bluuebunny/crossref_metadata_2025 huggingface dataset:
Autoimmune hepatitis presenting as acute liver failure: A 20-year retrospective review of North America
Authors: Enke Thomas , Livingston Sherry , Rule Jody , Stravitz Todd , Rakela Jorge , Bass Nathan , Reuben Adrian , Tujios Shannan , Larson Anne , Sussman Norman , Durkalski Valerie , Lee William , Ganger Daniel
Published: February 2023

Autoimmune hepatitis is a common cause of acute liver failure. Treatment includes steroids for acute liver injury and liver transplantation in those who fail to respond or develop acute liver failure. The aim of this study is to further characterize acute liver failure secondary to autoimmune hepatitis and identify variables that predict 21-day transplant-free survival. This study included adults hospitalized with acute liver failure enrolled in the Acute Liver Failure Study Group Registry between 1998 and 2019 from 32 centers within the US. The etiology of all cases was reviewed by the Adjudication Committee, and all cases identified as autoimmune hepatitis were included. Acute liver injury was defined as an INR ≥2.0 without encephalopathy and acute liver failure as INR ≥ 1.5 with encephalopathy. Laboratory and clinical data were reviewed. Variables significantly associated with 21-day transplant-free survival were used to develop a multivariable logistic regression model.  A total of 193 cases of acute liver failure secondary to autoimmune hepatitis were identified and reviewed. There were 161 patients (83.4%) diagnosed with acute liver failure on enrollment, and 32 (16.6%) developed acute liver failure during hospitalization. At 21 days, 115 (59.6%) underwent liver transplantation, 28 (14.5%) had transplant-free survival, and 46 (23.8%) died before liver transplantation. Higher admission values of bilirubin, INR, and coma grade were associated with worse outcomes. A prognostic index incorporating bilirubin, INR, coma grade, and platelet count had a concordance statistic of 0.84. Acute liver failure secondary to autoimmune hepatitis is associated with a high short-term mortality. We developed a model specifically for autoimmune hepatitis that may be helpful in predicting 21-day transplant-free survival and early identification of patients in need of expedited liver transplant evaluation.
Granular cell tumor of the neck treated using a local flap: A case report
Authors: Lee Chan Mi , Hong Yong Tae
Published: February 2023

Rationale:

Granular cell tumors are rare soft tissue neoplasms derived from nerve that can arise in the oral cavity, skin, or gastrointestinal tract. Various hypotheses have proposed that granular cell tumors originate from the nervous system, skeletal muscle, and Schwann cells.

Patient concerns:

A 47-year-old male patient presented with a 5 cm cervical mass.

Diagnoses:

Computed tomography showed a 4 cm-sized homogeneous enhancing mass infiltrating the sternocleidomastoid muscle and even the surrounding skin.

Interventions:

Extensive surgical resection of the tumor including the skin was performed. A submental transposition local flap was used for the wide skin defect.

Outcomes:

Histologic finding showed polygonal granular cells with rich eosinophilic coarse granular cytoplasm without interstitial tissue without mitosis or necrosis. Immunohistochemically, the tumor cells were positive for S100 and CD68, which is consistent with classic granular cell tumors.

Lessons:

In microscopic observations, granular cell tumors do not have a defined boundary with surrounding tissues, and they display an infiltrating pattern that can expand to adjacent tissue. As a result, the tumor should be removed with a sufficient margin, including the normal tissues surrounding it. The authors experienced granular cell tumor in the muscle layer of the head and neck. It could be treated without recurrence through extensive surgical resection and local flap.
The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis
Authors: Rodrigues-Santana Luiz , Hugo Louro , Pérez-Gómez Jorge , Hernández-Mocholí Miguel A. , Carlos-Vivas Jorge , Saldaña-Cortés Pilar , Contreras-Barraza Nicolás , Adsuar José C.
Published: February 2023

Background:

This systematic review and meta-analysis set out to determine the efficacy of whole-body muscle electrostimulation on body composition, strength, and muscle power in active and non-active adults (aged ≥18 years).

Method:

This review was reported in accordance with the Protocol Statement of Preferred Reporting Element Guidelines for Systematic Reviews and Meta-Analysis included controlled trials; whole-body electromyostimulation trials with at least 1 exercise and control group; participants >18 years old. Outcome measures were defined as standardized mean differences for muscle mass, body fat mass, strength, and power. Studies were searched in the following electronic databases: PubMed, Web of Science, Scopus, SPORTDiscus, and EMBASE for all articles published up to July 30, 2021. The risk of bias was assessed by 2 independent researchers using the Physiotherapy Evidence Database scale and Grading of Recommendations, Assessment, Development and Evaluations approach. Analyses were performed using the metafor package of the statistical software R (version 4.0.3; R Core Team, 2020). Random effects models, forest, and funnel plots to quantify the asymmetry associated with publication bias were fitted using the metafor library in R. Statistical heterogeneity was assessed using I
2 statistics.

Results:

In total, 26 studies representing 1183 participants were included (WB-electromyostimulation: n = 586 and control group: n = 597). The mean age of the participants ranged from a minimum of 20.4 to a maximum of 77.4 years old. Interventions lasted a minimum of 4 and a maximum of 54 weeks. Standardized mean difference was 0.36 (95% confidence interval [CI]: 0.16–0.57) for muscle mass, −0.38 (95% CI: −0.62–0.15) for body fat, 0.54 (95% CI: 0.35–0.72) for strength, and 0.36 (95% CI: 0.02–0.71) for power with significant differences between groups (all P < .04). I
2 revealed low heterogeneity of muscle mass (15%) and power (0%) between trials and medium heterogeneity of body fat (45%) and strength (55%).

Conclusion:

We concluded that WB-electromyostimulation has significant positive effects on muscle mass, body fat, strength, and power.
Which patients with hydrosalpinx will benefit more from reproductive surgery to improve natural pregnancy outcomes?: A systematic review and meta-analysis
Authors: Hao Hong-Juan , Wang Zhao-Hua , Feng Li , Zhao Xiao-Li , Chen Xiao
Published: February 2023

Background:

The most common tubal disease leading to infertility occurs in the distal region, manifesting as hydrosalpinx. Tubal surgery is an effective alternative treatment. However, subpopulations that benefit the most from tubal repair surgery remain unclear. The objective of this study was to investigate the natural pregnancy outcomes of patients with hydrosalpinx after reproductive surgery and those with different grades of hydrosalpinx.

Methods:

We searched the major online databases (PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials) to collect observational studies on patients with hydrosalpinx who underwent surgeries to preserve natural fertility from January 2000 to August 2022. The outcome indicators were natural intrauterine pregnancy (IUP) and ectopic pregnancy (EP) rates. Studies on patients with hydrosalpinx who underwent laparoscopic surgeries and those who intended to be conceived naturally were included. Studies on patients with non-hydrosalpinx diseases, those who underwent open surgery, and those who intended to undergo assisted conception were excluded. The Newcastle–Ottawa scale for observational studies was used for quality evaluation. Meta-analysis of a single rate was performed using RevMan5.3 software.

Results:

A total of 10 articles were included in this study, including 1317 patients with hydrosalpinx. Seven studies were retrospective and 3 were prospective. It was found that after surgery for preserving natural fertility function, the IUP and EP rates of patients with hydrosalpinx were 27% (95% confidence interval [CI]: 22–32%) and 4.8% (95% CI: 2.91–8.26%), respectively. In addition, the IUP and EP rates in patients with mild (n = 254), moderate (n = 252), and severe (n = 473) hydrosalpinx were 50.5% (95% CI: 38.65–61.97%), 32.9% (95% CI: 21.88–46.24%), 10.7% (95% CI: 4.76–21.88%), and 7.4% (95% CI: 2.91–19.35%), 9.09% (95% CI: 6.54–13.79%), 8.3%, 8.26% (95% CI: 3.85–18.03%), respectively.

Conclusion:

Patients with mild to moderate hydrosalpinx will benefit more from reproductive surgery to improve natural pregnancy outcomes. However, the small sample size in our study needs to be further expanded, and the grouping needs to be more refined, such as grouping based on age. This may provide more guidance in clinical practice.
Combination therapy of oral cyclophosphamide and bevacizumab for patients with recurrent ovarian and peritoneal cancer
Authors: Goto Mayako , Tsubamoto Hiroshi , Isono-Taniguchi Roze , Takimoto Yumi , Tashima Lena , Hori Kensuke , Ito Kimihiko
Published: February 2023

Chemotherapy for patients with recurrent cancer aims to obtain survival benefits, relieve symptoms, and improve quality of life. We used oral cyclophosphamide and bevacizumab (BEV) combination therapy in recurrent ovarian and peritoneal cancer cases, where standard chemotherapy was infeasible. Subsequently, we evaluated the safety and efficacy of this treatment. Between August 2014 and June 2020, patients received the following regimen: oral cyclophosphamide 50 mg daily and intravenous cyclic BEV 15 mg/kg every 3 weeks. Data from 2 facilities were retrospectively analyzed. Twenty-two patients were enrolled (20 with ovarian cancer and two with peritoneal cancer). The median follow-up period and age were 18.9 months (range, 5.0–51.5) and 60 years (range 37–81), respectively. Sixteen patients had platinum resistance. The median number of previous chemotherapy regimens was 2.5 (range 0–5). The median implementation cycle was five (range 2–14). Eighteen patients discontinued treatment due to side effects (3 patient) and disease progression (15 patient). Grade 2 toxicities included neutropenia (1 patient), proteinuria (1 patient), hypertension (2 patient), and esophagitis (1 patient). Two patients had complete response and one had a partial response. Five patients had stable disease. The response rate in platinum-sensitive recurrence was 33.3%, and 7.1% in platinum-resistant recurrence, and a clinical benefit was found in 8 (36.3%) patients. The median PFS and overall survival from cyclophosphamide and BEV initiation was 5.3 months (range, 0.8–23.5) and 9.2 months (range, 4.8–51.5), respectively. The combination of oral cyclophosphamide and BEV does not have a high response rate, but is well-tolerated and can be used safely in patients who are difficult to treat after second-line chemotherapy.

Data from 2 facilities were retrospectively analyzed.
Probiotics to prevent necrotizing enterocolitis and reduce mortality in neonates: A meta-analysis
Authors: Wang Hongbo , Meng Xinyao , Xing Shihan , Guo Baotong , Chen Yuhan , Pan Yu-Qing
Published: February 2023

Background:

Probiotics are gradually being used as a supplementation to prevent necrotizing enterocolitis (NEC) and reduce mortality in neonates. We performed an updated meta-analysis to systematically evaluate the efficacy and safety of prophylactic probiotic supplementation for preventing NEC.

Methods:

The databases including PubMed, Embase, Scopus, Web of Science, and China National Knowledge Infrastructure were used to search the relevant articles. The latest retrieval date was up to December 2021. The meta-analysis was performed using Stata version 10.0. Finally, a total of 70 studies containing 8319 cases and 9283 controls were included. The strength of the association between the supplementation of probiotics and NEC was measured by risk ratios (RRs) with 95% confidence intervals (CIs). Pooled effect sizes across studies were performed by a random effect model.

Results:

The results showed that the probiotics could significantly reduce the incidence of NEC (stage II or more) (RR = 0.436, 95% CI = 0.357–0.531, P < .001), the overall mortality (RR = 0.651, 95% CI = 0.506–0.836, P < .001), and NEC-related mortality (RR = 0.639, 95% CI = 0.423–0.966, P = .034). Due to the lack of sufficient sample size, we did not perform the subgroup analysis by types of probiotic strain.

Conclusion:

This meta-analysis indicates that the use of probiotics can effectively reduce the occurrence of NEC and mortality in neonates.
Financial InceNtives for cArdiac rehabilitatioN ComplEtion (FINANCE) (single blind pragmatic RCT)
Authors: Lee Jae In , Han Jae-Young , Gwak Hae-Bin , Moon Chang-Won , Sohn Min Kyun , Jee Sungju , Kim Chul
Published: February 2023

Introduction:

Cardiac rehabilitation (CR) is strongly indicated in patients with acute myocardial infarction (MI), and has been proven to reduce mortality and recurrence and improve patients quality of life. Although clinical guidelines for CR have already been developed domestically and internationally, hospital-based CR remains underutilized. Currently, studies exploring strategies to improve CR participation in South Korea and Asia are limited.

Objectives:

This study aims to compare the effect of providing CR financial incentives to post-MI patients referred for outpatient CR and to confirm the effect of increasing CR participation and completion rates.

Methods:

This single-blind, pragmatic, randomized controlled trial will be conducted at 2 tertiary hospitals for CR after acute MI. The control and experimental groups will be randomized, with each group consisting of 24 participants (total of 48 participants) assigned in a 1:1 ratio. The experimental group will receive 4, 7, and 11 USD per completed session of CR during the 1st to 12th, 13 to 24th, and 25th to 36th sessions of CR, respectively, for 3 months after enrollment. Participants who completed the 36 sessions will receive 260 USD incentives. The primary outcomes at 3 months will be used to assess the CR participation rate, as the number of CR sessions completed, and CR completion, as attendance of sessions greater than 50%, thus completion of ≥18 sessions. The outcomes will be used to compare changes in cardiorespiratory function (VO2 max, VO2 at anabolic threshold), the Korean activity scale index, EuroQol 5 dimensions, and the patient health questionnaire at 3 months after discharge and 6 and 12 months after baseline.

Discussion:

Providing financial incentives may confirm the effect of increasing CR on participation and completion rates.
Comprehensive analysis of the prognosis of S100 family members and their relationship with tumor-infiltrating immune cells in human pancreatic adenocarcinoma
Authors: Ren Yajun , Chen Bing , Zhang Meng , Xu Feng
Published: February 2023

S100 family members (S100s) are small molecular EF hand calcium binding proteins and widely expressed in many tissues and organs. S100s are shown to be biomarkers of disease progression and prognosis in various types of cancers. Nevertheless, the expression patterns, function, and prognostic values of S100s and its association with tumor-infiltrating immune cells in pancreatic adenocarcinoma (PAAD) patients have not been systematically clarified. We explored the expression and roles of the entire 20 S100s in PAAD patients by using the following public databases: Oncomine, gene expression profiling interactive analysis, cBioPortal, Metascape, search tool for recurring instances of neighboring genes, Tumor IMmune Estimation Resource, and GeneMANIA. The S100A2/A3/A4/A6/A8/A9/A10/A11/A13/A14/A16/B/P mRNA expressions were significantly upregulated in PAAD patients. The mRNA expression of S100A3/A4/A5/A6/A10/A11/A14/A16/Z were significantly negatively related with the tumor stage in PAAD patients. We found that the S100A2/A3/A5/A10/A11/A14/A16 were significantly correlated with poor overall survival, whereas the increased levels of S100A1/B/G/Z were strongly associated with good overall survival. We found significant correlations among S100s and tumor-infiltrating immune cells. Cox proportional risk models revealed that B cells, Dendritic cells and S100A1/A5/A6/A8/A9/A13/A14 were significantly related with outcomes in PAAD patients. These results suggest that S100A2/A3/A10/A11/A14/A16 may serve as new diagnostic and prognostic biomarkers for PAAD patients and provide new clues for immunotherapy in PAAD patients.
The diagnosis and treatment of scrub typhus should be emphasized in non-endemic areas: A retrospective case series study
Authors: Song Xin , Xie Shu , Huang Xinhui , Chen Zhi
Published: February 2023

The morbidity of tsutsugamushi is increasing and is no longer limited to endemic areas. Delayed diagnosis and inappropriate treatment can cause severe complications and increase mortality rates. We conducted a retrospective case series of patients with scrub typhus at our institution to report our experience and discuss the diagnostic modalities. We encountered 21 cases of scrub typhus at our institution between 2014 and 2022. The average age of the patients was 52 years (range: 22–63 years), 11 (52%) were farmers, and 11 (52%) had clear outdoor activities. Twenty (95%) patients had an ineffective history of general antibiotic treatment. The classic presentation was repeated fever in 95% of patients. Seventeen patients (81%) had eschar mainly on the groin (35%) and armpit (35%). Common laboratory findings included eosinophilia (95%), elevated alanine aminotransferase (95%), elevated aspartate aminotransferase (86%), thrombocytopenia (76%), lower hemoglobin (71%), and neutrophilia (38%). Six (29%) patients received the treatment of tigecycline, 4 (19%) patients received the treatment of doxycycline, and 11 (52%) patients received the treatment of minocycline. After 3 days of specific treatment, the eosinophilic levels showed a recovery trend. Twenty (95%) patients fully recovered, and 1 (5%) died. Careful physical examination and medical history are important for the early diagnosis of scrub typhus; clinicians in non-endemic areas need to strengthen their understanding of scrub typhus.
High-intensity and moderate-intensity interval training in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials
Authors: Lai Ping , Xue Jin-Hua , Xie Mu-Jin , Ye Jin-Hua , Yang Ning , Zhong Yi-Ming , Liao Yong-Ling
Published: February 2023

Background:

Exercise training significantly improves cardiorespiratory fitness (CRF) in heart failure with reduced ejection fraction (HFrEF) patients, but high-intensity interval training (HIIT) is not superior to moderate-intensity interval training (MIIT). Whether HIIT is more beneficial than MIIT in patients with heart failure with preserved ejection fraction (HFpEF) remains unclear.

Methods:

On August 29, 2021, we conducted a comprehensive computerized literature search of the Medline, EMBASE, Web of Science, and Cochrane databases using the following keywords: “HF or diastolic HF or HFpEF or HF with normal ejection fraction and exercise training or aerobic exercise or isometric exercises or physical activity or cardiac rehabilitation.” Only randomized controlled trials (RCTs) reporting comparisons between HIIT and MIIT in HFpEF were included in the final analysis to maintain consistency and obtain robust pooled estimates. Methodological quality was assessed based on the ratings of individual biases. To generate an overall test statistic, the data were analyzed using the random-effects model for a generic inverse variance. Outcome measures were reported as an odds ratio, and confidence intervals (CIs) were set at 95%. The study followed PRISMA guidelines.

Results:

This meta-analysis included only RCTs comparing the efficacy of HIIT and MIIT in HFpEF patients. This study included 150 patients from 3 RCTs. In the current pooled data analysis, HIIT significantly improves diastolic function measured by E/A ratio (WMD, 0.13; 95% CI, 0.03–0.23, P = .009). However, no significant change was observed in the diastolic function measured by E/e’ ratio (WMD, 0.39; 95% CI, −2.40 to 3.18, P = .78), and CRF evaluated by both VO2 (mL/kg per min; WMD, −0.86; 95%CI, −5.27 to 3.55, P = .70) and VE/CO2 slope (WMD, 0.15; 95% CI, −10.24 to 10.53, P = .98), and systolic function (EF-WMD, −2.39; 95% CI, −12.16% to 7.38%, P = .63) between HIIT and MIIT in patients with HFpEF.

Conclusion:

In HFpEF patients, HIIT may be superior to MIIT in improving diastolic function, measured by E/A, but not CRF and left ventricular systolic function.
A phase 2/3 study of S-217622 in participants with SARS-CoV-2 infection (Phase 3 part)
Authors: Yotsuyanagi Hiroshi , Ohmagari Norio , Doi Yohei , Imamura Takumi , Sonoyama Takuhiro , Ichihashi Genki , Sanaki Takao , Tsuge Yuko , Uehara Takeki , Mukae Hiroshi
Published: February 2023

Background:

Limited treatment options exist for patients with mild-to-moderate coronavirus disease 2019 (COVID-19), irrespective of vaccination history or risk status. Ensitrelvir is a novel oral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3C-like (3CL) protease inhibitor. While phase 2 studies of ensitrelvir have demonstrated promising results in treating mild-to-moderate COVID-19, evaluation of its clinical efficacy due to shifting vaccination status and emergence of the Omicron variant represents significant challenges. Here, we describe the protocol for a phase 3 study designed to evaluate the efficacy and safety of ensitrelvir in patients with mild-to-moderate COVID-19, regardless of risk status or vaccination history.

Methods:

This is a multicenter, randomized, double-blind, placebo-controlled, phase 3 study. Patients with mild-to-moderate COVID-19 within 120 hours from onset will be randomized in a 1:1:1 ratio into 3 treatment arms–ensitrelvir 125 mg (375 mg loading dose on Day 1), ensitrelvir 250 mg (750 mg loading dose on Day 1), and placebo. The study interventions will be administered orally, once-daily, for 5 days. The primary endpoint will be the time to resolution of 5 symptoms of COVID-19 (stuffy or runny nose, sore throat, cough, feeling hot or feverish, and low energy or tiredness), and the key secondary endpoints will include the change from baseline on Day 4 in the amount of SARS-CoV-2 viral ribonucleic acid (RNA) and the time to first negative SARS-CoV-2 viral titer. The primary population for the primary and key secondary endpoints will be patients with <72 hours from COVID-19 onset to randomization and, subsequently, patients in entire patient population (<120 hours) in the ensitrelvir 125 mg group. Closed testing procedure will be used for the primary and key secondary endpoints in both the primary and entire patient populations. All safety assessments and adverse events (AE) will be reported.

Discussion:

In a post hoc analysis of the phase 2b study, compared with placebo, ensitrelvir demonstrated a reduced time to resolution of 5 symptoms in patients with mild-to-moderate COVID-19. Through this study, we intend to validate and establish the efficacy and safety of ensitrelvir in patients with mild-to-moderate COVID-19.
Neuraxial analgesia during labor and postpartum depression: Systematic review and meta-analysis
Authors: Li Bin , Tang Xiaohui , Wang Tingting
Published: February 2023

Background:

Severe pain has been linked to depression, which raises the question of whether neuraxial analgesia during childbirth is associated with a reduced risk of postpartum depression. This association has been explored, but previous studies did not control or analyze relevant confounders. We conducted a systematic review and meta-analysis to determine the association between neuraxial analgesia and postpartum depression.

Methods:

A systematic review was conducted using PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Studies that tested the effect of neuraxial analgesia during labor on depression or depressive symptoms in the first year postpartum were included. Relevant articles were extracted independently by 2 authors.

Results:

In total, 14 studies (86,231 women) were included. The association between neuraxial analgesia and the long-term incidence of postpartum depression after childbirth was the risk ratio = 0.75, 95% confidence interval (CI): 0.56–1.00, P = .05; I
2 = 79%, P < .00001. There was a significant association (pooled risk ratio = 0.55, 95% CI: 0.34–0.90, P = .02; I
2 = 55%, P = .06) between neuraxial analgesia and the incidence of postpartum depression in the first week after delivery. The subgroup analysis showed a trend suggesting that in Asian populations, those who received neuraxial analgesia had lower postpartum depression rates than those who received non-neuraxial analgesia (risk ratio = 0.57, 95% CI: 0.38–0.86; P = .008; I
2 = 82%) at ≥4 weeks after delivery.

Conclusion:

Neuraxial analgesia may be beneficial for the short-term and long-term mental effects of parturient women, especially for short term after delivery. High-quality studies addressing the role of neuraxial analgesia during labor and its impact on postpartum depression remain necessary.
Association of TLR4 gene 2026A/G (rs1927914), 896A/G (rs4986790), and 1196C/T (rs4986791) polymorphisms and cancer susceptibility: Meta-analysis and trial sequential analysis
Authors: Wang Fengzhen , Wen Xianming , Wen Ting , Liu Ziyou
Published: February 2023

Background:

This study was performed to assess the association of TLR4 gene 2026A/G (rs1927914), 896A/G (rs4986790), and 1196C/T (rs4986791) polymorphisms and cancer susceptibility based on published case-control studies.

Methods:

Web of Science, PubMed, Embase, CBM, WanFang Data, CNKI, and VIP database were used for article retrieving. Then, these articles were screened according to the study inclusion and exclusion criteria. The data was extracted, and the study quality was evaluated according to the principle of Newcastle-Ottawa Scale. Meta-analysis was performed by RevMan 5.4 and Stata MP-17 software. Trial sequential analysis was performed by TSA 0.9.5.10 Beta software.

Results:

Eighty-seven case-control studies including 25,969 cases and 32,119 controls were included in the meta-analysis. The diseases involved in case groups include prostate cancer, lung cancer, gastric cancer, hepatocellular carcinoma, colorectal cancer, etc. A versus G model of rs1927914, A versus G model of rs4986790 and C versus T model of rs4986791 showed that odds ratio (OR) = 1.08, OR = 0.85, and OR = 0.74 respectively. All the 3 comparisons were statistically significant. Sensitivity analysis showed that the results were stable. Publication bias analysis and trial sequential analysis showed that no significant publication bias was found in the results of the meta-analysis, and the probability of false positives was small.

Conclusion:

People with A allele of rs1927914, G allele of rs4986790, or T allele of rs4986791 have higher risks of cancer. The results of meta-analysis are stable and have less probability of false positives.
Hemodynamic response related to the Airway Scope versus the Macintosh laryngoscope: A systematic review and meta-analysis with trial sequential analysis
Authors: Nagumo Takumi , Hoshijima Hiroshi , Maruyama Koichi , Mihara Takahiro , Mieda Tsutomu , Sato (Boku) Aiji , Shiga Toshiya , Nagasaka Hiroshi
Published: February 2023

Background:

It is important to reduce the hemodynamic response during tracheal intubation. We performed a systematic review and meta-analysis of the Airway Scope and Macintosh laryngoscope to determine whether they reduce the hemodynamic responses of heart rate (HR) and mean blood pressure (MBP) after tracheal intubation under general anesthesia.

Methods:

We performed a comprehensive literature search of electronic databases for clinical trials comparing hemodynamic response to tracheal intubation. The primary aim of our meta-analyst is to determine if the Airway Scope reduces hemodynamic responses (HR and mean MBP) 60 seconds after tracheal intubation compared to the Macintosh laryngoscope. We expressed pooled differences in hemodynamic responses between the 2 devices as weighted mean differences with 95% confidence intervals. We conducted trial sequential analysis. Secondarily, we investigated the ability of the Airway Scope and Macintosh laryngoscope to reduce hemodynamic responses at 120 seconds, 180 seconds, and 300 seconds after tracheal intubation.

Results:

We identified clinical trials comparing hemodynamic response via a comprehensive literature search. Of 185 articles found in the search, we selected 8. In comparison to the Macintosh laryngoscope, the Airway Scope significantly reduced HR and MBP at 60 seconds after tracheal intubation (HR; weighted mean difference = −7.29; 95% confidence interval, −10.9 to −3.62; P < .0001; I
2 = 57%, MBP; weighted mean difference = −11.5; 95% confidence interval, −20.4 to −2.65; P = .01; I
2 = 91%). At the secondary outcome, the Airway Scope significantly reduced the fluctuation of HR after 120 seconds and 180 seconds of tracheal intubation. However, the Airway Scope did not significantly reduce MBP 120 seconds, 180 seconds, and 300 seconds after tracheal intubation. Trial sequential analysis suggested that the total sample size reached the required information size for heart rate.

Conclusions:

Our finding suggested that the Airway Scope attenuated hemodynamic responses at 60 seconds after tracheal intubation in comparison with that of the Macintosh laryngoscope. However, the MBP sample size is small and further research is needed.
Descriptive study: Feasibility of integrating hypertension screening into HIV assisted partner notification services model in Kenya
Authors: Mogaka Jerusha N. , Lagat Harrison , Otieno George , Macharia Paul , Wamuti Beatrice , Masyuko Sarah , Sharma Monisha , Kariithi Edward , Farquhar Carey , Temu Tecla M.
Published: February 2023

Prevalence of hypertension (HTN) and human immunodeficiency virus (HIV) are high among men while screening rates are low. Assisted partner notification service is a strategy recommended by the World Health Organization that aims to increase HIV testing and treatment uptake and may present an opportunity to offer integrated HIV/HTN screening and treatment services. In this prospective cohort study, we assessed the feasibility of integrating HTN screening for male sexual partners of females newly tested HIV-positive in 10 health facilities in Kenya. Participants were notified of the exposure and offered HIV testing and HTN screening; if they accepted and tested positive for either HTN, HIV, or both, they were referred for care. HTN was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90, or the use of antihypertensive medication. Among 1313 male partners traced, 99% accepted HIV testing and HTN screening. Overall, 4% were found to have HTN, 29% were in the pre-HTN stage, and 9% were HIV-positive. Only 75% had previously been screened for HTN compared to 95% who had previously tested for HIV. A majority preferred non-facility-based screening. The participants who refused HTN screening noted time constraints as a significant hindrance. HIV and HTN screening uptake was high in this hard-to-reach population of men aged 25 to 50. Although HTN rates were low, an integrated approach provided an opportunity to detect those with pre-HTN and intervene early. Strategic integration of HTN services within assisted partners services may promote and normalize testing by offering inclusive and accessible services to men.
Factors predicting mortality in patients with alcoholic liver cirrhosis visiting the emergency department
Authors: Jeong Jin Hee , Lee Sang Bong , Sung Aejin , Shin Hyuntack , Kim Dong Hoon
Published: February 2023

Liver cirrhosis (LC) is a major cause of morbidity and mortality worldwide and is becoming a regional and healthcare burden. South Korea is one of the 10 countries with the highest age standardized prevalence of decompensated LC. Moreover, the proportion of patients with alcoholic LC is increasing and there has been no decrease in the incidence of decompensated alcoholic LC. Patients with decompensated LC frequently visit the emergency department (ED). Several studies focused on patients with LC who visited the ED, but the studies about alcoholic LC were limited. This study aimed to identify predicting factors for mortality in alcoholic LC patients visiting the ED. This was a retrospective study of alcoholic LC patients who visited an ED between November 2017 and June 2021. The baseline characteristics, complications of LC, model for end-stage liver disease (MELD) score, and laboratory values including lactate were assessed. The primary outcome was in-hospital mortality. In total, 433 patients with alcoholic LC were included for analysis and the in hospital mortality rate was 15.9% (n = 69). Univariate regression analyses identified that MELD score, lactate, platelet, international normalized ratio, bilirubin, creatinine, albumin, and C-reactive protein (CRP) predicted in-hospital mortality. Multivariate regression analysis showed that MELD score, lactate, albumin, and CRP were significantly associated with in-hospital mortality. MELD score, lactate, albumin, and CRP predicted the mortality in alcoholic LC patients visiting the ED.
Identification and validation of the pyroptosis-related long noncoding rna signature to predict the prognosis of patients with bladder cancer
Authors: Wu Zhenyu , Zeng Jie , Wu Mengxi , Liang Quan , Li Bin , Hou Guoliang , Lin Zhe , Xu Wenfeng
Published: February 2023

Bladder cancer ranked the second most frequent tumor among urological malignancies. This work investigated bladder cancer prognosis, including the relevance of pyroptosis-related long noncoding RNA (lncRNA) in it and its potential roles. The Cancer Genome Atlas database offered statistics on lncRNAs and clinical data from 411 bladder cancer patients. Pearson correlation analysis was used to evaluate pyroptosis-related lncRNAs. To explore prognosis-associated lncRNAs, we performed univariate Cox regression, least absolute shrinkage and selection operator regression analyses, as well as the Kaplan–Meier method. Multivariate Cox analysis was leveraged to establish the risk score model. Afterward, a nomogram was constructed according to the risk score and clinical variables. Finally, to investigate the potential functions of pyroptosis-related lncRNAs, gene set enrichment analysis was employed. Eleven pyroptosis-related lncRNAs were screened to be closely associated with patients prognosis. On this foundation, a risk score model was created to classify patients into high and low risk groups. The signature was shown to be an independent prognostic factor (P < .001) with an area under the curve of 0.730. Then a nomogram was established including risk scores and clinical characteristics. The nomogram prediction effect is excellent, with a concordance index of 0.86. The 11-lncRNAs signature was associated with the supervision of oxidative stress, epithelial-mesenchymal transition, cell adhesion, TGF-β, and Wingless and INT-1 signaling pathway, according to the gene set enrichment analysis. Our findings indicate that pyroptosis-related lncRNAs, which may affect tumor pathogenesis in many ways, might be exploited to assess the prognosis of bladder cancer patients.
A risk prediction nomogram of endometrial carcinoma and precancerous lesions in postmenopausal women: A retrospective study
Authors: Wang Jinhua , Gao Songkun , Wang Jiandong , Wang Tong
Published: February 2023

This study aimed to develop a risk prediction nomogram for endometrial carcinoma and precancerous lesions in postmenopausal women to provide postmenopausal patients with more information on disease probability, work out personalized medical plans, and reduce unnecessary invasive clinical examinations. We enrolled 340 patients who underwent hysteroscopy at Beijing Maternity Hospital between March 2016 and July 2018. The patients were divided into the low-risk (275 patients) and high-risk (65 patients) groups, according to the results of the pathological examinations. Binary logistic analysis was performed to evaluate the 20 potential risk factors for endometrial cancer and precancerous lesions in postmenopausal women and to screen for certain risk factors using the Statistical Package for the Social Sciences version 26.0. Using R 4.0.3, we built a prediction nomogram that incorporated the selected factors. The discrimination, calibration, and clinical usefulness of the prediction model were assessed using the concordance (C)-index, calibration plot, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Predictors included in the prediction nomogram included obesity, vaginal bleeding, family history of gynecological malignancies, endometrial thickness ≥ 1.15 cm, and color Doppler flow imaging blood flow. The model displayed good discrimination, with a C-index of 0.853, and good calibration. Decision curve analysis showed that the model was clinically useful, with a benefit range of 2% to 93%. A high C-index value of 0.844 could still be reached in the interval validation. Obesity, vaginal bleeding, family history of gynecological malignancies, endometrial thickness ≥ 1.15 cm, and color Doppler flow imaging blood flow were independent risk factors for endometrial cancer and precancerous lesions. Thus, the prediction nomogram can be conveniently used to facilitate individual risk prediction in patients with endometrial cancer and precancerous lesions.
Systemic immune-inflammation index in predicting non-curative resection of endoscopic submucosal dissection in patients with early gastric cancer
Authors: Tang Yun-he , Ren Lin-lin , Yu Ya-Nan , Zhang Shao-hua , Tian Zi-Bin , Mao Tao
Published: February 2023

Background and purpose

Although endoscopic submucosal dissection (ESD) is considered standard treatment for early gastric cancer (EGC), patients with non-curative resection (NCR) of ESD may still require gastrectomy. The systemic immune-inflammation index (SII) showed great potential in predicting the prognosis of gastric cancer patients. This study aims to investigate the predictive validity of SII of NCR in EGC patients.

Methods

We reviewed data from EGC patients who underwent ESD in the past. The relationship between SII and clinicopathologic features was investigated. We used Receiver operating characteristic curves to compare the predictive values of NCR between SII and other inflammation indices. Binary logistic analysis was used to identify independent risk factors for NCR. These factors were then used to construct a predictive nomogram.

Results

SII was associated with larger tumor size, male gender, older age, submucosal invasion, and a greater risk of NCR. SII showed better predictivity of NCR than platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). SII [odds ratio (OR) = 1.003, P = 0.001], NLR (OR = 1.520, P = 0.029), PLR (OR = 1.009, P = 0.010), upper stomach tumors (OR = 16.393, P < 0.001), poorly differentiated type (OR = 29.754, P < 0.001), ulceration (OR = 4.814, P = 0.001), and submucosal invasion (OR = 48.91, P < 0.001) were independent risk factors for NCR. The nomogram model based on these factors exhibited superior concordance and accuracy.

Conclusion

SII could be considered a simple and effective predictor of NCR of ESD in EGC patients.
Variability of estimated glomerular filtration rate and 99mTc-DTPA glomerular filtration rate: implications for a single time-point sampling regime
Authors: Bonney Lara M. , McGowan Daniel R.
Published: February 2023

Background

This work aimed to determine the implications of the variability in estimated glomerular filtration rate (eGFR) for the prediction of measured GFR (mGFR) for selection of sampling time-point in single-sample 99mTc-diethylene–triamine–pentaacetate (DTPA) mGFR.

Methods

Patient studies were used to compare eGFR and mGFR (n = 282). The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration 2009 equation, from serum creatinine values measured in the laboratory (n = 27) or using a point-of-care testing device (n = 255). The mGFR was taken as the true value, and the root mean square error (RMSerr) in eGFR was calculated. Receiver operator characteristic curves were generated comparing the sensitivity and specificity of eGFR for the prediction of mGFR within the British Nuclear Medicine Society (BNMS) 2018 guideline ranges.

Results

The overall eGFR RMSerr was 19.3 mL/min/1.73 m2. Use of eGFR to predict mGFR in the ranges specified in the BNMS 2018 guidelines (25–50; 50–70; 70–100; and >100) achieved the following specificity and sensitivity for each individual range (97%, 71%; 92%, 47%; 81%, 48%; and 74%, 90%). For the middle ranges (50–70 and 70–100) the sensitivity is very low, less than 50%; more studies are classified incorrectly on the basis of eGFR in these ranges than correctly.

Conclusion

This work shows that serum creatinine eGFR is not sufficiently accurate to predict the optimum single-sample time-point for 99mTc-DTPA mGFR prior to measurement. It is the recommendation of this study that a single sampling time-point should be chosen for studies eGFR > 40 ml/min/1.73 m2 as opposed to the use of eGFR to determine the sampling time-point.
Increasing Nurse-Physician Family-Centered Rounds Communication
Authors: Kulesa John T. , Tyris Jordan N. , McQuiston-Lane Keira , Herstek Jessica , Rush Margaret L.
Published: February 2023

Background:

High-quality nurse-physician communication during family-centered rounds (FCRs) can increase patient safety.

Local Problem:

In our hospital, interdisciplinary team members perceived that nurse-physician communication during FCRs declined during the COVID-19 pandemic.

Methods:

Using quality improvement methodology, we measured nurses' perceived awareness of components of the shared mental model, nurses' attendance during FCRs, compliance with completing FCR summaries, and average time spent per FCR encounter.

Interventions:

A structured resident huddle took place prior to an FCR. Residents used a tool to send individualized alerts to bedside nurses to prepare them for an FCR. Residents developed comprehensive summaries after each FCR encounter and sent a summary text to nurses who were unable to attend the FCR.

Results:

We assessed 40 FCRs over 16 weeks. Nurses' perceived awareness increased from 70% to 87%. Nurse attendance increased from 53% to 75%.

Conclusions:

We successfully piloted multiple interventions to improve nurse perceived awareness after an FCR.
Comparing Experiences of Women Who Were Direct Breastfeeding and Women Who Used Expressed Breast Milk to Feed Their Infants
Authors: Anders Lisa A. , Robinson Karen , Ohlendorf Jennifer M. , Hanson Lisa
Published: February 2023

Purpose:

To provide understanding about feeding experiences of women who provide breast milk through direct breastfeeding and exclusive expression and to compare these experiences.

Study Design and Methods:

A qualitative study was conducted to gather experiences from the perspectives of women who had given birth to a healthy, term infant within the past 12 months and exclusively fed breast milk for at least 2 weeks. The sample was recruited from motherhood and breastfeeding support groups on Facebook. Groups had state- or national-based memberships. Interviews were examined for themes that were compared between feeding groups using thematic analysis.

Results:

Fifteen new mothers participated. Under the primary themes of Similarities and Differences, seven subthemes were identified: Fatigue, Importance of Support, Finding Joy in a Common Goal, Mixed Feelings, Trusting versus Tracking, Latching versus Body Failure, and Pumping in Isolation.

Clinical Implications:

Mothers who provide breast milk share common experiences and feelings of satisfaction. Expressed breast milk feeding offers some mothers a way to provide the benefits of breast milk while preserving a balance between maternal and infant physical and mental health needs. Understanding the different ways in which women manage breast milk feeding while balancing maternal and infant needs can prepare nurses to discuss various methods of breast milk feeding and provide individualized support.
A Multimodal Protocol to Limit Opioid Exposure and Effectively Manage Postoperative Cesarean Birth Pain
Authors: Harden Ronda , Dawkins Denise , Stallings-Saints Keya , Hampton Michelle DeCoux , DeLilly Carol
Published: February 2023

Purpose:

To evaluate the impact of implementing a multimodal plan of care in treating the pain of the postoperative cesarean birth patient that limited opioid exposure.

Study Design and Methods:

A retrospective medical record review was conducted to evaluate a pain management protocol implemented for postoperative cesarean patients before and after a practice change. Sample included term postoperative cesarean patients ≥ 37 weeks of gestation, who had spinal or epidural, were 18 years or older, gave birth to a singleton newborn, admitted to the maternal child health department, and were prescribed opioids as a postoperative pain management treatment plan. Participants (N = 150) were evaluated based on two groups: n = 75 in the preimplementation group and n = 75 in the postimplementation group.

Results:

There was a significant difference in the total oral opioid milligrams administered between the pregroup (M = 27.13) and postgroup (M = 8.43), after the practice change (p < .001). There was an increase of nonopioids administered to treat and manage postoperative cesarean pain, Motrin PO (p = < .001) and Tylenol PO (p = .002).

Clinical Implications:

Fewer milligram equivalents of morphine were administered when postoperative cesarean patients were placed on scheduled nonopioids to treat pain.
Defense Mechanisms and Parenting Styles in Patients With Anorexia and Bulimia
Authors: Craba Ambra , Mazza Marianna , Marano Giuseppe , Crosta Maria Luigia , Moroni Federica , Di Pietro Salvatore , Balocchi Marta , Della Casa Silvia , Rinaldi Lucio , Janiri Luigi , Sani Gabriele
Published: February 2023

Dysfunctional parenting styles are risk factors for eating disorders (EDs). In this observational study, we examined 57 women with ED, a psychiatric control group (n = 26), and healthy participants (n = 60). Several instruments were administered: Defense Style Questionnaire (DSQ-40) to examine the type of defense mechanism used, Parental Bonding Instrument (PBI) to investigate the perception of the relationship with parents, Eating Disorder Examination Questionnaire and Eating Disorder Inventory-3 to assess the severity of the ED, and Body Shape Questionnaire to investigate the perception of their body shape. In patients with anorexia and bulimia, neurotic factor (p = 0.007) and immature factor (p = 0.002) are associated with perception of relationship with their own parents. In the PBI, maternal care was associated with higher scores in the DSQ-40 in the immature factor (p = 0.012), whereas paternal overprotection was associated with lower scores in the DSQ-40 in the mature factor (p = 0.016). Patients with anorexia and bulimia overutilize more neurotic and primitive defense mechanisms compared with nonclinical subjects, and this use is associated with greater severity of eating symptomatology. This can be related to diversified ego forces, can inform about the nature and severity of disease, and can characterize prognostic and psychotherapeutic value.