bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nomogram for determining the disease-specific survival in invasive lobular carcinoma of the breast
Authors: Fu Rong , Yang Jin , Wang Hui , Li Lin , Kang Yuzhi , Kaaya Rahel Elishilia , Wang ShengPeng , Lyu Jun 
Published: October 2020

Abstract
We aimed to establish and validate a nomogram for predicting the disease-specific survival of invasive lobular carcinoma (ILC) patients.
The Surveillance, Epidemiology, and End Results program database was used to identify ILC from 2010 to 2015, in which the data was extracted from 18 registries in the US. Multivariate Cox regression analysis was performed to identify independent prognostic factors and a nomogram was constructed to predict the 3-year and 5-year survival rates of ILC patients based on Cox regression. Predictive values were compared between the new model and the American Joint Committee on Cancer staging system using the concordance index, calibration plots, integrated discrimination improvement, net reclassification improvement, and decision-curve analyses.
In total, 4155 patients were identified. After multivariate Cox regression analysis, nomogram was established based on a new model containing the predictive variables of age, the primary tumor site, histology grade, American Joint Committee on Cancer TNM (tumor node metastasis) stages II, III, and IV, breast cancer subtype, therapy modality (surgery and chemotherapy). The concordance index for the training and validation cohorts were higher for the new model (0.781 and 0.832, respectively) than for the old model (0.733 and 0.779). The new model had good performance in the calibration plots. Net reclassification improvement and integrated discrimination improvement were also improved. Finally, decision-curve analyses demonstrated that the nomogram was clinically useful.
We have developed a reliable nomogram for determining the prognosis and treatment outcomes of ILC. The new model facilitates the choosing of superior medical examinations and the optimizing of therapeutic regimens with cooperation among oncologists.
Case report: fatal pneumonia caused by new sequence type Legionella pneumophilia serogroup 1
Authors: Jiang Luxi , Tao Sixu , Mu Deguang , Zhang Naxin , Zhao Li , Chen Yu 
Published: October 2020

Abstract

Introduction:
Legionnaires’ disease is caused by Legionella bacteria, and commonly manifests as pneumonia and has a high fatality rate.

Patient concerns:
This case study reports on the fatal incident of a patient, initially diagnosed with pneumonia, and subsequently diagnosed with Legionnaires’ disease caused by a new sequence type (ST) of Legionella.

Diagnosis:
It is speculated that the patient acquired Legionnaires’ disease from a contaminated water source. Legionnaires’ disease was diagnosed using the Legionella urinary antigen assay and bacterial cultures of respiratory secretions; Legionella pneumophilia Type 1 was also identified through serological testing. Sequence-based typing of the cultured bacterium revealed it to be a previously unidentified species, and it was named ST2345 new-type.

Interventions:
In addition to the treatment of Legionnaires’ disease, blood samples taken on the second day of admission showed a co-infection of Candida tropicalis, which was treated with anti-fungal treatment. The patient improved after a week, however, on the seventh day of administration lower respiratory secretions showed the growth of Klebsiella pneumonia, indicative of ventilator-associated pneumonia.

Outcomes:
Despite active treatment, the patient passed away due to multiple organ failure. As this was a fatal case, further research is needed to determine whether the critical condition of this case was related to the virulence of the novel Legionella strain.

Conclusion:
A key finding of this study is that treatment for suspected Legionnaires’ disease must be administered rapidly, as infection with Legionella may give rise to secondary pathogenic infections.
Successful en bloc resection of large esophageal hemangioma by endoscopic submucosal dissection
Authors: Yu Yan , Shen Bingzheng , Zhang Chao , Zhang Jiqiao , Cao Li , Lu Panpan , Liu Mei 
Published: October 2020

Abstract

Rationale:
With the development of endoscopic techniques, endoscopic therapy began to play an important role in the management of esophageal hemangiomas.

Patients concerns:
A large esophageal submucosal tumor (2.5 cm), which was suspected to be an esophageal hemangioma, was diagnosed in a 50-year-old woman.

Diagnosis:
Esophageal hemangioma

Interventions:
Endoscopic submucosal dissection was performed for tumor removal.

Outcomes:
Histopathological results revealed hemangioma. No complication or recurrence was observed in the 17-month follow-up period.

Lessons:
Our successful experience showed that endoscopic submucosal dissection is an effective and a safe approach to treat large esophageal hemangiomas (2.5 cm).
Efficacy and tolerability of combination therapy with alpha-blockers and phosphodiesterase-5 inhibitors compared with monotherapy for lower urinary tract symptoms
Authors: Qiangzhao Liu , Xiaofeng Zhang , Fenghai Zhou , Qiong Lian , Fa Zhang , Bohong Guo , Xinsheng Xi 
Published: October 2020

Abstract

Purpose:
This study aimed to compare the efficacy and safety of combination therapy consisting of α-blockers and different phosphodiesterase type 5 inhibitors for lower urinary tract symptoms (LUTS) by performing a network meta-analysis.

Method:
Relevant articles were retrieved from the Cochrane Library, PubMed, and EMBASE databases. Bayesian network meta-analyses were performed with a random-effect model to compare the efficacy and safety of combination therapy with α-blockers and phosphodiesterase-5 inhibitors for LUTS. The odds ratio (OR), mean difference (MD) and surface under the cumulative ranking curve (SUCRA) were calculated with the GeMTC R package.

Results:
Twenty randomized trials with 4131 patients were included in this network meta-analysis. Based on the SUCRA values, vardenafil (10 mg) combined with α-blockers ranked first, first and sixth; sildenafil (25 mg) combined with α-blockers ranked second, third and first; and tadalafil (20 mg) combined with α-blockers ranked third, second and fourth in IPSS, post void residual, and maximum flow rate, respectively.

Conclusions:
Combination therapy with α-blockers and phosphodiesterase-5 inhibitors was effective and well tolerated for LUTS. For men who prioritize high efficacy, vardenafil (10 mg) combined with α-blockers seems to be the treatment of choice. For men wishing to optimize minimally invasive treatment, sildenafil (25 mg) and tadalafil (20 mg) combined with α-blockers appears to have a possible advantage in terms of avoiding adverse effects.
Factors affecting the Apgar score of offsprings born to mothers suffering from systemic lupus erythematosus
Authors: Shimada Hiromi , Kameda Tomohiro , Kanenishi Kenji , Miyatake Nobuyuki , Nakashima Shusaku , Wakiya Risa , Kato Mikiya , Miyagi Taichi , Mansour Mai Mahmoud Fahmry , Hata Toshiyuki , Kadowaki Norimitsu , Dobashi Hiroaki 
Published: October 2020

Abstract
To reveal which disease activity parameters affect low Apgar scores of newborns, which is considered as a predictive parameter for neurological development.
We examined retrospectively the data from 42 newborns who were delivered from systemic lupus erythematosus (SLE) mothers from 2006 to 2019. We evaluated whether the disease activity parameters, such as the achievement ratio of lupus low disease activity state (LLDAS), SLE disease activities index (SLEDAI), complement level, titer of anti-double stranded DNA (anti-dsDNA) antibody, therapeutic agents were related with low Apgar scores of newborns.
In 42 newborns, adverse pregnancy outcomes, especially preterm birth (16.7%), low birth weight (31.0%) light-for-date (11.9%) were associated with disease activity parameters or prednisolone dose. Apgar scores at 1 minute were related with unachieved LLDAS and the titer of anti-dsDNA antibody at first and third trimester, SLEDAI score and complement level at third trimester, mean prednisolone dose. Apgar scores at 5 minutes were also associated with the titer of anti-dsDNA antibodies at first and third trimester and mean prednisolone dose. Multivariate analysis showed only high titer of anti-dsDNA antibody was significantly associated with low Apgar score at both one minute and 5 minutes.
In our retrospective study, high titer of anti-dsDNA antibodies at first and third trimester was a risk factor for low Apgar scores of newborns born to SLE mothers. We considered that high titer of anti-dsDNA antibody influenced on childrens neurological development, therefore, there is a need for long-term follow-up study of SLE offsprings.
Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction
Authors: Chen Huang-Chung , Lee Wei-Chieh , Fang Hsiu-Yu , Fang Chih-Yuan , Chen Chien-Jen , Yang Cheng-Hsu , Wu Chiung-Jen 
Published: October 2020

Abstract
The ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) has been proposed as an easily obtainable atherogenic marker and high TG/HDL-C ratio is associated with insulin resistance. This study investigated the associated between a high TG/HDL-C ratio and cardiovascular mortality in patients with ST-segment elevation myocardial infarction (STEMI), with or without diabetes mellitus (DM).
Between January 2005 and December 2014, 1661 patients with STEMI underwent primary percutaneous coronary intervention in our hospital. Of these, 289 were classified into group 1 (with both DM and a high TG/HDL-C ratio), 295 into group 2 (with DM, but without a high TG/HDL-C ratio), 501 into group 3 (without DM, but a high TG/HDL-C ratio), and 576 into group 4 (without DM or a high TG/HDL-C ratio).
Older age, longer chest pain to reperfusion time, poor hemodynamic condition, and higher prevalence of multiple vessel coronary artery disease were noted in those with DM. Poor outcomes including higher 30-day and 1-year cardiovascular mortality and all-cause mortality rates were noted in those with DM but without a high TG/HDL-C ratio. Patients with DM but without a high TG/HDL-C ratio had a Hazard ratio of 3.637 for cardiovascular mortality relative to those without DM, but without a high TG/HDL-C ratio.
Even though a high TG/HDL-C ratio is associated with insulin resistance, patients with or without DM, but with a high TG/HDL-C ratio had better 30-day and 1-year outcomes.
The COVID-19 research landscape
Authors: Wang Junhui , Hong Na 
Published: October 2020

Abstract

Objectives:
The Coronavirus Disease 2019 (COVID-19) caused heavy burdens and brought tremendous challenges to global public health. This study aimed to investigate collaboration relationships, research topics, and research trends on COVID-19 using scientific literature.

Method:
COVID-19-related articles published from January 1 to July 1, 2020 were retrieved from PubMed database. A total of 27,370 articles were included. Excel 2010, Medical Text Indexer (MTI), VOSviewer, and D3.js were used to summarize bibliometric features.

Results:
The number of the COVID-19 research publications has been continuously increasing after its break. United States was the most productive and active country for COVID-19 research, with the largest number of publications and collaboration relationships. Huazhong University of Science and Technology from China was the most productive institute on the number of publications, and University of Toronto from Canada ranked as Top 1 institute for global research collaboration. Four key research topics were identified, of which the topic of epidemiology and public health interventions has gathered highest attentions. Topic of virus infection and immunity has been more focused during the early stage of COVID-19 outbreak compared with later stage. The topic popularity of clinical symptoms and diagnosis has been steady.

Conclusions:
Our topic analysis results revealed that the study of drug treatment was insufficient. To achieve critical breakthroughs of this research area, more interdisciplinary, multi-institutional, and global research collaborations are needed.
Comparative effectiveness of East Asian traditional medicine for treatment of idiopathic short stature in children
Authors: Lee Boram , Kwon Chan-Young , Jang Soobin 
Published: October 2020

Abstract

Background:
There are many East Asian traditional medicine (EATM) therapies that are widely used and effective for idiopathic short stature (ISS) in children. However, the comparative effectiveness of these therapies remains unclear. We describe the methods that will be used to comparatively evaluate the efficacy and safety of EATM therapies for the treatment of pediatric ISS.

Methods and analysis:
Fourteen electronic English, Korean, Chinese, and Japanese databases will be searched up to August 2020 for relevant randomized controlled trials of various EATMs for the treatment of pediatric ISS, without language or publication status restrictions. The primary outcome will be growth-related anthropometric indicators, and acceptability, measured through drop-outs that occur during treatment for any reason. We will conduct a pairwise meta-analysis for direct comparisons if multiple studies use the same types of intervention, comparison, and outcome measure. A frequentist network meta-analysis will be performed to summarize the available direct and indirect evidence regarding various EATM options for pediatric ISS. The risk of bias for the included studies will be evaluated using the Cochrane Collaboration's risk of bias tool.

Conclusions:
The findings of this review will provide evidence for the comparative effectiveness and ranks of current EATMs and help to inform clinical practitioners, patients, and policy makers in decision making.

Ethics and dissemination:
Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentations.

Protocol registration number:
OSF (URL: https://osf.io/s4vp7), PROSPERO CRD42020187160
Clinical features of capsule endoscopy in 825 children
Authors: Wu Jie , Huang Zhiheng , Wang Yuhuan , Tang Zifei , Lai Lingyu , Xue Aijuan , Huang Ying 
Published: October 2020

Abstract
Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel.
Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases.
In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed.
Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ± 3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis.
VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.
Implementation of a clinical nursing pathway for percutaneous coronary intervention
Authors: Zhang Zhimin , Bai Jincheng , Huang Yongmei , Wang Lingling 
Published: October 2020

Abstract

Background:
Acute myocardial infarction is a very common disease in the emergency room. Emergency percutaneous coronary intervention (PCI) is the first choice to open infarct-related artery in time to regain the active blood flow of myocardial tissue. Clinical nursing pathway (CNP), namely clinical project, is an original nursing mode with good quality, outstanding efficiency, and low treatment spending, so it has attracted more and more attention. However, few studies have reported the implementation of a CNP in PCIs. The purpose of the protocol is to assess the impact of CNP on the clinical efficacy of transradial emergency PCI.

Methods:
This is a randomized controlled, single center trial which will be implemented from January 2021 to June 2021. Hundred samples diagnosed with acute myocardial infarction will be included in this study. It was authorized via the Ethics Committee of Changshan County People's Hospital (CCPH002348). Patients are assigned to the following groups: control group, given normal routine care; CNP group, treated with CNP plan. The time from door to balloon, hospitalization expenses, length of stay, postoperative complications, patients’ satisfaction with treatment are compared and analyzed. All data are collected and analyzed by Social Sciences software version 21.0 (SPSS, Inc., Chicago, IL) program.

Results:
Differences of clinical outcomes between groups (Table 1).

Conclusion:
This original evidence-based nursing model can be used as the foundation for further research.

Trial registration number:
researchregistry6030
Effect of shenfu injection on microcirculation in shock patients
Authors: Zhang Xuemei , Guo Ting , Zhang Kaichen , Guo Wenhui , An Xing , Gao Peiyang 
Published: October 2020

AbstractBackground:Shock is a major public health problem worldwide. At present, the morbidity and mortality of shock patients are relatively high. Vasomotor dysfunction is 1 of the key pathological aspects of shock. Shenfu injection has been widely used for the treatment of shock in China. Pharmacological studies have suggested that Shenfu injection can reduce peripheral circulation resistance and improve microcirculation. The purpose of this study is to evaluate the effect and safety of Shenfu injection on the microcirculation of patients with shock.Methods:This review summarizes and meta-analyzes randomized controlled trials of Shenfu injection for the treatment of shock.Searched the following electronic databases: PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data. The Cochrane risk assessment tool was used to evaluate the methodological quality of randomized controlled trials. All tests are analyzed according to the standards of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and Grading of Recommendations Assessment, Development, and Evaluation pro GDT web solution are used for data synthesis and analysis.Results:This review focuses on the effects of Shenfu injection on the microcirculation of shock patients (blood lactic acid level, arteriovenous oxygen saturation, arteriovenous carbon dioxide partial pressure difference, sublingual microcirculation), 28-day mortality, 28-day ICU hospitalization and adverse reaction rate.Conclusion:This review provides a clear basis for evaluating the impact of Shenfu injection on the microcirculation of shock patients, as well as the effectiveness and safety of the treatment.
Comparison of hemostatic agents in patients with spontaneous intracerebral hemorrhage
Authors: Li Yujian , Zheng Jun , Zhou Huiqing , Yang Xiang , Li Hao 
Published: October 2020

Abstract

Background:
Spontaneous intracerebral hemorrhage (sICH) is a serious stroke subtype. The effective therapies for patients with sICH are still unclear, and the role of hemostatic agents in sICH is still unclear. Although some studies have shown that hemostatic agents could benefit patients with sICH, different hemostatic drugs have different effects on patients with sICH, and which hemostatic drug has the best effect on the prevention of hematoma expansion and neurological deterioration in sICH patients remains unclear. To better understand the effects of hemostatic agents in patients with sICH, it is necessary to carry out a network meta-analysis to comprehensively compare the effects of different hemostatic agents.

Methods:
This protocol has been designed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. Related studies in the following databases will be searched until September 2020: PubMed, Embase, Scopus, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP and Wanfang. Randomized controlled trials and nonrandomized controlled studies comparing at least 2 different hemostatic agents in sICH patients will be included. A quality assessment will be conducted with the Cochrane Collaboration tool or the Newcastle-Ottawa Scale based on the study design. The primary outcome will be the incidence of hematoma expansion, and the secondary outcome will be the functional outcome. Pairwise and network meta-analyses will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate every agent. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.

Results:
According to disseminate through academic conferences, the results of this network meta-analysis are expected to publish in a peer-reviewed journal.

Conclusion:
This study will provide high quality evidence about effects of different hemostatic agents in patients with sICH.

Registration number:
CRD42020196039.
Association of inferior vena cava diameter ratio measured on computed tomography scans with the outcome of patients with septic shock
Authors: Kim Jee Hyeon , Kim Won Young , Oh Jaehoon , Kang Hyunggoo , Lim Tae Ho , Ko Byuk Sung 
Published: October 2020

Abstract
The collapsibility and diameter of the inferior vena cava (IVC) are known to predict the volume state in critically ill patients. However, no study has examined the prognostic value of the IVC diameter ratio measured on computed tomography (CT) in patients with septic shock. A retrospective observational study was conducted on adult septic shock patients visiting the emergency department at a university hospital in Korea. The IVC diameter ratio was calculated by dividing the maximal transverse and anteroposterior diameters. Multivariable logistic regression analysis was conducted to investigate whether the IVC diameter ratio predicted in-hospital mortality. The area under the curve (AUC) was calculated, and the sensitivity, specificity, positive predictive value, and negative predictive value with the cut-off values were computed. A total of 423 adult septic shock patients were included, and the in-hospital mortality rate was 17%. The median IVC diameter ratio in non-survivors was significantly greater than in survivors (1.56 cm vs 1.4 cm, P = .004). The IVC diameter ratio was found to be significantly associated with in-hospital mortality on multivariate logistic regression analysis after adjustment for confounding variables (odds ratio = 1.48, confidence interval: 1.097–1.998, P = 0.01). The AUC for IVC diameter ratio was 0.607. A cut-off IVC diameter ratio of ≥1.31 cm had 75% sensitivity and 42% specificity for predicting in-hospital mortality. The IVC diameter ratio measured on CT may to be helpful in predicting the prognosis of septic shock patients. However, due to its low diagnostic performance and sensitivity, further research is warranted.