bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exercise as an intervention for patients with end-stage liver disease
Authors: Locklear Cameron T. , Golabi Pegah , Gerber Lynn , Younossi Zobair M. 
Published: October 2018

AbstractBackground:Various etiologies of chronic liver disease often result in cirrhosis. Beside obvious liver-related complications, cirrhosis also leads to loss of muscle mass and decreased exercise capacity. In this study, our aim was to conduct a systematic review of literature to investigate the efficacy of exercise interventions in patients with cirrhosis.Method:PubMed was used to perform the literature search. The mesh terms used were the following: (liver (and) cirrhosis (and) exercise or (exercise therapy)). The following terms were excluded: Non-alcoholic fatty liver disease (NAFLD). The search was limited to the English language and human research. The initial search was conducted on December 6, 2016 and re-reviewed May 2017.Results:Seven studies met selection criteria. Training interventions ranged between 4 and 14 weeks in duration with an exercise frequency of 3 to 5 days per week. Most studies demonstrated an increase in maximal oxygen consumption using gas exchange techniques. Two of 3 studies demonstrated increased distance covered in the 6-minute walk test. One study showed a clinically significant decrease in hepatic venous pressure gradient, while another showed a transient increase only during exercise. There were no adverse effects of the exercise program reported.Conclusions:Exercise in selected patients with cirrhosis can have potential benefit in endurance and functional outcome measures without adverse effect from exercise.
Value of using the international classification of functioning, disability, and health for stroke rehabilitation assessment
Authors: Zhang Tong , Liu Lixu , Xie Rong , Peng Ying , Wang Huifang , Chen Zhuoming , Wu Shizheng , Ni Chaomin , Zheng Jiejiao , Li Xueping , Liu Heyu , Xu Guangxu , Fan Jianzhong , Zhu Yuhong , Zhang Fang , Du Yanhui , Wang Xin , Wang Yulong , Xiao Weimin , Liu Ming , Mou Xiang , Zhao Jun , Song Luping , Li Bingjie 
Published: October 2018

Abstract
This study aimed to evaluate the efficiency of the International Classification of Functioning, Disability, and Health (ICF) in stroke rehabilitation assessment in China and to identify correlations between the ICF and several commonly used clinical assessment instruments for stroke.
In total, 52 hospitals and 5 premier rehabilitation and neurology research centers participated in this cross-sectional multicenter clinical study. A total of 2822 stroke patients admitted to a neurology or rehabilitation department of a participating medical center between July 2012 and June 2014 were included. The ICF checklist contains 4 parts with 128 two-level items: body functions, body structures, activities and participation, and environmental factors. We analyzed the results of ICF assessments and determined whether correlations existed between the various items of the ICF and several commonly used clinical assessment instruments.
In all but 3 instances, the scores for the ICF-b-body function, ICF-s-body structure-degree of impairment, ICF-s-body structure-impairment location, ICF-d-activity performance, ICF-d-ability performance, ICF-e-facilitator, and ICF-e-barrier correlated significantly (P < .05) with the scores for the commonly used clinical assessment instruments.
The ICF checklist is a new rehabilitation assessment instrument that is compatible with commonly used clinical assessment scales for stroke and can be used in combination with these scales.
Preliminary development of a questionnaire assessing the impact of psoriasis and psoriatic arthritis on patient's perception of sexuality
Authors: Esteve Eric , Maccari François , Delavierre Dominique , Vicariot Catherine , Charles Bénédicte , Marty Marc , Lespessailles Eric 
Published: October 2018

Abstract
Psoriasis and psoriatic arthritis impact sexuality and intimate relationships in both men and women, and can be associated with sexual dysfunctions.
The aim of this study was to develop and validate a specific questionnaire assessing the impact of psoriasis and psoriatic arthritis on patients’ sexuality. Two focus groups of patients, concerned by sexuality, were conducted in February 2015. Based on the verbatim transcripts, a content analysis was performed by a psychologist trained in qualitative procedures.
After analysis of the verbatim reports by the research group, a preliminary questionnaire comprising 22 questions was drawn up. The areas covered by the questions concerned: the quality of daily life, tolerance of the cutaneous state by the patient, tiredness, mobility and flexibility of the joints, outside activities involving movement of all or part of the body. In the following step the questions were then submitted to a panel of experts for selection using a Delphi method. The experts were questioned about item relevance and content. After expert consensus had been reached, the instructions to participants completing the questionnaire, the wording of items, and the possible answers were finalized.
The final questionnaire (comprising 14 questions) is entitled “Questionnaire of sexual quality of life perceived by patients with cutaneous and/or articular psoriasis” (short denomination: Qualipsosex). The quantitative step has not yet been conducted. This step will aim to evaluate the metrologic qualities (reliability, validity, and responsiveness) of the questionnaire and will need to be validated according to the consensus-based standards for the selection of health measurement instrument checklist.
The modified balloon crush technique
Authors: Roh Jae-Hyung , Kim Young-Hak , Kang Hee Jun , Lee Pil Hyung , Yoon Sung-Han , Chang Mineok , Ahn Jung-Min , Park Duk-Woo , Kang Soo-Jin , Lee Seung-Whan , Lee Cheol Whan , Park Seong-Wook , Park Seung-Jung 
Published: October 2018

Abstract
This study aimed to investigate the feasibility and safety of the modified balloon crush technique.
The conventional crush technique accompanies difficult and suboptimal final kissing balloon inflation (FKI)
In a single-center percutaneous coronary intervention registry, 515 patients with 515 bifurcation lesions were treated with the modified balloon technique (n = 70) or the conventional crush technique (n = 445). In contrast to the conventional crush technique, where the implanted side branch (SB) stent is crushed by expansion of the main branch (MB) stent, the modified balloon crush technique uses balloon crushing and additional SB ballooning across the crushed SB stent before MB stenting to facilitate FKI. The primary outcome of interest was major adverse cardiovascular event (MACE), a composite of all-cause death, spontaneous myocardial infarction, and target vessel revascularization.
Baseline clinical and angiographic characteristics were similar between the 2 treatment groups. FKI had comparable success rates in both groups (97.1% for the modified balloon group and 98.4% for the conventional crush group; P = .35). There were no differences in procedure time, fluoroscopic time, or contrast amount between the 2 groups. At 1-year follow up, the cumulative MACE incidences were comparable between the 2 groups (7.3% vs 8.8%; P = .73). The incidence of target lesion revascularization (TLR) was significantly lower after the modified balloon crush technique compared with the conventional crush technique (0% vs 5.6%; P = .048).
The modified balloon crush technique appears to be a feasible and safe alternative to the conventional crush technique with the potential to reduce the revascularization rate.
Effectiveness of surgical hand antisepsis using chlorhexidine digluconate and parachlorometaxylenol hand scrub
Authors: Vallejo Ricardo Becerro de Bengoa , Fernandez David Sevillano , Cervera Luis Alou , Aragón Laura Martín , Iglesias Marta Elena Losa , Yurrita Luis Rodolfo Collado , Lopez Daniel Lopez 
Published: October 2018

Abstract

Background:
Chlorhexidine and parachlorometaxylenol (PCMX) are antiseptics recommended for surgical hand antisepsis. To our knowledge, PCMX has not been evaluated for bactericidal efficacy “in vivo.

Methods:
We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). We assessed bacterial load after a prewash with soft soap, immediately after application of an antiseptic, and 3 hours after application and wearing of sterile, powder-free gloves. Our procedures followed those specified by European Norm (EN) 12791 for evaluating surgical hand antiseptics and using cotton swab for fingertips and fingernails.

Results:
Chlorhexidine digluconate 4% and PCMX 3% did not decrease bacterial load on the hands. The bactericidal performances of chlorhexidine digluconate 4% and PCMX 3% did not differ significantly. Chlorhexidine digluconate 4% and PCMX 3% increased bacterial load on the fingertips after participants had worn gloves for 3 hours. Fingernails had greater bacterial loads than skin on the fingertips.

Conclusions:
Chlorhexidine digluconate 4% and PCMX 3% had similar bactericidal efficacy, but they failed to meet the EN 12791 efficacy standard. Fingernails should be a particular focus of antisepsis in preparation for surgery.
The trial was registered at ClinicalTrials.gov (ID: NCT02500758).
Sertoli–Leydig cell tumors of ovary
Authors: Xu Qiong , Zou Yu , Zhang Xiao Fei 
Published: October 2018

Abstract

Introduction:
The purpose of this study was to report the clinical features, computed tomography (CT) and magnetic resonance imaging (MRI) findings, clinical management, and prognoses of 7 patients with Sertoli–Leydig cell tumors (SLCT) of ovary, and to review the literature of this rare condition.

Methods:
Seven patients with pathologically confirmed ovarian SLCT were included. Their clinical, CT and MRI characteristics (CT images obtained from 6 patients and MR images from 4 patients), clinical management, and prognoses of 7 patients were retrospectively analyzed.

Results:
Patients symptoms included irregular menstruation (n = 3), infertile (n = 1), vaginal bleeding after 7 years of menopause (n = 1), a palpable abdominal mass (n = 1), and abdominal pain (n = 1). Three patients had elevated alpha-fetoprotein (AFP), 1 had elevated cancer antigen 125 (CA125), and 2 had elevated Testosterone (T). The 7 tumors of 7 patients were solid or mixed solid-cystic mass with clear boundaries. The solid components of the tumors showed iso-dense on CT. On MRI, the solid components showed iso- or slightly low signal intensity (SI) on T1-weighted imaging (T1WI), high or slightly high SI on T2WI, and high on diffusion-weighted imaging (DWI) with low apparent diffusion coefficient (ADC) value. On contrast-enhanced CT and MRI, 1 tumor exhibited heterogeneous enhancement consisting of multiple nodules with relatively marked homogeneous enhancement, and other 6 tumors showed moderate or marked and constantly heterogeneous enhancements. All patients were treated with surgical excision. Only 3 had received postoperative chemotherapy. With the exception of 1 patient lost to follow-up, the other 6 patients exhibited tumor-free survival with a median follow-up time of 13.5 months, the longest follow-up time being 24 months.

Conclusion:
The patients of SLCT can present with hormonal magnification and manifest high AFP, CA125, and T levels. SLCT is characterized by a solid or mixed solid-cystic mass on CT/MR scans, and shows marked or moderated heterogeneous and constantly enhancement upon postcontrast study. The clinical characteristics and imaging findings are features and appropriated imaging should be performed whenever an SLCT is suspected.
Giant primary liposarcoma of the anterior mediastinum
Authors: Yang Yu-Shang , Bai Cheng-Yun , Li Zhong-Cheng , Li Wen-Jun , Li Yong 
Published: October 2018

Abstract

Rationale:
Liposarcoma is a cancerous mesenchymal tumor and the most common soft-tissue sarcoma that starts in the adipose tissue. Liposarcoma is commonly found in lower extremities and retroperitoneum, but rarely occurs in the mediastinum.

Patient concerns:
A 63-year-old male was referred to our clinic with a 6-month history of chronic cough and dyspnea.

Diagnose:
Chest x-rays demonstrated a large mass occupying the left hemithorax. Contrast-enhanced computed tomography (CT) revealed a large mass in the anterior mediastinum, which caused the extrinsic compression of the main and left pulmonary artery and the right shift of mediastinum. Diagnosis of liposarcoma was confirmed by microscopic examination and immunohistochemistry analysis.

Interventions:
The patient underwent a thoracotomy for resection of the mediastinal lesion via left thoracic approach.

Outcomes:
The patient discharged without any complications and has been continuing to follow up in clinic without any complaints.

Lessons:
The primary mediastinal liposarcoma is rare, and we recommend that the liposarcoma should be considered in the differential diagnosis of a patient presenting with a mediastinal mass.
Brachial plexus schwannoma mimicking cervical lymphadenopathy
Authors: Ryu Kyeong Hwa , Moon Jin Il , Baek Hye Jin , Cho Soo Buem , Choi Bo Hwa , An Hyo Jung , Song Dae Hyun 
Published: October 2018

Abstract

Rationale:
Brachial plexus schwannomas are rare benign tumors that are derived from Schwann cells. Because they are rare, and because of the complexity of the anatomy of the neck, these tumors can be a challenge to diagnose for radiologists and clinicians. In the present study, we describe a clinical case of brachial plexus schwannoma detected on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), and presenting as a palpable neck mass.

Patient concerns:
A 49-year-old woman had a palpable mass in the right neck, which had been there for the last 1 year. Metastatic cervical lymphadenopathy was suspected in the primary health clinic; therefore, the patient was referred to our hospital.

Diagnoses:
The right neck mass was a well-circumscribed oval soft tissue mass on US, CT, and MRI. US-guided core needle biopsy was performed and the mass was proved to be a schwannoma.

Interventions:
The patient did not undergo surgical excision because the brachial plexus schwannoma was small and there was no accompanying neurological symptom.

Outcomes:
The patient is being followed up regularly at the outpatient department.

Lessons:
Brachial plexus schwannoma should be considered for a differential diagnosis in patients with a palpable neck mass, and imaging studies play an important role in diagnosing the brachial plexus schwannoma.
Higher age at diagnosis of hemochromatosis is the strongest predictor of the occurrence of hepatocellular carcinoma in the Swiss hemochromatosis cohort
Authors: Nowak Albina , Giger Rebekka S. , Krayenbuehl Pierre-Alexandre 
Published: October 2018

Abstract
Hereditary hemochromatosis (HH) is the most common genetic disease in Caucasians which is characterized by an increased intestinal iron absorption, resulting into a progressive accumulation of iron in organs including liver, heart, and pancreas, leading to their progressive dysfunction. Hepatocellular carcinoma (HCC) is a long-term complication of HH, which contributes to increased mortality.
We evaluated the risk factors of HCC in a prospective cohort of Swiss hemochromatosis patients with a long-term follow-up.
We included 147 patients with the mean age at diagnosis of 48 years, in whom 70% were men. Overall, 9% of the patients developed HCC during the mean follow-up time of 14 years (range 1–40 years). Patients with HCC had higher age at diagnosis (61 ± 11 vs 47 ± 13 years, P = .003), more frequently liver cirrhosis on biopsy (90% vs 37.5%, P = .004), and higher serum ferritin levels [3704 (Q1:2025, Q3:4463) vs 1338 (Q1:691, Q3:2468) μg/L, P < .001], they needed more iron removed by phlebotomy until its depletion [8.9 (Q1:7.2, Q3:10.1) vs 3.8 (Q1:1.6, Q3:8.9) g, P = .029], compared to non-HCC patients. After adjustment for possible confounders, only higher age at diagnosis remained significantly associated with HCC development (odds ratio 1.19, 95% CI 0.056–0.397, P = .001, per year).
Higher age at diagnosis showed the strongest association with the occurrence of HCC in Swiss hemochromatosis patients. Patients who were diagnosed at a higher age and with a high iron overload (serum ferritin levels >1000 μg/L) require regular screening even if they have no liver cirrhosis.
Hormonal biomarkers for the noninvasive diagnosis of endometriosis
Authors: Shen Minghui , Gao Ya , Ma Xueni , Wang Bo , Wu Jiarui , Wang Jiancheng , Li Jipin , Tian Jinhui , Jia Junhai 
Published: October 2018

Abstract

Background:
Endometriosis is a major cause of disability and compromised the quality of life in women and teenage girls. The gold standard for diagnosis of endometriosis is laparoscopy with histology of excised endometriosis lesions. However, women can suffer for 8 to 12 years before obtaining a correct diagnosis. Several biomarkers showed good diagnostic value for endometriosis, but no studies directly or indirectly compare the diagnostic value of different biomarkers. We perform this network meta-analysis (NMA) to assess the diagnostic accuracy of hormonal biomarkers, and to find a most effective hormonal biomarker for the diagnosis of endometriosis.

Methods:
A systematic search will be performed using PubMed, EMBASE, Cochrane Library and Chinese Biomedicine Literature to identify relevant studies from inception to August 2018. We will include random controlled trials, cross-sectional studies, case-control studies, and cohort studies that evaluated the diagnostic accuracy of hormonal markers for endometriosis. The Quality Assessment of Diagnostic Accuracy Studies 2 quality assessment tool will be used to assess the risk of bias in each study. Standard pairwise meta-analysis and NMA will be performed using STATA V.12.0, MetaDiSc 1.40 and R 3.4.1 software to compare the diagnostic efficacy of different hormonal biomarkers.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
This study will summarize the direct and indirect evidence to determine the diagnostic accuracy of the hormonal biomarkers for endometriosis and attempt to find a most effective biomarker for the diagnosis of endometriosis.

Ethics and dissemination:
Ethics approval and patient consent are not required as this study is a meta-analysis based on published studies.

PROSPERO registration number:
CRD42018105126.
Prevalence of nonsuicidal self-injury in chinese middle school and high school students
Authors: Lang Junjie , Yao Yingshui 
Published: October 2018

Abstract
Recent studies have revealed a high rate of nonsuicidal self-injury (NSSI) behavior in Chinese students, but quantitative syntheses of pooled prevalence are sparse. There have been several NSSI prevalence meta-analyses in other populations. However, given the existence of cultural diversity, racial difference, educational system difference and so on, these results may not be ideal for Chinese populations. Furthermore, the above-mentioned meta-analyses did not include Chinese database which may have led to unintentional bias. Thus, we conducted this meta-analysis to estimate the prevalence of NSSI in Chinese middle-school students.
The databases searched included PubMed, Embase, Web of Science, CBM (Chinese database), Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (Chinese database) and the Weipu database (Chinese database). The search terms included: self-injury/self-harm/self-abuse/nonsuicidal self-injury/deliberate self-harm, adolescen∗/youth/teen/students, and China/Chinese. All relevant articles published between January 2000 to November 2017, in either Chinese or English, were included. Two investigators were engaged in this process, and any disagreements were settled by a third investigator. A random effects model was then used to calculate the pooled prevalence.
A total of 420 studies with 160,348 participants were retrieved. The pooled prevalence was 22.37% (95% CI: 18.84%–25.70%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the pooled estimate of prevalence of life time NSSI was 14.5% (95%CI: 0.06%–22.7%), and 6–24 months NSSI was23.3% (95%CI: 20.5%–26.1%). The prevalence for males was 20.6% (95% CI: 16.1%–25.0%), and for females was 21.9% (95% CI: 17.6%–26.2%).
The prevalence of NSSI in Chinese middle-school students is relatively high. More attention should be paid to the current situation.
A randomized interventional study to promote milk secretion during mother–baby separation based on the health belief model
Authors: Liu Yi , Yao Jianrong , Liu Xinghui , Luo Biru , Zhao Xiufang 
Published: October 2018

Abstract

Background
Breast milk is the most important nutrition for premature babies, but mothers of premature infants have difficulty in initiating and sustaining lactation. Breastfeeding infants who are separated with mothers have decreased morbidity. Nevertheless, such decrease is limited due to insufficient milk supply resulting from mother–baby separation during lac.

Objective
To evaluate the effect of intervention methods based on the health belief model on promoting the secretion of milk among mothers who were separated with their babies.

Methods
In this prospective, randomized controlled clinical trial, we enrolled 260 separation mothers between September 26, 2016 and March 7, 2017, in a 3rd-grade women and children hospital of Chengdu. The mothers all had cesarean delivery and were randomized into 2 groups: the intervention group (educated by investigators based on the health belief) and the control group (routinely educated by obstetric nurses). Data on the onset of lactation and the milk volume during 3 days postpartum were collected. The breast swelling rate within 3 days postpartum and the exclusive breastfeeding rate at 42 days postpartum were compared. The psychologic scores of separation maternal in both groups were assessed with State-Trait Anxiety Inventory at the 3rd day postpartum.

Results
Compared with the control group, the intervention group had significantly earlier lactation time (P < .01), significantly larger milk volume (P < .01) during 24, 24 to 48, and 48 to 72 hours, and significantly lower psychologic scores (P < .01) at the 3rd-day postpartum.
The onset of lactation among mothers who initiated milk expression within 1 hour after childbirth were earlier than those who initiated milk expression between 1 and 6 hours (P < .01); the milk volume within 24-hour postpartum did not differ significantly between the 2 groups (P > .05). However, the milk volume of the early-expression group (<1 hour) was significantly higher than that of the late-expression group (1–6 hours) during 24 to 48 and 48 to72 hours (P < .05).
The breast swelling rate of separation mothers within 3 days postpartum in the intervention group was lower than that in the control group (P < .05). The exclusive breastfeeding rate of mothers in the intervention group was significantly higher than that in the control group (59% vs 35%; P < .01) at 42 days postpartum.

Conclusion
Nursing intervention based on the health belief model can stimulate milk secretion in mothers who were separated with their babies.