bluuebunny/crossref_metadata_2025_split huggingface dataset:
Financial Toxicity in Crohn’s Disease
Authors: Voit Antanina , Cross Raymond K. , Bellavance Emily , Bafford Andrea C. 
Published: October 2018

Background:
A patient-reported outcome measure called Comprehensive Score for Financial Toxicity (COST) was previously developed and validated in patients with cancer.

Goals:
We sought to assess the financial toxicity associated with Crohn’s disease (CD) by administering the COST questionnaire to patients treated at a tertiary care center.

Study:
Forty-eight patients diagnosed with CD completed questionnaires, which included the COST quality of life instrument as well as questions with regard to sociodemographics and clinical characteristics. Analysis of results was performed with Minitab.

Results:
Forty-eight completed questionnaires were scored. The mean age of the cohort was 37.6±13.4 years and 58% of patients were women. COST scores had a normal distribution (Anderson-Darling, P=0.31). The median COST score was 22, a result associated with mild negative impact on health-related quality of life. Patients’ COST score stratum differed based on their education level (P<0.001), employment status (P=0.037), disability status (P=0.016), household income (P=0.004), and housing arrangement (P=0.006). Disease activity in the past 6 months and more frequent feelings of anxiety and depression also correlated with higher COST score.

Conclusions:
In this survey study, we found that the majority of our patients with CD experienced at least mild financial distress. Lower income and education level increased disease activity, and the presence of anxiety and depression increased the financial distress experienced by patients. Further research is needed to develop effective interventions to minimize financial toxicity in this patient population.
Combined administration of problem- and lecture-based learning teaching models in medical education in China
Authors: Jia Xue , Zeng Wen , Zhang Qin 
Published: October 2018

Abstract

Introduction:
The aim of this meta-analysis is to assess the effectiveness of the combined administration of problem-based learning (PBL) and lecture-based learning (LBL) teaching models in Chinese medical education.

Materials and methods:
We searched the following Chinese electronic databases: China National Knowledge Infrastructure, WanFang Data, China Science Periodical Database, and the Chinese BioMedical Literature Database. We also searched the following English electronic databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Search Engine. We searched for published studies involving the combined administration of PBL+LBL teaching models in Chinese medical education. All randomized controlled trials were included. The focus of the meta-analysis was on the outcomes of knowledge scores, skill scores, medical writing scores, comprehensive ability scores and teaching satisfaction. A subgroup analysis was also performed.

Results:
A total of 23 RCTs were included, with a total sample size of 2589 medical students. The PBL+LBL teaching model significantly increased knowledge scores (95% CI, 2.85–5.78; P < .00001), skill scores (95% CI, 0.51–3.71; P = .01), medical writing scores (95% CI, 1.04–4.04; P = .0009), comprehensive ability scores (95% CI, 2.04–8.71; P = .002) and teaching satisfaction (RR, 1.32; 95% CI, 1.10–1.59; P = .003) compared with the LBL teaching model alone. Additionally, a subgroup analysis showed significant differences in the effect of PBL+LBL on knowledge scores, medical writing scores, and comprehensive ability scores when comparing practical and theoretical courses. Another subgroup analysis that looked at the level of training showed that the PBL+LBL teaching model also significantly improved the knowledge scores of Freshman, Sophomore, Junior, Senior and Masters students.

Discussion and Conclusions:
Based on the current evidence, this meta-analysis showed that the PBL+LBL teaching model is an effective way to increase knowledge scores, skill scores, medical writing scores, and comprehensive ability scores and to improve teaching satisfaction.
Meditation-based clinical study to determine the correlation of quantitative electroencephalogram (qEEG) and 24-hour EEG activity
Authors: Cheong Moon Joo , Son Sung-Eun , Kang Hyung Won , Lee Youngseop , Bae Kwang-Ho , Kang Yeonseok , Lee Eun Mi , Lee Go-Eun , Seo Joo-Hee , Weon Hee-Wook , Lee Ji-Yoon , Lyu Yeoung-Su 
Published: October 2018

Abstract

Background:
The heart continuously transmits information to the cerebrum during each pulse, and influences information processing such as perception, cognition, and emotion, which are processed in the cerebrum. This is the basis for the theory of oriental medicine widely used in psychiatric medicine and clinical practice, so-called Simjushinji (heart and brain) theory, that the heart controls the mind. The present study aims to analyze the correlation between heart and brain function by 24-hour active electrocardiogram and quantitative electroencephalogram (EEG) measurement under meditation.

Methods:
This randomized, controlled, assessor-blinded, 2-armed, parallel, multicenter clinical trial will analyze a total of 50 subjects, including 25 each for the test group and the active control group. Subjects will be randomly allocated to the test group (performing resource mindfulness) and the control group (performing stress mindfulness) in a 1:1 ratio. The clinical trial consists of 3 stages. The first and third stages are stable states. The second stage is divided into the test and active comparator groups. Quantitative EEG (qEEG) measurements at stages 1 and 3 will be recorded for 10 minutes; measurements at stage 2 will be recorded for 20 minutes with the eyes closed. The 24-hour Holter Monitoring and heart rate variability will be evaluated at each stage. Before the beginning of stage 3, subjects will complete the questionnaires. The primary outcome will be analyzed by independent t tests of both groups.

Discussion:
Scientific studies based on clinical epistemology are expected to serve as a basis for sustainable medical services in the field of psychiatric medicine in Korea. HRV, blood pressure index, and biometric index in qEEG, as determined by 24-hour Holter monitoring, will complement quantitative biomarkers and be useful in various fields.
CARE—Placental site trophoblastic tumor presenting with thrombotic microangiopathy
Authors: Zhao Cai-Fu , Du Ze-Qing , Li Nan , Wang Yan , Zhao Su-Fen 
Published: October 2018

Abstract

Rationale:
Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic neoplasm (GTN).

Patient concerns:
A 28-year-old Chinese female with initial presentation of thrombotic microangiopathy (TMA) with symptoms of edema of the lower extremities and eyelid, thrombocytopenia and anemia.

Diagnoses:
The primary diagnosis was chronic glomerulonephritis according to the related laboratory tests and clinical symptoms.

Interventions:
A total abdominal hysterectomy with a bilateral salpingectomy was performed.

Outcomes:
The PSTT patient was cured, which contributed to the symptom relief of TMA.

Lessons:
This case report aims to elucidate the relationship between TMA and PSTT, so as to achieve timely diagnosis and treatment and reduce misdiagnosis.
Comparative effectiveness of extracorporeal shock wave, ultrasound, low-level laser therapy, noninvasive interactive neurostimulation, and pulsed radiofrequency treatment for treating plantar fasciitis
Authors: Li Xian , Zhang Li , Gu Shuming , Sun Jianfeng , Qin Zongshi , Yue Jiaji , Zhong Yu , Ding Ning , Gao Rui 
Published: October 2018

Abstract

Background:
Plantar fasciitis is one of the most common causes of adult heel pain. The aim of this study is to comprehensively compare the effectiveness of various therapies for plantar fasciitis using network meta-analysis.

Methods:
Studies were comprehensively searched on Embase, MEDLINE via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and the Physiotherapy Evidence Database (PEDro) up to December 4, 2017. Randomized controlled trials that used extracorporeal shock wave therapy, ultrasound, ultrasound-guided pulsed radiofrequency treatment (UG-PRF), intracorporeal pneumatic shock therapy (IPST), low-level laser therapy (LLLT), and noninvasive interactive neurostimulation (NIN) for the treatment of plantar fasciitis were included. The primary outcome is change in pain relief. Risk of bias was assessed using the Cochrane risk of bias tool. Quality assessment was performed using the GRADE system.

Results:
Nineteen trials with 1676 patients with plantar fasciitis plantar fasciitis were included. In the pair-wise meta-analysis, radial extracorporeal shock wave therapy (RSW), LLLT, and IPST showed a significant pooled reduction in the visual analogue scale (VAS) compared with placebo at 0 to 6 weeks [mean difference (MD) = 6.60, 95% confidence interval (CI): (6.04, −7.16); MD = 2.34, 95% CI: (1.60, 3.08); MD = 2.24, 95% CI: (1.44, 3.04), respectively]. Compared with placebo, UG-PRF [MD = 2.31, 95% CI: (1.26, 3.36)] and high-intensity focused extracorporeal shock wave (H-FSW) [MD = 0.82, 95% CI: (0.20, 1.45)] showed superior pain-relieving effects at 2 to 4 months; UG-PRF [MD = 1.11, 95% CI: (0.07, 2.15)] and IPST [MD = 4.92, 95% CI: (4.11, 5.73)] showed superior effects at 6 to 12 months. In the network meta-analysis, only RSW induced significant pain reduction compared with placebo at 0 to 6 weeks [MD = 3.67, 95% CI: (0.31, 6.9)]. No significant differences were found for the 2 to 4-month and 6 to 12-month periods because of the wide 95% CIs.

Conclusions:
We recommend treating plantar fasciitis with RSW. The commonly used ultrasound and focused extracorporeal shock wave (FSW) therapies can be considered as alternative treatment candidates. IPST, NIN, and LLLT may potentially be better alternatives, although their superiority should be confirmed by additional comprehensive evidence.

PROSPERO registration number: PROSPERO (CRD42015017353).
Phlebosclerotic colitis
Authors: Chen Wenguo , Zhu Huatuo , Chen Hongtan , Shan Guodong , Xu Guoqiang , Chen Lihua , Dong Fei 
Published: October 2018

Abstract
The aim of the current study was to enhance the awareness of phlebosclerotic colitis (PC) through our clinical experience.
A retrospective review of 25 patients who were diagnosed as PC in our 2 affiliated hospitals from January 2013 to October 2017 was conducted.
The patients were found at a mean age of 63.5 years, range 47 to 87years. The majority of patients were male (23 cases). Only 4 patients (16%, 4/25) had the history about long-term use of Chinese herbs and medical liquor. The most common symptoms were abdominal pain (40%) and intestinal obstruction (16%), followed by diarrhea (12%), and gastrointestinal bleeding (12%), etc. Three cases (12%) had no symptoms. The varying degrees of calcifications along the colon and mesenteric venous were found in all of their computed tomography (CT) images. The lesions mainly located in transverse and ascending colon (60%, 15/25). The terminal ileum, the whole colon and rectum involvement were also been found. Fourteen patients had the examination of colonoscopy which all presented characteristic dark purple-colored endoscopic findings. Conservative treatment with close follow-up was preferred in our group. Three cases had the surgery of colectomy due to the repeatedly intestinal obstruction, perforation.
The PC was a very rare but characteristic entity with unclear etiopathogenesis. Examination of abdomen CT and colonoscopy could help you to make clinical diagnosis.
Cutaneous comorbidities in patients with multiple myeloma
Authors: Woo Yu Ri , Jung Yu Jin , Kim Jong Sic , Kim Miri , Park Young Min , Min Chang-Ki , Kim Dong-Wook , Park Hyun Jeong 
Published: October 2018

Abstract
Multiple myeloma (MM) is a common hematologic malignancy characterized by the presence of the clonal proliferation of tumor cells. Studies on cutaneous comorbidities in Asian patients with MM have yet to be conducted.
This study aimed to analyze the prevalences, characteristics, overall survivals, and risk factors of various cutaneous comorbidities in patients with MM.
A retrospective cohort study using medical records from January 1, 2008, to December 31, 2017, in patients with MM was conducted.
Of 1438 patients with MM, 354 patients (24.61%) had one or more cutaneous comorbidities. Among them, herpes zoster infection was found to be the most common cutaneous comorbidity. The development of herpes zoster was found to be a possible candidate for good prognostic factor for overall survival [hazard ratio, 0.62; 95% confidence interval (95% CI), 0.44–0.86], while the occurrence of cutaneous malignant tumor was found to be a possible candidate for poor prognostic factor for overall survival (hazard ratio, 3.13; 95% CI, 1.76–5.56).
The development of some cutaneous comorbidities heralds the prognostic importance in patients with MM. A better understanding of the prevalences, clinical characteristics, and risk factors of various cutaneous comorbidities in patients with MM may help clinicians identify the clinical course and prognosis of the disease.
The effect of dexmedetomidine on the perioperative hemodynamics and postoperative cognitive function of elderly patients with hypertension
Authors: Du Xuejiang , Yu Jianshe , Mi Weidong 
Published: October 2018

Abstract

Introduction:
Cognitive dysfunction after surgery, a common clinical manifestation of postoperative psychonosema. It usually occurs after heart surgery, hip replacement, mandibular fractures, and other major operations. Dexmedetomidine can exert sedative, analgesic, anxiolytic effect, inhibits the sympathetic activity, maintains hemodynamic balance, helps reduce the amount of anesthetic agents, and relatively slightly depresses respiration. Preoperative administration of dexmedetomidine for sedation has been reported to reduce the incidence of acute postoperative delirium. But currently there is no study on the effect of dexmedetomidine on the postoperative cognitive function of elderly patients with essential hypertension.

Methods/Design:
This study is a prospective, single-center, double-blind controlled clinical trial. Elderly patients aged between 60 and 80 years old, diagnosed with primary hypertension for 1 year or longer will be included, and randomized into 2 groups. Patients in observational group will be given a loading dose of dexmedetomidine at 0.8 μg/kg, pumped for over 10 minutes. Although patients in control group will be pumped of the same volume of normal saline within 10 minutes, before the induction of anesthesia. Minimental state examination and levels of interleukin-6, tumor necrosis factor alpha, and C-reactive protein will be set as primary endpoints. Baseline characteristics of patients will be summarized by groups and compared using Chi-square or Fisher exact tests for categorical variables and 2-sample t tests or Wilcoxon rank sum test for the continuous variables. Repeated measurement analysis of covariance model will also be used for the comparison of endpoints between 2 groups.

Conclusion:
The present study is designed to investigate the effect of the application of dexmedetomidine on postoperative myocardial injury and postoperative cognitive dysfunction, also to explore the association between inflammatory factors and postoperative cognitive function. With this study, we are expecting to find out an appropriate anesthesia method for elderly people with hypertension to alleviate the postoperative adverse effects caused by medical treatments.

Trials registration: This study was registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn/) with the ID ChiCTR-IPR-16009156.
Prognostic value of 18F-fluorodeoxyglucose bone marrow uptake in patients with solid tumors
Authors: Jeong Shin Young , Kim Seong-Jang , Pak Kyoungjune , Lee Sang-Woo , Ahn Byeong-Cheol , Lee Jaetae 
Published: October 2018

Abstract

Background:
Several studies have reported the prognostic value of 18F-fluorodeoxyglucose (18F-FDG) bone marrow uptake (BMU) measured by 18F-FDG positron emission tomography (18F-FDG PET) in various cancers. We performed a meta-analysis to evaluate the prognostic value of 18F-FDG BMU in patients with solid tumors.

Methods:
Systematic searches of MEDLINE and Embase databases were performed using the keywords “18F-FDG,” “bone marrow,” and “prognosis.” All published human studies of the prognostic value of 18F-FDG BMU in patients with solid tumors were searched. The primary outcome was event-free survival (EFS), and the secondary endpoint was overall survival (OS); both of these were extracted directly from each study. The effects of 18F-FDG BMU on survival were assessed by using hazard ratios (HRs).

Results:
Ten studies with 1197 patients (8 studies reporting EFS in 1096 patients and 7 studies reporting OS in 836 patients) were included. In the EFS analysis, the combined HR was 1.75 (95% confidence interval [CI]: 1.45–2.11, P < .00001) in the random effects model (I
2 = 51%, P
= .05). The combined HR of OS was 1.40 (95% CI: 1.13–1.73, P = .002) in the random effects model (I
2 = 52%, P = .05).

Conclusion:
This meta-analysis has demonstrated that patients with a low level of 18F-FDG BMU have better EFS and OS than those with a high level of 18F-FDG BMU. Based on our results, we suggest that 18F-FDG BMU could be used as a biomarker for stratifying the risk of tumor progression in patients with solid tumors.
Choroidal thickness changes in non-treated acute and ranibizumab-treated chronic central serous chorioretinopathy
Authors: Yumusak Erhan , Gokcinar Nesrin Buyuktortop , Ornek Kemal 
Published: October 2018

Abstract
To evaluate the changes in subfoveal retinal, and choroidal thicknesses (CT) in the non-treated acute and the ranibizumab-treated chronic central serous chorioretinopathy (CSCR) patients.
This retrospective study included 32 eyes of 32 consecutive patients with CSCR. There were 12 patients who presented with a spontaneous resolution of CSCR (Group 1) and 20 patients who were treated with ranibizumab for persistent subretinal fluid (SRF) (Group 2). Optical coherence tomography (OCT) imaging of subfoveal retinal thickness and enhanced depth imaging OCT of CT at subfoveal; at nasal and temporal 500 μm (T500); at nasal and temporal 1500 μm (T1500) were analyzed. The Student t test and multivariate analysis were used to compare variables within and between groups, respectively and correlations were analyzed using Pearson correlation coefficient. A P value of P < .05 was accepted as significant.
The mean patient age was 38.94 ± 8.41 years (range, 20–53 years). Female/male ratio was 4/28. The mean duration of follow-up was 21.6 ± 8.2 months in the chronic CSCR group. Visual acuity improved and central foveal thickness (FT) decreased significantly in both groups. CT decreased significantly only at nasal 1500 μm (N1500) in the acute group and at all measured points in the chronic group compared with baseline, except at T500 (P
= .07). No significant difference in central FT was detected between the 2 groups. Compared with the acute group, baseline subfoveal CT was significantly higher in chronic patients. There was a significant difference between the groups in baseline and final CT at T500. No significant difference was found at T1500. At nasal 500 μm and N1500, the difference between the groups was significant only for final CT values.
Chronic CSCR was associated with higher baseline CT values in the subfoveal region and at T500. CT significantly decreased at most of the measured points in ranibizumab-treated chronic CSCR patients, whereas it significantly decreased only at 1 point in spontaneously resolved acute CSCR patients.
Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects
Authors: Xu Weize , Li Jianhua , Ye Jingjing , Yu Jin , Yu Jiangen , Zhang Zewei 
Published: October 2018

Abstract
The aim of the study was to compare transesophageal echocardiography (TEE) and fluoroscopy for percutaneous atrial septal defect (ASD) closure.
This was a retrospective analysis of children who underwent percutaneous ASD closure. The procedure was guided by TEE without fluoroscopy in 130 patients (TEE group) and by fluoroscopy in 163 patients (fluoroscopy group). Baseline demographic/clinical characteristics were recorded. Patients were followed until hospital discharge. Outcomes were procedure duration, peri/postoperative complications, hospital stay, and costs.
The TEE and fluoroscopy groups showed no significant differences in age (71.7 ± 40.7 vs 62.5 ± 38.8 months), male/female ratio (54/76 vs 66/97), weight (22.0 ± 12.0 vs 20.1 ± 9.0 kg), ASD diameter (9.9 ± 4.2 vs 9.3 ± 3.9 cm), distances to the superior vena cava (13.4 ± 4.6 vs 13.3 ± 4.2 cm), inferior vena cava (13.4 ± 4.3 vs 13.9 ± 4.1 cm) and atrial septal roof (12.1 ± 4.0 vs 12.3 ± 3.2 cm), or atrial septal size (38.2 ± 6.2 vs 39.4 ± 26.6 cm); distance to the mitral valve was greater in the TEE group (13.2 ± 4.4 vs 11.3 ± 3.9 cm; P < .001). The TEE and fluoroscopy groups showed no significant differences in occlusion device size (14.3 ± 4.6 vs 13.8 ± 4.0 cm) or sheath size (8.7 ± 1.8 vs 8.7 ± 0.9 cm), but procedure duration was shorter in the TEE group (21.5 ± 14.6 vs 28.6 ± 10.9 minutes; P < .001). Postoperative fever (>38°C) occurred less frequently in the TEE group than in the fluoroscopy group (0.8% vs 9.2%; P < .001); there were no significant differences for the other complications. No patient had postoperative residual shunt, occlusion device shedding/displacement, or pericardial effusion. The TEE group had longer hospital stay (3.2 ± 0.6 vs 2.9 ± 0.6 days; P < .001) and higher procedure cost (29,687 ± 4218 vs 28,530 ± 1668 CNY (China Yuan); P = .002) than the fluoroscopy group.
TEE-guided percutaneous ASD closure can be used as an alternative to fluoroscopy-guided procedures and avoids the use of radiation or contrast agents.
Age-related variations in corneal geometry and their association with astigmatism
Authors: Namba Hiroyuki , Sugano Akira , Nishi Katsuhiro , Murakami Takanori , Nishitsuka Koichi , Konta Tsuneo , Ishizawa Kenichi , Kayama Takamasa , Yamashita Hidetoshi 
Published: October 2018

Abstract
To investigate how aging affects corneal geometry in Japanese adults, and the association between corneal geometry and astigmatism.
We included 421 participants who had undergone systemic and ophthalmological examinations in 2015 in Funagata town, Yamagata, Japan. Corneal topographic data were obtained using anterior-segment optical coherence tomography (CASIA SS-1000). Astigmatism was evaluated using power vector analyses where J0 represents the power of the orthogonal astigmatism. Positive values of J0 indicate with-the-rule astigmatism, while negative values indicate against-the-rule (ATR) astigmatism.
Regarding age-related variations in corneal geometry, the anterior elevations at axis 0° and 180° decreased, and those at axis 90° and 270° increased with increasing age in linear regression analyses, demonstrating horizontal steepening and vertical flattening of the corneal surface. There were no significant age-related variations in posterior elevations and pachymetry findings, including central corneal thickness. Regarding age-related variations in orthogonal astigmatism, the mean values of J0 and corneal J0 (cJ0) decreased by –0.014 and –0.015 per year of increase in age, indicating astigmatic shift toward ATR. Regarding the correlation between corneal geometry and astigmatism, the shift toward ATR was positively correlated with horizontal steepening and vertical flattening, in accordance with the age-related corneal variations. In addition, the posterior surface of the cornea also has an association with this shift to some extent.
The results of our population-based study demonstrated that the age-related variation in astigmatism is associated with geometrical changes in the cornea, especially those in the anterior surface of the cornea.