bluuebunny/crossref_metadata_2025 huggingface dataset:
The BAS2IC Score: A Useful Tool to Identify Patients at High Risk of Early Progression to Severe Coronavirus Disease 2019
Authors: Kaeuffer Charlotte , Ruch Yvon , Fabacher Thibaut , Hinschberger Olivier , Mootien Joy , Eyriey Magali , Greigert Valentin ,   COVID-19 Alsace Study Group, Gravier Simon , Jocelyn André , Dervieux Benjamin , Pointurier Valentin , Clere-Jehl Raphael , Collange Olivier , Ludes Pierre-Olivier , Harlay Marie-Line , Bilbaut Pascal , Terrade Jean Édouard , Felten Renaud , Andrès Emmanuel , Dieudonne Yannick , Lescuyer Sylvain , Ederlé Carole , Perrin Peggy , Curtiaud Anais , De Marcillac Fanny , Schmitt Elise , Weill François , Nisand Gabriel , Le Hyaric Coralie , Zhu Yves-Jean , Hugerot Antonin , Zecchi Adrien , Maitrepierre Flavie , Risser Clémence , Goetsch Thibaut , Du Sablon Noémie Leclerc , Ehret Marion , Vinee Frederic , Bernard Myriam , Koch Clémence , Waegell Arnaud , Dormegny Léa , Meyer Nicolas , Fafi-Kremer Samira , Lefebvre Nicolas , Hansmann Yves , Martinot Martin , Danion François
Published: September 2020

We developed a score, with easily accessible data (age, sex, body mass index, dyspnea, inflammatory parameters), to predict the risk of rapid progression to severe coronavirus disease 2019. Using a cutoff of >6 points, the negative predictive value was 87%.
Infinite Lotteries, Spinners, Applicability of Hyperreals†
Authors: Bottazzi Emanuele , Katz Mikhail G
Published: September 2020

We analyze recent criticisms of the use of hyperreal probabilities as expressed by Pruss, Easwaran, Parker, and Williamson. We show that the alleged arbitrariness of hyperreal fields can be avoided by working in the Kanovei–Shelah model or in saturated models. We argue that some of the objections to hyperreal probabilities arise from hidden biases that favor Archimedean models. We discuss the advantage of the hyperreals over transferless fields with infinitesimals. In Paper II we analyze two underdetermination theorems by Pruss and show that they hinge upon parasitic external hyperreal-valued measures, whereas internal hyperfinite measures are not underdetermined.
Development of a Musculoskeletal Imaging Competency Examination for Physical Therapists
Authors: Burley Troy , Brody Lori T , Boissonnault William G , Ross Michael D
Published: September 2020

Objective

The number of physical therapists with imaging ordering privileges is increasing; however, a known level of competency and knowledge is generally lacking within the profession, as is a method to determine practitioner competency. The purpose of this study was to develop a valid musculoskeletal (MSK) imaging competency examination for physical therapists.

Methods

This 3-round Delphi method study utilized experts to reach consensus on examination content and development. Round 1 was completed by 37 experts. The last 2 rounds were completed by 35 experts. Experts rated questions on a 5-point Likert rating scale of importance (1 = not at all important, 5 = very important). Consensus was achieved with an a priori decision of (1) >75% agreement of the expert panel rating and ≥4 on the Likert scale, and (2) ≥.90 on Cronbach alpha and intraclass correlation coefficients. Experts recommended a passing score of 75%. The examination was subsequently reviewed by a panel of 5 radiologists.

Results

The Delphi method and radiologist panel review resulted in the 151-question Burley Readiness Examination (BRE) for MSK Imaging Competency. Interrater agreement and internal consistency of the Delphi panel were excellent, with an average intraclass correlation coefficient and Cronbach alpha of .928 and .950, respectively.

Conclusions

The BRE is a tool that has the potential to demonstrate practitioners’ level of baseline competency with MSK imaging. Additional testing among physical therapists will provide further validation and reliability of the examination.

Impact

The use and application of diagnostic imaging is becoming more widespread in physical therapist practice throughout the United States. The BRE could potentially have broader implications for health care utilization and cost in the area of MSK imaging.
South Dakota State University Beef 2020 increases participant knowledge of the beef industry1
Authors: Bakker Christina E , Underwood Keith R , Grubbs Judson K , Walker Julie A , Wright Cody L , Olson Kenneth C , Rusche Warren C , Blair Amanda D
Published: September 2020

South Dakota State University has developed a hands-on program that addresses the preharvest management factors that influence beef carcass value to aid producers in their management and marketing decisions. The 3-d program includes live cattle and carcass evaluation, beef carcass fabrication, a harvest demonstration, sensory panel, and presentations on topics including live market cattle evaluation, health, and disposition in relation to carcass quality, feeding and management, and value-added beef cuts. To evaluate program effectiveness, data were collected from all programs held between 2013 and 2019. Participants were asked to evaluate their perceived value for each program component, as well as their knowledge of the industry prior to and after completing the program. Upon completion of the 2018 Beef 2020, a focus group of program alumni was assembled to better understand participant experiences, application of the material, and guide future programming. The recommendations of the focus group were implemented during the 2019 program. Component value scores are reported in a box and whisker plot and participant knowledge was evaluated using a paired t-test with significance determined at P < 0.05. Special attention was given to the results of 2019 compared to previous years to determine the efficacy of the program changes. Overall, the average value scores for the sessions all ranked above 8 on a scale of 1–10, indicating a relatively large value to participants. Knowledge of carcass traits, carcass value, and management factors that influence those traits increased after participation in the Beef 2020 program (5.18 vs. 7.67 ± 0.16; P < 0.0001). The use of a focus group was concluded to be an effective means of assessing program value, strengths, and weaknesses. The Beef 2020 program can be used as a model for other Extension professionals to create programs intended to link livestock producers to their end products.
Establishing Serum Reference Ranges for Antihypertensive Drugs
Authors: Rognstad Stine , Søraas Camilla L. , Bergland Ola U. , Høieggen Aud , Strømmen Magnus , Helland Arne , Opdal Mimi S.
Published: September 2020

Background:

Therapeutic drug monitoring (TDM) involves the measurement of serum drug concentrations to optimize pharmacotherapy. Traditionally, blood pressure measurements alone, and not TDM, have been used to evaluate the antihypertensive drug response. However, approximately 50% of hypertensive patients treated with lifestyle changes and antihypertensive drugs fail to achieve blood pressure control. Serum drug concentration measurements could be useful to select the optimal drugs in adjusted doses and to identify nonadherence. Implementation of TDM in clinical routine for antihypertensive drugs depends on established serum reference ranges.

Methods:

Commonly used antihypertensive drugs were identified based on prescription data. The authors performed a review of authoritative literature on reported serum drug concentrations and calculated expected concentrations from previously reported pharmacokinetic parameters with commonly prescribed daily doses. Finally, serum drug concentrations in samples from patients undergoing antihypertensive treatment were measured.

Results:

Serum reference ranges for 24 frequently used antihypertensive drugs were established based on results from 3 approaches.

Conclusions:

Serum drug concentration measurements, interpreted in light of the established reference ranges, together with blood pressure measurements and other clinical data, may help identify nonadherent patients and tailor individual antihypertensive treatment when deviant drug responses appear in line with the concept of personalized medicine.
A Review of Synthetic Cathinone–Related Fatalities From 2017 to 2020
Authors: La Maida Nunzia , Di Trana Annagiulia , Giorgetti Raffaele , Tagliabracci Adriano , Busardò Francesco P. , Huestis Marilyn A.
Published: September 2020

Background:

Synthetic cathinones (SCs) are designer analogs of the natural active principle of khat. Since their appearance on the black market in 2003, their popularity has increased annually, and they have become the most seized class of new psychoactive substances reported to the UNODC Early Warning Advisory system. The constant introduction of newly synthesized molecules makes this issue difficult to monitor. The authors reviewed the most recent SC-related fatalities worldwide to highlight new trends of consumption, reporting acute pharmacological and toxicological symptoms, scene investigations, analytical methods, and reported SC concentrations in diverse biological matrices.

Methods:

A literature search was performed using scientific databases such as PubMed, Scopus, Science Direct, Web of Science, and Research Gate to identify relevant scientific publications from 2017 to 2020. In addition, a search was conducted through the EU EWS.

Results:

From 2017 to 2020, 31 different SCs were identified in 75 reported fatal intoxications in the literature, alone or in combination with other substances. The most abused SCs were N-ethylpentylone, N-ethylhexedrone, and 4-chloromethcathinone. The EU EWS included less detail on 72 additional SC-related fatalities from 2017 to 2020.

Conclusions:

New SCs continuously replace older natural and synthetic stimulant drugs, making determining the cause of death difficult. Analytical methods and high-performance mass spectrometry instruments are essential to detect the low concentrations of these potent new SCs. Little data are available on the pharmacology of these new drugs; the evaluation of toxicological antemortem and postmortem findings provides critical data on the drug's pharmacology and toxicology and for the interpretation of new SC cases.
Accounting for Unfissioned Plutonium from the Trinity Atomic Bomb Test
Authors: Beck Harold L. , Simon Steven L. , Bouville André , Romanyukha Anna
Published: September 2020

The Trinity test device contained about 6 kg of plutonium as its fission source, resulting in a fission yield of 21 kT. However, only about 15% of the 239Pu actually underwent fission. The remaining unfissioned plutonium eventually was vaporized in the fireball and after cooling, was deposited downwind from the test site along with the various fission and activation products produced in the explosion. Using data from radiochemical analyses of soil samples collected postshot (most many years later), supplemented by model estimates of plutonium deposition density estimated from reported exposure rates at 12 h postshot, we have estimated the total activity and geographical distribution of the deposition density of this unfissioned plutonium in New Mexico. A majority (about 80%) of the unfissioned plutonium was deposited within the state of New Mexico, most in a relatively small area about 30–100 km downwind (the Chupadera Mesa area). For most of the state, the deposition density was a small fraction of the subsequent deposition density of 239+240Pu from Nevada Test Site tests (1951–1958) and later from global fallout from the large US and Russian thermonuclear tests (1952–1962). The fraction of the total unfissioned 239Pu that was deposited in New Mexico from Trinity was greater than the fraction of fission products deposited. Due to plutonium being highly refractory, a greater fraction of the 239Pu was incorporated into large particles that fell out closer to the test site as opposed to more volatile fission products (such as 137Cs and 131I) that tend to deposit on the surface of smaller particles that travel farther before depositing. The plutonium deposited as a result of the Trinity test was unlikely to have resulted in significant health risks to the downwind population.
Methods and Findings on Diet and Lifestyle Used to Support Estimation of Radiation Doses from Radioactive Fallout from the Trinity Nuclear Test
Authors: Potischman Nancy , Salazar Silvia I. , Scott Mary Alice , Naranjo Marian , Haozous Emily , Bouville André , Simon Steven L.
Published: September 2020

The Trinity nuclear test was detonated in south-central New Mexico on 16 July 1945; in the early 2000s, the National Cancer Institute undertook a dose and cancer risk projection study of the possible health impacts of the test. In order to conduct a comprehensive dose assessment for the Trinity test, we collected diet and lifestyle data relevant to the populations living in New Mexico around the time of the test. This report describes the methodology developed to capture the data used to calculate radiation exposures and presents dietary and lifestyle data results for the main exposure pathways considered in the dose reconstruction. Individual interviews and focus groups were conducted in 2017 among older adults who had lived in the same New Mexico community during the 1940s or 1950s. Interview questions and guided group discussions focused on specific aspects of diet, water, type of housing, and time spent outdoors for different age groups. Thirteen focus groups and 11 individual interviews were conducted among Hispanic, White, and Native American participants. Extensive written notes and audio recordings aided in the coding of all responses used to derive ranges, prevalence, means, and standard deviations for each exposure variable for various age categories by region and ethnicity. Children aged 11–15 y in 1940s or 1950s from the rural plains had the highest milk intakes (993 mL d−1), and lowest intakes were among 11- to 15-y-olds in mountainous regions (191 mL d−1). Lactose intolerance rates were 7–71%, and prevalence was highest among Native Americans. Meat was not commonly consumed in the summer in most communities, and if consumed, it was among those aged 11-15 y of age or older who had relatively small amounts of 100-200 g d−1. Most drinking and cooking water came from covered wells, and most homes were made of adobe, which provided more protection from external radiation than wooden structures. The use of multiple approaches to trigger memory and collect participant reports on diet and other factors from the distant past seemed effective. These data were summarized, and together with other information, these data have been used to estimate radiation doses for representative persons of all ages in the main ethnic groups residing in New Mexico at the time of the Trinity nuclear test.
Transmucosal Boston Keratoprosthesis Type I in a Patient With Advanced Ocular Cicatricial Pemphigoid
Authors: Camacho Luís , Soldevila Anna , Fideliz de la Paz María
Published: September 2020

Purpose:

To describe a novel surgical technique using the Boston Keratoprosthesis (KPro) type I in a patient with advanced ocular cicatricial pemphigoid (OCP) using oral mucosa for covering the prosthesis.

Methods:

We present the case of an 85-year-old man previously diagnosed with type 2 diabetes and advanced OCP nonresponsive to immunosuppressive treatment, whose best-corrected visual acuity was light perception and projection in both eyes. After examination, Boston KPro type I in the right eye was contemplated because osteo-odonto KPro and Tibial bone KPro were not feasible because of the patient's osteoporosis and edentulism. Reconstruction of the ocular surface was first performed using oral mucosa to release the symblepharon and try to deep the fornices. Three months later, the oral mucosa was lifted, and the Boston KPro type I was implanted using the patient's own cornea. Then, a modification of the standard surgical technique was carried out, replacing the use of contact lens for covering the prosthesis with an oral mucosa graft with a central trephination as an alternative option in fornix foreshortening cases.

Results:

After 11 months, visual acuity was stable to 0.2 decimal. No postoperative complications have been encountered, and prosthesis was in place.

Conclusions:

The surgical technique of transmucosal Boston KPro type I may be considered a surgical alternative in patients with advanced OCP who present with severe fornix foreshortening, where osteo-odonto KPro or Tibial bone KPro cannot be performed due to osteoporosis or edentulism or when the Boston KPro type II is not readily available.
Acute Corneal Endothelial Graft Rejection With Coinciding COVID-19 Infection
Authors: Jin Sierra X. , Juthani Viral V.
Published: September 2020

Purpose:

To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms.

Methods:

Case report.

Results:

A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection.

Conclusions:

Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection.
Effect of Obesity on Cervical Cancer Screening and Outcomes
Authors: Gnade Colette M. , Hill Emily K. , Botkin Hannah E. , Hefel Alison R. , Hansen Hayley E. , Sheets Kelsey A. , Mott Sarah L. , Hardy-Fairbanks Abbey J. , Stockdale Colleen K.
Published: September 2020

Objectives

The aims of the study were to identify whether obese women are less appropriately screened for cervical cancer before diagnosis and to explore related cancer outcomes.

Methods

We retrospectively reviewed all cervical cancer patients at a single institution between 1986 and 2016 and collected demographic information including age, cancer stage, body mass index (BMI), screening information, and cancer outcomes. Morbid obesity was defined as BMI of 40 kg/m2 or greater, obesity as BMI of 30 to less than 40 kg/m2, and nonobese as BMI of less than 30 kg/m2. χ2, Fisher exact, and Wilcoxon rank sum tests were used to compare variables between BMI categories. Cox regression models were used to evaluate recurrence-free survival and overall survival (OS).

Results

A total of 1,080 patients were reviewed, of whom 311 (29.4%) were obese and 107 (10.1%) morbidly obese. A significant association between BMI and cytology screening was evidenced with morbidly obese women having the highest incorrect rate (64.4%), followed by obese (51.5%) and nonobese women (46.0%, p < .01). There was no significant difference in presence of symptoms at presentation (p = .12) or stage (p = .06) between BMI categories. In multivariable analysis of cancer outcomes, higher BMI was associated with worse OS (p < .01) with a hazard ratio of 1.25 (95% CI = 0.92–1.69) for obese women and hazard ratio 2.27 (95% CI = 1.56–3.31) for morbidly obese women relative to normal weight but recurrence-free survival did not differ between BMI groups (p = .07).

Conclusions

Our study strengthens evidence that obese and morbidly obese women have disproportionate inappropriate screening before cervical cancer diagnosis, and morbidly obese women have worse OS than their counterparts.
A retrospective study of the relationship between the pathologic subtype and lymph node metastasis of lung adenocarcinomas of ≤3 cm diameter
Authors: Lin Wenwei , Huang Mingcheng , Zhang Zhenyang , Chai Tianci , Chen Sui , Gao Lei , Lin Jiangbo , Kang Mingqiang
Published: September 2020

To analyze the relationship between pathologic subtype and lymph node metastasis for lung adenocarcinomas of ≤3 cm diameter.

We retrospectively studied 384 patients with operable lung adenocarcinomas of ≤3 cm diameter that had been radically resected by lobectomy or anatomic segmentectomy with systematic nodal dissection, at the Fujian Medical University Union Hospital between March 2014 and March 2016.

Lymph node metastasis pN1 + pN2 (pN+) was found in 2 of 104 (1.9%) patients with tumor diameter ≤1.0 cm, 12 of 159 (7.5%) patients with tumor diameter >1.0 cm but ≤2.0 cm, and 35 of 121 (28.9%) patients with tumor size >2.0 cm but ≤3.0 cm (P < .01). Lymph node metastasis pN+ was found in 19 of 53 (35.8%) patients with visceral invasion pleural (VIP) and 30 of 331 (9.0%) patients without VIP (P < .05). It was also found in 16 of 51 (31.3%) patients with high serum CEA concentrations and 28 of 297 (9.4%) patients with normal concentrations (P < .05). In a multivariate analysis, tumor diameter, VIP, high serum CEA concentration, and pathologic subtype were significant risk factors. The prevalences of lymph node metastasis pN+ were: 0.0% (0/2), 0.0% (0/89), 3.2% (1/31), 16.2% (34/209), 7.7% (1/13), 46.7% (7/15), 100% (4/4), and 11.8% (2/17) for adenocarcinoma in situ (AIS); minimally invasive adenocarcinoma (MIA); predominantly lepidic (LEP), acinar (ACI), papillary, solid (SOL), and micropapillary (MIP) tumors; and variants of invasive adenocarcinoma, respectively (P < .05). For predominant SOL and MIP tumors, the prevalences of lymph node involvement were significantly higher than for the other subtypes.

We have shown that lymph node metastasis in patients with tumor diameter ≤3 cm differs according to lung adenocarcinoma subtype. AIS and MIA were not associated with lymph node metastasis; therefore, systematic nodal dissection may be unnecessary. The prevalence of lymph node metastasis rate was low for LEP, suggesting that systemic lymph node sampling is sufficient. In contrast, for other pathologic subtypes, including SOL and MIP, systematic lymph node dissection should be performed.
Convalescent plasma therapy in critically ill coronavirus disease 2019 patients with persistently positive nucleic acid test, case series report
Authors: Wang Min , Yang Xiaohong , Yang Fang , Zhu Xinxin , Sun Zhibing , Bao Peiling , Yan Yimin
Published: September 2020

Introduction:

Globally, the coronavirus disease 2019 (COVID-19) is still spreading rapidly. At present, there are no specifically approved therapeutic agents or vaccines for its treatment. Previous studies have shown that the convalescent plasma therapy (CPT) is effective in patients with COVID-19. However, its efficacy in patients with persistently positive nucleic acid test is unknown.

Patient concerns:

In this report, we present the clinical data of 5 critically ill COVID-19 patients admitted, between January 16 and February 26, 2020, in intensive care unit of Xiaogan Central Hospital.

Diagnosis and interventions:

All these patients had a persistently positive nucleic acid test and received CPT. All 5 patients had severe respiratory failure, and thus, required invasive mechanical ventilation. The median time from the onset of symptoms to initiating the CPT was 37 (Interquartile range, 34-44) days.

Outcomes:

Only 2 patients were cured and subsequently discharged, while 3 patients succumbed due to multiple organ failure.

Conclusion:

The time of initiating the CPT may be an important factor affecting its efficacy, and its therapeutic effect in the treatment of COVID-19, in the late stage, is limited.
Non-tuberculous mycobacterial infection and reactive dermatosis associated with adult-onset immunodeficiency due to anti–interferon-gamma autoantibodies
Authors: Liang Xiao-Na , Bin Yan-Fei , Lai Guan-Ting , Li Ying-Hua , Zhang Jian-Quan , Zhong Xiao-Ning , Bai Jing , Li Mei-Hua , Deng Jing-Min , He Zhi-Yi
Published: September 2020

Introduction:

Anti–interferon-gamma (anti–IFN-γ) autoantibody increases susceptibility to lower-virulence pathogens and causes immunodeficiency syndrome in HIV–negative patients.

Patient concerns:

A 69-year-old Chinese man presented with a 2-month history of pruritic skin lesions on his forearms, trunk, and legs. He was diagnosed with 5 opportunistic infections without conventional immunosuppression-associated factors in past. The most conspicuous characteristics were recurrent pulmonary infection, persistent immunoglobulin E elevation and eosinophilia during the whole disease course.

Diagnosis:

Enzyme-linked immunosorbent assay showed anti–IFN-γ autoantibody positive. The final diagnosis for the patient was adult-onset immunodeficiency due to anti–IFN-γ autoantibody, non-tuberculous mycobacterial (NTM) infection and reactive dermatosis.

Interventions:

The patient underwent long-term anti-NTM and corticosteroid maintenance treatment.

Outcomes:

The patient was followed for 2 years during which opportunistic infection no longer happened, the immunoglobulin E level and eosinophil count reduced, the autoantibody levels remained largely steady and lung lesions absorbed.

Conclusion:

Clinicians should be vigilant for NTM infection in patients with anti–IFN-γ autoantibodies, even when culture results are negative. Long-term anti–non-tuberculous mycobacteria and glucocorticoid regimens were effective.
Impact of triglyceride playing on stroke severity correlated to bilirubin
Authors: Li Zheng , Zhang Jiahui , Luo Yun
Published: September 2020

Major lipids making effects on the occurrence of acute ischemic stroke (AIS) is well recognized, but their roles on stroke severity remain uncertain. To explore the exact roles of lipids playing on stroke severity and the possible mechanism, we conduct this observational study.

Data was collected from patients with AIS from February 2008 to May 2012. The level of major lipids was compared among AIS groups with different severity and investigated the correlation. Also, the relationship existed between major lipids and bilirubin. Mechanism of major lipids playing on stroke severity was researched to determine if oxidative stress reflected by bilirubin.

Lower triglyceride (TG) and higher high density lipoprotein cholesterol (HDL-C) were observed in severe stroke, and obvious correlation existed between TG and stroke severity or HDL-C and stroke severity. TG was associated negatively with direct bilirubin (DBIL) and total bilirubin (TBIL), and lower level of DBIL and TBIL were related to higher quartiles of TG. There was no obvious difference of DBIL and TBIL among the groups of quartiles of HDL-C. TG was the influence factor of stroke severity in severe stroke through multiple univariable logistic regression. But it was not the independent influence factor after multivariable logistic regression adjusted by DBIL or TBIL. However, HDL-C was the influence factor of stroke severity through both univariable and multivariable logistic regression.

Lower TG or higher HDL-C predicted severer stroke. The effect of TG on stroke severity was mediated by bilirubin, not HDL-C.
Gallbladder neuroendocrine carcinoma
Authors: Chu Hongwu , Zhang Chengwu , Shi Ying , Wu Weiding , Hu Zhiming , Zhang Jungang , Huang Dongsheng
Published: September 2020

Gallbladder neuroendocrine carcinoma (GB-NEC) is a group of rare and heterogeneous neoplasms and there are few reports at present.

We analyzed the clinical and pathological features of 7 patients with GB-NEC who were admitted to Zhejiang Provincial People's Hospital from January 2011 to October 2019.

The median age of 7 patients was 58 years with male to female ratio of 1:2.5. Right upper quadrant discomfort was the main complaint and no patients presented carcinoid syndrome-related symptoms. In contrast-enhanced computed tomography (CT) examination, 5 of 6 patients showed well-defined margin and continuous thin line-like contrast enhancement on the mucosa. Among the patients with liver metastases before surgery, 66.7% of patients were cancer antigen 125 (CA-125) positive, and among the patients presented with liver metastases during follow-up period, all patients were CA-125 positive. All patients with elevated CA-125 did not have ascites, ovarian carcinoma, peritoneal carcinoma, and endometrial carcinoma. According to postoperative pathological report, 1 patient was stage IIIA, and the other 6 patients were stage IVB. Six patients underwent surgery, and 1 patient just underwent liver biopsy. Two patients underwent laparoscopic radical cholecystectomy, and neither of them encountered serious complications after surgery with the overall survival time of 4.6 and 16.8 months, respectively. Compared with the patients without chemotherapy, 3 patients postoperatively treated with chemotherapy lived longer. The median survival of all 7 patients was 4.6 months and the 1-, 2-year survival rates were 14.29%, 0%.

Surgical resection, including laparoscopic radical cholecystectomy, is feasible for the treatment of advanced GB-NEC in selected patients and has the advantages of prolonging survival in combination with chemotherapy. The elevation of CA-125 can be utilized as an important predictor of poor prognosis, while more investigations are necessary to confirm it.
Glutathione S-transferase gene polymorphisms (GSTT1 and GSTM1) and risk of schizophrenia
Authors: Zhang Xin , Yang Jinmei , Liu Xia , Zhao Gaofeng , Li Xue , Xun Guanglei
Published: September 2020

Schizophrenia (SCZ) is a chronic disability disorder related to oxidative stress. Glutathione S-transferase (GST) is a group enzyme that protects cells and tissues from oxidative stress damage. Among GSTs, GSTT1 and GSTM1 have well defined genetic polymorphisms. The purpose of our research was to explore the correlation between GSTT1 and GSTM1 polymorphism and SCZ risk in Chinese Han population.

A total of 650 subjects (386 SCZ patients and 264 healthy individuals) were included in this case–control designed study. The GSTT1 and GSTM1 polymorphisms were analyzed by multiplex polymerase chain reaction (PCR). We explored the relationship between these 2 polymorphisms and the risk of SCZ.

We found that the GSTT1 null genotype had a protective effect on the development of SCZ [odds ratio (OR) = 0.601, 95% confidence interval (95% CI) = 0.412–0.986, P = .031]. We also found that the combination of null genotypes of the GSTT1 and GSTM1 genes was made at a lower risk of SCZ (OR = 0.452, 95% CI = 0.238–0.845, P = .028). However, we found no correction between Positive and Negative Syndrome Scale score (PANSS) and GSTM1, GSST1 genotypes in SCZ patients.

Our finding revealed that GSTT1 null polymorphisms may be related to the reduced risk of SCZ in Chinese Han population, and this risk was further reduced with the combination of GSTT1 null polymorphisms and GSTM1 null polymorphisms.
Significant associations between 5-hydroxytryptaminetransporter-linked promoter region polymorphisms of the serotonin transporter (solute carrier family 6 member 4) gene and Thai patients with autism spectrum disorder
Authors: Wongpaiboonwattana Wikrom , Plong-On Oradawan , Hnoonual Areerat , Limprasert Pornprot
Published: September 2020

Autism spectrum disorder (ASD) is a form of pervasive developmental disorder manifested by impairment in social interactions and repetitive behaviors. Although genetic contribution is strongly suspected in autism, the specific genetic factors remain unidentified. Hyperserotoninemia has been reported in some autistic patients, and several studies have demonstrated an association between 5-hydroxytryptamine-transporter-linked promoter region (5-HTTLPR) polymorphisms and rs25531 single nucleotide polymorphism in the serotonin transporter gene (solute carrier family 6 member 4; SLC6A4) and ASD, indicating a possible involvement of the serotonin system in the etiology of ASD.

To explore this situation further, a case-control association study of 5-HTTLPR and rs25531 polymorphisms on Thai ASD patients was conducted. A total of 188 ASD cases fulfilling the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria (156 males and 32 females) and a total of 250 normal controls were recruited from the same ethnic backgrounds. 5-HTTLPR polymorphisms (Long, L; Short, S) and rs25531 (A/G) single nucleotide polymorphism were genotyped and compared between the patients and normal controls using chi-square statistics.

The L/L genotype was more common in patients than in the controls (13.8% vs 5.2%, P = .006), and the LA haplotype was found in patients more than the controls (16.9% vs 12.2%, P = .048). When male patients were analyzed alone (156 individuals), the associations were also statistically significant with P = .017 for L/L genotype, and P = .019 for LA haplotype distribution.

Our findings support previous reports suggesting an association between the 5-HTTLPR and rs25531 polymorphisms of SLC6A4 and patients with ASD.
Mahaenggamseok-tang, a herbal medicine, for lower respiratory tract infections in pediatric patients
Authors: Jeong Aram , Yang Seung-Bo , Lee Hye-Yoon , Hwang Man-Suk
Published: September 2020

Background:

The aim of this study is to assess the clinical evidence for or against Mahaenggamseok-tang (MHGT) as a treatment for lower respiratory tract infections (LRTIs) in pediatric patients.

Method:

This systematic review will include randomized clinical trials (RCTs) of MHGT, as a treatment for LRTIs, compared with other therapies such as placebo and western medicine. The search terms will be selected according to the medical subject heading. We will search the following databases for systematic reviews from 2000 to Feb 2020: 5 English databases (The Cochrane Database of Systematic reviews, MEDLINE, Excerpta Medica dataBASE, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature), 1 Chinese database, 5 Korean databases (Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic (DBPIA), Research Information Service System, Korean Studies Information Service System, and National Digital Science Library), and 1 Japanese database (J-Stage). All RCTs of decoctions or alternate forms of MHGT will be included. We will search for all parallel or crossover RCTs without language restrictions. The methodological quality of the RCTs will be assessed using Cochrane risk of bias. Furthermore, the studies will be limited to those performed in children under 16 years of age.

Results and Conclusions:

Our systematic review and meta-analysis will provide evidence for MHGT as a treatment for LRTI. The findings can help practitioners and patients recognize more effective and safer therapeutic methods.

Prospero registration number:

CRD42020165698
Efficacy and safety of thread embedding acupuncture on knee osteoarthritis
Authors: Jun Purumea , Han Chang-Hyun , Yang Chang Sop , Kim Min Ji , Kim Jae Soo , Lee Cho In , Lee Jung Hee , Park Chung A. , Lee Young Joon , Lee Hyun-Jong
Published: September 2020

Introduction

: Although there are various therapeutic methods for the treatment of knee osteoarthritis, each has its advantages and shortcomings, and a definitive treatment method is yet to be determined. This pilot study is designed to obtain basic data for a further large-scale trial as well as provide information about the feasibility of thread embedding acupuncture (TEA) with polydioxanone thread in knee osteoarthritis patients.

Methods and analysis:

This study is a clinical trial to evaluate the efficacy and safety of TEA for knee osteoarthritis. Forty participants will be recruited at the hospital and after randomization into 2 groups of 20 (experimental and control); they will be treated for 6 weeks. The experimental group will receive TEA treatment 6 times (1 time/week) in 6 weeks on 14 defined knee areas, and the control group, acupuncture treatments 12 times (2 times/week) in 6 weeks on 9 defined acupuncture points. The visual analogue scale (VAS) will be used for the primary efficacy assessment and Short-form McGill Pain Questionnaire (SF-MPQ), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) will be used for the secondary efficacy assessment. The follow-ups before clinical trial, 3 weeks after procedure, 6 weeks after procedure, and 4 weeks after the end of procedure will be done to compare the degree of pain with the control group, which received the acupuncture treatment.

Conclusion:

The trial based on this study will provide clinical information on the efficacy and safety of TEA treatment on knee osteoarthritis.

Trial registration number:

KCT0004844
Increased proportion of the squamous cell carcinoma component is associated with worse survival in resected gastric adenosquamous carcinoma
Authors: Li Hong-Shuai , Chen Ye , Zhang Ming-Yi , Cheng Ke , Zhou Yu-Wen , Liu Ji-Yan
Published: September 2020

For the diagnosis of gastric adenosquamous carcinoma (ASC), discrepancies regarding a rational diagnostic proportion of the squamous cell carcinoma (SCC) component exist among different organizations. Our study aimed to evaluate the impact of the SCC component on the survival of gastric cancer patients and identify the optimal cutoff value for the SCC component necessary for diagnosing gastric ASC.

Cases of gastric cancer with an SCC component were obtained from our center and from case reports and series extracted from Medline. Univariate and multivariate analyses were conducted to compare the overall survival between groups and examine the prognostic value of various clinical parameters.

We identified 45 qualified cases in published literature and 13 in our center. Forty-two of them were males and 16 females (M: F = 2.6:1). Thirty of them were Asian patients and the rest were mainly from the United States and Europe. The mean age was 61.1 years (median 64 years, range 32–84 years). The average tumor size was 6.9 cm (median 6.0 cm, range 2.0–16.0 cm). The most common location of the cancer was the lower third (39.7%). Although a statistical difference was not achieved, the Kaplan–Meier curve demonstrated that as the proportion of the SCC component in the primary lesion increased, the patients’ survival risk increased (P = .489), and the presence of the SCC component in metastatic lymph nodes also increased the risk of survival (P = .259); both of these findings indicated a negative impact of the SCC component on survival. Furthermore, we identified the optimal cutoff for the SCC component as 35% (χ2 = 6.544, P = .011), which was subsequently validated in a Cox regression model as an independent prognostic factor (P = .026).

An increased proportion of the SCC component is associated with worse survival in gastric cancer patients with an SCC component. The optimal cutoff for the proportion of the SCC component necessary for the diagnosis of gastric ASC is 35%.
Efficacy and safety of Zhibitai in treating coronary heart disease patients with hyperlipemia
Authors: Chen Mingtai , Li Ying , Men Ling , Zhang Zhong , Zhong Xiaoling , Yang Shudong , Luan Jienan
Published: September 2020

Objective

: To assess the clinical efficacy and safety of Zhibitai, as a kind of natural lipid-lowering Chinese medicine, in treating coronary heart disease patients with hyperlipemia

Methods

: A systematic literature search for articles up to July 2020 will be performed in following electronic databases: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, Chinese Biomedical Database, Chinese Biomedical Literature Service System, and Wanfang Database. Inclusion criteria are randomized controlled trials of Zhibitai applied on coronary heart disease patients with hyperlipemia. The primary outcome measures will be serum lipid levels (including total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and acute cardiovascular events. The secondary outcome measures will be inflammatory factors (high sensitive C-reactive protein, interleukin-6, etc), safety index (liver function, renal function, etc), and adverse events. RevMan 5.3 software will be used for data synthesis, sensitivity analysis, meta-regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Egger tests will be used to assess funnel plot symmetries. We will use the grading of recommendations assessment, development, and evaluation system to assess the quality of evidence.

Trial registration number PROSPERO CRD42018103341.
The safety and effectiveness of self-administered coffee enema
Authors: Son Heejung , Song Hyun Jin , Seo Hyun-Ju , Lee Heeyoung , Choi Sun Mi , Lee Sanghun
Published: September 2020

Background:

As the self-administration of coffee enema is being used as a mean of self-care for detoxication in various indications, it is important that evidence-based public health information is provided for effective and safe use. However, the evidence is so far rare. This systematic review was conducted to investigate the safety and effectiveness of self-administered coffee enema in a wide range of use, and to provide evidence about its benefits and risks.

Methods:

Relevant studies were retrieved from Ovid MEDLINE, Ovid Embase, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature; and also from oriental databases, KoreaMed, Korean Medical Database, Korean Studies Information Service System, National Discovery for Science Leaders, and Korea Institute of Science and Technology Information, Oriental Medicine Advanced Searching Integrated System, China National Knowledge Infrastructure, and Japan Science and Technology Information Aggregator. Considering self-administered coffee enema being used in a various indication, study population was not restricted. Any types of published studies that included outcomes of effectiveness and safety of self-administered coffee enema with or without comparators were eligible for this systematic review. Data on biomedical indications, patient-reported outcomes, and adverse events were collected. Descriptive analyses were planned because diverse health conditions and outcome variables did not allow for quantitative synthesis.

Results:

Nine case reports that describe adverse events were identified and included in the analysis. Of these, 7 recent ones reported colitis after self-administration, mentioning that the most plausible cause assumed was the coffee fluid itself, which contained numerous chemical substances. Two others reported more critical adverse events. All 9 case reports with acceptable quality of evidence warned against the self-administration of the procedure. No study that reports the effectiveness of coffee enema was found.

Conclusions:

Based on the evidences reviewed, this systematic review does not recommend coffee enema self-administration as a complementary and alternative medicine modality that can be adopted as a mean of self-care, given the unsolved issues on its safety and insufficient evidence with regard to the effectiveness.
Evidence for acupotomology in the management of cervical radiculopathy
Authors: Dai Wenkang , Xie Rui , Wang Xiongwei , Zhuang Minghui , Chang Xiaojuan , Wei Xu , Jin Zhefeng , Wang Shangquan , Feng Minshan , Yu Jie , Zhu Liguo
Published: September 2020

Background:

Cervical radiculopathy (CR) describes compression or stimulation secondary to the cervical nerve root, 1 or 2 types of upper limb pain, and/or with neck. In clinical practice, both acupotomology and acupuncture are very widely and popular for the management of CR. So, we conducted a systematic review and meta-analysis to explore the efficacy, safety of acupotomology in the treatment of CR.

Methods:

We will search the following databases from inception to the September 2019 : MEDLINE(PubMed), Web of Science(Thomson Reuters), Cochrane Library, Embase (Ovid, Elsevier), SinoMed, Clinical Trials. gov, the China National Knowledge Infrastructure, Wanfang database, and VIP database. We will apply no language restrictions. We will not use a randomized controlled trial filter in EMBASE, as the set of intervention terms will limit the results sufficiently. The randomised controlled trials of acupotomology versus acupuncture for CR; two independent researchers will use the bias risk tool provided by the Cochrane Collaboration to evaluate the quality of the literature using RevMan 5.3 software (Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration, 2014).

Results:

This systematic review and meta-analysis will provide a synthesis of existing evidence-based medical evidence for acupotomology/ acupotomy/needle knife in the treatment of CR.

Conclusion:

The conclusions of this systematic review and meta-analysis will provide evidence to evaluate the effectiveness of acupotomology/ acupotomy/needle knife for CR and further guide clinical decision-making.

Ethics and Dissemination:

This study is based on literature and therefore does not require ethical approval or patient consent. The study will be published in a peer-reviewed journal.

PROSPERO registration number:

CRD42020172274
The efficacy and safety of Chinese herbal compound or combined with western medicine for pediatric adenoidal hypertrophy
Authors: Wang Penglin , Kong Weidong , Shan Yanchun
Published: September 2020

Background:

Traditional Chinese medicine (TCM) or combined with western medicine in the treatment of pediatric adenoidal hypertrophy has been widely used in clinical practice, but the overall efficacy and safety is still unclear. This paper aims to evaluate the efficacy and safety analysis of TCM or combined with western medicine for pediatric adenoidal hypertrophy.

Methods:

PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) were searched for randomized controlled trials of TCM or combined with western medicine for pediatric adenoidal hypertrophy from the date of establishment to July 2020, and Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform (ICTRP), and Chinese Clinical Trials Registry (ChiCTR) were searched for unpublished grey literature. Two researchers independently applied RevMan 5.3 software for data extraction and risk assessment of bias.

Results:

The effectiveness and safety of TCM or combined with western medicine for pediatric adenoidal hypertrophy is evaluated by means of the Adenoid (A) /(Nasopharyngeal (N) ratio, clinical efficacy, integral score of TCM syndromes, clinical single symptom score, disease specific quality of life for children with obstructive sleep apnea 18 items survey (OSA-18), Interleukin 4 (IL-4) and adverse reaction incidence.

Conclusion:

This study will provide theoretical support for the clinical application of TCM or combined with western medicine for pediatric adenoidal hypertrophy.

OSF Registration number:

DOI 10.17605/OSF.IO/J76AG.