bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of diagnostic accuracy of biomarkers to assess lung consolidation in calves with induced bacterial pneumonia using receiver operating characteristic curves
Authors: Martin Miriam , Kleinhenz Michael D , Montgomery Shawnee R , Blasi Dale A , Almes Kelli M , Baysinger Angela  K , Coetzee Johann F
Published: December 2021

Bovine respiratory disease (BRD) is the most economically significant disease for cattle producers in the U.S. Cattle with advanced lung lesions at harvest have reduced average daily gain, yield grades, and carcass quality outcomes. The identification of biomarkers and clinical signs that accurately predict lung lesions could benefit livestock producers in determining a BRD prognosis. Receiver operating characteristic (ROC) curves are graphical plots that illustrate the diagnostic ability of a biomarker or clinical sign. Previously we used the area under the ROC curve (AUC) to identify cortisol, hair cortisol, and infrared thermography imaging as having acceptable (AUC > 0.7) diagnostic accuracy for detecting pain in cattle. Herein, we used ROC curves to assess the sensitivity and specificity of biomarkers and clinical signs associated with lung lesions after experimentally induced BRD. We hypothesized pain biomarkers and clinical signs assessed at specific time points after induction of BRD could be used to predict lung consolidation at necropsy. Lung consolidation of > 10% was retrospectively assigned at necropsy as a true positive indicator of BRD. Calves with a score of < 10% were considered negative for BRD. The biomarkers and clinical signs analyzed were serum cortisol; infrared thermography (IRT); mechanical nociceptive threshold (MNT); substance P; kinematic gait analysis; a visual analog scale (VAS); clinical illness score (CIS); computerized lung score (CLS); average activity levels; prostaglandin E2 metabolite (PGEM); serum amyloid A; and rectal temperature. A total of 5,122 biomarkers and clinical signs were collected from 26 calves, of which 18 were inoculated with M. haemolytica. All statistics were performed using JMP Pro 14.0. Results comparing calves with significant lung lesions to those without yielded the best diagnostic accuracy (AUC > 0.75) for right front stride length at 0 h; gait velocity at 32 h; VAS, CIS, average activity and rumination levels, step count, and rectal temperature, all at 48 h; PGEM at 72 h; gait distance at 120 h; cortisol at 168 h; and IRT, right front force and serum amyloid A, all at 192 h. These results show ROC analysis can be a useful indicator of the predictive value of pain biomarkers and clinical signs in cattle with induced bacterial pneumonia. AUC values for VAS score, average activity levels, step count, and rectal temperature seemed to yield good diagnostic accuracy (AUC > 0.75) at multiple time points, while MNT values, substance P concentrations, and CLS did not (all AUC values < 0.75).
Partial Ribosomal Nontranscribed Spacer Sequences DistinguishRhagoletis zephyria(Diptera: Tephritidae) From the Apple Maggot,R. pomonella
Authors: Smith J J , Brzezinski P , Dziedziula J , Rosenthal E , Klaus M
Published: December 2021

The apple maggot, Rhagoletis pomonella (Walsh), was introduced into the apple-growing regions of the Pacific Northwest in the U.S.A. during the past 60–100 yr. Apple maggot (larvae, puparia, and adults) is difficult to distinguish from its morphologically similar sister species, Rhagoletis zephyria Snow, which is native and abundant in the Pacific Northwest. While morphological identifications are common practice, a simple, inexpensive assay based on genetic differences would be very useful when morphological traits are unclear. Here we report nucleotide substitution and insertion–deletion mutations in the nontranscribed spacer (NTS) of the ribosomal RNA gene cistron of R. pomonella and R. zephyria that appear to be diagnostic for these two fly species. Insertion–deletion variation is substantial and results in a 49 base-pair difference in PCR amplicon size between R. zephyria and R. pomonella that can be scored using agarose gel electrophoresis. PCR amplification and DNA sequencing of 766 bp of the NTS region from 38 R. pomonella individuals and 35 R. zephyria individuals from across their geographic ranges led to the expected PCR fragments of approx. 840 bp and 790 bp, respectively, as did amplification and sequencing of a smaller set of 26 R. pomonella and 16 R. zephyria flies from a sympatric site in Washington State. Conversely, 633 bp mitochondrial COI barcode sequences from this set of flies were polyphyletic with respect to R. pomonella and R. zephyria. Thus, differences in NTS PCR products on agarose gels potentially provide a simple way to distinguish between R. pomonella and R. zephyria.
Distal partial gastrectomy for gastric tube cancer with intraoperative blood flow evaluation using indocyanine green fluorescence
Authors: Sakai Ayano , Okumura Tomoyuki , Miwa Takeshi , Watanabe Toru , Numata Yoshihisa , Araki Misato , Ito Ayaka , Kanaya Emi , Sakurai Taro , Fukazawa Mina , Hoshino Yui , Tohmatsu Yuuko , Tokai Ryutaro , Baba Hayato , Hirano Katsuhisa , Igarashi Takamichi , Hashimoto Isaya , Shibuya Kazuto , Hojo Shozo , Matsui Koshi , Yoshioka Isaku , Fujii Tsutomu
Published: December 2021

With recent advances in the treatment of esophageal cancer and long-term survival after esophagectomy, the number of gastric tube cancer (GTC) has been increasing. Total gastric tube resection with lymph node dissection is considered to be a radical treatment, but it causes high post-operative morbidity and mortality. We report an elderly patient with co-morbidities who developed pyloric obstruction due to GTC after esophagectomy with retrosternal reconstruction. The patient was treated using distal partial gastric tube resection (PGTR) and Roux-en-Y reconstruction with preservation of the right gastroepiploic artery and right gastric artery. Intraoperative blood flow visualization using indocyanine green (ICG) fluorescence demonstrated an irregular demarcation line at the distal side of the preserved gastric tube, indicating a safe surgical margin to completely remove the ischemic area. PGTR with intraoperative ICG evaluation of blood supply in the preserved gastric tube is a safe and less-invasive surgical option in patients with poor physiological condition.
Couvelaire uterus resulting in haemoperitoneum
Authors: Lee Yi Jia , Calvert Katrina , Jape Kedar
Published: December 2021

First described by Dr Alexandre Couvelaire in 1911, a Couvelaire uterus is a rare complication of severe placental abruption (PA), which is diagnosed by the direct visualization of the uterus. There has been only one case report thus far that reported of an intraperitoneal bleed due to PA resulting in a poor outcome. We present a rare and serious case of Couvelaire uterus resulting in haemoperitoneum with a good outcome (live healthy infant, uterus preservation and total blood loss of 800 ml) in a primigravida with no prior risk factors and low-risk pregnancy other than a complete placenta praevia diagnosed during anatomy scan, which subsequently was reported as clear of cervix in third trimester ultrasound scan. She was diagnosed with placenta abruption and pre-eclampsia post-partum. Most cases of PA cannot be predicted or prevented. However, in some cases, close monitoring and timely decision-making can prevent adverse maternal and foetal outcomes.
Cosmic age problem in holographic and ghost dark energy models
Authors: Zarandi H R M , Ebrahimi E
Published: December 2021

In this paper, we study the cosmic age problem in holographic (HDE) and generalized ghost dark energy (GGDE) models. To this end, we consider these two models in presence of non-linear interaction terms for three special cases, presented in the literature. We explain the impacts of the mentioned interaction terms on the cosmic age during the evolution of the Universe. There are many old cosmic objects (OCOs) which their evaluated age is not consistent with that of dark energy models. Here, we confine our attention on five cases of more known OCOs at different redshift. The purpose is to constrain the DE models, using the age of these OCOs. We obtain boundary values for free parameters of the HDE (b2 and c) using the age test and find that, such non-linear interactions can alleviate the age problem in spite of the linear one. The GGDE was already constrained using a joint analysis of data sets SHBC. We find a new bound for ξ that wasn’t predicted via SHBC analysis. Beside, we find that the GGDE can completely alleviate the cosmic age problem.
Prevention of Chemotherapy-Induced Peripheral Neuropathy With PRESIONA, a Therapeutic Exercise and Blood Flow Restriction Program: A Randomized Controlled Study Protocol
Authors: Lopez-Garzon Maria , Cantarero-Villanueva Irene , Legerén-Alvarez Marta , Gallart-Aragón Tania , Postigo-Martin Paula , González-Santos Ángela , Lozano-Lozano Mario , Martín-Martín Lydia , Ortiz-Comino Lucía , Castro-Martín Eduardo , Ariza-García Angélica , Fernández-Lao Carolina , Arroyo-Morales Manuel , Galiano-Castillo Noelia
Published: December 2021

Objective

This trial will analyze the acute and cumulative effects of a tailored program called PRESIONA that combines therapeutic exercise and blood flow restriction to prevent chemotherapy-induced peripheral neuropathy (CIPN) in individuals with early breast cancer undergoing neoadjuvant chemotherapy.

Methods

PRESIONA will be a physical therapist–led multimodal exercise program that uses blood flow restriction during low-load aerobic and strength exercises. For the acute study, only 1 session will be performed 1 day before the first taxane cycle, in which 72 women will be assessed before intervention and 24 hours post intervention. For the cumulative study, PRESIONA will consist of 24 to 36 sessions for 12 weeks following an undulatory prescription. At least 80 women will be randomized to the experimental group or control group. Feasibility will be quantified based on the participant recruitment to acceptance ratio; dropout, retention, and adherence rates; participant satisfaction; tolerance; and program security. In the efficacy study, the main outcomes will be CIPN symptoms assessed with a participant-reported questionnaire (EORTC QLQ-CIPN20). In addition, to determine the impact on other participant-reported health and sensorimotor and physical outcomes, the proportion of completed scheduled chemotherapy sessions will be examined at baseline (t0), after anthracycline completion (t1), after intervention (t2), and at the 2-month (t3) and 1-year follow-ups (t4).

Conclusion

The proposed innovative approach of this study could have a far-reaching impact on therapeutic options, and the physical therapist role could be essential in the oncology unit to improve quality of life in individuals with cancer and reduce side effects of cancer and its treatments.

Impact

Physical therapists in the health care system could be essential to achieve the planned doses of chemotherapy to improve survival and decrease the side effects of individuals with breast cancer. The prevention of CIPN would have an impact on the quality of life in these individuals, and this protocol potentially could provide an action guide that could be implemented in any health care system.
Integrating pore architectures to evaluate vascularization efficacy in silicate-based bioceramic scaffolds
Authors: Wu Fanghui , Yang Jun , Ke Xiurong , Ye Shuo , Bao Zhaonan , Yang Xianyan , Zhong Cheng , Shen Miaoda , Xu Sanzhong , Zhang Lei , Gou Zhongru , Yang Guojing
Published: December 2021

Pore architecture in bioceramic scaffolds plays an important role in facilitating vascularization efficiency during bone repair or orbital reconstruction. Many investigations have explored this relationship but lack integrating pore architectural features in a scaffold, hindering optimization of architectural parameters (geometry, size and curvature) to improve vascularization and consequently clinical outcomes. To address this challenge, we have developed an integrating design strategy to fabricate different pore architectures (cube, gyroid and hexagon) with different pore dimensions (∼350, 500 and 650 μm) in the silicate-based bioceramic scaffolds via digital light processing technique. The sintered scaffolds maintained high-fidelity pore architectures similar to the printing model. The hexagon- and gyroid-pore scaffolds exhibited the highest and lowest compressive strength (from 15 to 55 MPa), respectively, but the cube-pore scaffolds showed appreciable elastic modulus. Moreover, the gyroid-pore architecture contributed on a faster ion dissolution and mass decay in vitro. It is interesting that both μCT and histological analyses indicate vascularization efficiency was challenged even in the 650-μm pore region of hexagon-pore scaffolds within 2 weeks in rabbit models, but the gyroid-pore constructs indicated appreciable blood vessel networks even in the 350-μm pore region at 2 weeks and high-density blood vessels were uniformly invaded in the 500- and 650-μm pore at 4 weeks. Angiogenesis was facilitated in the cube-pore scaffolds in comparison with the hexagon-pore ones within 4 weeks. These studies demonstrate that the continuous pore wall curvature feature in gyroid-pore architecture is an important implication for biodegradation, vascular cell migration and vessel ingrowth in porous bioceramic scaffolds.
The Genetic Association Identified Between Intervertebral Disc Degeneration and Associated Risk Factors Based on a Systems Biology Approach
Authors: Xiang Hao , Yan Fang , Liu Haihong
Published: December 2021

Study Design.

Genetic cross-over study of intervertebral disc degeneration (IDD) and its associated risk factors.

Objective.

The purpose is to identify molecular biomarkers that may be involved in the IDD process and to provide effective recommendations in combination with drug analysis via systems biology methods.

Summary of Background Data.

The pathogenesis and genetic links of IDD are still unclear. Related research is mainly based on a single data set or gene, and the impact of related risk factors on IDD is often ignored.

Methods.

Identifying disease-associated biomarkers and therapeutic targets through a systems biology approach that Integrative network-based gene and multi-omics analysis. In this study, the differential expression of genes was analyzed through NCBI datasets, followed by enrichment analysis. The central protein was identified through the establishment of protein-protein interaction (PPI) network. Key genes were screened out by VENN diagram and reasonable suggestions were put forward based on gene-chemical drug analysis.

Results.

The IDD database analysis revealed 669 differentially expressed genes (DEGs) which were 22, 26, 168, 5, 38, 36, and 16 common DEGs with AG, SM, DEP, NAD, CED, OB, and HFD, respectively. GO and KEGG enrichment analysis may reveal the pathway by which these DEGs were involved. PPI network identified 10 central proteins including CCNB1, RETN, HMMR, BUB1, MPO, OIP5, HP, KIF11, BUB1B, and CDC25A. Three key genes BUB1, BUB1B, and CCNB1 were screened out and their expression might be related to the pathogenesis of IDD. According to the three chemical Dexamethasone, Nicotine, and Resvera-trol obtained from the analysis of genes-chemical drugs, reasonable treatment suggestions were put forward.

Conclusion.

Genetic association between IDD and risk factors in the general population was revealed by association network. Important gene-related molecular pathways and chemical drugs closely related to IDD have been found. Further study can provide guidance for the treatment and prognosis of IDD.

Level of Evidence: N/A
Which objective emergency department parameters leads to expedited intervention in patients with acute urinary tract calculi
Authors: Kranz Zachary , Peifer Greggory , Rohloff Matthew , Maatman Thomas , Shockley Kenneth
Published: December 2021

Objectives:

To retrospectively determine which objective measurements had an increased likelihood of requiring immediate surgical intervention in patients presenting to the emergency department (ED) with acute ureteral calculi.

Materials and methods:

Employing our institution's electronic medical record system, we conducted a retrospective cohort study of 4366 patients who presented to the ED with an acute ureteral calculus over an 8-year period. Data consisting of relevant demographic information, vital signs, laboratory parameters, and interventional history was obtained and analyzed.

Results:

This study consisted of 4366 patients presenting to the ED with acute ureteral calculi, of whom 312 (7%) required a procedure prior to being discharged. Of these 312 patients, 290 (6.6%) underwent cystoscopy with ureteral stent placement and 22 (0.5%) were sent to interventional radiology for percutaneous nephrostomy tube placement. Patients who tested positive for nitrites in their urine had a relative risk of 3.48 of receiving intervention when compared to the nitrite negative group.

Conclusions:

Through this retrospective cohort study, we were able to find what objective measurements were associated with an increased need for immediate surgical intervention in patients who presented to the ED with acute ureteral calculi. With this data, urologists can be better equipped to identify the patients that present in the emergency setting that will require urgent intervention.
Sustained but Declining Humoral Immunity Against SARS-CoV-2 at 9 Months Postvaccination With BNT162b2: A Prospective Evaluation in 309 Healthy Individuals
Authors: Terpos Evangelos , Karalis Vangelis , Ntanasis-Stathopoulos Ioannis , Apostolakou Filia , Gumeni Sentiljana , Gavriatopoulou Maria , Papadopoulos Dimitris , Malandrakis Panagiotis , Papanagnou Eleni-Dimitra , Korompoki Eleni , Kastritis Efstathios , Papassotiriou Ioannis , Trougakos Ioannis P. , Dimopoulos Meletios A.
Published: December 2021

The sustainability of coronavirus 19 (COVID-19) vaccine-induced immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to be determined to inform public health decisions on vaccination programs and prevention measures against COVID-19. The aim of the present study was to prospectively evaluate the kinetics of neutralizing antibodies (NAbs) and anti-S-receptor binding domain (RBD IgGs) against SARS-CoV-2 after full vaccination with the BNT162b2 mRNA vaccine for up to 9 months in healthy individuals (NCT04743388). The assessments were performed at the following time points after the second vaccination: 2 weeks, 1 month, 3 months, 6 months, and 9 months. The measurements were performed with the GenScript’s cPassTM SARS-CoV-2 NAbs Detection Kit (GenScript, Inc.; Piscataway, NJ) and the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics GmbH; Mannheim, Germany). Three hundred nine participants with a median age of 48 years were included. A gradual decline in both NAbs and anti-S-RBD IgGs became evident from 2 weeks to 9 months postvaccination. Both NAbs and anti-S-RBD IgGs levels were significantly lower at 9 months compared with the previous timepoints. Interestingly, age was found to exert a statistically significant effect on NAbs elimination only during the first-trimester postvaccination, as older age was associated with a more rapid clearance of NAbs. Furthermore, simulation studies predicted that the median NAb value would fall from 66% at 9 months to 59% and 45% at 12 and 18 months postvaccination, respectively. This finding may reflect a declining degree of immune protection against COVID-19 and advocates for the administration of booster vaccine shots especially in areas with emerging outbreaks.
PIGMENTATION IN FOCAL SCLERAL NODULE
Authors: Go Christopher , Mok Adrian , Fung Adrian T.
Published: December 2021

Purpose:

To report a case of pigmentation in focal scleral nodule (FSN).

Methods:

This is a single case report.

Result:

An asymptomatic 61-year-old woman was referred with small, partially pigmented raised lesion located at the superior margin of the optic nerve head. The lesion's clinical and multimodal imaging features were consistent for FSN including a dome-shaped elevation confined to the sclera with overlying choroidal thinning. However, the pigmentation within our lesion is a novel finding in FSN that has not been described before.

Conclusion:

To our knowledge, we report the first case of pigmentation in FSN. It is likely that our case was a typical FSN that then became pigmented, with melanosomes involving the flanges of the lesion where thin choroid remains. The understanding that FSN can be partially pigmented may eventually help unravel the origins of this poorly understood lesion.
VENOUS OVERLOAD CHOROIDOPATHY ASSOCIATED WITH IDIOPATHIC INTRACRANIAL HYPERTENSION
Authors: Rana Vipin , Gupta Vishali , Spaide Richard F. , Sukhija Jaspreet , Singh Simar R. , Agrawal Rupesh , Takkar Aastha , Lal Vivek
Published: December 2021

Purpose:

To report a case of venous overload choroidopathy associated with idiopathic intracranial hypertension in a 41-year-old man.

Methods:

History and clinical examination, fluorescein angiography, ultra-widefield indocyanine green angiography, swept-source optical coherence tomography, and contrast-enhanced magnetic resonance imaging.

Results:

The patient was diagnosed as having idiopathic intracranial hypertension 2 years ago, was being managed on oral acetazolamide, and retained 20/20 visual acuity in both eyes until now when he presented with a complaint of visual loss in the right eye. Ophthalmoscopy revealed serous detachment in the fovea of the right eye. Swept-source optical coherence tomography showed the presence of subretinal fluid and detachments of the retinal pigment epithelium in both eyes. Fundus fluorescein angiography showed multiple dot leaks at the level of the retinal pigment epithelium in both eyes. Indocyanine green angiography revealed vortex vein anastomoses and choroidal vascular hyperpermeability in both eyes. Contrast-enhanced magnetic resonance imaging revealed dilated optic nerve sheath diameter and a partial empty sella and magnetic resonance venography showed bilateral stenosis of the transverse sinus.

Conclusion:

Transverse sinus stenosis is a common finding in “idiopathic” intracranial hypertension and contributes to the intracranial pressure through intracranial venous hypertension. Increased venous back pressure seemed to have overloaded the choroid resulting in choroidal vascular congestion and hyperpermeability, leaks from the level of the retinal pigment epithelium, and accumulation of subretinal fluid.
The Effect of Lighting and Photograph Exposure on Perceived Attractiveness
Authors: Roelofs Kelsey A. , Esfandiari Mahtash , Diniz Stefania B. , Cohen Liza M. , Baugh Samuel , Karlin Justin N. , Goldberg Robert A. , Rootman and Daniel B.
Published: December 2021

Purpose:

To assess the effect of various lighting conditions and photograph exposures on perceived attractiveness.

Methods:

In the first experiment, 5 variably exposed photographs were taken of 10 subjects using a consistent lighting condition (45° superior box light). In the second experiment, 10 subjects were photographed under variable lighting conditions with consistent exposure: 1) 90° overhead box light, 2) ring light, 3) 45° superior box light, 4) built-in camera flash, 5) 2 straight on box lights, each 45° from midline, and 6) natural light. Participants were instructed to maintain a neutral expression, were placed in front of a standardized blue-gray background, and were photographed during a single session. Photographs were imported into an online survey platform (Qualtrics 2020) and displayed in random order. Volunteer survey respondents were instructed to rate the subject’s attractiveness on a scale of 0 to 10. Between the two experiments, a total of 22,000 scored photographs were included in the analysis. Mixed ANOVA and pairwise comparisons with Bonferroni correction were used to compare between- and within-subject ratings.

Results:

Lighting condition had a significant impact on perceived attractiveness (p < 0.001), with the 90° overhead box light achieving lower scores and the 45° superior box light yielding greater scores of attractiveness relative to the other conditions. Photograph exposure did not have a significant impact on subjective attractiveness (p = 1.000).

Conclusions:

Our findings suggest that perceived attractiveness is enhanced when a 45° superior box light is used for illumination, and attractiveness is reduced when 90° overhead exposure is utilized. Exposure did not play a prominent role in perceived attractiveness.
Clinico-Radiological-Pathological Correlation of Visual Loss in COVID-Associated Rhino-Orbito-Cerebral Mucormycosis
Authors: Goel Ruchi , Arora Ritu , Shah Shalin , Chhabra Mohit , Kumar Jyoti , Khurana Nita , Gupta Swati , Khanam Samreen , Kumar Sumit , Singh Sonam , Meher Ravi , Thakar Meenakshi , Garg Anju
Published: December 2021

Purpose:

To correlate the clinical, radiological, and histopathological features in Covid-associated Rhino-orbito-cerebral mucormycosis cases presenting with acute visual loss.

Design:

Cross-sectional study.

Methods:

Covid-associated Rhino-orbito-cerebral mucormycosis cases with unilateral visual loss, planned for exenteration, underwent orbital and ophthalmological ocular examination. The available radiological sequences, doppler ultrasonography and histopathology findings were correlated with clinical manifestations.

Results:

The median age was 51 years and the male: female ratio was 3:1. All except one presented with unilateral ophthalmoplegia. The ocular media were hazy in 2 eyes. In 8 eyes, retinal changes were suggestive of occlusion of CRA (6), combined occlusion of CRA and central retinal vein (1), and myopic degeneration with hypertensive retinopathy (1). The contralateral eye showed retinal ischemic changes in one patient. Radiological imaging showed orbital apex involvement in the 10 affected eyes and one contralateral eye. Ipsilateral cavernous sinus thrombosis, diffusion restriction on MRI of optic nerve, internal carotid artery narrowing/thrombosis, and cortical watershed infarcts were seen in 8, 4, 4, and 2 cases, respectively. The blood flow in CRA and ophthalmic artery was absent or reduced in all the 10 affected eyes and in 1 contralateral eye. On histopathology, orbital fat necrosis, fungal hyphae, acute inflammation, granuloma formation, ischemic thrombosis of ophthalmic artery was observed in 10 specimens. CRA was patent in 9 and thrombosed in 1 eye. Optic nerve was ischemic in 8 and viable in 2 eyes.

Conclusion:

Acute visual loss in ROCM cases is associated with orbital apex involvement and thrombotic ischemia of ophthalmic artery. Cessation of flow in CRA possibly occurs secondary to ophthalmic artery thrombosis.
60 Years of Combining Tranylcypromine
Authors: Wagner Elias , Seemüller Florian , Hasan Alkomiet
Published: December 2021

Background

Tranylcypromine is the only irreversible monoamine oxidase inhibitor that is approved in the United States and in Europe for the management of treatment-resistant major depressive disorder. Comprehensive data in the literature regarding the efficacy and tolerability of tranylcypromine (TCP) combination strategies have not been systematically investigated yet.

Methods

We conducted a systematic review of available literature based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study types considered eligible for inclusion were studies that reported information on efficacy and/or tolerability/adverse effects of pharmacological TCP add-on or coadministration strategies among people with psychiatric disorders.

Results

Ninety-six articles were included in qualitative analyses. A relevant body of evidence shows that TCP combined with first- and second-generation antipsychotics seems relatively safe and might have beneficial effects in some patients with depressive disorders, although caution is needed with some second-generation antipsychotics that have proserotonergic activity. Although evidence is not entirely consistent, amitriptyline as add-on agent might be efficacious and associated with a low rate of severe adverse events. Although available data from case reports are scarce, certain other agents, such as trazodone, but also lithium, seem to have a good risk-benefit profile with regard to TCP that should be further investigated in the context of high-quality studies.

Conclusions

Any combination of a psychotropic with TCP should be preceded by an evaluation of drug-to-drug interaction and an informed consent process and followed by close monitoring. Before any combination strategy, doctors should reevaluate factors of pseudo–treatment resistance, such as rapid-metabolizing status, noncompliance, trauma, alternative diagnosis, or drug abuse.
Effect of Valproic Acid on the Metabolic Spectrum of Clozapine in Patients With Schizophrenia
Authors: Smith Robert Løvsletten , Wollmann Birgit M. , Kyllesø Lennart , Tran Thu Thuy Anh , Tveito Marit , Molden Espen
Published: December 2021

Background

Valproic acid (VPA) is frequently used with clozapine (CLZ) as mood stabilizer and/or seizure prophylaxis. Valproic acid is known to reduce N-desmethylclozapine (N-DMC) but not CLZ levels. This leads to the hypothesis that VPA induces the CLZ metabolism via non–N-desmethylation pathways. Therefore, we aimed to investigate the effect of concurrent VPA use on the serum concentrations of a spectrum of CLZ metabolites in patients, adjusting for smoking.

Methods

In total, 288 patients with an overall number of 737 serum concentration measurements of CLZ and metabolites concurrently using VPA (cases, n = 22) or no interacting drugs (controls, n = 266) were included from a routine therapeutic drug monitoring service. Linear mixed model analyses were performed to compare the dose-adjusted concentrations (C/D) of CLZ, N-DMC, CLZ 5N/N
+-glucuronides, and metabolite-to-parent ratios in cases versus controls.

Results

After adjusting for covariates, the N-DMC (−40%, P < 0.001) and N
+-glucuronide C/Ds (−78%, P < 0.001) were reduced in cases versus controls, while the CLZ C/D was unchanged (P > 0.7). In contrast, the 5N-glucuronide C/D (+250%, P < 0.001) and 5N-glucuronide-to-CLZ ratios (+120%, P = 0.01) were increased in cases versus controls.

Conclusions

Our findings show that complex changes in CLZ metabolism underly the pharmacokinetic interaction with VPA. The lower levels of N-DMC seem to be caused by VPA-mediated induction of CLZ 5N-glucuronide formation, subsequently leading to reduced substrate availability for N-desmethylation. Whether the changes in CLZ metabolism caused by VPA affects the clinical outcome warrants further investigation.
The efficacy and safety of different bismuth agents in Helicobacter pylori first-line eradication
Authors: Cao Yaping , Zhang Jian , Liu Yuan , Zhang Lifeng , Wang Lu , Wang Jie , Qi Ying , Lv Huanhuan , Liu Juan , Huo Lijuan , Wei Xiaoguo , Shi Yongquan
Published: December 2021

Background:

The aim of this study was to evaluate the efficacy and safety of bismuth pectin capsules and bismuth pectin granules in the first-line quadruple treatment of Helicobacter pylori (H. pylori).

Methods:

This study was a multicenter, randomized, open-labelled controlled clinical trial. Patients with a H. pylori infection were randomized into 4 groups (1:1:1:1) and treated with a 14-day bismuth-containing quadruple therapy. The 4 groups received either bismuth potassium citrate capsules (220 mg), colloidal bismuth pectin capsules (200 mg), bismuth pectin granules (150 mg), or bismuth pectin granules (300 mg). The primary outcome was the eradication rate of H. pylori. The secondary outcomes included symptom improvement, patient compliance, and incidence of adverse events. This study was registered at ClinicalTrials.gov (NCT04209933).

Result(s):

A total of 240 patients were included in this study, and 211 patients completed the follow-up. An intention-to-treat analysis showed that the H. pylori eradication rates of the 4 groups were 73.3%, 76.7%, 75.0%, and 71.7%, respectively. The per-protocol analysis showed that the H. pylori eradication rates of the 4 groups were 86.3%, 82.1%, 83.3%, and 86.0%. There was no significant difference among the 4 groups in the H. pylori eradication rate (P > .05). There were also no significant differences in the symptom improvement rate, overall adverse reaction rate, or patient compliance among the 4 groups.

Conclusion(s):

Bismuth pectin capsules and bismuth pectin granules had similar efficacy and safety for H. pylori eradication compared to bismuth potassium citrate. These data suggest that bismuth pectin can be an alternative to bismuth potassium citrate to eradicate H. pylori when using bismuth-containing quadruple therapy.
Efficacy and safety of Tuina for treatment of pediatric recurrent respiratory tract infections
Authors: Tian Ye , Wang Lie , Wang Zhongtian , Ding Lizhong , Wei Lina , Guo Lei , Sun Xiaozhou , Wang Lei , Yang Fushuang , Sun Liping
Published: December 2021

Background:

Recurrent respiratory tract infections (RRTIs) are common respiratory ailments in children. RRTIs are often difficult to control and thus generally have a long-term disease course. Children who receive ineffective treatments or those that experience poor treatment outcomes are prone to developing complications such as edema, cough and asthma. Such complications can seriously hinder a child's growth and development, while also adversely affecting the child's physical and mental health. Tuina massage, a traditional Chinese technique that has been practiced in China for >5000 years, has recently been used to treat RRTIs, with good effect. However, no systematic review of research studies focusing on massage as a treatment for RRTIs can be found in the literature to date. The purpose of this study will be to evaluate the efficacy and safety of Tuina massage for the treatment of pediatric patients who experience RRTIs.

Methods:

We will search the following databases using electronic methods: the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wanfang Data (WAN FANG), VIP Information (VIP), MEDLINE, PUBMED, EMBASE, and CINAHL. For each database search, the scope will include articles published between the date of database inception to September 2021. Revman5.4 software will be used to conduct this systematic review and meta-analysis.

Results:

This meta-analysis will confirm whether Tuina massage is of clinical benefit to pediatric patients who experience RRTIs.

Conclusion:

The results of our systematic review and meta-analysis will be used to formulate conclusions as to whether massage therapy is an effective treatment for children suffering from RRTIs.

Ethics and dissemination:

This systematic review will evaluate the efficacy and safety of tuina in the treatment of recurrent respiratory tract infections. Since all the data included were published, the systematic review did not require ethical approval.

INPLASY registration number:

INPLASY202190107.
Efficacy and safety of acupuncture combined Chinese herbal medicine for diabetic peripheral neuropathy
Authors: Shi Yong , Liu Le , Sun Xuefeng , Jiao Jundong
Published: December 2021

Background:

Acupuncture combined with Chinese herbal medicine has been widely utilized for pain management in patients with diabetic peripheral neuropathy (DPN). However, its results are still inconsistent, and no systematic review has specifically addressed this issue. Thus, this systematic review will comprehensively and systematically investigate the effectiveness and safety of acupuncture combined with Chinese herbal medicine for pain relief in DPN.

Methods:

Randomized controlled trials on acupuncture combined with Chinese herbal medicine treatment of DPN published before September of 2021 will be searched in 9 databases including Medline, Web of Science, PubMed, Cochrane Library, Excerpta Medica Database, Sinomed, China National Knowledge Infrastructure, WanFang, and China Science and Technology Journal Database. The methodological assessment performed using the risk of bias assessment tool of Cochrane, and the level of evidence quality for the main results will be evaluated by a recommended grading, evaluation, formulation, and evaluation system approach. Bayesian network meta-analysis will be conducted using STATA V.14.0 and WinBUGS V.1.4.3.

Results:

This study will provide a high-quality comprehensive evaluation of the safety of acupuncture combined with Chinese herbal medicine for treating DPN.

Conclusion:

This systematic review will evaluate the efficacy and safety of Chinese herbal medicine combined with acupuncture in the treatment of DPN, and provide the latest evidence for clinical application.

Ethics and dissemination:

The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

Registration number: INPLASY2021100004.
Comparison of prediction accuracies between mathematical models to make projections of confirmed cases during the COVID-19 pandamic by country/region
Authors: Tsai Kang-Ting , Chien Tsair-Wei , Lin Ju-Kuo , Yeh Yu-Tsen , Chou Willy
Published: December 2021

Background:

The COVID-19 pandemic caused >0.228 billion infected cases as of September 18, 2021, implying an exponential growth for infection worldwide. Many mathematical models have been proposed to predict the future cumulative number of infected cases (CNICs). Nevertheless, none compared their prediction accuracies in models. In this work, we compared mathematical models recently published in scholarly journals and designed online dashboards that present actual information about COVID-19.

Methods:

All CNICs were downloaded from GitHub. Comparison of model R

2
was made in 3 models based on quadratic equation (QE), modified QE (OE-m), and item response theory (IRT) using paired-t test and analysis of variance (ANOVA). The Kano diagram was applied to display the association and the difference in model R

2
on a dashboard.

Results:

We observed that the correlation coefficient was 0.48 (t = 9.87, n = 265) between QE and IRT models based on R

2
when modeling CNICs in a short run (dated from January 1 to February 16, 2021). A significant difference in R

2
was found (P < .001, F = 53.32) in mean R
2 of 0.98, 0.92, and 0.84 for IRT, OE-mm, and QE, respectively. The IRT-based COVID-19 model is superior to the counterparts of QE-m and QE in model R
2 particularly in a longer period of infected days (i.e., in the entire year in 2020).

Conclusion:

An online dashboard was demonstrated to display the association and difference in prediction accuracy among predictive models. The IRT mathematical model was recommended to make projections about the evolution of CNICs for each county/region in future applications, not just limited to the COVID-19 epidemic.
Prognostic significance of PTOV1 expression in cancers
Authors: Yang Yue , Li Nan , Tian Guangwei
Published: December 2021

Background:

Prostate tumor overexpressed-1 (PTOV1) was firstly depicted as gene and protein overexpressed in prostate cancers and preneoplastic lesions of high-grad intraepithelial neoplasia. Recently, people have paid recent attention to the oncogenic PTOV1 protein as a regulator with various cellular functions and pathways that tend to enhance cell growth and self-renewal in numerous cancer cell types. Its prognostic role in cancers remains controversial.

Methods:

Eligible studies are identified by comprehensively searching literature in all available databases. The associations between PTOV1 expression and overall survival, disease-free survival, relapse-free survival, progression-free survival, and clinicopathological characteristics are estimated by employing hazard ratios and the confidence intervals of 95%. STATA 12.0 software was adopted to perform the meta-analysis.

Results:

This study will provide high-quality synthesis to evaluate the associations between PTOV1 expression and overall survival, disease-free survival /relapse-free survival , progression-free survival, and clinicopathological features.

Conclusion:

The study will provide updated evidence to assess whether the expression of PTOV1 is in association with poor prognosis in patients with cancers.

PROSPERO registration number:

CRD42020183853.
Significant vision improvement and successful prevention of recurrence by electroacupuncture in hemiretinal vein occlusion combined with macular edema
Authors: Yan Yan , Chen Yu , Liu ZhiShun
Published: December 2021

Rationale:

Retinal vein occlusion (RVO) is the second commonest retinal vascular pathology, with macular edema (ME) as one of its major complications, which could finally cause vision loss. Anti-vascular endothelial growth factor (anti-VEGF therapy), as the standard therapy, has an unsustainable effect and needs repeated injections, which associates with frequent adverse events and significant economic burden. We reported a patient who had developed RVO and ME, and finally recovered after electroacupuncture treatment.

Patient concerns:

A 56-year-old woman complained a decrease of visual acuity in the right eye for 1 year. She received injection of 0.5 mg Conbercept, one of the anti-VEGF therapies, in the vitreous cavity 6 times in 1 year, and finally turned to acupuncture for help out of short-term effectiveness after each injection and high expenditure (CNY 40,800). No other severe medical history was reported.

Diagnosis:

Under comprehensive consideration of clinical manifestations and the results of fluorescein fundus angiography and optical coherence tomography, the patient was diagnosed with hemi-RVO and ME.

Interventions:

The patient received electroacupuncture 3 sessions per week throughout 8 months (93 sessions in total).

Outcomes:

The visual acuity of the patient was improved from 0.6 to 0.9 after the 8-month electroacupuncture treatment and remained stable during the 24-month follow-up; the central retinal thickness remained stable between 350 and 414 throughout the treatment and follow-up periods. Patients regarded the vision-related quality of life as satisfactory. The total expenditure of electroacupuncture treatment was CNY 6045. The patient did not receive any Conbercept injection over the whole period of 32 months. No relevant adverse events occurred.

Lessons:

Electroacupuncture might be effective in alleviating the symptoms of hemi-RVO-associated ME, with a potential of long-lasting effect. The frequency of anti-VEGF therapy could be reduced to the most extent, and the possibility of recurrence could be reduced as well, resulting good economic benefits.
Antegrade recanalization of parent artery in proximal occlusion of distal posterior inferior cerebellar artery ruptured aneurysm
Authors: Jang Hyung-Gyu , Park Jung-Soo
Published: December 2021

Rationale:

Distal posterior inferior cerebellar artery (PICA) aneurysms are extremely rare. Herein, we describe a case of PICA pseudoaneurysm with proximal occlusion achieved using detachable coils, but antegrade recanalization, which showed a normal PICA configuration on follow-up angiography. Possible mechanisms of the recanalization and lesions are also discussed.

Patient concerns:

The patient was an 80-year-old woman with a subarachnoid hemorrhage (SAH) resulting from a distal PICA-ruptured aneurysm, initially misdiagnosed as a non-aneurysmal traumatic SAH.

Diagnosis:

On hospitalization day 10, the patient developed rebleeding, and brain computed tomography angiography confirmed a distal PICA pseudoaneurysm.

Intervention:

Endovascular coil embolization was performed. Inevitably, the proximal PICA was occluded using detachable coils, and complete occlusion of the affected PICA was confirmed on the final angiogram.

Outcome:

Fortunately, the patient recovered fully without any neurological sequelae. One year after the procedure, a follow-up angiography was performed, which revealed recanalization of the previously occluded PICA, with normal configuration and no visible aneurysmal dilatation.

Conclusion:

Even if the SAH is scanty and predominantly in the perimesencephalic cistern, performing a catheter-based angiography is essential. In the case of proximal occlusion of the parent artery without internal trapping in endovascular treatment of PICA pseudoaneurysm, follow-up examination with a short-term angiography might be crucial.
Undifferentiated embryonal sarcoma of the liver with epithelioid features in an adult patient
Authors: Jiang Peng , Jiao Yan , Niu Chun-Yuan , Liu Ya-Hui
Published: December 2021

Introduction:

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare form of liver malignancy, with most cases reported in the pediatric population. This disease is extremely uncommon in adults. Herein, we report the first case of UESL with epithelioid features in an adult patient.

Patient concerns:

A 50-year-old man was admitted to our hospital due to epigastric pain.

Diagnosis and interventions:

Computed tomography and magnetic resonance imaging revealed a space-occupying lesion in the right lobe of the liver. A right hemihepatectomy was performed. Postoperative pathological and immunohistochemical examinations confirmed the diagnosis of UESL and features of epithelioid differentiation.

Outcomes:

The patient recovered well and refused adjuvant therapy. Unfortunately, the patient died of tumor recurrence 3 months after hospital discharge.

Conclusion:

UESL is a rare form of liver cancer, with most cases reported in the pediatric population. This case study highlights an extremely uncommon case of UESL with epithelioid features and a very poor prognosis. The findings suggest that complete intraoperative resection and postoperative adjuvant therapy should be considered to improve the prognosis of adult patients with UESL with epithelioid features.
Accuracy of ultrasonic artificial intelligence in diagnosing benign and malignant breast diseases
Authors: Liu Qiyu , Qu Meijing , Sun Lipeng , Wang Hui
Published: December 2021

Background:

Artificial intelligence system is a deep learning system based on computer-assisted ultrasonic image diagnosis, which can extract morphological features of breast mass and conduct objective and efficient image analysis, thus automatically intelligent classification of breast mass, avoiding subjective error and improving the accuracy of diagnosis.
[1–2]
A large number of studies have confirmed that artificial intelligence (AI) has high effectiveness and reliability in the differential diagnosis of benign and malignant breast diseases.
[3–4]
However, the results of these studies have been contradictory. Therefore, this meta-analysis tested the hypothesis that artificial intelligence system is accurate in distinguishing benign and malignant breast diseases.

Methods:

We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the November 20, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:

This systematic review will determine the accuracy of AI in the differential diagnosis of benign and malignant breast diseases.

Conclusion:

Its findings will provide helpful evidence for the accuracy of AI in the differential diagnosis of benign and malignant breast diseases.

Systematic review registration:

INPLASY2021110087.