to analyze the utility of a website of a large tertiary referral center in ophthalmology in terms of various target audiences (patients, applicants, medical students, referring ophthalmologists).
The web access data from our institutional website was assessed with Google Analytics. Data collection started in 2016.
From 2016 to 2018, we counted a total of 763,942 page views. The overall number of users dropped from 81,572 to 67,740. This drop's onset correlates with a change in the website structure. All target audience pages received constant traffic from 2016 to 2019, with the patients’ and doctors’ sites attracting the most traffic. The pages for medical students and job applicants, although not viewed often, revealed a long session duration.
Our website is used by all our target audiences. The behavior and the user numbers of each target group differ. Changes to a website's structure can influence the number of users and their behavior. It is not possible to make a direct comparison to other institutions’ websites as there are so few similar reports available. By adding more parameters to the analytics profile in a prospective setting, more detailed analyses of user behavior may be possible in the future.