bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trichilemmal Cysts With Divergent Ductal Differentiation: A Series of 4 Cases
Authors: Khan Irfan , Fraga Garth R. , Dai Hongyan 
Published: November 2020

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

Abstract
Cataract surgery is the most common ambulatory surgery at our outpatient surgery center. Several studies have shown that patients with bilateral cataracts may experience different levels of anxiety, pain, and awareness during the first and second cataract extraction.
A prospective observational cohort study was conducted at The Ohio State University Wexner Medical Center Eye and Ear Institute in order to compare anxiety, general comfort, awareness, and pain levels in patients undergoing sequential cataract surgeries. Likert and numerical rating scale were used to assess the outcomes. Patients receiving monitored anesthesia care and topical anesthesia were included.
A total of 198 patients were enrolled in this study, 116 patients (59%) were female and 157 patients (78%) were Caucasians with a median age of 67 years among participants. Patients with rating “no anxiety” or feeling “somewhat anxious” were significantly higher during surgery 2 (P =< .001). Most of the patients felt “extremely comfortable” during surgery 1 when compared to surgery 2 (54% vs 42.9%; P = .08). No significant differences were found between surgeries regarding intraoperative awareness (P = .16). Overall, patients experienced mild pain during both procedures (92.4% in surgery 1 compared to 90.4% in surgery 2; P = .55). During the postoperative visit, 54% of the patients associated surgery 2 with less anxiety levels, 53% with no differences in general comfort, 60% felt more aware, and 59% had no differences in pain levels.
Previous exposure to surgery could have been associated with a significant reduction in anxiety levels reported during surgery 2. Non-pharmacological strategies aiming to reduce perioperative anxiety may be considered an alternative or additional approach to premedication in patients undergoing consecutive cataract surgeries.
Evaluation of walking exercise on glycemic control in patients with type 2 diabetes mellitus
Authors: Hu Hengchang , Lei Yuanhong , Yin Liping , Luo Xiaoqiong 
Published: November 2020

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

Methods:
This study is designed as a monocentral randomized controlled trial at University Hospital Brno in the Czech Republic. After the coronary heart event, the suitable patients will be randomized (1:1 ratio) and separated into 2 groups: the experimental HIIT group and the control MICT group. Both groups undergo a 12-week telerehabilitation with a 1-year follow-up period. Study participants will be telemonitored during physical training in their home environment via a heart rate monitor and a web platform. Once a week, the patients will give their feedback and motivation by a telephone call.
The primary outcome observed will be the effect of intervention expressed by changes in cardiorespiratory fitness. Secondary outcomes will be the health-related quality of life, anxiety, training adherence, body composition, safety, and satisfaction.

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

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

Abstract
Digital tourniquets are widely used for the management of digital injuries in emergency departments or outpatient clinics. This study is focused on the pressure analysis of digital tourniquets on some points not covered in the existing literature.
A total of thirty volunteers were enrolled in this study. Instantaneous surface pressure was measured at the thumbs, index fingers, and little fingers. We investigated the pressure according to the circumference of digits, tourniquet types, and measurement sites (dorsal and mid lateral volar sides) above the digital vessels. Continuous pressure was measured in artificial silicone models to determine the change of pressure over 2 hours.
The average pressure measured on the mid lateral volar side of volunteers fingers were 154.3 ± 54.9 mm Hg by T-RingTM and 162.6 ± 61.0 mm Hg by surgical glove. The pressure on the dorsal side were 224.7 ± 57.7 mm Hg by T-RingTM and 228.8 ± 66.0 mm Hg by surgical glove, each significantly higher than the mid lateral volar side. The circumference of digits did not significantly affect the surface pressure. The pressure pattern did not change significantly over 2 hours in both tourniquet types.
The surface pressure of the mid lateral volar side was significantly lower than that of the dorsal side. However, there was no significant pressure difference according to the circumference of digits. Time dependent pressure change were not significantly different between 2 tourniquets.
Dexamethasone prevents TACE-induced adverse events
Authors: Chang Lei , Wang Wei , Jiang Nanhui , Rao Fengying , Gong Cheng , Wu Ping , Yang Jian , Liu Zhisu , Guo Tao 
Published: November 2020

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

PROSPERO registration number:
CRD42020156362.