bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for death in patients with sepsis admitted to an obstetric intensive care unit
Authors: Holanda Ana Maria Coêlho , de Amorim Melania Maria Ramos , Bezerra Sammyle Maria Barros , Aschoff Larissa Miranda Silva , Katz Leila 
Published: December 2020

Abstract
Improving understanding of the prognostic factors associated with death resulting from sepsis in obstetric patients is essential to allow management to be optimized. This retrospective cohort study aimed to determine the risk factors for death in patients with sepsis admitted to the obstetric intensive care unit of a tertiary teaching hospital in northeastern Brazil between April 2012 and April 2016.
The clinical, obstetric, and laboratory data of the sepsis patients, as well as data on their final outcome, were collected. A significance level of 5% was adopted. Risk factors for death in patients with sepsis were evaluated in a multivariate analysis.
During the period analyzed, 155 patients with sepsis were identified and included in the study, representing 5.2% of all obstetric intensive care unit (ICU) admissions. Of these, 14.2% (n = 22) died. The risk factors for death were septic shock at the time of hospitalization (relative risk [RR] = 3.45; 95% confidence interval [CI]: 1.64–7.25), need for vasopressors during hospitalization (RR = 17.32; 95% CI: 4.20–71.36), lactate levels >2 mmol/L at the time of diagnosis (RR = 4.60; 95% CI: 1.05–20.07), and sequential organ failure assessment score >2 at the time of diagnosis (RR = 5.97; 95% CI: 1.82–19.94). Following multiple logistic regression analysis, only the need for vasopressors during hospitalization remained as a risk factor associated with death (odds ratio [OR] = 26.38; 95% CI: 5.87–118.51).
The need for vasopressors during hospitalization is associated with death in obstetric patients with sepsis.
Dosimetric comparison among cyberknife, helical tomotherapy and VMAT for hypofractionated treatment in localized prostate cancer
Authors: Serra Marcello , Ametrano Gianluca , Borzillo Valentina , Quarto Maria , Muto Matteo , Di Franco Rossella , Federica Savino , Loffredo Filomena , Paolo Muto 
Published: December 2020

Abstract
Hypofractionation for localized prostate cancer treatment is rapidly spreading in the medical community and it is supported by radiobiological evidences (lower α/β ratio compared with surrounding tissues). Stereotactic body radiation therapy (SBRT) is a technique to administer high doses with great precision, which is commonly performed with CyberKnife (CK) in prostate cancer treatment. Since the CyberKnife (CK) is not available at all radiotherapy center, alternative SBRT techniques are available such as Volumetric Modulated Arc Therapy (VMAT) and Helical Tomotherapy (HT). The aim of the present study was to compare the dosimetric differences between the CK, VMAT, and HT plans for localized prostate cancer treatment.
Seventeenpatients have been recruited and replanned using VMAT and HT to this purpose: they received the treatment using the CK with a prescription of 36.25 Gy in 5 fractions; bladder, rectum and penis bulb were considered as organs at risk (OAR). In order to compare the techniques, we considered DVHs, PTV coverage, Conformity Index and new Conformity Index, Homogeneity Index, beam-on time and OARs received dose.
The 3 treatments methods showed a comparable coverage of the lesion (PTV 95%: 99.8 ± 0.4% CK; 98.5 ± 0.8% VMAT; 99.4 ± 0.5% HT. P < .05) and good sparing of OARs. Nevertheless, the beam-on time showed a significant difference (37 ± 9 m CK; 7.1 ± 0.3 m VMAT; 17 ± 2 m HT. P < .05).
Our results showed that, although CK is the best SBRT technique for prostate cancer treatment, in case this technology is not available, it can be replaced by a similar treatment delivered by VMAT technique. VMAT can be administrated only if it has an appropriate Image Guided Radiation Therapy (IGRT) tracking system.
Peony and licorice decoction fumigation treatment for strephenopodia after stroke
Authors: Jing Chengyang , Zhou Li , Ai Juanjuan , Li Zongheng , Wu Jiabao , Sun Yiting , Zhao Shuang 
Published: December 2020

Abstract

Background:
As one of the most common functional disabilities in stroke patients with hemiplegia, poststroke strephenopodia (PSS) seriously affects the life quality of patients, and causes mental and emotional disorders. Some studies have suggested that the traditional Chinese medicine fumigation therapy could be an effective intervention method for patients with PSS. This study aims to investigate the biomechanical effect of the classic prescription peony and licorice decoction (PLD) fumigation treatment for PSS.

Methods/Design:
This study is a multicenter, randomized, placebo-controlled, double blind trial. A total of 190 patients with PSS according to the inclusion criteria will be recruited in 3 centers and randomly distributed to either the intervention group or the control group in a 1:1 ratio. The intervention group will receive PLD fumigation treatment, while the control group will receive placebo fumigation treatment. All patients will receive standardized modern rehabilitation treatment according to the “Chinese Guidelines for Stroke Rehabilitation” (2011 version). The primary outcome measure is medial plantar area (Metatarsal 1+ Metatarsal 2 + Heel Medial) generating from the RSSCAN gait system. The secondary outcome measures contain the scores of clinical scales including Berg Balance Scale, Fugl-Meyer Assessment, Modified Ashworth Scale, Barthel Index, and Stroke-Specific Quality of Life Scale. All assessments will be implemented at baseline, 4 weeks after intervention and at the end of 3 months’ follow-up. Intention-to-treat analysis and per-protocol analysis will be applied in this trial.

Discussion:
The results of this study are expected to verify the clinical effect of PLD fumigation treatment for strephenopodia after stroke, and to explore the related biomechanical mechanisms by objective evaluation parameter.

Trial registration:
Chinese Clinical Trial Registry, ChiCTR2000032433. Registered on 28 April 2020. http://www.chictr.org.cn/showprojen.aspx?proj=52644
Combination of DNA-hypomethylating agent and hematopoietic stem cell transplantation in treatment of juvenile myelomonocytic leukemia
Authors: Ai Yuan , Lu Xiaoxi , Zhu Tingting , Zhu Yiping , Liu Hanmin , Sun Shuwen 
Published: December 2020

Abstract

Introduction:
Juvenile myelomonocytic leukemia (JMML) is a rare myeloproliferative neoplasm of early childhood characterized by excessive proliferation of myelomonocytic cells and an aggressive clinical course. Allogenic hematopoietic stem cell transplantation (HSCT) is a firmly established treatment, but patients without fully matched donors have poor prognoses. Disease recurrence is the main cause of treatment failure. Meanwhile, most cases with splenomegaly present with platelet transfusion refractoriness, but splenectomy remains controversial. DNA hypermethylation correlates with poor prognosis in JMML; however, hypomethylating therapy alone does not eradicate leukemic clones. Thus, a suitable treatment with a good success rate remains elusive.

Patient concerns:
Here, we report our experience with a patient who suffered from recurrent fever, pallor, abdominal distention, leukocytosis, and thrombocytopenia with a silent past history and family history of somatic KRAS mutation. The patient was treated with decitabine as a bridging therapy before haploidentical HSCT. Decitabine was also used prophylactically after transplantation.

Diagnosis:
We arrived at a JMML diagnosis after observing leukocytosis, less than 20% blast cells in the peripheral blood and bone marrow, increased monocyte counts, negativity for the BCR-ABL fusion gene, positivity for somatic KRAS mutation, and massive splenomegaly.

Interventions:
The patient accepted splenectomy before HSCT, and haploidentical HSCT was applied after treatment with a DNA-hypomethylating agent. The hypomethylating agent was administered for 1 year after HSCT to prevent disease recurrence.

Outcomes:
The patient presented with complete remission of the disease and mild graft versus host disease for 26 months after treatment with decitabine and HSCT.

Lessons:
Combining haploidentical HSCT and DNA-hypomethylating agents may improve the prognosis of JMML. Meanwhile, splenectomy could be an effective option in cases with massive splenomegaly and platelet transfusion refractoriness.
Self-care education program improves quality of life in patients with chronic heart failure
Authors: Wang Jing , Li Weiwei 
Published: December 2020

Abstract

Objective:
The objective of our research is to explore the efficiency of self-care education on the life quality in chronic heart failure (CHF) patients.

Methods:
The experiment will be implemented from July 2021 to July 2022 and was granted through the Research Ethics Committee of Shengjing Hospital of China Medical University (423507-037). Eighty patients are included in the study. The recruitment criteria of patients includes: the patients have been diagnosed with CHF by physician on the basis of echocardiography; being stabilized in the acute disease state; in accordance with medical record, the patients have no sensory-cognitive problems. Any reason for not participating in education course (such as not wishing to continue taking part in our experiment or discharge from hospital) is regarded as the exclusion criterion. The primary outcome is the patients’ life quality, which is evaluated with Iranian heart failure quality of life questionnaire. Other outcomes include the incidence of hospitalization and total medical cost.

Results:
Table 1 suggests the comparison of patients’ life quality between control group and study group after receiving the education of self-care.

Conclusion:
The program of self-care education can be regarded as the proper method to improve the life quality in CHF patients.

Trial registration:
The protocol was registered in Research Registry (researchregistry6225).
Clinical safety and efficacy of neoadjuvant combination chemotherapy of tranilast in advanced esophageal squamous cell carcinoma
Authors: Shiozaki Atsushi , Kudou Michihiro , Fujiwara Hitoshi , Konishi Hirotaka , Shimizu Hiroki , Arita Tomohiro , Kosuga Toshiyuki , Yamamoto Yusuke , Morimura Ryo , Ikoma Hisashi , Kuriu Yoshiaki , Kubota Takeshi , Okamoto Kazuma , Otsuji Eigo 
Published: December 2020

Abstract

Background:
Transient receptor potential vanilloid 2 (TRPV2) was previously shown to play an important role in the maintenance of cancer stem cells, and its specific inhibitor, tranilast, also has potential as a targeted therapeutic agent for esophageal squamous cell carcinoma (ESCC). The present study is being conducted to confirm the safety and efficacy of the additional use of tranilast with conventional preoperative adjuvant chemotherapy for patients with advanced ESCC.

Patients and methods:
Between 56 and 59 patients aged between 20 and 74 years with clinically diagnosed Stage II or Stage III ESCC will be enrolled. Eligible patients will receive preoperative adjuvant chemotherapy, 2 cycles of combination therapy with cisplatin, 5-fluorouracil, and tranilast. Recruitment started in November 2019, with the final follow-up being planned for March 2029. One subject has been enrolled since October 21st, 2020. The pathological therapeutic effect is the primary endpoint. The objective response rate, safety of preoperative adjuvant chemotherapy, recurrence-free survival (RFS), and overall survival (OS) are the secondary endpoints. RFS and OS will be calculated as the time from surgery to first recurrence and all-cause death, respectively.

Ethics and dissemination:
This protocol has been approved by the Institutional Review Boards of Kyoto Prefectural University of Medicine and all participating hospitals in August 30, 2019 (Number: CRB5180001). Written informed consent will be obtained from all patients before their registration, which is in accordance with the Declaration of Helsinki. The results of the present study will be disseminated via publication in peer-reviewed journals.

Trial registration:
Trial registration number jRCTs051190076
Association of cytochrome P450 2C19 polymorphisms with coronary heart disease risk
Authors: Yang Yongxin , Zhang Yaping , Ren Ming , Wang Yonglan , Cairang Zhuoma , Lin Rongxiang , Sun Haixia , Liu Jianju 
Published: December 2020

Abstract

Background:
Polymorphisms in the cytochrome P450 2C19 (CYP2C19) gene have been reported to be associated with coronary heart disease (CHD), but the results were not consistently analyzed among different patient groups. To derive a more precise estimation of these associations, we will conduct a meta-analysis to investigate the polymorphisms of CYP2C19 in all published studies.

Methods:
Electronic databases (Google Scholar, ISI Web of Science, Pubmed, Embase, China National Knowledge Infrastructure, Wanfang, and China Biological Medicine) will be used to search clinical case-control or cohort studies about CYP2C19 polymorphism and CHD published until November 2020. Two reviewers will independently select the study, extract the data, and evaluate the quality of the study. Odds ratios with 95% confidence interval will be used to evaluate the strength of the association between the CYP2C19 polymorphism and CHD susceptibility under 4 genetic models. Subgroup analysis will be conducted by different ethnicity and genotyping method. Sensitivity analysis will be performed via sequentially omitting each of the included studies 1 at a time. Begg funnel plots and Egger test will be used to examine the potential publication bias. All the statistical analyses will be performed using Review Manager 5.3 and Stata 12.0.

Results:
This study will provide a better understanding of the association between CYP2C19 polymorphisms and coronary heart disease risk.

Conclusion:
The publication of this protocol will minimize the possibility of bias due to post hoc changes to the analysis protocol, thus helping to obtain reliable evidence.

OSF registration number:
DOI 10.17605/OSF.IO/R7U93
A comparative study of four Bowie-Dick test under the condition of pressure steam sterilizer simulating gas leakage
Authors: Yu Xiaomei , Zhang Qing , Deng Xingling , Liang Jinxiu , Hao Shuqin , Chen Jianling , Du Heying 
Published: December 2020

Abstract
We aimed to understand the evaluation of different Bowie-Dick test (B-D test) on the performance of pressure steam sterilization equipment in the case of simulated gas leakage, and we selected a pulsating vacuum steam sterilizer to set 4 different gas leakage levels: 1.1, 1.3, 1.5, and 1.7 mbar/min during the B-D test phase. In terms of methods, 4 different brands of B-D test kits (devices) were tested at 4 different leakage rates, and a total of 48 experiments were conducted. The results from univariate analysis revealed that there are statistically significant differences in the judgment of test results among different personnel and brands. The results from multivariate logistic regression analysis displayed that the difference between different personnel was statistically significant (χ
2 = 45.34, P < .001); the difference between different products was statistically significant (χ
2 = 129.37, P < .001); and there was no statistically significant difference between different degree of leakage (χ
2 = 6.99, P > .05). Result judgments of brand 1 and brand 2 are susceptible to subjective factors. The judgment of brand 3 is intuitive and consistent with the evaluation result of brand 4. In conclusion, the order of capacity to evaluate air leakage from best to worst is brand 4→brand 3→brand 1→brand 2.
Constructing a new health education model for patients with chronic hepatitis B
Authors: Chen Qinhua , Jiang Minyu , Zeng Meixing , Jiesisibieke Zhu Liduzi , Chen Pei-En , Chien Ching-Wen , Tung Tao-Hsin 
Published: December 2020

Abstract
To explore the effects of the project-achievement quality control circle in constructing a new health education model for patients with chronic hepatitis B.
The quality control circle group was established and the theme of “constructing a new health education model for patients with chronic hepatitis B” was selected. The circle staff determined that this quality control circle was of project-achievement according to the quality control story judgment table, and then carry out activities in strict accordance with the 10 steps of project-achievement quality control circle, evaluate the tangible results and non-tangible results before and after the activity.
After the implementation of the activity, the health education integrity of patients with chronic hepatitis B increased from 74.75 ± 11.00 to 95.00 ± 5.55 points (P < .001). The awareness of health education increased from 71.90 ± 13.48 to 95.60 ± 2.84 points (P < .001), the satisfaction rate of health education increased from 76.60 ± 8.71 points to 98.00 ± 2.03 points (P < .001), and the evaluation rate after health education increased from 10% to 100% (P < .001).
The circle members have much more confidence in quality control circle activities, the use of techniques, and the knowledge related to scientific research.
Regulatory effect of traditional Chinese medicine on gut microbiota in patients with atherosclerosis
Authors: Huang Langlang , Wang Jianan , Xu Ri , Liu Yanwei , Liu Zhongyong 
Published: December 2020

Abstract

Background:
Atherosclerosis is the pathological basis of many cardiovascular and cerebrovascular diseases, and its pathogenesis is complex. Recent studies revealed a significant role of gut microbiota in the onset and development of atherosclerosis. Traditional Chinese medicine has rich clinical experience and unique advantages in the treatment of atherosclerosis. A large number of studies have proved that traditional Chinese medicine has the functions of reducing blood lipid, regulating gut microbiota, and resisting inflammation. The aim of this systematic review is to observe the randomized controlled trial of traditional Chinese medicine in treating gut microbiota, so as to evaluate the effectiveness and safety of traditional Chinese medicine in treating atherosclerosis patients.

Methods:
The English database (PubMed, Web of Science, Embase, the Cochrane Library) and Chinese database (China National Knowledge Infrastructure, the Chongqing VIP Chinese Science, and Technology Periodic Database, Wanfang Database, and China Biomedical Literature Database) will be searched up to October 2020. We will also manually search the Chinese clinical trial register, conference papers, and unpublished studies or references. Randomized control trials of traditional Chinese medicine treatment of atherosclerosis were collected comprehensively, and 2 researchers will independently screen literature, data extraction, and evaluation the quality of literature methodology. The primary outcomes are lipid metabolism and gut microbiota and their metabolites. The secondary outcomes are the change of inflammatory markers. Meta-analysis was performed by RevMan 5.3.5 software. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to evaluate the outcome quality of evidence.

Results:
This study will comprehensively review the existing evidence of traditional Chinese medicine in treating atherosclerosis from the perspective of gut microbiota.

Conclusion:
This study will provide information on the effectiveness and safety of traditional Chinese medicine in treating atherosclerosis from the perspective of gut microbiota.

Unique INPLASY number:
INPLASY2020110056.
Repeatability of glomerular filtration rate studies performed using 99mTc-DTPA in a population including cancer patients
Authors: Berndorfler Bianca D. , Holness Jennifer L. , Warwick James M. 
Published: December 2020

Objective
Glomerular filtration rate (GFR) measurement remains an integral investigation in clinical practice and is particularly important in the prediction and follow-up of renal side-effects of nephrotoxic chemotherapy in cancer patients. Knowing the coefficient of variation (CV) of a test is vital for the correct interpretation of serial studies. Recent difficulties with 51Cr-EDTA availability have renewed interest in 99mTc-DTPA, but there is a paucity of data on the test-retest variability of this radiopharmaceutical. Furthermore, the authors are unaware of published repeatability data in cancer patients. The aim of this study was to determine the CV of repeat 99mTc-DTPA GFR measurements in a clinical patient population that included cancer patients.

Methods
Patients who had undergone ≥2 GFR studies at our department between January 2009 and December 2019 were retrospectively identified. Patients with chronic kidney disease and those who had received chemotherapy, radiotherapy or surgery between measurements were excluded. The CV for each patient was calculated and the mean CVs of cancer and prospective renal donor groups were calculated and compared.

Results
Fifty-four patients were included in the final analysis. The mean CV in the cancer group (38 patients) was 8.5% [95% confidence interval (CI) 6.9–10.2%] and in the renal donor group (16 patients) 7.1% (95% CI 4.2–10.1%). These figures did not differ significantly (P = 0.37). The groups were combined to calculate the final overall mean CV of 8.1% (95% CI 6.7–9.6%).

Conclusion
In both non-cancer and cancer patients the CV of GFR studies performed with 99mTc-DTPA was comparable with mostly 51Cr-EDTA figures presented in literature.
Comparing the diagnostic accuracy of 4D CT and 99mTc-MIBI SPECT/CT for localizing hyperfunctioning parathyroid glands: a systematic review and meta-analysis
Authors: Wan Qi-chang , Li Jian-fang , Tang Lei-lei , Lv Jie , Xie Liang-jun , Li Jin-ping , Qin Lu-ping , Cheng Mu-hua 
Published: December 2020

Purpose
To compare the diagnostic accuracy of dual-phase 99mTc-MIBI single photon emission computed tomography/computed tomography (SPECT/CT) and 4D CT for the localization of hyperfunctioning parathyroid glands, a systematic review and meta-analysis was performed. Whether 4D CT combined to SPECT/CT [contrast-enhanced (CE)-SPECT/CT] had a better diagnostic performance than SPECT/CT alone in this scenario was also evaluated.

Material and methods

PubMed and Embase databases were searched for eligible studies. To reduce interstudy heterogeneity, only studies with clear head-to-head comparison were included. Publication bias was assessed by the Deeks funnel plot. The pooled sensitivity, specificity and the area under the curve (AUC) for 4D CT, SPECT/CT and CE-SPECT/CT were determined by random-effect analysis, respectively.

Results
Nine studies met the inclusion criteria, with a total of 911 participants. The sensitivity and specificity of 4D CT were 0.85 [95% confidence interval (CI), 0.69–0.94] and 0.93 (95% CI, 0.88–0.96), whereas the sensitivity and specificity for SPECT/CT were 0.68 (95% CI, 0.51–0.82; P = 0.048 compared with 4D CT) and 0.98 (95% CI, 0.95–0.99; P = 0.014 compared with 4D CT), respectively. CE-SPECT/CT is comparable to SPECT/CT in specificity and AUC, but it may improve the sensitivity (although there was a lack of statistical difference, 0.87 vs. 0.78; P = 0.125).

Conclusion
Although 4D CT shows comparable AUC and borderline better sensitivity than SPECT/CT, its clinical application is confined by relatively low specificity and high radiation exposure. CE-SPECT/CT may improve the sensitivity without compromising the specificity and AUC of SPECT/CT.