bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smartphone and medical application use among dentists in China
Authors: Zhang Chao , Fan Lin , Chai Zhaowu , Yu Cong , Song Jinlin 
Published: August 2020

Abstract
Background: With the development of information technology, more and more healthcare professionals are using smartphones and mobile medical applications (apps) in their clinical practice. The objective of this study was to survey the use of smartphone based medical apps among dentists in China and their perceptions on such apps.Methods: All data were collected using anonymous questionnaires. The questionnaires for this cross-sectional study were randomly sent to dentists by email, and 379 dentists completed the questionnaires. Dentists’ demographics and their perceptions on Wechat, QQ (the most popular social media apps in China) and other medical apps were assessed, including questions on the purpose, frequency, daily use, and opinion of these apps they used. Questions were answered using a Likert scale (1 = strongly agree, 2 = agree, 3 = not sure, 4 = disagree, and 5 = strongly disagree).Results:A total of 379 valid responses were received with a median age of 33.6 years old (63.3% female). All subjects (100%) owned a smartphone, and all of them installed and used WeChat or QQ in their clinical practice. Only 76% subjects installed medical apps (except Wechat and QQ) on their smartphones. Male dentists would like to install medical apps than female dentists (p < 0.05). With the increasing of age, the percentage of dentists to install medical apps was decreasing ( p < 0.001). The frequency and daily use of WeChat or QQ were more often than medical apps. Medical apps were positively perceived, with dentists reporting to recommend these medical apps to other peers (Likert score: 1.67 ± 0.68).Conclusion: Medical apps were perceived to provide positive impact on clinical practice, education and patient care in dentistry by providing relevant medical information. But there will be still much room for improvement in the future.
High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study
Authors: Lee Junhaeng , Oh Joo Suk , Zuh Jong Ho , Hong Sungyoup , Park Sang Hyun , Kim Ji Hoon , Kim Hyungsoo , Seo Mingu , Kim Kiwook , Lee Doo Hyo , Jung Hyun Ho , Park Jungtaek , Oh Young Min , Choi Semini , Choi Kyoung Ho 
Published: August 2020

Abstract
Background: To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature management (TTM).Methods: This single-center retrospective cohort study included adult OHCA survivors who underwent hypothermic TTM from December 2011 to December 2019. High HbA1c at admission was defined as a level higher than 6%. Poor neurological outcomes were defined as cerebral performance category scores of 3-5. The primary outcome was 6-month mortality. The secondary outcome was the 6-month neurological outcome. Descriptive statistics, log-rank tests, and multivariable regression modeling were used for data analysis.Results: Of the 302 patients included in the final analysis, 102 patients (33.8%) had HbA1c levels higher than 6%. The high HbA1c group had significantly worse 6-month survival (12.7% vs. 37.5%, p < 0.001) and 6-month outcomes (89.2% vs. 73.0%, p = 0.001) than the non-high HbA1c group. Kaplan-Meier analysis and the log-rank test showed that the survival time was significantly shorter in the patients with HbA1c >6% than in those with HbA1c ≤6%. In the multivariable logistic regression analysis, HbA1c >6% was independently associated with 6-month mortality (OR 5.85, 95% CI 2.26-15.12, p < 0.001) and poor outcomes (OR 4.18, 95% CI 1.41-12.40, p < 0.001).Conclusions: This study showed that HbA1c higher than 6% at admission was associated with increased 6-month mortality and poor outcomes in OHCA survivors treated with hypothermic TTM. Poor long-term glycemic management may have prognostic significance after cardiac arrest.
Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: A meta-analysis
Authors: Du Jun , Shen Yangchao , Yan Wenwu , Wang Jinguo 
Published: August 2020

Abstract
BackgroundThe issue of whether or not splenic hilum lymph nodes (SHLN) should be excised in radical gastrectomy with D2 lymph node dissection remains controversial. In this study, we identified the clinicopathological features in patients with gastric cancer that could serve as predictive risk factors of SHLN metastasis. MethodsWe searched Medline, Embase, PubMed and Web of Science databases from inception to May 2020 and consulted the related references. Overall, 15 articles evaluating a total of 4377 patients were included for study. The odds ratios (OR) of each risk factor and corresponding 95% confidence intervals (CI) were determined using Revman 5.3 software.ResultsOur meta-analysis revealed tumor size greater than 5 cm (p < 0.01), tumor localization in the greater curvature (p < 0.01), diffuse type (Lauren’s classification) (p < 0.01), Borrmann type 3–4 (p < 0.01), poor differentiation and undifferentiation (p < 0.01), depth of invasion T3–T4 (p < 0.01), number of lymph node metastases N2–N3 (p < 0.01), distant metastasis M1 (p < 0.01), TNM stage 3–4 (p < 0.01), vascular invasion (p = 0.01), and lymphatic invasion (p < 0.01) as potential risk factors of SHLN metastasis. Moreover, positivity of Nos. 1, 2, 3, 4sa, 4sb, 4d, 6, 7, 9, 11, and 16 lymph nodes for metastasis was strongly associated with SHLN metastasis.ConclusionsTumor size, tumor location, Lauren’s diffuse type, Borrmann type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes are risk factors for SHLN metastasis.
Prenatal Diagnosis of Fetal Skeletal Dysplasia Using 3-Dimensional Computed Tomography: A Prospective Study
Authors: Waratani Miyoko , Ito Fumitake , Tanaka Yukiko , Mabuchi Aki , Mori Taisuke , Kitawaki Jo 
Published: August 2020

Abstract
Background: Fetal skeletal dysplasia (FSD) comprises a complex group of systemic bone and cartilage disorders. Many FSD phenotypes have indistinct definitions, making definitive prenatal diagnosis difficult. The condition is typically diagnosed using sonography; however, three-dimensional computed tomography (3D-CT) also aids in making a prenatal diagnosis. This study aimed to examine the efficacy of 3D-CT in the prenatal diagnosis of FSD by comparing the diagnostic accuracy of fetal sonography and 3D-CT.Methods: On suspicion of FSD based on ultrasound examination, we performed 3D-CT prenatally to confirm this diagnosis. To minimize exposure of the fetuses to radiation without compromising image quality, we used predetermined 3D-CT settings for volume acquisition.Results: Sixteen fetuses were suspected of having skeletal dysplasia based on ultrasonography findings. Of these, 15 were diagnosed with FSD using 3D-CT. All 15 fetuses diagnosed with skeletal dysplasia prenatally were confirmed postnatally to have the condition. The definitive postnatal diagnosis (campomelic dysplasia) differed from the prenatal diagnosis (osteogenesis imperfecta) in only one infant. Fourteen cases (93.3%) were diagnosed with an accurate classification. Five infants had lethal skeletal dysplasia; one died in utero, and four died as neonates. We determined the appropriate delivery method for each infant based on the prenatal diagnosis.Conclusions: 3D-CT is a valuable tool for augmenting ultrasound examinations in the diagnosis of FSD. While improving the diagnostic tool of sonography is essential in cases of suspected FSD, 3D-CT imaging is indispensable for diagnosis and classification, enabling better planning for resuscitation of the infant after birth.Trial registration: University Hospital Medical Information Network (UMIN) Center trial registration number is UMIN000034744. Registered 1 October, 2018 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=Roooo39610.
Can we safely reduce the administration of 131-iodine in patients with differentiated thyroid cancer? – experience of the Brugmann hospital in Brussels
Authors: Iconaru Laura , Baleanu Felicia , Taujan Georgiana , Duttmann Ruth , Spinato Linda , Karmali Rafik , Bergmann Pierre , Hambye Anne-Sophie 
Published: August 2020

Abstract
Background 131-iodine (131I) administration after surgery remains a standard practice in differentiated thyroid cancer (DTC). In 2014, the American Thyroid Association presented new guidelines for the staging and management of DTC, including no systematic 131I in patients at low-risk of recurrence and a reduced 131I activity in intermediate risk. The present study aims at evaluating the rate of response to treatment following this new therapeutic management compared to our previous treatment strategy in patients with DTC of different risks of recurrence. Methods Patients treated and followed up for DTC according to the 2014-ATA guidelines (Group 2) were compared to those treated between 2007 and 2014 (Group 1) in terms of general characteristics, risk of recurrence (based on the 2015-ATA recommendations), preparation to 131I administration, cumulative administered 131I activity and response to treatment. Results In total, 136 patients were included: 78 in Group 1 and 58 in Group 2. The two groups were not statistically different in terms of clinical characteristics nor risk stratification: 42.3% in Group 1 and 31% in Group 2 were classified as low risk, 38.5% and 48.3% as intermediate risk and 19.2% and 20.7% as high risk (P=0.38). Two patients (one in each group) with distant metastases were excluded from the analysis. Preparation to 131I administration consisted in rhTSH stimulation in 23.4% of the patients in Group 1 and 100% in Group 2 (p<0.001). 131I was administered to 46/77 patients (59.7%) in Group 1 (5 at low risk of recurrence) and 38/57 patients (66.7%) in Group 2 (0 with a low risk). Among the patients treated by 131I, median cumulative activity was significantly higher in Group 1 (3.70GBq [100mCi] range 1.11-11.1 GBq [30-300 mCi]) than in Group 2 (1.11 GBq [30 mCi], range 1.11-7.4 GBq [30-200 mCi], P<0.001). Complete response was found in 90.9% in Group 1 vs. 96.5% in Group 2 (P=0.20). Conclusions Using the 2015-ATA evidence-based guidelines for the management of DTC, meaning no 131I administration in low-risk patients, a low activity in intermediate and even high risk patients, and a systematic use of rhTSH stimulation before 131I therapy allowed us to reduce significantly the median administered 131I activity, with a similar rate of complete therapeutic response.
Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A
Authors: Niu Sihua , Huang Jianhua , Li Jia , Liu Xueling , Wang Dan , Zhang Ruifang , Wang Yingyan , Shen Huiming , Qi Min , Xiao Yi , Guan Mengyao , Liu Haiyan , Li Diancheng , Liu Feifei , Wang Xiuming , Xiong Yu , Gao Siqi , Wang Xue , Zhu Jiaan 
Published: August 2020

Abstract
Background: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions.Methods: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed.Results: Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P=0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions.Conclusions: Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.
Long non-coding RNA H19 deficiency ameliorates bleomycin-induced pulmonary inflammation and fibrosis
Authors: WAN XIAOYU , TIAN XINBEI , DU JUN , LU YING , XIAO YONGTAO 
Published: August 2020

Abstract
Background: The poor understanding of pathogenesis in idiopathic pulmonary fibrosis (IPF) impaired development of effective therapeutic strategies. The aim of the current study is to investigate the roles of long non-coding RNA H19 (lncRNA H19) in the pathogenesis of IPF. Methods: Bleomycin was used to induce pulmonary inflammation and fibrosis in mice. The mRNAs and proteins expression in lung tissues was determined by quantitative real-time polymerase chain reaction and western blot. H19 knockout (H19-/-) mice were generated by CRISPR/Cas9 and used to investigate the roles of H19 in the pulmonary inflammation and fibrosis in vivo.Results: The expression of H19 mRNA was up-regulated in fibrotic lungs patients with IPF as well as in lungs tissues that obtained from bleomycin-treated mice. H19-/- mice suppressed bleomycin-mediated pulmonary inflammation and inhibited the Il6/Stat3 signaling. H19 deficiency ameliorated bleomycin-induced pulmonary fibrosis and repressed the activation of TGF-β/Smad and S1pr2/Sphk2 in the lungs of bleomycin-treated mice. Conclusions: Our data suggests that H19 is a profibrotic lncRNA and a potential therapeutic target for pulmonary fibrosis.
Determinants of Maternal and Neonatal Outcomes of Oligohydramnios After 37+0 Weeks of Gestation in Mekelle Public Hospitals, Northern Ethiopia
Authors: Teka Hale , Gidey Hagos , Gebreezgabher Tesfay , Yemane Awol , Ebuy Hiluf , Berhe Yibrah , Abate Ermias 
Published: August 2020

Abstract
Background Oligohydramnios is a state of deficient amniotic fluid defined objectively using ultrasound measurements as single deepest vertical pocket less than 2 centimeters and/or amniotic fluid index less than 5 centimeters. It has been correlated with conditions that threaten both maternal and fetal health. The aim of this stuy is to assess determinants of adverse maternal and perinatal outcome in women with oligohydramnios after 37+0 weeks in Ayder Comprehensive Specialized Hospital and Mekelle General Hospital from April 1, 2018 – March 31, 2019.Methods This was prospective observational study. Total population purposive sampling method was employed to collect data prospectively. Result During the study period, there were a total of 10,451 deliveries, of which 273 were complicated with oligohydramnios, making the prevalence of term oligohydramnios 2.6%. The composite adverse perinatal and maternal outcomes were 38.1% and 89.4% respectively. Primigravidity, degree of oligohydramnios, presence of intrauterine growth restriction and postterm pregnancy were associated with adverse perinatal outcome. Degree of oligohydramnios and hypertensive disorders of pregnancy were found to be predictor of composite adverse maternal outcome. Conclusion Appreciation of determinants of composite adverse maternal and neonatal outcome can aid prompt interventions and mobilization of resources for resuscitation and early transfer to neonatal intensive care unit. Knowledge of determinants of maternal outcome can serve as a tool for patient counseling and for anticipation of maternal complications.
A randomized-controlled pilot study on the effects of naproxen for the treatment of bleeding and spotting among new Copper T 380A IUD users
Authors: Godfrey Emily M , Andrilla C. Holly A. , Odem-Davis Katherine 
Published: August 2020

Abstract
Background: The most common reason women report discontinued use of the Copper T 380A (TCu380A) IUD is because of bleeding irregularities after method initiation. The objective of this study was to determine whether an over-the-counter NSAID, naproxen sodium, reduces the number of bleeding and spotting days and heavy or prolonged bleeding episodes among new users of the TCu380A IUD compared to placebo.Methods: In this double-blind pilot trial, we randomized 28 new TCu380A IUD users who reported menstrual cycle changes within 4-6 weeks after IUD placement to either naproxen 440 mg or placebo twice daily for 7 days for three consecutive 28-day cycles and one additional 28-day cycle without treatment. Participants completed a daily bleeding and other symptom diary, and monthly questionnaires. Results: Although not statistically significant, participants in the naproxen arm reported more mean number of spotting-only days during the three treatment cycles compared those in the placebo group (13.5 days (SE 5.1) vs.7.5 days (SE 1.7), respectively). Otherwise, the mean number of bleeding-only days during treatment and post-treatment and spotting-only post-treatment were similar between the groups. During each treatment cycle, fewer participants in the treatment group reported heavy bleeding compared to placebo group (30.7% fewer in cycle 2; 5.4% fewer in cycle 3). More women in the treatment group, however, reported prolonged menstrual bleeding of greater than 7 days for each cycle, although the percentage reporting prolonged bleeding decreased each consecutive treatment and post-treatment cycle (+27.5%, +19.8%, +9.1%, +4.5%, cycles 1-4 respectively). Other symptoms experienced by new TCu380A users did not differ between the study arms.Conclusions: Treatment with naproxen did not significantly reduce the number of bleeding or spotting days among new TCu380A users. Although not statistically different, proportionally fewer participants in the naproxen group reported moderate-heavy or heavy periods, but more reported prolonged menstrual bleeding compared to placebo. Participants tolerated oral naproxen use well.Trial registration: ClinicalTrials.gov: NCT02519231. Registered on August 10 2015.
Can the act of sexual intercourse before embryo transfer improve IVF treatment outcome? A Randomized Clinical Trial
Authors: Sun Zhen-Gao , Yuan Li Hua , Cao Xian Ling 
Published: August 2020

Abstract
Background: Exposure of the female reproductive tract to either seminal plasma or fluid component of the ejaculate is beneficial to achieving successful embryo implantation and normal embryo development. Can the act of sexual intercourse during the peri-transfer period have any influence on pregnancy outcome? Methods: We conducted a randomized trial that included 300 patients undergoing IVF treatment at a University-affiliated reproductive center from 19 July to 20 August 2018. Enrolled patients undergoing IVF treatment were randomized either to engage sexual intercourse using the barrier contraception (n=116) or to abstain (n=107) one night before FET. The follow-up parameters included biochemical pregnancy, clinical pregnancy, early abortion, implantation rate and pregnancy rate. Results: Patients having intercourse had higher pregnancy rate (51.72% vs. 37.07%, P=0.045) and implantation rate (38.31% vs. 24.77%, P=0.005) compared to those did not engage intercourse. However, there was no significant difference of the spontaneous abortion rate between two groups (11.67% vs. 14.63%, P=0.662). Conclusions: Sexual intercourse before the day of embryo transfer can improve the clinical pregnancy and implantation rates during the frozen-thawed embryo transfer (FET) cycle. But it's important to note that the selected time of coitus for patients was only once, the night before the embryo transfer. Our interpretation of the results obtained in the present study has been too brief an interval to show beneficial effects. In general, we do not recommend that patients undergoing IVF have sexual intercourse after embryo transfer, because this may lead to uterine contractions or introduce infection sources into the uterine cavity.TRIAL REGISTRATION NUMBER: This study was registered at the China Clinical Trial Registration Center, with the registration number ChiCTR1800017209（http://www.chictr.org）
Tinnitus in Noise Exposed Workers
Authors: Bai Lu , Yu Jianping , Du Hong , Shen Zhuang , Yang Hongyan 
Published: August 2020

Abstract
Background: Tinnitus in noise exposed workers is worse, which seriously affects the normal life and work. Workers with tinnitus often complain that even going to see the doctor is ineffective. They think tinnitus is caused by occupational noise exposure, which makes tinnitus worse. To find the truth the investigation and analysis of tinnitus including reason, treatment and effect and hearing level was proceeded among all noise-exposed workers in railway transportation mechanical manufacturers in Beijing in 2015. Methods: Cross-section study was conducted. 519 noise-exposed workers were selected as exposed group, 515 non noise-exposed workers were selected as control group. Self-designed questionnaire was used in the way of face-to-face to get subjects’ information including social statistical data, occupational history, past history and living habits. Results: The incidence of tinnitus was 36.6% among noise-exposed workers, which was significantly higher than that in the control group (c2= 40.725, P < 0.05). Meanwhile the incidence of seeing the doctor was 15.8%. The incidence of tinnitus was significantly different in different subgroups of exposed group (c2= 6.072, P < 0.05). There was no significant difference between using earphones and tinnitus (P > 0.05). In the exposed group the incidence of hearing abnormal in workers with tinnitus was significantly higher than those without tinnitus (c2= 18.570, P < 0.05). Conclusions: Right knowledge, attitude and practice (KAP) would be helpful for workers with tinnitus. Occupational health education and supervision of noise-exposed workers should be further strengthened in this industry. Personal protection should be enhanced so as to improve occupational health.