bluuebunny/crossref_metadata_2025_split huggingface dataset:
Triple metachronous primary cancer of uterus, colon, and breast cancer
Authors: Li Guanqiao , Yao Jia , Wu Tangna , Chen Yaxiong , Wang Zhenping , Wang Yiming , Wang Fen , Zhong Rui , Yang Shiping 
Published: August 2020

Abstract

Rationale:
Triple or more primary malignancies are rare, with only 23 previous cases including breast cancer reported in the English language studies between January 1990 and December 2019.

Patient concerns:
The patient was a 67-year-old woman with a mass in her right breast. She had a previous history of uterine and colon cancer. Both ultrasonography and mammography revealed a Breast Imaging Reporting and Data System (BI-RADS) category 3 breast lesion, in which proliferative nodules are more likely. Given her previous history of 2 malignancies, her doctors strongly recommended a biopsy.

Diagnosis and interventions:
The biopsy pathology suggested intraductal breast cancer. Mastectomy and sentinel lymph node biopsy were performed. The postoperative pathological diagnosis was invasive ductal carcinoma, grade II, stage I. The sample was positive for estrogen receptor and progesterone receptor and negative for cerbB-2. No radiotherapy or chemotherapy was administered except for endocrine therapy. A follow-up at 19 months showed no breast recurrence or distant metastases.

Outcomes:
No recurrence or distant metastasis occurred within the 19-month, 11-year, and 20-year follow-ups for breast, colon, and uterine cancers, respectively.

Lessons:
To our knowledge, this is the first review of triple or more primary malignancies including breast cancer. These malignancies occur predominantly in older female patients. The most prevalent tumors of triple or more primary malignancies including breast cancer occur in the colon, uterus, and lung. A favorable prognosis is associated with early-stage malignancies.
Effectiveness and safety of adjunctive traditional Chinese medicine therapy for constipation after cancer chemotherapy
Authors: Dai Qianxiang , Yan Hang , Wu Xiaoping , Liu Yuan , Huang Fei , Dong Xing 
Published: August 2020

Abstract

Background:
As an alternative for constipation after cancer chemotherapy, Chinese medicine has gradually attracted the attention of clinicians based on the theory of syndrome differentiation and treatment. However, due to the lack of evidence-based medical evidence, the author designed the program to evaluate the effectiveness and safety of Chinese medicine.

Methods:
From the beginning to August 2020, 8 electronic databases will be searched. Two of our researchers will independently conduct research selection, data extraction, and risk assessment of bias. We will use Review Manager 5.3 software for meta-analysis and heterogeneity assessment. In addition, we will use the grading of recommendations assessment, development, and evaluation to evaluate the evidence quality.

Results:
This study will demonstrate an evidence-based review of traditional Chinese medicine (TCM) for constipation after cancer chemotherapy.

Conclusion:
The study will provide clear evidence to assess the effectiveness and side effects of TCM for constipation after cancer chemotherapy.

Trial registration number:
INPLASY202070027
Clinical importance of respiratory muscle fatigue in patients with cardiovascular disease
Authors: Taya Masanobu , Amiya Eisuke , Hatano Masaru , Saito Akihito , Nitta Daisuke , Maki Hisataka , Hosoya Yumiko , Minatsuki Shun , Tsuji Masaki , Sato Tatsuyuki , Murakami Haruka , Narita Koichi , Konishi Yuto , Watanabe Shogo , Yokota Kazuhiko , Haga Nobuhiko , Komuro Issei 
Published: August 2020

Abstract
Patients with cardiovascular diseases frequently experience exertional dyspnea. However, the relationship between respiratory muscle strength including its fatigue and cardiovascular dysfunctions remains to be clarified.
The maximal inspiratory pressure/maximal expiratory pressure (MIP/MEP) before and after cardiopulmonary exercise testing (CPX) in 44 patients with heart failure and ischemic heart disease were measured. Respiratory muscle fatigue was evaluated by calculating MIP (MIPpost/MIPpre) and MEP (MEPpost/MEPpre) changes.
The mean MIPpre and MEPpre values were 67.5 ± 29.0 and 61.6 ± 23.8 cm H2O, respectively. After CPX, MIP decreased in 25 patients, and MEP decreased in 22 patients. We evaluated the correlation relationship between respiratory muscle function including respiratory muscle fatigue and exercise capacity evaluated by CPX such as peak VO2 and VE/VCO2 slope. Among MIP, MEP, change in MIP, and change in MEP, only the value of change in MIP had an association with the value of VE/VCO2 slope (R = −0.36, P = .017). In addition, multivariate analysis for determining factor of change in MIP revealed that the association between the change in MIP and eGFR was independent from other confounding parameters (beta, 0.40, P = .017). The patients were divided into 2 groups, with (MIP change < 0.9) and without respiratory muscle fatigue (MIP change > 0.9), and a significant difference in peak VO2 (14.2 ± 3.4 [with fatigue] vs 17.4 ± 4.7 [without fatigue] mL/kg/min; P = .020) was observed between the groups.
Respiratory muscle fatigue demonstrated by the change of MIP before and after CPX significantly correlated with exercise capacity and renal function in patients with cardiovascular disease.
Efficacy and safety of Huaier granules combined with chemotherapy for gastric cancer
Authors: Hou Daorui , Xiong Jian , Yang Liangjun , Xiong Lu 
Published: August 2020

AbstractBackground:Huaier granules, the aqueous product of Huaier (Trametes robiniophila Murr.) extract, are a broad-spectrum anti-tumor drug and have been widely used for the treatment of gastric cancer (GC). The aim of this study is to systematically investigate the efficacy and safety of Huaier granules combined with chemotherapy in the treatment of GC.Methods:Three English databases and four Chinese databases will be searched from its inception to July 2020. Two methodological trained researchers will select the qualified studies for data extraction independently. Cochrane Risk of Bias tool will be used to assess the risk of bias of included studies. The RevMan 5.2 and stata 14.0 software will be applied for statistical analyses. Statistical heterogeneity will be computed by CochraneX2andI2tests. Sensitivity analysis will be conducted to evaluate the stability of the results. The publication bias will be evaluated by funnel plots and Egger's test. The quality of evidence will be assessed by the GRADE system.Results:The results of our research will be published in a peer-reviewed journal.Conclusion:The conclusion of our systematic review will provide evidence to judge whether Huaier granules combined with chemotherapy is an effective intervention for patient with GC.OSF registration number:10.17605/OSF.IO/9BVJD.
Efficacy and safety evaluation of acupoint embedding for patients with ulcerative colitis
Authors: Lu Jinhua , Zhou Jun , Wang Lu , Zhong Chun , Chen Xu , Jia Bo 
Published: August 2020

AbstractBackground:Ulcerative colitis is a recurring digestive disease characterized by inflammation in the intestinal tract, which seriously affects the life of the patient. In recent years, it has played a role in obesity, osteoporosis, and gastrointestinal disorders, and has received more and more attention. However, there are no clear conclusions about its effectiveness and safety in the treatment of UC.Method and analysis:This systematic review will collect 7 databases, including Web of science, Pubmed, Embase, VIP, Wanfang, CNKI, and the Chinese Biomedical Literature Database (CBM), to collect all eligible RCTs from database inception to December 31, 2019. The 2 researchers will rigorously follow the selection process, including study screening, data extraction, and quality assessment. The primary outcome is clinical effectiveness. The main software used in this study is Review Manager V5.3 software.Result:This study will provide a meaningful and comprehensive evaluation on the effectiveness and safety of acupoints embedding for UC.Conclusion:This meta-analysis was designed to provide clinicians with valid evidence regarding acupoint embedding for UC.INPLASY registration number:INPLASY202040166.
Effect and safety of intravenous versus oral acetaminophen after unicompartmental knee replacement
Authors: Li Xiaoming , Guo Donghui , Wang Hengjun , Zhou Tingting 
Published: August 2020

Abstract

Background:
Due to the soft tissue injury and large amount of bone destruction involved, undesirable postoperative pain remains a challenge for both patients and surgeons after unicompartmental knee replacement (UKR). However, there are no studies comparing the effectiveness of oral and intravenous acetaminophen as part of a standard multimodal perioperative pain regimen after UKR. Thus, this prospective randomized study was conducted to compare pain control outcomes with postoperative oral versus intravenous acetaminophen use in adults undergoing UKR.

Methods:
The institutional review board of the Traditional Chinese Medicine- western Medicine Hospital of Cangzhou approved the study protocol. This blinded and randomized study was carried out in accordance with the principles of the Helsinki Declaration. We included patients who were scheduled for UKR with an American Society of Anesthesiologists status of I to III, who were mentally competent, and who were able to give consent for enrolment in the study. Patients were randomly assigned on a 1:1 basis to receive either intravenous acetaminophen or oral acetaminophen. We ensured that the patients, care providers, and outcome assessors were blinded to the group assignment during the study period. Primary outcomes were postoperative pain at rest and during motion (knee flexion of 45°) measured using a visual analog scale score. Secondary outcomes included morphine consumption at 24, 48, and 72 hours after surgery, length of hospital stay, range of motion, daily ambulation distance, and adverse events occurrence. All statistical analyses were performed using SPSS 25.0. Differences associated with a P value of <.05 were considered statistically significant.

Results:
It was hypothesized that patients receiving intravenous acetaminophen would exhibit similar postoperative outcomes compared with patients receiving oral acetaminophen.

Trial registration:
This study was registered in Research Registry (researchregistry5825).
Effects of herb-partitioned moxibustion for diarrhoea-predominant irritable bowel syndrome
Authors: Wang Fen , He Shuxing , Yan Jian , Mai Lianren , Yang Liangjun 
Published: August 2020

Abstract

Background:
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common functional intestinal disease characterized by abdominal pain and diarrhea. Herb-partitioned moxibustion (HPM), a characteristic external therapy, is effective in treating IBS-D. However, no systematic review has been carried out to assess the efficacy and safety of HPM for IBS-D. The aim of this study will systematically evaluate the efficacy and safety of HPM for the treatment of patients with IBS-D.

Methods:
We will perform the comprehensive literature search in both English and Chinese electronic database including PubMed, Embase, Cochrane Library, Web of Science database, Medline, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, Wanfang database, Chongqing VIP information, and SinoMed from their inception to July 2020. All randomized controlled trials of HPM for the treatment of IBS-D will be included. RevManV5. 3 will be applied to analyze the data.

Results:
This study will provide high-quality synthesis of current evidence of effectiveness and safety on HPM for patients with IBS-D.

Conclusion:
The conclusion of our systematic review will provide evidence to judge whether HPM is an effective intervention for IBS-D.

Trial registration number:
10.17605/OSF.IO/3JXCZ.
Delayed emergence from propofol anesthesia in a patient with Lesch-Nyhan syndrome
Authors: Lee Jungwon , Jung Sung Mee , Jeon Sungmin 
Published: August 2020

Abstract

Rationale:
Lesch-Nyhan syndrome (LNS) is an X-linked recessive disorder presenting with uric acid overproduction, neurocognitive disability, and behavioral disturbances. Inhalational anesthesia has been frequently used in LNS patients undergoing surgery. Characteristic compulsive self-injurious behavior and high risk of emesis may hinder inhalational induction. Propofol may be beneficial for these patients because of its easy and rapid titration for anesthetic depth during induction, early recovery from anesthesia, and antiemetic effect as well as uricosuric effect.

Patient concerns:
A 16-year-old male adolescent was scheduled for percutaneous nephrolithotomy. He exhibited poorly controlled muscle, self-injurious behaviors and intellectual disability.

Diagnosis:
The patient presented with neurodevelopmental delay in the first year of life, and was diagnosed with LNS, with a substitution of phenylalanine to leucine in hypoxanthine-guanine phosphoribosyltransferase (HPRT) 1 gene on the X-chromosome at 3 years of age.

Interventions:
Total intravenous anesthesia was used for induction and maintenance of anesthesia with propofol and remifentanil using target-controlled infusion.

Outcomes:
Time to recovery of consciousness was prolonged after uneventful surgery. Serum uric acid levels gradually increased during postoperative period.

Lessons:
Propofol anesthesia using target-controlled infusion does not provide significant clinical advantages in rapid emergence from anesthesia and management of hyperuricemia in LNS patients undergoing urological surgery.
Acupuncture for the treatment of marrow suppression after chemotherapy
Authors: Geng Guoyan , Yin Zihan , Sun Mingsheng , Xu Guixing , Chen Jiao , Liang Fanrong , Zhao Ling 
Published: August 2020

Abstract

Background:
Cancer continues to be a severe global health problem and the leading cause of death worldwide. Chemotherapy as the main treatment has various side effects, of which marrow suppression is the most common one. Acupuncture had shown clinical effects for marrow suppression after chemotherapy in many studies. However, the efficacy and safety of acupuncture therapy for marrow suppression after chemotherapy remains unclear.

Objective:
This protocol aims to evaluate the efficacy and safety of acupuncture for marrow suppression after chemotherapy according to the existing randomized controlled trials.

Methods and analysis:
The randomized controlled trials on acupuncture therapy for marrow suppression after chemotherapy will be searched in the database of Embase, PubMed and Cochrane Library, Allied and Complementary Medicine Database (AMED), Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and related registration platforms (WHO ICTRP, Clinical Trials, and Chinese Clinical Trial Register [ChiCTR]), Grey Literature Database from inception to 1 August 2020. The primary outcomes will be assessed using white blood cell (WBC) count, platelet count, hemoglobin count and the number of neutrophils (N). Review Manager V.5.3 software will be applied for statistical analyses. We will measure the risk of bias of the included studies with Cochrane Collaboration Risk of Bias Tool. Finally, Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) will be used to grade the overall quality of evidence. And we will use the intra-group correlation coefficient to assess the consistency of reviewers.

Result:
This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of acupuncture treatment in marrow suppression after chemotherapy.

Conclusion:
The conclusion of this systematic review will provide evidence to assess acupuncture therapy is an efficacy and safe intervention to treat and control marrow suppression after chemotherapy.

PROSPERO registration number:
PROSPERO CRD42020163336
Effect of enhancer of zeste homolog 2 mutations on the prognosis of patients with myelodysplastic syndrome
Authors: Huang Xinyue , Wang Xiaoxue 
Published: August 2020

Abstract

Background:
Gene mutations with important prognostic roles have been identified in patients with myelodysplastic syndrome (MDS). Overall, it is not yet fully clear whether enhancer of zeste homolog 2 (EZH2) is affected and contributes to the disease in MDS patients. Thus, we performed a meta-analysis to investigate the effects of EZH2 mutations on the prognosis of patients with MDS.

Methods:
We searched English-language databases (PubMed, Embase, and Cochrane Library) for studies published on the effects of EZH2 mutations in MDS patients. The study had to include at least 1 of the following indices as therapeutic evaluation data: overall survival (OS), transformation time to leukemia, and International Prognostic Scoring System risk. Revman, version 5.2 software was used for all statistical processing. We calculated the risk ratio and the 95% confidence interval (CI) of continuous variables, and determined the hazard ratio and 95% CI of time-to-event data.

Results:
We included 5 studies with a total enrolment of 994 patients. There was a significant adverse effect on OS in the EZH2-mutation group compared to the unmutated group (hazard ratio = 2.47, 95% CI: 1.37–4.47, P < .00001), while the heterogeneity was relatively high (I
2 = 68%). There was no significant correlation between EZH2 mutations and IPSS risk (low/int-1 vs int-2/high) (odds ratio: 0.69, 95% CI: 0.14–3.39, P = .65), with significant heterogeneity (I
2 = 78%). The analysis did not show significant publication bias in the studies.

Conclusion:
This meta-analysis indicated an adverse effect of EZH2 mutations with regard to OS in patients with MDS. However, larger cohort trials are still needed to better understand the prognostic impacts of EZH2 mutations on MDS patients.
Klatskin tumor diagnosed concurrently with IgG4 related sclerosing cholangitis
Authors: Hwang Ha Won , Park Jin-Seok , Jeong Seok , Lee Don Haeng , Choi Suk Jin 
Published: August 2020

Abstract

Rationale:
IgG4-related disease (IgG4-RD) is a systemic disease that can involve various organs and is characterized by the infiltrations of IgG4-positive plasma cells and lymphocytes, fibrosis, and elevated serum IgG4 levels. IgG4-related sclerosing cholangitis (IgG4-RSC) is a subtype of IgG4-RD. No certain relationship between IgG4-RSC and cholangiocarcinoma has been established as yet, and there have been few reports of the simultaneous diagnosis of IgG4-RSC and cholangiocarcinoma.

Patient concerns:
A 76-year-old male visited our gastroenterology department due to the recent occurrence of pruritus and jaundice.

Diagnosis:
Computed tomography (CT) scan showed ductal wall swelling and enhancement from both intrahepatic duct confluence to the common bile duct, upper biliary dilatation, and accompanying autoimmune pancreatitis (a sub type of IgG4-RD). Biopsy of the distal common bile duct by endoscopic retrograde cholangiopancreatography (ERCP) resulted in a diagnosis of IgG4-RSC. Subsequently, adenocarcinoma was identified by repeated cytology of bile juice. Finally, Klatskin tumor type IIIA and IgG4-RSC were concurrently diagnosed.

Interventions:
IgG4-RSC was treated with steroid and Klatskin tumors by gemcitabine + cisplatin chemotherapy.

Outcomes:
The jaundice had improved and CT showed substantial improvement of the intrahepatic duct dilatation.

Lessons:
IgG4-RSC and cholangiocarcinoma are easily confused, but their treatments are quite different, and thus, care must be taken during diagnosis. Furthermore, these 2 diseases may co-exist. Therefore, even if IgG4-RSC is diagnosed first, the possibility of accompanying cholangiocarcinoma should be thoroughly investigated.
The AdS
5
× S
5
superstring
Authors: Schwarz John H. 
Published: August 2020

The duality between the type IIB superstring theory in an AdS
5
× S
5
background with
N
units of five-form flux and

N

=
4

super Yang–Mills theory with a
U
(
N
) gauge group has been studied extensively. My version of the construction of the superstring world-sheet action is reviewed here.
Precision Breast Cancer Screening with a Polygenic Risk Score
Authors: Tasa Tõnis , Puustusmaa Mikk , Tõnisson Neeme , Kolk Berit , Padrik Peeter 
Published: August 2020

AbstractBreast cancer (BC) is the leading cause of cancer deaths in women in the world. Genome-wide association studies have identified numerous genetic variants (SNPs) independently associated with BC. The effects of such SNPs can be combined into a single polygenic risk score (PRS). Stratification of women according to PRS could be introduced to primary and secondary prevention. Our aim was to revalidate a PRS model and to develop a pipeline for individualizing breast cancer screening.Previously published PRS models for predicting the risk of breast cancer were collected from the literature. Models were validated on the Estonian Biobank (EGC) dataset consisting of 32,548 quality-controlled genotypes with 315 prevalent and 365 incident BC cases and on 249,062 samples in the UK Biobank dataset consisting of 8637 prevalent and 6825 incident cases. The best performing model was selected based on the AUC in prevalent data and independently validated in both incident datasets. Using Estonian BC background information, we performed absolute risk simulations and developed individual risk-based recommendations for prevention.The best-performing PRS included 2803 SNPs. The C-index of the Cox regression model associating BC status with PRS was 0.656 (SE = 0.05) with a hazard ratio of 1.66 (95% confidence interval 1.5 - 1.84) on the incident EGC dataset. The PRS is able to stratify individuals with more than a 3-fold risk increase. The observed 10-year risks of individuals in the 99th percentile exceeded the 1st percentile more than 10-fold.PRS is a powerful predictor of breast cancer risk. Currently, PRS scores are not implemented in routine BC screening. We have developed PRS-based recommendations for personalized primary and secondary prevention and our approach is easily adaptable to other nationalities by using population-specific background data of other genetically similar populations.