bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revision surgery with dermal regeneration template and vacuum sealing drainage for reconstruction of complex wounds following necrosis of reattached avulsed skins in a degloving injury
Authors: Lv Zhenmu , Yu Lili , Fu Lei , Wang Qiusheng , Jia Rui , Ding Wenyuan , Shen Yong 
Published: June 2019

Abstract

Rationale:
Degloving injury of the upper limb often extends to underlying tendons and bone, which is at high risk of treatment failure if only simple reattachment of defatted avulsed skins was performed. Pelnac dermal regeneration template could be used as a treatment choice for necrosis of the reattached avulsed skins in a degloving injury.

Patient concerns:
A 48-year-old woman with a degloving injury of the right forearm, wrist, and hand received initial treatment by reattachment of the defatted avulsed skins over the wound bed. However, 17 days postoperatively, the reattached skins developed complete necrosis, leaving large size of tissue defects and tendon/bone exposure.

Diagnosis:
Failure to reconstruct the skin and soft-tissue envelop by reattachment of the defatted avulsed skins in a severe degloving injury of the upper limb.

Interventions:
We decided to use a 2-stage procedure of Pelnac dermal regeneration template and secondary skin graft to solve this issue, in consideration of these conditions and the patient’ demanding of limb function and aesthetic appearance.

Outcomes:
At the final follow-up, this patient obtained an excellent result, in term of scar quality, aesthetic appearance, and the ability to perform the daily activities.

Lessons:
We believe this could become an interesting option in patients who needed revision procedure for management of complex wounds with tendon/bone exposure following the necrosis of reattached skins in degloving injuries.
Risk factors for lymph node metastasis in duodenal neuroendocrine tumors
Authors: Park Sang Gyu , Lee Bong Eun , Kim Gwang Ha , Park Joon Woo , Lee Moon Won , Kim Su Jin , Choi Cheol Woong , Lee Sojeong , Park Do Youn 
Published: June 2019

Abstract
Duodenal neuroendocrine tumors (NETs) are rare, and risk factors associated with lymph node (LN) metastasis are still not well defined. The aim of this study was to investigate risk factors of LN metastasis in duodenal NETs based on the final histopathologic results and clinical follow-up data.
This study included a total of 44 duodenal NETs in 38 patients who underwent endoscopic or surgical resection between January 2008 and December 2015. Diagnosis of duodenal NETs was confirmed based on immunohistochemical staining of chromogranin A, synaptophysin, and CD56; the clinicopathologic records were collected at the time of the initial diagnosis of duodenal NETs.
Most duodenal NETs were small (≤1 cm in 33 tumors), World Health Organization (WHO) grade G1 (in 32 tumors), limited to the mucosa and/or submucosa (in 40 tumors), and located at the duodenal bulb (in 32 tumors). Of 44 tumors, lymphovascular invasion was present in 4 (9.1%), and among 38 patients, LN metastasis was detected in 4 (10.5%). LN metastases were significantly associated with the non-bulb location, tumor size >10 mm, tumor invasion into the muscularis propria or deeper, WHO grade G2, and lymphovascular invasion. During the mean follow-up period of 54.5 months (range, 24–123 months), recurrence occurred in 1 patient.
Non-bulb location, tumor size >10 mm, invasion beyond the submucosa, WHO grade G2, and lymphovascular invasion are risk factors of LN metastasis in duodenal NETs. These findings can help clinicians choose the appropriate therapeutic modality for duodenal NETs.
Effect of pregabalin for the treatment of chronic refractory cough
Authors: Li Jun , Ye Ling 
Published: June 2019

Abstract

Rationale:
Chronic refractory cough (CRC) is a common clinical problem which is more likely associated with some physical problems. Although many patients have received satisfactory treatment, there were still many patients suffered from long-term cough symptoms after standardized treatment.

Patient concerns:
A patient suffered from postherpetic neuralgia (PHN) and also he complained CRC for more than 20 years.

Diagnosis:
The patient was diagnosed with PHN and CRC.

Interventions:
Pregabalin was originally administered to treat PHN.

Outcomes:
pregabalin not only alleviated her pain of PHN but also relieved chronic cough.

Lessons:
This report demonstrated the surprising effect of pregabalin on the treatment of CRC.
Advantages of laparoscopic left hemihepatectomy
Authors: Yin Xiangbao , Luo Dilai , Huang Yong , Huang Mingwen 
Published: June 2019

Abstract

Background:
Laparoscopic left hemihepatectomy (LLH) has been widely accepted as a minimally invasive alternative to open liver surgery. We assessed the benefits and drawbacks of LLH compared with open left hemihepatectomy (OLH) using meta-analysis.

Methods:
Relevant literature was retrieved using PubMed, Embase, Cochrane, and Ovid Medline databases. Multiple parameters of efficacy and safety were compared between the treatment groups. Results are expressed as odds ratio (OD) or mean difference (MD) with 95% confidence interval (95% CI) for fixed- and random-effects models.

Results:
The meta-analysis included 13 trials involving 1163 patients. Compared with OLH, LLH significantly reduced intraoperative blood loss (MD, −91.01; 95% CI, −139.12 to −42.89; P = .0002), transfusion requirement (OR, 0.24; 95% CI, 0.11–0.54; P = .0004), time to oral intake (MD, −0.80; 95% CI, −1.27 to −0.33; P = .0008), and hospital stay (MD, −3.94; 95% CI, −4.85 to −3.03; P < .0001). However, operative time; complications rate; and postoperative alanine transferase, albumin, and total bilirubin levels did not differ significantly between the 2 surgical groups (P > .05). For hepatolithiasis treatment, there were no significant differences in operative time, residual stones, stone recurrence, and complications rate between the groups (P > .05), but LLH resulted in lower incisional infection rate (OR, 0.44; 95% CI, 0.22–0.89; P = .02) than OLH. The LLH group demonstrated higher bile leakage rate (OR, 1.79; 95% CI, 1.14–2.81; P = .01) and incurred greater hospital costs (MD, 618.56; 95% CI, 154.47–1082.64; P = .009).

Conclusions:
LLH has multiple advantages over OLH and should thus be considered as the first choice for left hemihepatectomy.
A meta-analytic investigation of the impact of mindfulness-based interventions on ADHD symptoms
Authors: Xue Jiaming , Zhang Yun , Huang Ying 
Published: June 2019

Abstract

Background:
Mindfulness-based interventions (MBIs) have been reported to be efficacious in treating attention deficit hyperactivity disorder (ADHD). However, the value of the control effect of MBIs on ADHD core symptoms remains controversial. To clarify the literature on the control effect of MBIs on the symptoms of ADHD and guide future researches, an effect-size analysis was conducted.

Methods:
A systematic search in PubMed, Embase, Web of Science, Medline, Cochrane Library, China National Knowledge Infrastructure, and Wangfang Data databases was performed up to January 11, 2019. The overall effect size of MBIs on ADHD core symptoms (ie, inattention and hyperactivity/impulsivity) was recorded by the metric of Hedges’ g with 95% confidence interval, Z-value, and P-value.

Results:
Eleven eligible studies featuring 682 participants were included in the meta-analysis. The overall results indicated that MBIs had large effects on inattention (Hedges’ g = −0.825) and hyperactivity/impulsivity (Hedges’ g = −0.676) relative to the control group. Results from subgroup analyses between self- and observer rating on ADHD symptoms revealed that the effect of MBIs both remained in a large range and self-rated ADHD core symptom had a greater impact on heterogeneity across the studies. Meta-regression found that the overall effect might be moderated by participant age group and control condition.

Conclusion:
The present meta-analysis suggested that MBIs had large effects in reducing ADHD core symptoms in comparison with the control group. Future researches are needed to assess follow-up effects of MBIs on ADHD core symptoms and explore the correlation between the individual level of mindfulness and reduction of ADHD symptoms.
TCM nonpharmacological interventions for chronic obstructive pulmonary disease (COPD)
Authors: Zhang Furong , Chen Xixi , Wu Xiaoyan , Liu Xicen , Sun Mingsheng , Shen Xiaoyu , Li Juan , Zheng Hui , Jin Rongjiang 
Published: June 2019

Abstract

Background:
Traditional Chinese medicine (TCM) nonpharmacological interventions are gaining an increasing popularity for chronic pulmonary obstructive disease (COPD) treatment and rehabilitation, yet their comparative effectiveness and safety remains unclear. Therefore, this study will aim to compare their effectiveness and safety for COPD by implementing a network-meta analysis.

Methods:
Electronic databases including MEDLINE via Ovid, and EMBASE via Ovid, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI) and Chinese BioMedical Literature Database (CBM) will be searched for related randomized controlled trials (RCTs) from inceptions to the search date without language restrictions. RCTs that compare TCM nonpharmacological interventions with placebo or conventional treatments will be included. The primary outcome will be lung function measures, dyspnea level and COPD-specified life quality and secondary ones will include functional exercise capacity, and general health-related life quality. Both classical meta-analysis and network meta-analysis will be implemented to investigate direct and indirect evidences on this topic. Continuous data will be expressed as standard mean differences (SMDs) and categorical data as risk ratios (RRs) with 95% confidence intervals. The evidence transitivity and consistency within network will be evaluated with Cochrane Q statistic and net-heat plot.

Results:
The study results will be disseminated through a peer-reviewed journal publication or conference presentation.

Conclusions:
The review findings will provide a ranking evidence of current TCM nonpharmacological interventions and help to inform clinical practitioners, COPD patients, and policy-makers in the decision-making.

Trial registration number:
PROSPERO CRD42019126554
Development and validation of a nomogram for osteosarcoma-specific survival
Authors: Zhang Jun , Yang Jin , Wang Hai-Qiang , Pan Zhenyu , Yan Xiaoni , Hu Chuanyu , Li Yuanjie , Lyu Jun 
Published: June 2019

Abstract
This study aimed to establish a comprehensive prognostic system for osteosarcoma based on a large population database with high quality.
The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify patients with osteosarcoma from 1973 to 2015. Multivariate analysis was performed to screen statistically significant variables. A nomogram was constructed by R software to predict the 3-, 5- and 10-year survival rates. Predictive abilities were compared by C-indexes, calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), as well as decision curve analysis (DCA).
In total, 4505 osteosarcoma patients were identified. They were divided into training (70%, n = 3153) and validating (30%, n = 1352) groups. Multivariate analyses identified independent predictors. Subsequently, the nomogram system of a new model was established, which comprised 7 variables as age, sex, site, decade of diagnosis (DOD), extent of disease (EOD), tumor size and patients undergoing tri-modality therapy (surgery, radiotherapy and chemotherapy). It provided better C-indexes than the model without therapies (0.727, 0.712 vs 0.705, 0.668) in the 2 cohort, respectively. As well, the new model had good performances in the calibration plots. Moreover, both IDI and NRI improved for 3-, 5- and 10-year follow-up of C-indexes. Finally, DCA demonstrated that the nomogram of new model was clinically meaningful.
We developed a reliable nomogram for prognostic determinants and treatment outcome analysis of osteosarcoma, thus helping better choose medical examinations and optimize therapeutic regimen under the cooperation among oncologists and surgeons.
Efficacy and safety of sertraline for the treatment of premature ejaculation
Authors: Yi Zhan-Miao , Chen Shi-Di , Tang Qi-Yu , Tang Hui-Lin , Zhai Suo-Di 
Published: June 2019

Abstract

Backgroud:
Evidence on the efficacy and safety of sertraline in patients with premature ejaculation (PE) was inconsistent. The objective of this article is to evaluate the efficacy and safety of sertraline for the treatment of PE.

Methods:
We searched Medline (OVID), Embase, the Cochrane Library, and 2 Chinese databases for randomized controlled trials (RCTs) and randomized crossover trials (RTs) that evaluated the efficacy and safety of sertraline in patients with PE. A meta-analysis was performed to calculate their pooled estimates with 95% confidence interval.

Results:
Of the 645 records obtained, we included 12 RCTs and 2 RTs (n = 977). Meta-analysis showed that sertraline prolonged intravaginal ejaculation latency time (IELT) in PE patients ((standard mean difference (SMD) = 2.14, 95% CI 1.20 to 3.08). Subgroup analyses indicated a prolonged IELT for different treatment courses: 4 weeks (SMD = 2.66, 1.06 to 4.26), 6 weeks (SMD = 0.95, 0.31 to 1.58), and 8 weeks (SMD = 1.81, 0.78 to 2.85). The sexual satisfaction rates of patients (SMD = 2.20, 1.57 to 2.84) and spouses (SMD = 2.27, 1.44 to 3.09) were also improved. We observed a significant increased risk of gastrointestinal upset (risk ratio = 2.71, 1.39 to 5.28) in the sertraline group.

Conclusion:
Sertraline can prolong IELT of PE patients, improve sexual satisfaction rates of patients and spouses, but increase risk of gastrointestinal upset.
Clinical outcomes of a cohort of migrants and citizens living with human immunodeficiency virus in Botswana: implications for Joint United Nation Program on HIV and AIDS 90-90-90 targets
Authors: Marukutira Tafireyi , Yin Dwight , Cressman Laura , Kariuki Ruth , Malone Brighid , Spelman Tim , Mawandia Shreshth , Ledikwe Jenny H. , Semo Bazghina-Werq , Crowe Suzanne , Stoove Mark , Hellard Margaret , Dickinson Diana 
Published: June 2019

Abstract
The aim of the study was to evaluate the human immunodeficiency virus (HIV) treatment cascade and mortality in migrants and citizens living with HIV in Botswana.
Retrospective 2002 to 2016 cohort study using electronic medical records from a single center managing a high migrant case load.
Records for 768 migrants and 3274 citizens living with HIV were included. Maipelo Trust, a nongovernmental organization, funded care for most migrants (70%); most citizens (85%) had personal health insurance. Seventy percent of migrants and 93% of citizens had received antiretroviral therapy (ART). At study end, 44% and 27% of migrants and citizens, respectively were retained in care at the clinic (P < .001). Among the 35% and 60% of migrants and citizens on ART respectively with viral load (VL) results in 2016, viral suppression was lower among migrants (82%) than citizens (95%) (P < .001). Citizens on ART had a median 157-unit [95% confidence interval (CI) 122–192] greater increase in CD4+ T-cell count (last minus first recorded count) than migrants after adjusting for baseline count (P < .001). Five-year survival was 92% (95% CI = 87.6–94.8) for migrants and 96% (95% CI = 95.4–97.2) for citizens. Migrants had higher mortality than citizens after entry into care (hazard ratio = 2.3, 95% CI = 1.34–3.89, P = .002) and ART initiation (hazard ratio = 2.2, 95% CI = 1.24–3.78, P = .01).
Fewer migrants than citizens living with HIV in Botswana were on ART, accessed VL monitoring, achieved viral suppression, and survived. The HIV treatment cascade appears suboptimal for migrants, undermining local 90-90-90 targets. These results highlight the need to include migrants in mainstream-funded HIV treatment programs, as microepidemics can slow HIV epidemic control.
Fecal microbiota transplantation in children: current concepts
Authors: Gurram Bhaskar , Sue Paul K. 
Published: June 2019

Purpose of review
Administration of fecal material into the gastrointestinal tract, termed fecal microbiota transplantation (FMT), is increasingly recognized as an effective treatment option for recurrent Clostridium difficile infection (RCDI). The impact of FMT on host microbial communities and subsequent disease states has also been explored in recent years for conditions as varied as inflammatory bowel disease especially ulcerative colitis, metabolic diseases, such as diabetes, graft-versus-host disease in hematopoietic stem cell transplant recipients, and autism and autism spectrum disorders. The purpose of this article is to review the evidence for FMT as a treatment option in various pediatric illnesses.

Recent findings
The rate of C. difficile infection is rising among children, and is associated with significant morbidity and disease, with recurrence in up to 20% of pediatric patients. Several randomized controlled trials evaluating the utility of FMT in RCDI in comparison to vancomycin have been published and demonstrate high rates of efficacy between 70 and 100%. In addition, the safety of FMT in the treatment of RCDI has been well described in the adult population, with several pediatric case series demonstrating similar rates of tolerability and adverse events. FMT in ulcerative colitis appears promising, especially with multiple infusions administered via the lower gastrointestinal tract. However, there are several limitations, including the lack of uniformity of protocols used, source of FMT, route of administration and the lack of standardization of concomitant therapies. The data on usage of FMT for other indications are preliminary and limited.

Summary
FMT is recognized as an effective treatment option for RCDI and is increasing sought by parents. Although limited, pediatric studies to date on the use of FMT for RCDI demonstrate similar efficacy rates as in the adult population. FMT has been proposed as a treatment option for an increasing number of pediatric conditions, and additional studies are needed to delineate the efficacy of FMT outside of RCDI, as well as its short and long-term impacts on human health.
Current state of organ transplant tolerance
Authors: Rickert Charles G. , Markmann James F. 
Published: June 2019

Purpose of review
Immunological tolerance has long been considered the ‘holy grail’ of organ transplantation. Although tolerance has been an active area of research for 70 years, its clinical application has only been possible in the last two decades and widespread use remains an, as yet, unattained goal. Recent advances in the understanding of immune regulation have identified many new approaches to tolerance induction and several clinical trials are currently aimed at bringing this treatment to more patients.

Recent findings
Mixed chimerism remains the most successful approach to tolerance induction. However, many treatments, including adoptive transfer of regulatory T cells, regulatory B cells, and immune suppressive dendritic cells and myeloid derived suppressor cells have shown great promise in preclinical models. Recent clinical studies have found that both kidney and liver operational tolerance are achievable in the appropriate settings. Furthermore, combining multiple tolerance approaches has shown potential to produce durable and safer tolerance.

Summary
Tolerance to protect kidney and liver allografts has become a valuable therapy in the correct circumstances. Through further clinical trials and an improved understanding of immune regulatory components, tolerance is poised to have a significant impact on transplantation in the years to come.
Placebo and nocebo effects and operant pain-related avoidance learning
Authors: Janssens Thomas , Meulders Ann , Cuyvers Bien , Colloca Luana , Vlaeyen Johan W.S. 
Published: June 2019

Abstract

Introduction:
Research on learning in placebo and nocebo has relied predominantly on Pavlovian conditioning procedures. Operant learning procedures may more accurately model learning in real-life situations in which placebo and nocebo effects occur.

Objectives:
To investigate the development and persistence of placebo and nocebo effects using an operant avoidance learning task.

Methods:
Pain-free participants (n = 58) could learn to avoid pain by performing movements that differed in difficulty and intensity of painful stimulation. Participants performed movements in 2 contexts. In the high cost of avoidance context, pain stimulus intensity reduced with increasing movement difficulty. In the low cost of avoidance context, contingencies were reversed. Participants rated pain expectations and pain intensity. During test, movement difficulties were unchanged, but participants always received a medium-intensity pain stimulus. Placebo and nocebo effects were defined as lower/higher pain intensity ratings for trajectories that previously resulted in low/high-intensity compared with medium-intensity stimulation.

Results:
As expected, participants acquired differential movement-pain expectations and differential movement choices. Testing with a medium-intensity pain stimulus quickly erased differences in movement choice across contexts, but differences in pain expectations were maintained. Pain modulation across context was in line with movement-pain expectations. However, we only observed placebo effects within the low cost of avoidance context and found no evidence of nocebo effects.

Conclusion:
Operant learning can change pain expectations, pain modulation, and pain-related avoidance behavior. Persisting pain expectations suggest that acquired pain beliefs may be resistant to disconfirmation, despite self-initiated experience with novel pain-movement contingencies.
National Patterns of Filled Prescriptions and Third-Line Treatment Utilization for Privately Insured Women With Overactive Bladder
Authors: Linder Brian J. , Gebhart John B. , Elliott Daniel S. , Van Houten Holly K. , Sangaralingham Lindsey R. , Habermann Elizabeth B. 
Published: June 2019

Objective
The aim of this study was to evaluate national patterns of care for women with overactive bladder (OAB) in an administrative data set and identify potential areas for improvement.

Methods
We performed an analysis using the OptumLabs Data Warehouse, which contains deidentified administrative claims data from a large national US health insurance plan. The study included women, older than 18 years, with a new OAB diagnosis from January 1, 2007, to June 30, 2017. We excluded those with an underlying neurologic etiology, with interstitial cystitis/painful bladder syndrome, were pregnant, or did not have continuous enrollment for 12 months before and after OAB diagnosis. Trends in management were assessed via the Cochran-Armitage test. Time to discontinuation among medications was compared using t test.

Results
Of 1.4 million women in the database during the study time frame, 60,246 (4%) were included in the study. Median age was 61 years [interquartile range (IQR), 50–73], and median follow-up was 2.6 years (IQR, 1.6–4.2). Overall, 37% were treated with anticholinergics, 5% with beta-3 agonists, 7% with topical estrogen, and 2% with pelvic floor physical therapy; 26% saw a specialist; and 2% underwent third-line therapy. Median time to cessation of prescription filling was longer for beta-3 agonists versus anticholinergics [median, 4.1 months (IQR, 1–15) vs 3.6 months (IQR, 1–10); P < 0.0001]. Use of third-line therapies significantly increased over the study time frame, from 1.1% to 2.2% (P < 0.0001).

Conclusions
Most of the patients do not continue filling prescriptions for OAB medications, and a minority of patients were referred for specialty evaluation. Although third-line therapy use is increasing, it is used in a small proportion of women with OAB. Given these patterns, there may be underutilization of specialist referral and other OAB therapies.