bluuebunny/crossref_metadata_2025_split huggingface dataset:
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Authors: Kim Myung Hee , Moon Hee Seok , Kwon In Sun , Kim Ju Seok , Kang Sun Hyung , Sung Jae Kyu , Lee Eaum Seok , Kim Seok Hyun , Lee Byung Seok , Jeong Hyun Yong 
Published: July 2020

Abstract
Sessile serrated adenomas (SSAs) are precursors of colorectal cancer (CRC). However, there are limited data on detection rates of this premalignant lesion during colonoscopy surveillance in patients with a history of left side colonic resection for cancer. We aimed to identify the incidence and risk factors of SSAs in post-left side colectomy patients.
We retrospectively reviewed the medical records of patients who had undergone left side colectomy for colon and rectal cancer between September 2009 and September 2016 and had at least 1 follow-up colonoscopy. Patient baseline characteristics, SSA diagnoses and characteristics, and colonoscopy information were collected.
In total, 539 patients were enrolled. At the first follow-up (mean duration 11.5 months), 98 SSAs were identified (22.2%). At the second follow-up (mean duration 25.8 months), 51 SSAs were identified in 212 patients (24.0%). Multivariate analysis showed that alcohol intake (hazard ratio [HR] 1.524; 95% confidence interval [CI] .963–2.411, P = .041), excellent bowel preparation (HR 2.081; 95% CI 1.214–3.567, P = .049), and use of a transparent cap (HR 1.702; 95% CI 1.060–2.735, P = .013) were associated with higher SSA incidence in the first surveillance colonoscopy, while body mass index (BMI) ≥ 25.0 (HR 1.602; 95% CI 1.060–2.836) was associated with a significantly increased risk of SSAs in the second surveillance.
Considering the endoscopic appearance of SSAs, adequate bowel preparation and use of transparent caps during postoperative surveillance colonoscopy can increase the diagnosis rate. Modification of alcohol intake and BMI may reduce the incidence of SSAs in left side colon cancer patients.
Effects of Sihogayonggolmoryeo-tang (Saikokaryukotsuboreito or Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for insomnia disorder with prehypertension or stage 1 hypertension
Authors: Lee Boram , Jeong Yeong-Eun , Park Hyo-Ju , Choi Young-Eun , Kim Hoseok , Kim Bo-Young , Yang Changsop , Jung In Chul 
Published: July 2020

Abstract

Background:
Insomnia and hypertension are diseases with a high prevalence and a known association with each other. Sihogayonggolmoryeo-tang (SYM) is an herbal medicine traditionally used for the treatment of insomnia disorder concurrent with hypertension. However, no scientific clinical evidence exists supporting the effects of SYM on these disorders. This study aims to explore the feasibility, effectiveness, and safety of SYM for the treatment of insomnia disorder with concurrent prehypertension or stage 1 hypertension.

Methods:
A prospective, randomized, wait-list controlled, parallel, pilot clinical trial has been designed for a study to be conducted in Daejeon, Republic of Korea. Thirty insomnia disorder patients with prehypertension or stage 1 hypertension will be randomly assigned to a SYM or wait-list group at a 1:1 ratio. The SYM group will be administered SYM granules twice a day for 4 weeks and followed-up for 2 weeks while the wait-list group will not receive SYM granules. All participants in both groups will be given brochures with instructions for maintaining sleep hygiene and lifestyle modifications to reduce hypertension. Data will be collected at baseline and at 2, 4, and 6 weeks after allocation. The primary outcome is the Insomnia Severity Index score at 4 weeks post-treatment. The secondary outcomes will consist of the Pittsburgh Sleep Quality Index, sleep diary, systolic and diastolic blood pressure, brachial-ankle pulse wave velocity, ankle-brachial index, atherosclerosis biomarkers, the Hospital Anxiety and Depression Scale, the 5-level EuroQol-5 dimensions, and the Patient Global Impression of Change. Adverse events and laboratory test results will be monitored to assess the safety. Data will be recorded in electronic case report forms and analyzed using SPSS Statistics, Version 24.0.

Discussion:
This is the first clinical trial to explore the effectiveness and safety of SYM for the treatment of insomnia disorder concurrent with prehypertension or stage 1 hypertension. The results of this study can form the foundation for a future multicenter, large-scale, confirmatory clinical trial.

Trial registration:
Clinical Research Information Service, KCT0005001 (registered on May 8, 2020).
Effects of Tai Chi Yunshou on upper limb function and balance in stroke survivors
Authors: Luo Xiao-Chao , Zhou Jin , Zhang Yong-Gang , Liu Yao-Yao , Li Jia-Jia , Zheng Zhen , Tong Feng , Feng Fen 
Published: July 2020

Abstract

Background:
Functional disability is the most common disorder that occurs after stroke and seriously affects the quality of life of stroke survivors. Tai Chi Yunshou (TCY), a fundamental form of Tai Chi, is a simple, convenient, and economical exercise therapy from ancient China. Some clinical trials have reported that it improves upper limb function and balance during stroke rehabilitation. Thus, we plan to conduct a systematic review to investigate the effects of TCY in stroke survivors.

Methods:
This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We will search English and Chinese databases for randomized controlled trials on TCY for stroke survivors from the dates when the databases were established to 1 July 2020. The English databases will include MEDLINE (PubMed), EMBASE (embase.com), and the Cochrane Central Register of Controlled Trials (Cochrane Library). In addition, the Chinese databases will include the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Science and Technology Periodical Database, the Wanfang database, and the Chinese Dissertation Database. The primary outcomes will include upper limb function and balance function, as measured by the Fugl-Meyer assessment and Berg balance scale, respectively. Two reviewers will independently screen the studies on the basis of the inclusion criteria and extract data. Review Manager (v5.3) will be used for data synthesis, and Cochrane Collaboration's tool will be used to assess the risk of bias. A fixed effects model or a random effects model will be selected based on the level of heterogeneity. The grading of recommendations assessment, development, and evaluation system will be used to evaluate the quality of the outcomes.

Results:
This systematic review results will be carried out after the completion of the protocol.

Conclusions:
This protocol aims to guide a systematic review and meta-analysis investigating the effects of JCY on upper limb function and body balance in stroke survivors, which will provide evidence for post-stroke rehabilitation training.

PROSPERO registration number:
CRD42020169549.
Type 2 diabetes mellitus caused by Gitelman syndrome-related hypokalemia
Authors: He Guangyu , Gang Xiaokun , Sun Zhonghua , Wang Ping , Wang Guixia , Guo Weiying 
Published: July 2020

Abstract

Introduction:
Gitelman syndrome (GS) is an autosomal-recessive disease caused by SLC12A3 gene mutations. It is characterized by hypokalemic metabolic alkalosis in combination with hypomagnesemia and hypocalciuria. Recently, patients with GS are found at an increased risk for developing type 2 diabetes mellitus (T2DM). However, diagnosis of hyperglycemia in GS patients has not been thoroughly investigated, and family studies on SLC12A3 mutations and glucose metabolism are rare. Whether treatment including potassium and magnesium supplements, and spironolactone can ameliorate impaired glucose tolerance in GS patients, also needs to be investigated.

Patient concerns:
We examined a 55-year-old Chinese male with intermittent fatigue and persistent hypokalemia for 17 years.

Diagnoses:
Based on the results of the clinical data, including electrolytes, oral glucose tolerance test (OGTT), and genetic analysis of the SLC12A3 gene, GS and T2DM were newly diagnosed in the patient. Two mutations of the SLC12A3 gene were found in the patient, one was a missense mutation p.N359K in exon 8, and the other was a novel insert mutation p.I262delinsIIGVVSV in exon 6. SLC12A3 genetic analysis and OGTT of 9 other family members within 3 generations were also performed. Older brother, youngest sister, and son of the patient carried the p.N359K mutation in exon 8. The older brother and the youngest sister were diagnosed with T2DM and impaired glucose tolerance by OGTT, respectively.

Interventions:
The patient was prescribed potassium and magnesium (potassium magnesium aspartate, potassium chloride) oral supplements and spironolactone. The patient was also suggested to maintain a high potassium diet. Acarbose was used to maintain the blood glucose levels.

Outcomes:
The electrolyte imbalance including hypokalemia and hypomagnesemia, and hyperglycemia were improved with a remission of the clinical manifestations.

Conclusion:
GS is one of the causes for manifestation of hypokalemia. SLC12A3 genetic analysis plays an important role in diagnosis of GS. Chinese male GS patients characterized with heterozygous SLC12A3 mutation should be careful toward occurrence of T2DM. Moreover, the patients with only 1 SLC12A3 mutant allele should pay regular attention to blood potassium and glucose levels. GS treatment with potassium and magnesium supplements, and spironolactone can improve impaired glucose metabolism.
Efficacy and safety of the traditional Chinese medicine tonifying kidney (bu shen) therapy in patients with hypertension
Authors: Tang Zhuoran , Sun Yize , Wang Chao , Liu Xiang , Qi Xin , Ma Di , Zhao Haibin 
Published: July 2020

Abstract

Background:
Hypertension becomes increasingly an alarming global health concern. There is a growing interest in treatment of traditional Chinese medicine (TCM), and tonifying kidney therapy (bushen, TKT) has been extensively used in the treatment of hypertension according to TCM theory. In this article, we outline the protocol of research projects and methods to examine comprehensively the effectiveness and safety of TKT in treating hypertensive patients.

Methods:
We will collect randomized controlled trails (RCTs) that report the application of TKT for patients with hypertension from electronic databases including PubMed, EMBASE, CENTRAL, CNKI, VIP, CBM, and Wanfang database. Time of literature retrieval is set from the beginning of database construction to the end of June, 2020. Two reviewers will independently perform literature screening, data extraction, and quality assessment of included literature, and any divergences will be worked out via discussion. The primary outcomes include total efficacy rate, systolic and diastolic blood pressure change will be assessed. The secondary outcomes include clinical symptoms and adverse events will also be assessed. RevMan5.3 software will be applied to analyzing data included studies.

Results:
This study will synthesize and analyze all collated data in order to evaluate TKT for the treatment of hypertension involves different aspects in total efficacy rate, systolic and diastolic blood pressure change, clinical symptoms, and adverse events.

Conclusion:
This study will determine the efficacy of TKT in the treatment of hypertension and recommend its clinical value based on the evaluated the effectiveness and security results.

Registration number:
INPLASY202050044.
The effectiveness of different exercise modalities on sleep quality
Authors: Cao Peiye , Cai Ying , Zhang Shifang , Wan Qiaoqin 
Published: July 2020

Abstract

Background:
Recently, the effect of exercise on sleep quality has been paid increasing attention by researchers. A number of systematic reviews and direct meta-analyses have explored the effectiveness of exercise on sleep quality. However, which type of exercise is optimal for sleep quality is still not clear. Therefore, this study aims to adopt network meta-analysis to evaluate the effect of different exercise modalities on sleep quality and find the most effective one for improving sleep quality.

Methods:
The databases searched included PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, and SPORTDiscus. Studies published in English and from the dates of database inception to October 8, 2019, were included. Besides, we also checked the reference lists of systematic reviews published in recent years. Two independent researchers screened all studies, included the studies that met eligible criteria and will then extract data. The risk of bias will be assessed by the 2 researchers according to the modified Cochrane Risk of Bias Tool. During these processes, any disagreement will be discussed to reach a consensus. STATA 14.0 software will be used for direct meta-analysis and network meta-analysis.

Results:
High-quality synthesis of current evidences will be provided from Pittsburgh sleep quality index. And the effectiveness of different exercise modalities for sleep quality will also be shown.

Conclusion:
This study will provide the evidence of the most effective exercise for better sleep quality.

Registration:
This study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (registration number: INPLASY202050096).
Molecular profile of a pleomorphic adenoma of the hard palate
Authors: Iida Yoshiyuki , Serizawa Masakuni , Mukaigawa Takashi , Kamijo Tomoyuki , Nakajima Takashi , Asakura Koiku , Kusuhara Masatoshi , Yamaguchi Ken , Onitsuka Tetsuro 
Published: July 2020

AbstractRationale:Pleomorphic adenoma (PA) is the most common benign tumor of salivary glands. PAs have the potential for regional and distant metastases that preserve their benign phenotype; they also have the potential for malignant transformation. The molecular pathogenesis of malignant neoplasms has been studied extensively in recent years, unlike that of benign tumors, such as PA.Patient concerns:In this case report, we identified the molecular signatures of a 57-year-old Japanese woman. Our patient presented with a swelling of the hard palate with an erosive appearance.Diagnoses:The patient was diagnosed with a right hard palate tumor suspected to be a malignant neoplasm.Interventions:Partial maxillary resection and reconstruction were performed.Outcomes:There was no obstacle to swallowing or dysarthria after surgery. There was no sign of recurrent palatal tumor 4 years after the operation. Using next generation sequencing, 5 nonsynonymous mutations andCHCHD7-PLAG1fusion genes were detected. Moreover, gene expression profiling indicated the possibility of the activation of several cancer-related signaling pathways. Although thePLAG1gene is predicted to play a crucial role in PA tumorigenesis, its over-expression is reported to mediate multiple downstream factors. In this case, various up- and downregulated RNA signaling pathways, including MAP kinase signaling, PI3K/AKT1/MTOR signaling, JAK/STAT signaling, and PD-L1 signaling, were revealed.Lessons:These molecular profiles of PA may elucidate the mechanism of metastasis, preserving its benign phenotype and carcinoma ex PA.
Stroke prevention and guideline adherent antithrombotic treatment in elderly patients with atrial fibrillation
Authors: Gorczyca Iwona , Jelonek Olga , Michalska Anna , Chrapek Magdalena , Wałek Paweł , Wożakowska-Kapłon Beata 
Published: July 2020

Abstract
Patients aged ≥75 years with the diagnosis of atrial fibrillation (AF) are at a higher risk of stroke and, according to recent recommendations, should receive oral anticoagulant (OAC) therapy. This study aimed to assess the recommended prophylactic antithrombotic therapy among patients with AF aged ≥ 75 years and its compliance with current guidelines. We also aimed to identify predisposing factors associated with the administration of non-vitamin K antagonist oral anticoagulants (NOACs) in elderly patients with AF.
This was a retrospective, single-center observational study. Patients with AF aged ≥75 years hospitalized at a reference cardiology center from 2014 to 2017 were included in the analysis.
Among the 1236 eligible patients (43.4% male; mean age, 82 years), OACs were recommended in 90.1% of cases. Of these, 59.8% of patients used NOACs and 40.2% used vitamin K antagonists. Additionally, 3.3% of patients received antiplatelet (AP) therapy and 2.5% were administered low molecular weight heparin. Only 4.5% of patients did not receive any anticoagulant treatment. The majority (89.9%) of patients received relevant prophylactic antithrombotic therapy according to current guidelines; only 1.4% were overtreated and 8.7% were undertreated. The significant predictors of NOAC therapy among patients treated with anticoagulants were non-permanent AF (odds ratio [OR] = 1.68, 95% confidence interval [CI] = 1.30–2.18, P = .0001), age-by 5 years (OR = 1.33, 95% CI = 1.16–1.52, P = .0001), and glomerular filtration rate-by 5 units (OR = 1.06, 95% CI = 1.02–1.10, P = .0066).
A high percentage of AF patients aged ≥75 years receive OACs, mainly NOACs. Most patients are treated according to the current guidelines; under treatment is primarily observed in patients receiving AP therapy. Non-permanent AF, age, and preservation of renal function are significant predictors of NOAC use.
The effect of early trough level of infliximab on subsequent disease course in patients with Crohn disease
Authors: Ishida Natsuki , Miyazu Takahiro , Sugiyama Tomohiro , Tamura Satoshi , Kagami Takuma , Tani Shinya , Yamade Mihoko , Iwaizumi Moriya , Hamaya Yasushi , Osawa Satoshi , Furuta Takahisa , Sugimoto Ken 
Published: July 2020

Abstract
Decreased trough level of infliximab (TLI) is associated with diminished efficacy in patients with Crohn disease (CD). We examined whether TLI at 14 weeks subsequent to the start of infliximab (IFX) treatment would impact long-term clinical course.
Serum IFX levels and antibodies to IFX (ATI) at 14 and 54 weeks after IFX administration were measured in 12 patients with mild to moderate CD. We examined patient background, clinical severity, blood test values, and the relationship between ATI and TLI up to 108 weeks.
We compared the group with TLI < 3 μg/mL at 14 weeks (TLI(14) < 3 group) the group with TLI > 3 μg/mL (TLI(14) ≥ 3 group). Patients in the TLI(14) ≥ 3 group were significantly more likely to use immunomodulators before IFX treatment induction (P = .01). At 54 weeks, 2 cases of ATI production were observed in the TLI(14) < 3 group, but no ATI production was observed in the TLI(14) ≥ 3 group. TLI in the TLI(14) ≥ 3 group at 54 weeks was significantly higher than in the TLI(14) < 3 group (6.5 μg/mL vs 1.0 μg/mL; P < .01). Although CD activity index and serum albumin values in the TLI(14) ≥ 3 group at 14, 54, and 108 weeks significantly improved compared to baseline, these improvements were not observed in the TLI(14) < 3 group. The remission maintenance rate at 108 weeks evaluated with the Kaplan–Meier method was significantly higher in the TLI(14) ≥ 3 group than the TLI(14) < 3 group (100% vs 33.3%; P = .02).
The TLI 14 weeks after IFX treatment in patients with CD affects long-term outcome.
Gliclazide monotherapy increases risks of all-cause mortality and has similar risk of acute myocardial infarction and stroke with glimepiride monotherapy in Korean type 2 diabetes mellitus
Authors: Cho Eun-Hee , Han Kyungdo , Kim Bongseong , Lee Dae Ho 
Published: July 2020

Abstract
Sulphonylureas (SUs) subclasses have different risks of all-cause mortality, acute myocardial infarction (AMI), and stroke. Therefore, we assessed these risks in patients with type 2 diabetes mellitus administered gliclazide, glimepiride, or metformin monotherapy with retrospective cohort study design. Total 195,235 subjects were included in the study who were ≥20 years’ old and prescribed monotherapy for at least 1 year as a first-line therapy for incident diabetes from January 01, 2009 to December 31, 2013 in the National Health Insurance Service Claim data. Incidence and hazard ratios (HRs) of all-cause mortality, AMI, and stroke were compared with glimepiride monotherapy as a reference. Gliclazide monotherapy increased all-cause mortality compared with glimepiride monotherapy. However, the gliclazide and glimepiride groups showed no difference in AMI and stroke incidences. In line with previous studies, metformin monotherapy showed significant clinical benefits in reducing risks of all-cause mortality, AMI, and stroke compared with glimepiride. This population-based cohort study suggested that gliclazide increases risks of all-cause mortality and has similar risk of AMI and stroke with gliclazide monotherapy in Korean.
Fully automatic classification of breast MRI background parenchymal enhancement using a transfer learning approach
Authors: Borkowski Karol , Rossi Cristina , Ciritsis Alexander , Marcon Magda , Hejduk Patryk , Stieb Sonja , Boss Andreas , Berger Nicole 
Published: July 2020

Abstract
Marked enhancement of the fibroglandular tissue on contrast-enhanced breast magnetic resonance imaging (MRI) may affect lesion detection and classification and is suggested to be associated with higher risk of developing breast cancer. The background parenchymal enhancement (BPE) is qualitatively classified according to the BI-RADS atlas into the categories “minimal,” “mild,” “moderate,” and “marked.” The purpose of this study was to train a deep convolutional neural network (dCNN) for standardized and automatic classification of BPE categories.
This IRB-approved retrospective study included 11,769 single MR images from 149 patients. The MR images were derived from the subtraction between the first post-contrast volume and the native T1-weighted images. A hierarchic approach was implemented relying on 2 dCNN models for detection of MR-slices imaging breast tissue and for BPE classification, respectively. Data annotation was performed by 2 board-certified radiologists. The consensus of the 2 radiologists was chosen as reference for BPE classification. The clinical performances of the single readers and of the dCNN were statistically compared using the quadratic Cohen's kappa.
Slices depicting the breast were classified with training, validation, and real-world (test) accuracies of 98%, 96%, and 97%, respectively. Over the 4 classes, the BPE classification was reached with mean accuracies of 74% for training, 75% for the validation, and 75% for the real word dataset. As compared to the reference, the inter-reader reliabilities for the radiologists were 0.780 (reader 1) and 0.679 (reader 2). On the other hand, the reliability for the dCNN model was 0.815.
Automatic classification of BPE can be performed with high accuracy and support the standardization of tissue classification in MRI.