bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of dangguijakyaksan on lower-extremity blood circulation disturbances in climacteric and postmenopausal women
Authors: Ahn Soo-Yeon , Baek Seon-Eun , Park Eun Ji , Kim Hye-Won , Ryuk Jin-Ah , Yoo Jeong-Eun 
Published: September 2019

Abstract

Background:
Climacteric women experience various disorders, including hot flush, depression, insomnia, arthralgia, and hand and foot numbness. Dangguijakyaksan is among the most common treatments for climacteric syndrome, and its effect on depression, insomnia, hot flush and quality of life (QOL) in climacteric women has been reported multiple times. A recent animal study found dangguijakyaksan decreased serum lipid factors and improved blood circulation in a menopausal rat model; however, these effects have not been assessed in clinical trials. This study aims to assess the clinical effects and safety of dangguijakyaksan for lower-extremity blood circulation disturbances in climacteric women.

Methods:
This is a single-center, randomized, double-blinded, placebo-controlled pilot study that will be conducted at Dunsan Korean Medicine Hospital at Daejeon University. Forty-six climacteric women with lower-extremity blood circulation disturbances will be recruited and randomized (1:1) into either the dangguijakyaksan or placebo group. After 8 weeks of administration, the effects and safety of dangguijakyaksan will be assessed.
The primary outcome is the visual analogue scale for lower-extremity blood circulation disturbances, and it will be assessed on visits 1, 2, and 3. The secondary outcomes, Kupperman's index and blood deficiency scoring system, will be assessed on visits 1, 2, and 3, and accelerated photoplethysmography and digital infrared thermal imaging will be performed on visits 1 and 3. Moreover, blood lipid profile, follicle-stimulating hormone, and estradiol levels will be measured at the screening visit and visit 3. Blood tests will be performed at the screening visit and visit 3 to assess the safety of dangguijakyaksan. Statistical analysis will be performed using R-3.3.3 (Another Canoe), and within-group study variable differences after drug administration will be analyzed using paired t-test or Wilcoxon signed-rank test.

Discussion:
We expect to confirm the effects and safety of dangguijakyaksan on lower-extremity blood circulation disturbances in menopause, which would provide foundational data for planning subsequent studies.
Breast lesion size assessment in mastectomy specimens
Authors: Wienbeck Susanne , Uhlig Johannes , Fischer Uwe , Hellriegel Martin , von Fintel Eva , Kulenkampff Dietrich , Surov Alexey , Lotz Joachim , Perske Christina 
Published: September 2019

Abstract
To compare the accuracy of breast lesion size measurement of cone-beam breast-CT (CBBCT), digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM).
Patients scheduled for mastectomy due to at least 1 malignant breast lesion were included. Mastectomy specimens were examined by CBBCT, DBT, FFDM, and histopathology.
A total of 94 lesions (40 patients) were included. Histopathological analyses revealed 47 malignant, 6 high-risk, and 41 benign lesions. Mean histopathological lesion size was 20.8 mm (range 2–100). Mean absolute size deviation from histopathology was largest for FFDM (5.3 ± 6.7 mm) and smallest for CBBCT 50 mA, high-resolution mode (4.3 ± 6.7 mm). Differences between imaging modalities did not reach statistical significance (P = .85).
All imaging methods tend to overestimate breast lesion size compared to histopathological gold standard. No significant differences were found regarding size measurements, although in tendency CBBCT showed better lesion detection and cT classification over FFDM.
Characteristics of carcinogenic HPV genotypes in North China Plain and the association with cervical lesions
Authors: Liu Lihua , Wang Dexue , Dong Haixin , Jin Chengqiang , Jiang Liqing , Song Hui , Jin Chao , Wang Tong , Shi Cuiming , Yang Linqing , Wang Yunfei 
Published: September 2019

Abstract
Human papillomavirus (HPV) infection is a crucial health problem and caused substantial malignancy diseases among female worldwide. We aim to investigate the distribution of HPV subtype and the status of cervical cancer and precancerous lesions caused by HPV infection in North China Plain population. A total of 61,870 samples of outpatients and inpatients from January 2015 to May 2017 at the Affiliated Hospital of Jining Medical University were collected. All of the samples were tested by rapid flow-through hybridization HPV genotyping. Approximately 17,280 of the cases tested positive for HPV, indicating an infection rate of 27.9%. Approximately 7009 cases were compared to the results of cytological diagnosis. The top five HPV genotypes were HPV-16 (4.5%), HPV-52 (2.9%), HPV-58 (2.8%), HPV-53 (1.9%), and HPV-81 (1.9%). The youngest age group (age < 20 years) showed the highest infection rate (59.9%), and then decreased with age. As the degree of cervical lesions worsened gradually, the rate of high-risk HPV infection increased, such as 24.3% (322/1324) in the Cervicitis, 31.30% (560/1785) in the CINI, 54.1% (568/1050) in the CINII, 80.1% (693/865) in the CIN III, and 99.5% (428/430) in the cervical cancer group. These findings were significantly different from the 9.7% (155/1555) observed in the normal medical examination group (P < .05). This is the first study to demonstrate the characteristics of HPV and the association with cervical lesions in North China Plain population.
Survival rates following medical intensive care unit admission from 2003 to 2013
Authors: Kim Do Yeun , Lee Mi Hyun , Lee Sung Yeon , Yang Bo Ram , Kim Hyun Ah 
Published: September 2019

Abstract
The decision as to whether patients should be admitted to a medical intensive care unit (ICU), in the absence of information concerning survival rates or prognostic factors in survival, is often challenging. We analyzed survival trends in relation to hospital discharge and examined patient and hospital characteristics associated with survival following ICU care, using a sample of nationwide claims data in Korea from 2002 through 2013. The Korean government implements a compulsory social insurance program that covers the country's entire population, and the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) data from 2002 based on this program were used for this study. The NHIS-NSC is a stratified random sample of 1,025,340 subjects selected from around 46 million Koreans. We evaluated annual survival trends using the Kaplan-Meier test. Analyses of the relationship between survival and patient and hospital characteristics were performed using Cox regression analyses. Employing a multivariate model, variables were selected using the forward selection method to consider the multicollinearity of variables. A total of 32,553 patients admitted to an ICU between 2002 and 2013 were identified among the eligible beneficiaries. The number of patients who had histories of ICU admission steadily increased throughout the study period, and patients older than 80 years constituted a progressively increasing proportion of ICU admissions, from 7.3% in 2002 to 16.9% in 2007 to 23.1% in 2013. The mean number of mechanical equipment items applied consistently increased, while no difference was observed in the trend for overall 1-year survival in patients following ICU treatment across the study period: the 1-year survival rate ranged from 66.7% (year 2003) to 64.2% (year 2010). Advanced age, cancer, renal failure, pneumonia, and influenza were all associated with heightened risk of mortality within 1 year. Our results should prove useful to older patients and their clinicians in their decisions regarding whether to seek ICU care, with the goals of improving the end-of life care and optimizing resource utilization.
Neointimal coverage after second generation drug-eluting stent implantation has a relationship with pre-existing atherosclerotic lesion characteristics
Authors: Nomoto Yohta , Nakagawa Masashi , Shirai Nobuyuki , Kajio Keiko , Mizutani Kazuki , Yamazaki Takanori , Sugioka Kenichi , Kamimori Kimio , Ueda Makiko , Izumiya Yasuhiro , Yoshiyama Minoru 
Published: September 2019

Abstract
The relationship between preexisting atherosclerotic lesion characteristics and neointimal thickness after second-generation drug-eluting stent (DES) placement is still unknown. Thus, we evaluated that relationship using optical coherence tomography (OCT).
A single-center, retrospective, observational study was conducted. Patients with stable angina or asymptomatic myocardial ischemia who received percutaneous coronary intervention for a de novo lesion using a second-generation DES under frequency domain OCT guidance and underwent follow-up coronary angiography (CAG) and OCT between December 2010 and December 2015 were included. The relationship between the neointimal thickness on the stent strut and the plaque characteristics was retrospectively evaluated using OCT immediately after stent implantation and at the time of follow-up CAG.
We analyzed 3459 struts from 20 stents in 15 patients. The mean follow-up period was 264 days. In the follow-up study, no angiographic in-stent restenosis was found. Of the 3459 struts, 3315 (95.8%) were covered with neointima. The median neointimal thicknesses of the stent struts on calcified, fibrous, and lipid-rich lesions were 20 μm (interquartile range [IQR], 10–50 μm), 70 μm (40–140 μm; P < .001), and 90 μm (50–170 μm; P < .001), respectively. These differences were observed regardless of the type of second-generation DES used.
Most of the stent struts were covered with neointima. The neointimal thickness after the second-generation DES implantation had a close relationship with the preexisting atherosclerotic lesion characteristics. In this study, we found differences in arterial healing processes due to underlying plaque; therefore, evaluating the lesion characteristics by OCT may predict the risk for future restenosis and thrombosis.
Clinical efficacy of weekly cisplatin for treatment of patients with breast cancer
Authors: Ma Ying , Zhang Nai-peng , An Ning , Li Wen-yuan , Zhao Wei , Liu Yan-cui 
Published: September 2019

Abstract

Background:
We will investigate the efficacy and safety of weekly cisplatin (WC) for treatment of patients with breast cancer (BC) systematically.

Methods:
This study will describe and critically appraise shared decision approaches used in randomized controlled trials of WC for treatment of patients with BC. We will comprehensively search the following databases: PubMed, EMBASE, Web of Science, Cochrane Library, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Wanfang, and Chinese Biomedical Literature Database from inception through July 1, 2019. We will utilize RevMan V.5.3 software (London, UK) for statistical analysis.

Results:
This study will systematically explore the efficacy and safety of WC for the treatment of patients with BC through evaluating primary outcomes of overall survival, pathological complete response; and secondary outcomes of cancer-specific survival, recurrence-free survival, disease-free survival, quality of life, and toxicities.

Conclusion:
This study will provide latest evidence of WC for the treatment of patients with BC.

Systematic review registration:
PROSPERO CRD42019145358.
Burnout among doctors in China through 2018
Authors: Zheng Qin , Yang Kun , Wang Xue , Ou Zhenghang , Su Xiaopeng , Zhang Jing , Qu Miao 
Published: September 2019

Abstract

Background:
Burnout negatively impacts the mental and physical health doctors. More seriously, it leads to poor patient care. In China, the situation is severe and more efforts are needed to reveal the epidemiological characteristics of doctor burnout to develop improved strategies of alleviating it. Due to the large number of heterogeneous and sample size-restricted surveys currently published, meta-analysis and systematic reviews are critical to a thorough understanding of burnout among Chinese doctors.

Methods:
The Cochrane Collaboration criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed to conduct and report the systematic review. We will conduct a comprehensive search on the data bases of China National Knowledge Infrastructure (CNKI), WanFang, PubMed, EMBASE, PsycINFO, and the Cochrane Library from their inception to December 2018. Prospective cohort and cross-sectional studies that described the prevalence of Chinese doctors’ prevalence will be eligible for inclusion. The risk of bias and methodological quality of the included studies will be assessed using a risk of bias tool and the Cochrane guidelines for observational studies. A generalized linear mixed model framework with the Poisson likelihood and the log link function will be used to access the incidence rate ratio. Multivariate Poisson regression framework will be conducted to adjust modeling heterogeneity and confounders, like difference regions and time periods. The risk of bias, heterogeneity, and quality of evidence will be assessed in accordance with the aforementioned guidelines.

Results:
The primary outcome will be the prevalence and distribution of 3 dimension of burnout in Chinese doctors, and the second will be the difference of prevalence between difference regions and time periods.

Discussion:
This systematic review and meta-analysis will help us to reveal the prevalence, characteristics, timeline, and correlation between these factors in burnout; we expect our work may provide a scientific basis for further prevention and intervention of burnout in Chinese doctors, eventually to improve the quality of health care.

PROSPERO registration number:
CRD42018104249.
Highly durable response to capecitabine in patient with metastatic estrogen receptor positive breast cancer
Authors: Barchiesi Giacomo , Krasniqi Eriseld , Barba Maddalena , Giulia Marina Della , Pizzuti Laura , Massimiani Gioia , Ciliberto Gennaro , Vici Patrizia 
Published: September 2019

Abstract

Rationale:
In estrogen receptor-positive HER2-negative (ER+HER2-) metastatic breast cancer, chemotherapy should be offered only to patients who develop endocrine resistance or have a rapid disease progression. However, the correct sequence of chemotherapy administration is still debated.

Patient concerns:
We report the case of a 49-year-old woman with ER+ HER2- metastatic breast cancer who experienced an exceptionally long response to capecitabine administered as second-line therapy following a first-line anthracycline-based chemotherapy.

Diagnoses:
The patient was diagnosed with ER+ HER2- metastatic breast cancer with massive liver involvement and mediastinal lymph nodes metastasis.

Interventions:
This patient was treated with capecitabine 1000 mg/mq bid given intermittently for 14 days within a 21-day cycle as a second-line therapy following a rapid progression on letrozole treatment given as a maintenance therapy.

Outcomes:
Our patient experienced a progression-free survival (PFS) >3 years with an exceptionally good quality of life (QoL).

Lessons:
In ER+HER2- metastatic breast cancer patients, capecitabine monochemotherapy in second line may be associated with a particularly satisfactory PFS and no impact in terms of QoL. Future studies focused on biomarkers with predictive ability may help select patients who represent the best candidates to this treatment.
Thoracic endovascular aortic repair in penetrating aortic ulcer combined with isolated left vertebral artery
Authors: Fan Weijian , Li Chuanyong , Zheng Guangfeng , Pan Zhichang , Rong Jianjie 
Published: September 2019

Abstract

Rationale:
Penetrating aorta ulcer (PAU) with isolated left vertebral artery (ILVA) is a rare condition, accounting for no more than 1% of all kinds of aorta diseases. And traditional treatment was open surgery with total arch replacement by elephant trunk. Here, we report a case of PAU combined with ILVA managed by thoracic endovascular aortic repair (TEVAR) technique.

Patient concerns:
A 65-year-old male with chronic hypertension and Nicotine abuse underwent intermittent back pain for 2 years and aggravated a bit for 1 week.

Diagnoses:
Preoperative computed tomography angiogram (CTA) indicated PAU combined with ILVA.

Interventions:
TEVAR was performed for PAU following with retrograde in situ fenestration and chimney technique for revascularization of ILVA and left subclavian artery (LSA), respectively.

Outcomes:
The operation was successfully and the patient was discharged from hospital after 1 week of treatment. Postoperatively, the images of CTA illustrated the patency of aorta, ILVA, and LSA without obvious endoleak. Besides, no ischemia attack or other relative syndromes were detected at 6-months follow-up.

Lessons:
This case demonstrates that TEVAR is an alternative to elephant trunk especially for PAU with ILVA. And it also showed the precise exposure of ILVA and necessity to reconstruct ILVA during TEVAR operation in order to reduce the occurrence of ischemia attack.
A novel scoring system predicting survival benefits of palliative primary tumor resection for patients with unresectable metastatic colorectal cancer
Authors: Cao Gaoyang , Zhou Wei , Chen Engeng , Wang Fei , Chen Li , Chen Min , Zhao Wei , Xu Jianbin , Zhang Wei , Zhang Guolin , Huang Xuefeng , Song Zhangfa 
Published: September 2019

Abstract
The role of palliative primary tumor resection (PPTR) in improving survival in patients with synchronous unresectable metastatic colorectal cancer (mCRC) is controversial. In this study, we aimed to evaluate whether our novel scoring system could predict survival benefits of PPTR in mCRC patients.
In this retrospective cohort study consecutive patients with synchronous mCRC and unresectable metastases admitted to Sir Run Run Shaw Hospital between January 2005 and December 2013 were identified. A scoring system was established by the serum levels of carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), neutrophil/lymphocyte ratio (NLR), and lactate dehydrogenase (LDH). Patients with scores of 0, 1–2, or 3–4 were considered as being in the low, intermediate, and high score group, respectively. Primary outcome was overall survival (OS).
A total of 138 eligible patients were included in the analysis, of whom 103 patients had undergone PPTR and 35 had not. The median OS of the PPTR group was better than that of the Non-PPTR group, with 26.2 and 18.9 months, respectively (P < .01). However, the subgroup of PPTR with a high score (3–4) showed no OS benefit (13.3 months) compared with that of the Non-PPTR group (18.9 months, P = .11). The subgroup of PPTR with a low score (52.1 months) or intermediate score (26.2 months) had better OS than that of the Non-PPTR group (P < .001, P = .017, respectively).
A novel scoring system composed of CEA, CA19-9, NLR, and LDH values is a feasible method to evaluate whether mCRC patients would benefit from PPTR. It might guide clinical decision making in selecting patients with unresectable mCRC for primary tumor resection.
“Implementation Is so Difficult”
Authors: Floyd Nicole , Peterson Kimberly , Christensen Vivian , Anderson Johanna 
Published: September 2019

Background:
Evidence use within learning health care systems can improve patient health outcomes. Embedded in the Veterans Health Administration (VHA) since 2007, the Veterans Affairs Evidence Synthesis Program (ESP) provides tailored evidence synthesis services to support VHA’s learning health care system goals. As part of the ESP’s ongoing quality improvement efforts, we have been surveying our users since 2016.

Methods:
We reviewed data from a survey of end-users received between September 5, 2016, and June 10, 2019. The survey assessed: (1) nature of decision-making needs; (2) actions resulting from the report’s findings; (3) implementation timeframe; and (4) overall perception of report content.

Results:
Feedback was received from 66 of the 138 operational partners requesting ESP products during the fiscal year 2015 through 2018. Requests commonly informed clinical guidance (58%), identified future research needs (58%), and determined VHA-specific implementation strategy (47%). A total of 91% of responders used reports, typically within 3 months after completion (82%). Use was typically for VHA publications and/or presentations to inform VHA policy or guidance (26%), to inform intervention/strategy adoption decisions (23%) and for medical device and therapy procurement decisions (21%). Over half (53%) of respondents indicated that it would be useful for ESP reports to include more guidance on implementing findings.

Conclusion:
Our survey of learning health system decision-makers’ actual patterns and timing of evidence use provides valuable new information that can further support development of other health system and evidence producer partnerships and identifies key needs for better supporting health systems’ uptake of evidence.
Differences in itch and pain behaviors accompanying the irritant and allergic contact dermatitis produced by a contact allergen in mice
Authors: Zhang Zhe , Malewicz Nathalie M. , Xu Xiaoyun , Pan Jianhao , Kumowski Nina , Zhu Tao , Shimada Steven G. , Nie Hong , LaMotte Robert H. 
Published: September 2019

AbstractIntroduction:Irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) are inflammatory skin diseases accompanied by itch and pain. Irritant contact dermatitis is caused by chemical irritants eliciting an innate immune response, whereas ACD is induced by haptens additionally activating an adaptive immune response: After initial exposure (sensitization) to the hapten, a subsequent challenge can lead to a delayed-type hypersensitivity reaction. But, the sensory and inflammatory effects of sensitization (ICD) vs challenge of ACD are insufficiently studied. Therefore, we compared itch- and pain-like behaviors and inflammatory reactions evoked in mice during the sensitization (ICD) vs challenge phase (ACD) of application of the hapten, squaric acid dibutylester (SADBE).Objectives:Our aim was to compare itch- and pain-like behaviors and inflammatory reactions evoked in mice during the sensitization (ICD) vs challenge phase (ACD) of application of the hapten, squaric acid dibutylester (SADBE).Methods:Mice were sensitized on the abdomen with 1% SADBE (ACD) or vehicle treated (ICD, control). Spontaneous and stimulus-evoked itch- and pain-like behaviors were recorded in mice before and after 3 daily challenges of the cheek with 1% SADBE (ACD, ICD). Cutaneous inflammation was evaluated with clinical scoring, ultrasound imaging, skin thickness, histology, and analyses of selected biomarkers for contact dermatitis, IL-1β, TNF-α, CXCL10, and CXCR3.Results:Allergic contact dermatitis vs ICD mice exhibited more spontaneous site-directed scratching (itch) and wiping (pain). Allergic contact dermatitis—but not ICD—mice exhibited allodynia and hyperalgesia to mechanical and heat stimuli. Inflammatory mediators IL-1β and TNF-α were upregulated in both groups as well as the chemokine receptor, CXCR3. CXCL10, a CXCR3 ligand, was upregulated only for ACD. Inflammatory responses were more pronounced in ACD than ICD.Conclusion:These findings provide new information for differentiating the behavioral and inflammatory reactions to hapten-induced ICD and ACD.