bluuebunny/crossref_metadata_2025_split huggingface dataset:
A deep learning-based automated diagnostic system for classifying mammographic lesions
Authors: Yamaguchi Takeshi , Inoue Kenichi , Tsunoda Hiroko , Uematsu Takayoshi , Shinohara Norimitsu , Mukai Hirofumi 
Published: June 2020

Abstract

Background:
Screening mammography has led to reduced breast cancer-specific mortality and is recommended worldwide. However, the resultant doctors’ workload of reading mammographic scans needs to be addressed. Although computer-aided detection (CAD) systems have been developed to support readers, the findings are conflicting regarding whether traditional CAD systems improve reading performance. Rapid progress in the artificial intelligence (AI) field has led to the advent of newer CAD systems using deep learning-based algorithms which have the potential to reach human performance levels. Those systems, however, have been developed using mammography images mainly from women in western countries. Because Asian women characteristically have higher-density breasts, it is uncertain whether those AI systems can apply to Japanese women. In this study, we will construct a deep learning-based CAD system trained using mammography images from a large number of Japanese women with high quality reading.

Methods:
We will collect digital mammography images taken for screening or diagnostic purposes at multiple institutions in Japan. A total of 15,000 images, consisting of 5000 images with breast cancer and 10,000 images with benign lesions, will be collected. At least 1000 images of normal breasts will also be collected for use as reference data. With these data, we will construct a deep learning-based AI system to detect breast cancer on mammograms. The primary endpoint will be the sensitivity and specificity of the AI system with the test image set.

Discussion:
When the ability of AI reading is shown to be on a par with that of human reading, images of normal breasts or benign lesions that do not have to be read by a human can be selected by AI beforehand. Our AI might work well in Asian women who have similar breast density, size, and shape to those of Japanese women.

Trial registration:
UMIN, trial number UMIN000039009. Registered 26 December 2019, https://www.umin.ac.jp/ctr/
The role of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation
Authors: Liu Xuyang , Huang Manxiang , Ye Caisheng , Zeng Junquan , Zeng Changai , Ma Jianyong 
Published: June 2020

Abstract

Background:
Given the huge burden of atrial fibrillation (AF) and AF-related stroke in Asia, stroke prevention represents an urgent issue in this region. We herein performed a network meta-analysis to examine the role of non-vitamin K antagonist oral anticoagulants (NOACs) in Asian patients with AF.

Methods:
A systematic search of the publications was conducted in PubMed and Embase databases for eligible studies until July 2019. The odds ratios (ORs) and 95% confidence intervals (CIs) were regarded as the effect estimates. The surface under the cumulative ranking area (SUCRA) for the ranking probabilities was calculated.

Results:
A total of 17 studies were included. For comparisons of NOACs vs warfarin, dabigatran (OR = 0.77, 95% CI 0.68–0.86), rivaroxaban (OR = 0.72, 95% CI 0.65–0.81), apixaban (OR = 0.56, 95% CI 0.49–0.65), but not edoxaban reduced the risk of stroke or systemic embolism, wheres dabigatran (OR = 0.56, 95% CI 0.41–0.76), rivaroxaban (OR = 0.66, 95% CI 0.50–0.86), apixaban (OR = 0.49, 95% CI 0.36–0.66), and edoxaban (OR = 0.34, 95% CI 0.24–0.49) decreased the risk of major bleeding. In reducing the risk of stroke or systemic embolism, apixaban and rivaroxaban ranked the best and second best (SUCRA 0.2% and 31.4%, respectively), followed by dabigatran (50.2%), edoxaban (75.2%), and warfarin (93.0%). In reducing the risk of major bleeding, edoxaban, and apixaban ranked the best and second best (1.5% and 30.8%, respectively), followed by dabigatran (48.4%), rivaroxaban (69.2%), and warfarin (100%).

Conclusion:
NOACs were at least as effective as warfarin, but more safer in Asians with AF. Apixaban was superior to other NOACs for reducing stroke or systemic embolism, while edoxaban showed a better safety profile than other NOACs.
Guipi decoction for insomnia
Authors: Li Mao , Lan Rui , Wen Yong , Shi Kejin , Yang Dongdong 
Published: June 2020

Abstract

Background:
Insomnia is a common sleep disorder with symptoms including difficulty falling asleep and early awakening. Guipi decoction is widely used in clinical treatment of insomnia in China. However, there is a lack of systematic evaluation and analysis of Guipi decoction. Therefore, our study will provide efficacy assessments and adverse events assessments.

Methods:
A comprehensive search for randomized controlled trials of Gupi decoction treatments for insomnia will be carried in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trial (CENTRAL), CINAHL, AMED and Chinese databases include CBM, CNKI, CQVIP, and Wanfang from their inceptions to May 2020. Relevant reference lists, Baidu Scholar and grey literature will also be checked. Two experienced reviewers will independently search all databases. Primary outcomes include Pittsburgh sleep quality index and clinical effective rate, and secondary outcomes include traditional Chinese medicine syndrome, adverse events, and Epworth Sleepiness Scale. Review Manager 5.3 software will be used analyze all data.

Results:
This article will be dedicated to assessing the efficacy and safety of Guipi decoction for insomnia.

Conclusion:
The conclusion of this systematic review will provide evidence to judge whether Guipi Decoction is an effective therapeutic intervention for patient with insomnia. Maybe these results could potentially be helpful for improving the therapeutic strategy of patients with insomnia.

PROSPERO registration number:
CRD 42020164911.
Nucleoside analogs assisted with Chinese compound prescription in treating hepatic fibrosis of chronic hepatitis B patients
Authors: Cheng Maoyuan , Feng Xianrong , Wang Long , Yang Yu , Ma Li , Wang Baojia 
Published: June 2020

Abstract

Background:
Chronic hepatitis B is often complicated with different degrees of hepatic fibrosis, which affects the quality of life. Nucleoside analogs are recommended by almost all guidelines in the world for the treatment of chronic hepatitis B. At present, there is no specific and effective chemical and biological agents for hepatic fibrosis. In China, Chinese compound prescription combined with nucleoside analogs have been used to treat hepatic fibrosis of chronic hepatitis B patients in more and more cases, and good results have been achieved. Several Chinese compound prescriptions that have been made into proprietary Chinese medicine for the convenience of use. This article aims to systematically evaluate the efficacy and safety of Chinese medicine compounds assisting nucleoside analogs in the treatment of hepatic fibrosis in chronic hepatitis B patients.

Method:
The following databases will be searched from their inception to September 2019: PubMed, EMBASE, EBSCOhost, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), VIP Database, Wanfang Database. Languages are limited to Chinese and English. The study includes randomized controlled trials using Chinese compound prescription combined with entecavir and Chinese compound prescription combined with tenofovir disoproxil fumarate to treat hepatic fibrosis of chronic hepatitis B patients. The primary outcomes including effective rate and biochemical parameters (levels of hyaluronic acid, laminin, pre-type-III collagen and type IV collagen will be tested. Additional outcomes include liver function indexes (levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin) and levels of hepatitis B virus DNA. Stata14.0 software will be used for meta-analysis.

Result:
The efficacy and safety of Chinese compound prescriptions assisting nucleoside analogs for hepatic fibrosis of chronic hepatitis B patients will be assessed from the effective rate, biochemical parameters, liver function indexes, and levels of hepatitis B virus DNA.

Conclusion:
The conclusion of this study will be used to evaluate the efficacy and safety of Chinese compound prescriptions assisting nucleoside analogs in the treatment of hepatic fibrosis of chronic hepatitis B patients, as well as the adjuvant effectiveness of Chinese compound prescriptions in combined therapy.

PROSPERO registration number:
CRD42020156859.
Distal third femoral shaft fractures in school-aged children
Authors: Li Jin , Rai Saroj , Ze Renhao , Tang Xin , Liu Ruikang , Hong Pan 
Published: June 2020

Abstract
Internal fixation such as elastic stable intramedullary(ESIN) nail and submuscular plate (SMP) is gaining popularity for femoral shaft fractures in school-aged children. However, external fixation (ExFix) might be a valuable option for the distal third femoral shaft fractures, where the fracture heals rapidly, but it is crucial to avoid angular malunion. This study aims to compare the clinical outcomes, postoperative complications of distal third femoral shaft fractures in school-aged children treated by ESIN versus ExFix.
Patients aged 5 to 11 years with distal third femoral shaft fractures treated at our institute from January 2014 to January 2016 were included and categorized into ESIN (n = 33) and ExFix (n = 38) group. The preoperative data, including baseline information of the patients, radiographic parameters, and type of surgical procedure, were collected from the hospital database, and postoperative data, including complications, were collected during the follow-up visit.
In all, 33 patients (average, 8.0 ± 2.1 years, male 20, female 13) in the ESIN group and 38 patients (average, 8.3 ± 2.3 years, male 23, female 15) in the ExFix group were included in this study. There was significantly less operative time for the ExFix group (45.4 ± 7.8 min) as compared to the ESIN group (57.8 ± 11.3 min) (P < .01), reduced estimated blood loss (EBL) in the ExFix group (9.9 ± 3.5) as compared to the ESIN group (16.4 ± 6.5) (P < .01). As for the frequency of fluoroscopy, there was a significant difference between the ExFix group (13.9 ± 2.4) and the ESIN group (15.5 ± 3.2) (P = .02). The rate of major complications was not significantly different between the 2 groups (P = .19). The rate of implant irritation was significantly higher in the ExFix group (28/38, 73.7%) than the ESIN group (12/33, 36.4%) (P < .01). The rate of surgical site infection (SSI) is significantly higher in the ExFix group (18/38, 47.4%)) than the ESIN group (1/33, 3%) (P < .01). The rate of scar concern was significantly higher in the ExFix (9/38, 23.7%) than the ESIN (2/33, 6.1%), (P = .04). According to the Flynn scoring system, 30(90.9%) patients in the ESIN group and 24(89.5%) patients in the ExFix group were rated as excellent. None of the patients had poor outcomes.
Both ESIN and ExFix produced satisfactory outcomes in distal third femoral shaft fractures. ExFix remains a viable choice for selected cases, especially in resource-challenged and austere settings.
Prevalence of food allergen and aeroallergen sensitization among children in Sichuan province
Authors: Liu Ting , Lai Shu-yu , Li Wen-sheng , Jiang Yong-mei 
Published: June 2020

Abstract
Food allergen and aeroallergen sensitization are common allergic diseases worldwide, with widely varying estimates of prevalence in children. Our study investigated the characteristics of ingestion and inhalation allergy among children from Sichuan province in Southwest China, so as to get public awareness of these disorders.
A total of 1722 children between 0 and 14 years’ old were enrolled in this study. They were outpatients in the West China Second University Hospital during June 2019 to September 2019. Serum specific IgE specific to 10 types of food allergen and 10 types of aeroallergen were estimated. Nutrition indicators were tested by electrochemical luminescence.
59.70% children were allergic to at least 1 allergen, comprising 24.90% to aeroallergen and 38.81% to food allergen, respectively, whereas 36.28% children were allergic to both aeroallergen and food allergen. Milk was the most common food allergen, and egg came in second place. With regard to aeroallergen, house dust mite held the maximum proportion (65.02%), whereas dust mite followed behind. Inhalation allergy was more commonly seen in boys than girls. Bronchitis was the most common symptom of both allergies. In addition, the highest incidence age for children to be sensitive to food allergen and aeroallergen were 0∼2 years’ old and 3∼5 years’ old, respectively. It is worth mentioning that there was no significant difference in nutritional status between children with or without allergic diseases.
Our findings reveal that milk, egg, house dust mite, and dust mite are the most common allergens among children in Sichuan province. Boys are more susceptible to aeroallergen than girls. Furthermore, the prevalence of ingestion and inhalation allergy varies from different age groups, and has no correlation with nutritional status. In brief, the analysis of the pattern of food allergen and aeroallergen sensitization is invaluable to effective diagnosis and treatment of allergic diseases.
Low-dose CT combined mammography in diagnosis of overflow breast disease
Authors: Tian Hao , Hu Shao-jun , Tang Qun , Ma Fei-hong , Yao Rong-rong 
Published: June 2020

Abstract

Background:
Overflow breast disease (OBD), also known as breast nipple discharge, refers fluid or liquid that comes out of nipple. Many patients with breast cancer experience such condition. However, it is not easy to detect it at early stage, especially for pathological OBD. Previous study found low-dose CT combined mammography (LDCTMG) could help in diagnosis of OBD. However, there is no systematic review investigating this issue. Therefore, this study will examine the accuracy of LDCTMG in diagnosis of OBD.

Methods:
This study protocol will search literature sources in electronic databases and other sources. The electronic databases will be retrieved in The Cochrane Library, the Cochrane Register of Diagnostic Test Accuracy Studies, PUBMED, EMBASE, Web of Science, CINAHL, CNKI, and WANGFANG from inception to the present. We will also search other sources. All literature sources will be sought without restrictions to the language and publication status. Two researchers will independently carry out study selection, data extraction, and study quality assessment. Statistical analysis will be performed using RevMan 5.3.

Results:
This study will exert a high-quality synthesis of eligible studies on the analysis of LDCTMG in diagnosis of OBD.

Conclusions:
The results of this study may provide evidence to help judge whether LDCTMG is accurate in diagnosis of OBD.

Study registration:
INPLASY202050116.
Association between arginine catabolism and major depressive disorder
Authors: Cao Bing , Deng Runze , Wang Dongfang , Li Li , Ren Zhongyu , Xu Lixin , Gao Xiao 
Published: June 2020

Abstract

Background:
Alterations in the levels of arginine and its related catabolic products (ie, ornithine, citrulline, and argininosuccinate) in the urea and nitric oxide cycles were reported to play roles in the pathogenesis of major depressive disorder (MDD). The aim of this meta-analysis study is to explore the associations between arginine with its related catabolic products and MDD, and to discuss the possible role of arginine catabolism in the pathoetiology of MDD.

Methods:
This study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The English language literature published in the databases of PubMed, EMBASE, PsycINFO and Web of Science will be systematically searched. Forest plots will be used to estimate the associations between arginine and its related catabolic products with MDD. Subgroup analysis and meta-regression will also be performed to investigate the source of the potential heterogeneity. Sensitivity analysis will be performed to strengthen the results and to investigate whether any single study would have a significant effect on the results of meta-analysis. Publication bias will be tested for using the funnel plot with Begg test and Egger test. The Newcastle-Ottawa Scale will be applied to assess the risk of bias of observational studies.

Results:
An integrated assessment of arginine with its related catabolic products may contribute to predict the risk of MDD.

Ethics and dissemination:
The results of associations between arginine with its related catabolic products and MDD will be reported in a peer-reviewed publication. With our findings from this meta-analysis, we hope to provide the most up-to-date evidence for the contributions of arginine and related catabolic products to predict the risk of MDD.

Systematic review registration:
The protocol of current meta-analysis has been registered at the Open Science Framework [Available at: https://doi.org/10.17605/osf.io/7fn59].
Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial
Authors: Liu Jintao , Zhu Yu , Wang Zhiqiang , Yu Pengfei , Xue Chunchun , Jiang Hong , Li Xiaofeng , Tang Dezhi 
Published: June 2020

Abstract
Lumbar disc herniation (LDH) is a common, disabling musculoskeletal disorder. Magnetic resonance imaging has clarified the natural history of lumbar disc lesions and has documented that disc lesions can become smaller and can even be completely resorbed. Previous studies have confirmed that some traditional Chinese medicine (TCM) therapies can promote resorption of the protrusion. However, high-quality research evidence is needed to support the effectiveness of the protocol.

Objective:
This clinical trial aims to establish whether TCM can promote the resorption of LDH and to assess the efficacy of such therapy for LDH, thereby evaluating its clinical effect.

Methods:
The present study design is for a single-center, 2-arm, open-label randomized controlled trial. A total of 150 eligible LDH patients will be randomly assigned to either a TCM treatment group or a control group in a 1:1 ratio. Patients in the TCM group will be administered a TCM decoction for 4 weeks. Patients in the conventional drug control group will be instructed to take a specific daily dose of celecoxib. The primary outcome measure is the change from baseline in the volume of the protrusion, as assessed using MR images. Secondary outcome measures include visual analog scale pain scores and Japanese Orthopaedic Association scores assessed at 3 and 6 months.

Discussion:
The design and methodological rigor of this trial will allow evaluation of the basic clinical efficacy and safety data for TCM in the treatment of patients with LDH. The trial will also assess whether TCM can promote the resorption of LDH. This research will therefore help provide a solid foundation for the clinical treatment of LDH and for future research in TCM therapy.

Trial registration:
ChiCTR1900022377.
The analgesic efficiency of pregabalin for the treatment of postoperative pain in total hip arthroplasty
Authors: Zhang Yuangui , Wang Xiaoqian , Dong Guimin 
Published: June 2020

Abstract

Background:
Only few studies have yet investigated whether perioperative administration of pregabalin can reduce the incidence of postoperative chronic neuropathic pain after total hip arthroplasty (THA). This prospective, randomized study compared placebo with pregabalin in the hope that a lower pregabalin dose would improve analgesia without increasing side-effects after THA.

Methods:
This study was a prospective randomized blinded study, with a parallel design and an allocation ratio of 1:1 for the treatment groups. The study was approved by the Institutional Review Board in Weifang People's Hospital and written informed consent was obtained from all subjects before enrolment. A total of 120 patients who meet inclusion criteria are randomized to either pregabalin or placebo group. The primary objective of the study was visual analog scale score. As secondary outcomes, opioid consumption measurement, Harris Hip Score, hip range of motion, patient satisfaction, and complications were made at different time points throughout the study for comparison.

Results:
The null hypothesis of this study was that pregabalin would reduce pain after THA.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5669).
Rapid induction of clinical remission in SAPHO syndrome using high-dose Tripterygium glycosides
Authors: Gong Liang , Wang Lun , Cao Yihan , Li Chen 
Published: June 2020

Abstract

Rationale:
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare disease without standard treatments. Tripterygium wilfordii hook f (TwHF) is a traditional Chinese herb with anti-inflammatory effect, and 1.0 mg/(kg·d) dose of Tripterygium glycosides has been reported to significantly improve the disease activity of a SAPHO patient in a case report. However, the optimal dose of TwHF is still unclear. Here, we report the first case of SAPHO patient who achieved rapid remission in clinical symptoms after receiving 1.5 mg/(kg·d) dose of Tripterygium glycosides treatment.

Patient concerns:
A 67-year-old woman noted palmoplantar pustulosis and pain in the anterior chest wall and waist. Bone scintigraphy demonstrated the typical tracer accumulation feature and magnetic resonance images showed bone marrow edema in lumbosacral vertebra.

Diagnoses:
The diagnosis was made by dermatological and osteoarticular manifestations and classical signs in bone scintigraphy in accordance with the diagnostic criteria proposed in 2012.

Interventions:
Tripterygium glycosides was given with a primary dose of 1.5 mg/(kg·d) for 1 month and then reduced at a rate of 10 mg every 2 weeks until 1.0 mg/(kg·d) for a long-term maintenance.

Outcomes:
Fast-induced remission on clinical manifestations was achieved and magnetic resonance imaging abnormality was improved significantly. Additionally, no apparent side effects were observed.

Lessons:
1.5 mg/(kg·d) dose of Tripterygium glycosides seems to have fast-induced remission than 1.0 mg/(kg·d) with reliable safety. Besides, Tripterygium glycosides may also have a pharmacological effect of inhibiting osteolysis and enhancing bone strength.