bluuebunny/crossref_metadata_2025 huggingface dataset:
A pixel space method for testing dipole modulation in the CMB polarization
Authors: Ghosh Shamik , Jain Pankaj
Published: January 2020

We introduce a pixel space method to detect dipole modulation or hemispherical power asymmetry in the cosmic microwave background (CMB) polarization. The method relies on the use of squared total polarized flux whose ensemble average picks up a dipole due to the dipole modulation in the CMB polarization. The method is useful since it can be easily applied to partial sky. We define several statistics to characterize the amplitude of the detected signal. Through simulations, we show that the method can be used to reliably extract the signal at a 2.7σ level or higher in future CORE-like missions, assuming that the signal is present in the CMB polarization at the level detected by the Planck mission in the CMB temperature. An application of the method to the 2018 Planck data does not detect a significant effect, when taking into account the presence of correlated detector noise and residual systematics in the data. Using the Full Focal Plane 10, we find the presence of a very strong bias that might be masking any real effect.
Influence of porosity on high-velocity mass-asymmetric collisions
Authors: Planes María Belén , Millán Emmanuel N , Urbassek Herbert M , Bringa Eduardo M
Published: January 2020

Using granular mechanics, we study the influence of porosity on the collisions of spherical granular aggregates with a mass ratio of around 60. At high filling factors, the projectile produces a crater on the target, similar to impacts on a granular bed. However, at low filling factors, the small projectile passes through the large target, strongly fragmenting it. By a consideration of the lateral grain velocities during the collision, we attribute this behaviour to the ‘piston effect’, in which the projectile loses momentum mainly to the grains below it. Due to an increase in grain–grain interactions as porosity decreases, the piston effect loses its importance for higher filling factors, ϕ ≳ 0.2. These results may prove useful in modelling collisions occurring in debris discs.
Approximate Random Allocation Mechanisms
Authors: Akbarpour Mohammad , Nikzad Afshin
Published: January 2020

We generalize the scope of random allocation mechanisms, in which the mechanism first identifies a feasible “expected allocation” and then implements it by randomizing over nearby feasible integer allocations. The previous literature has shown that the cases in which this is possible are sharply limited. We show that if some of the feasibility constraints can be treated as goals rather than hard constraints, then, subject to weak conditions that we identify, any expected allocation that satisfies all the constraints and goals can be implemented by randomizing among nearby integer allocations that satisfy all the hard constraints exactly and the goals approximately. By defining ex post utilities as goals, we are able to improve the ex post properties of several classic assignment mechanisms, such as the random serial dictatorship. We use the same approach to prove the existence of $\epsilon$-competitive equilibrium in large markets with indivisible items and feasibility constraints.
A new species of Bottosaurus (Alligatoroidea: Caimaninae) from the Black Peaks Formation (Palaeocene) of Texas indicates an early radiation of North American caimanines
Authors: Cossette Adam P
Published: January 2020

Morphological and molecular data suggest a close relationship for alligators and caimans. The first fossil appearances combined with phylogenetic hypotheses suggest a divergence of the groups near the Cretaceous–Palaeogene boundary, but the early fossil record of Caimaninae is incomplete, and large gaps exist between the earliest representatives of the group. A new caimanine from lower Palaeocene (Tiffanian) deposits in the Black Peaks Formation of Brewster County, Texas is established upon two specimens of different size that bear similarities to Bottosaurus harlani from the uppermost Cretaceous and lowermost Palaeogene of New Jersey. The larger individual consists of a partial skull and lower jaw in addition to postcranial material. The smaller individual preserves a snout and posterior portions of the skull. Both specimens suggest an animal with a comparatively short, flat, broad snout. Species of Bottosaurus share diagnostic morphological character states but are differentiated in meaningful ways. Phylogenetic analysis shows that the new species is sister to B. harlani, indicates an early radiation of North American caimanines and elucidates a more complicated biogeographical history than previously hypothesized. A growing body of evidence suggests that Caimaninae may be diagnosed by ancestral characters, potentially drawing basal alligatoroids crownwards in phylogenetic trees.
Do Professionalism Lapses in Medical School Predict Problems in Residency and Clinical Practice?
Authors: Krupat Edward , Dienstag Jules L. , Padrino Susan L. , Mayer John E. , Shore Miles F. , Young Aaron , Chaudhry Humayun J. , Pelletier Stephen R. , Reis Ben Y.
Published: January 2020

Purpose

Recognizing that physicians must exhibit high levels of professionalism, researchers have attempted to identify the precursors of clinicians’ professionalism difficulties, typically using retrospective designs that trace sanctioned physicians back to medical school. To better establish relative risk for professionalism lapses in practice, however, this relationship must also be studied prospectively. Therefore, this study investigated the sequelae of medical school professionalism lapses by following students with medical school professionalism problems into residency and practice.

Method

Beginning in 2014, 108 graduates from Harvard Medical School and Case Western Reserve University School of Medicine who appeared before their schools’ review boards between 1993 and 2007 for professionalism-related reasons were identified, as well as 216 controls matched by sex, minority status, and graduation year. Prematriculation information and medical school performance data were collected for both groups. Outcomes for the groups were studied at 2 points in time: ratings by residency directors, and state medical board sanctions and malpractice suits during clinical practice.

Results

Compared with controls, students who appeared before their schools’ review boards were over 5 times more likely to undergo disciplinary review during residency (16% vs 3%, respectively) and almost 4 times more likely to require remediation or counseling (35% vs 9%, respectively). During clinical practice, 10% of those who had made review board appearances were sued or sanctioned vs 5% of controls. Logistic regression for these outcomes indicated, however, that professional lapses in medical school were not the only, or even the most important, predictor of problems in practice.

Conclusions

Students with professionalism lapses in medical school are significantly more likely to experience professionalism-related problems during residency and practice, although other factors may also play an important predictive role.
A quantitative analysis of deltoid lengthening and deltoid-related complications after reverse total shoulder arthroplasty: A retrospective case-control study
Authors: Acott Thomas R. , Brolin Tyler J. , Azar Frederick M. , Smith Richard A. , Throckmorton Thomas W.
Published: January 2020

Background:

Over-lengthening of the deltoid has been hypothesized to increase the risk of specific complications, including acromial fractures, deltoid dehiscence or rupture, and prolonged deltoid pain. We hypothesized that progressive deltoid lengthening would be associated with an increasing number of these complications and that there would be a threshold of deltoid length beyond which these complications would be more common.

Methods:

After database review, three patient cohorts were established for comparison: nine patients with deltoid-related complications (acromial fractures and deltoid dehiscence) and four with persistent deltoid pain and/or tightness that persisted at least 2 yr postoperatively; these were matched with a 1:2 control group drawn from the same database (26 patients without these complications).

Results:

The overall average deltoid lengthening was 20.6 mm. For patients with acromial fractures or deltoid dehiscence, the length averaged 28.5 mm; for patients with persistent deltoid pain, the average length was 26.3 mm; and for controls, the length was 17.0 mm.

Conclusions:

Sufficient deltoid tensioning is vital to the stability of a reverse prosthesis as well as patient range of motion and outcomes; however, increased deltoid lengthening during reverse total shoulder arthroplasty increases the risk of postoperative tension-related complications. These data suggest that lengthening more than 26 mm is a risk factor for deltoid-related complications after reverse total shoulder arthroplasty.

Level of Evidence:

Level III.
Protective Effect of Epigallocatechin Gallate on Endothelial Disorders in Atherosclerosis
Authors: Yamagata Kazuo
Published: January 2020

Healthy vascular endothelial cells regulate vascular tone and permeability, prevent vessel wall inflammation, enhance thromboresistance, and contribute to general vascular health. Furthermore, they perform important functions including the production of vasoactive substances such as nitric oxide (NO) and endothelium-derived hyperpolarizing factors, as well as the regulation of smooth muscle cell functions. Conversely, vascular endothelial dysfunction leads to atherosclerosis, thereby enhancing the risk of stroke, myocardial infarction, and other cardiovascular diseases (CVDs). Observational studies and randomized trials showed that green tea intake was inversely related to CVD risk. Furthermore, evidence indicates that epigallocatechin gallate (EGCG) found in green tea might exert a preventive effect against CVDs. EGCG acts as an antioxidant, inducing NO release and reducing endothelin-1 production in endothelial cells. EGCG enhances the bioavailability of normal NO by reducing levels of the endogenous NO inhibitor asymmetric dimethylarginine. Furthermore, it inhibits the enhanced expression of adhesion molecules such as vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 and attenuates monocyte adhesion. In addition, EGCG prevents enhanced oxidative stress through the Nrf2/HO-1 pathway. These effects indicate that it might prevent the production of reactive oxygen species, inhibit inflammation, and reduce endothelial cell apoptosis during the initial stages of atherosclerosis. The current review summarizes recent research in this area and discusses novel findings regarding the protective effect of EGCG on endothelial dysfunction and CVDs in general.
A Phase 1 Randomized, Placebo-controlled, Observer-blinded Trial to Evaluate the Safety and Immunogenicity of Inactivated Streptococcus pneumoniae Whole-cell Vaccine in Adults
Authors: Keech Cheryl A. , Morrison Royce , Anderson Porter , Tate Andrea , Flores Jorge , Goldblatt David , Briles David , Hural John , Malley Richard , Alderson Mark R.
Published: January 2020

Background:

Broadly protective pneumococcal vaccines that are affordable for low-resource countries are needed. Streptococcus pneumoniae whole cell vaccine (wSp) is an investigational vaccine that contains killed cells from a nonencapsulated strain of S. pneumoniae (SPn) with aluminum hydroxide adjuvant. Studies in mice demonstrated protection against nasopharyngeal carriage (T-cell-mediated) and invasive pneumococcal disease (antibody-mediated). The aim of this randomized, double-blind, placebo-controlled Phase 1 study was to assess safety, tolerability and immunogenicity of wSp in healthy adults.

Methods:

Forty-two participants were randomized into 3 dose cohorts to receive 0.1, 0.3, or 0.6 mg of wSp or saline intramuscularly. Participants received a 3-dose vaccination schedule spaced by 4-week intervals. Postvaccination assessments included solicited reactogenicity events through day 7, blood chemistry and hematology assessments at day 7, and adverse events (AEs) through day 84. Participants were monitored for serum antibody and peripheral blood mononuclear cell cytokine responses to pneumococcal antigens. A 6-month telephone follow-up was completed to assess for any additional AEs.

Results:

wSp was safe and well tolerated. Reactogenicity was acceptable and no untoward safety signals were observed. wSp elicited potentially clinically significant rises (defined arbitrarily as at least a 2-fold rise) in immunoglobulin G responses to multiple pneumococcal antigens, including pneumococcal surface protein A and pneumolysin. Functional antibody responses were observed with the highest dose of wSp (0.6 mg). Increases in T-cell cytokine responses, including interleukin 17A, were also seen among wSp vaccines.

Conclusions:

wSp was safe and well tolerated in healthy US adults, eliciting pneumococcal antigen-specific antibody and T-cell cytokine responses.
Lacrimal Gland Botulinum Toxin Injection Versus Simple Glandular Needling: Histopathological and Electron Microscopic Evidence and Potential Clinical Implications
Authors: Trakos Nikolaos , Singh Swati , Mishra Dilip Kumar , Ali Mohammad Javed
Published: January 2020

Purpose:

To investigate the histopathological and ultrastructural changes in the lacrimal glands (LGs) of rabbits following either botulinum toxin (BTX) injection or simple glandular needling.

Methods:

Twenty-four LGs of 24 eyes of 12 healthy New Zealand white rabbits were included in the study. Of these, 4 LGs of 4 eyes of 2 rabbits were used as controls. In the intervention group, all the right LG received 5 U in 0.1 ml of BTX-A (Botox, Allergan, Dublin, Ireland) and the left LG received simple glandular needling under general anesthesia. The BTX-A was injected directly into the LG via the transconjunctival route under direct visualization. For simple needling, 5 LG passes were made through a single-entry point using a 29-gauge needle mounted on an empty tuberculin syringe. The rabbits did not receive any postoperative medications other than lubricants. The rabbits were sacrificed at 8 weeks and the 20 treated and 4 control LG’s were retrieved for histopathological and transmission electron microscopic (TEM) analysis as per standard protocols.

Results:

In comparison to the control LG samples, both the treated groups showed pathological changes, which were more pronounced in the simple needling group. The BTX-A-treated LGs showed mild to moderate acinar atrophy, few degenerating acini and patchy chronic inflammatory infiltrates with thick hyalinized collagen within the glandular stroma. TEM analysis showed the cytosol of few acinar cells to contain vacuoles and autophagosomes with marginal chromatin condensation of the nucleus and an eccentric nucleolus. The LGs treated with simple needling showed marked pathological changes which include moderate to severe, focal, and diffuse acinar atrophy, dense stromal fibrosis, inflammatory infiltrates, and peri-vasculitis. TEM analysis showed focal disorganized acinar morphology, loss of intra-acinar and ductal architecture, and needle track zones with surrounding fibrotic areas.

Conclusions:

Histopathological and ultrastructural changes were noted in the LGs treated with BTX-A and simple glandular needling. Simple needling of the LG has the prospect to be an effective and cheaper alternative to BTX-A.
Obesity Increases Costs With Productivity Loss Due to Disability Retirements, Independent of Physical Activity
Authors: Araujo Monique Yndawe Castanho , Norberto Maria Carolina Castanho Saes , Mantovani Alessandra Madia , Turi-Lynch Bruna Camilo , Santos Lionai Lima dos , Ricardo Suelen Jane , Morais Luana Carolina de , Codogno Jamile Sanches
Published: January 2020

Objective:

Investigate whether obesity is responsible for costs due to productivity loss (PL) in adults, during 30 months of follow-up.

Methods:

Absenteeism and disability retirement were considered as PL. For classification of obesity, body mass index (BMI) and waist circumference (WC) values were considered. The statistical software BioEstat (release 5.0) was used and the significance level was set at P value < 0.05.

Results:

For the men, BMI and WC accounted for ∼60% and ∼30% of retirement due to disability (P = 0.001). For the women, this percentage represented ∼19% for BMI and ∼8% for WC, both P < 0.05. Physical activity was not a significant confounder in any of the analyses (P > 0.05).

Conclusion:

Total and abdominal obesity were responsible for increased costs from PL due to early retirement among adults aged 50 years or older.
Yoga and Tai Chi: a mind–body approach in managing respiratory symptoms in obstructive lung diseases
Authors: Ratarasarn Kavita , Kundu Anjana
Published: January 2020

Purpose of review

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation because of airway and/or alveolar abnormalities. Symptoms include dyspnea, cough, chronic sputum production. As the third-ranked cause of death as well as disability-adjusted life years (DALYs), it poses a significant burden on patients, families, healthcare system and society. Regular physical activity is linked to decrease in morbidity and mortality associated with COPD, but implementation remains challenging. There is a need for community-based interventions that promote physical activity. Yoga and Tai Chi are widely available in the community and have been shown to be beneficial in patients with COPD as well as many of the co-morbid conditions associated with COPD.

Recent findings

Yoga and Tai Chi have been found to be more effective than usual care in COPD with clinically meaningful improvements in 6-min walk distance (6MWD), forced expiratory volume in 1 s (FEV1), and health-related quality of life (HRQoL). They have also been found to be comparable to pulmonary rehabilitation interventions.

Yoga and Tai Chi provide community-based options for patients with COPD to improve their physical activity, quality of life, and pulmonary function.
Fetal outcomes after intentional ingestion of paraquat
Authors: Chen Jianshi , Jian Xiangdong , Yu Guangcai , Si Min , Kan Baotian
Published: January 2020

Rationale:

Despite the fact that treatment of paraquat poisoning in pregnant women and their fetuses is challenging and raises ethical issues, it is rarely reported in the literature. We report the case of a pregnant woman who took paraquat intentionally.

Patient concerns:

A 36-year-old woman at 38+ weeks gestational age, in an apparent suicide attempt, drank 1 mouthful (about 20 ml) of paraquat solution. Ten hours later, her urine dithionate test showed light blue color with a plasma paraquat concentration of 0.547 μg/ml. Six hours after admission, a male infant, whose plasma paraquat concentration was 0.761 μg/ml, together with 0.673 μg/ml in the amniotic fluid measured by high-performance liquid chromatography, was delivered but the woman's lung, liver, and kidney function declined rapidly.

Diagnosis:

Interventions:

Because of placenta previa and multiple organ failure, emergency cesarean section, and panhysterectomy were performed for the pregnant woman. Intravenous injection of antibiotic to prevent infection and dexamethasone 30 mg once a day were administered. Mechanical ventilation was performed for the infant and meropenem and penicillin injection was administered.

Outcomes:

The infant died 33 hours after birth while the mother died on the 3rd day after ingestion.

Lessons:

Paraquat can enter the fetus through the placenta and the amniotic fluid via fluid exchange. The pathological changes of fetal organs may relate to gestational age, and the prognosis was very poor in both the mother and the fetus.
Dietary meat intake and risk of asthma in children
Authors: Zhang Dan , Cao Lihua , Wang Zhenshan , Wang Zhenqiang
Published: January 2020

Background:

Many studies have been reported that dietary meat intake may be associated with the risk of asthma in children, but the results are inconsistent. Therefore, we performed a meta-analysis to evaluate the effect of meat on the risk of asthma in children.

Methods:

The databases PubMed, Embase, and Web of Science were searched. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated with random-effect model using Stata software.

Results:

A total of 9 articles were included in this meta-analysis. Results from our study suggest that dietary meat intake 3 or more times per week compared with never/occasionally intake has no significant association with asthma risk among children (OR = 1.27, 95% CI = 0.80–2.01, P = .308). Similarly, daily intake of meat did not affect the risk of asthma in children when compared with never/occasionally intake (OR = 1.13, 95% CI = 0.93–1.37, P = 0.234). In addition, no publication biases were detected in our meta-analysis.

Conclusion:

Dietary meat intake most probably is not a risk factor for asthma in children. Due to some limitations that exist in our study, more studies are needed to further assess the association between meat intake and asthma risk in children.
Complete laparoscopic cholecystectomy for a duplicated gallbladder
Authors: Zhou Dong-Kai , Huang Yu , Kong Yang , Ye Zhou , Ying Li-Xiong , Wang Wei-Lin
Published: January 2020

Introduction:

Duplication of the gallbladder (GB) is a rare congenital abnormality occurring in 1 in 4000 to 5000 births. Three types have been reported: type I (split primordial GB), type II (2 separate GBs with their own cystic ducts), and type III (triple GBs drained by 1 to 3 separate cystic ducts). Patients with a duplicated GB are usually asymptomatic and are sometimes not diagnosed on preoperative imaging, which might increase the difficulty and risk of cholecystectomy. The key to successful treatment is total removal of the duplicated GB to avoid the recurrence of disease. Intraoperative cholangiography is recommended for identifying and resecting duplicated GBs. The final diagnosis depends on the histopathology.

Patient concerns:

A 62-year-old woman had recurrent upper abdominal pain and nausea for 1 year, with no fever, jaundice, or other symptoms. An ultrasound of the abdomen indicated polyps in the GB. Computed tomography (CT) revealed moderate dense structures attached to the wall of the GB and an unusual 47 × 21 mm elliptical structure with an extra tubule located above the main GB.

Diagnosis:

A diagnosis of duplicated GB was made based on the histopathology.

Interventions:

The patient underwent a laparoscopic cholecystectomy with total removal of the duplicated GB.

Outcomes:

The patient's postoperative course was uneventful and she was discharged from the hospital on the second postoperative day. She had no upper abdominal pain at the 6-month follow-up.

Conclusion:

Duplicated gallbladder is a rare congenital biliary anatomy, which is usually asymptomatic and sometimes cannot be diagnosed on preoperative imaging. With gallbladder disease, the duplicated GBs should be removed totally; a laparoscopic approach should be attempted first and cholangiography is recommended to aid in identifying and resecting the duplicated GBs. The final diagnosis depends on the histopathology. There is still insufficient evidence on the need to remove duplicated GBs found incidentally.
Coronary sequelae of Kawasaki disease treated with rotational atherectomy and drug coated balloon
Authors: Shi Yongfeng , Li Longbo , Liu Meijia , Song Chunli , Wu Junduo , Liu Bin
Published: January 2020

Introduction:

Kawasaki disease (KD) is an acute vasculitis syndrome that mainly affects children and is the first cause of acquired heart disease. Coronary artery lesion is the most serious complication of KD. Only two previous studies have reported similar cases, but we reported patient was younger and had a longer follow-up.

Patient concerns:

We reported a case of coronary sequelae of KD treated with rotational atherectomy and drug coated balloon (DCB). During the week after surgery, the patient complained of a slight chest pain intermittently, but no longer appeared after that.

Diagnosis:

We diagnosed by electrocardiogram and angiography. Angiography showed that the anterior descending branch (LAD) proximal stenosis was 95%, the right coronary artery (RCA) middle stenosis was 99%, and the calcification was severe.

Interventions:

We treat the patient with rotational atherectomy using a 1.25 mm burr, pre-dilatation of the stenosis lesion with a 3.5 mm × 15 mm non-compliant balloon was achieved. Then 3.5 mm × 15 mm drug eluting balloon was inflated at 10 atm for 60 seconds.

Outcomes:

After the 6-month follow-up (from October 2018 to March 2019), the symptom of angina disappeared. Coronary angiography 6 months later showed no apparent progression of vessel narrowing.

Conclusion:

The present case suggests that rotational atherectomy followed by DCB dilation could be an alternative revascularization therapy of choice in coronary KD sequelae complicated with atherosclerosis.
Individualized Chinese medicine for the treatment of diabetic patients with dry eye disease
Authors: Liu Ruibao , Zhao Ying , Wu Yanxia , Guo Minglu , Duan Yu , Ye Jianbin , Lu Xuejing
Published: January 2020

Background:

The high incidence of Diabetes mellitus (DM) has become a serious challenge for the global epidemic. Increased blood glucose leads to abnormal ocular surface structure and metabolic disorder in patients. DM is a high-risk factor for dry eye disease (DED), with high incidence and increased difficulty in treatment. The disease can cause discomfort, visual impairment, tear film instability and ocular surface damage, and even cause corneal erosion in severe cases, which has a serious impact on people's daily life. Traditional Chinese Medicine (TCM) plays an important role in the evaluation and treatment of DM and its complications. However, whether TCM treatment could improve the treatment efficacy of DM suffering from DED remains poorly understood.

Objective:

To investigate the curative effect of TCM for the alleviation of clinical symptoms in Diabetic patients with DED, and to evaluate its long-term efficacy.

Methods:

This trial is a single-case randomized, single-blind, placebo-controlled study. A total of 12 subjects will be recruited in this trial. The trial is divided into three cycles, and one cycle has 2 treatment periods. There is a washout period at each adjacent treatment stage. TCM individualized treatment and placebo will be randomized during the treatment period. The test period will last for 29 weeks, with 4 weeks for each treatment period and 1 week for each washout period to minimize carryover effects. Subjects will be selected by the researcher strictly in accordance with the inclusion and exclusion criteria. The outcomes will evaluate the efficacy of treatment by changes in the various observation indicators.

Discussion:

This study will realize a patient-centered outcome approach necessary to provide clinical researchers with the evidence that TCM treatment can effectively improve the objective indicators of the eye and systemic symptoms in Diabetic patients with DED.

Trial registration:

This study has been registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn, No. ChiCTR1900024481), (October, 2019).
Relationship between the prevalence of polycythemia and factors observed in the mental health and lifestyle survey after the Great East Japan Earthquake
Authors: Sakai Akira , Nakano Hironori , Ohira Tetsuya , Maeda Masaharu , Okazaki Kanako , Takahashi Atsushi , Kawasaki Yukihiko , Satoh Hiroaki , Ohtsuru Akira , Shimabukuro Michio , Kazama Junichiro , Hashimoto Shigeatsu , Hosoya Mitsuaki , Yasumura Seiji , Yabe Hirooki , Ohto Hitoshi , Kamiya Kenji
Published: January 2020

We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.

We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.

The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.

Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.
Prevalence and associated factors of influenza vaccination coverage in Korean adults with cardiovascular disease
Authors: Kim Eun Young , Ko Jae Ho , Kim Young Saing , Oh Pyung Chun
Published: January 2020

Infection with influenza virus increases morbidity and mortality in patients with risk factors, including cardiovascular disease (CVD). This study aimed to evaluate factors associated with influenza vaccination coverage in Korean CVD patients.

We included 19,599 adults from the 2010 to 2012 Korea National Health and Nutrition Examination Survey. Influenza vaccination rates were compared in subjects with and without CVD. Logistic regression analysis was performed to identify factors associated with influenza vaccination in Korean adults with CVD before and after stratification for age (<65 and ≥65 years).

Significantly higher vaccination rates were observed in individuals with CVD than in those without CVD (61.4% vs 31.0%, P < .001). However, young individuals (19–49 years) had decreased influenza vaccination rates, with no difference based on CVD status (20.3% vs 21.6%, P = .859). A lack of private insurance (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.23–0.98) and recent health screening (OR, 4.56; 95% CI, 1.90–10.92) were independent factors for influenza vaccination in CVD patients aged <65 years, whereas female sex (OR, 3.71; 95% CI, 1.24–11.07) and less education (OR, 4.59; 95% CI, 1.27–16.61) were independent factors in CVD patients aged ≥65 years.

Improving influenza vaccination coverage for Korean adults with CVD is important, especially in young patients. For young patients with CVD, influenza vaccination status is independently associated with the presence of private insurance and recent health screening. This finding could help establish public health policies to promote influenza vaccination in this population.
Analysis of the effectiveness of cinnamon (Cinnamomum verum) in the reduction of glycemic and lipidic levels of adults with type 2 diabetes
Authors: Neto José Claudio Garcia Lira , Damasceno Marta Maria Coelho , Ciol Márcia Aparecida , de Freitas Roberto Wagner Júnior Freire , de Araújo Márcio Flávio Moura , de Souza Teixeira Carla Regina , Carvalho Gerdane Celene Nunes , de Siqueira Coelho Lisboa Kenya Waléria , de Souza Danilo Ferreira , de Menezes Nogueira Jéssica , Marques Regina Lúcia Lino , Alencar Ana Maria Parente Garcia
Published: January 2020

Background:

Type 2 Diabetes Mellitus (T2DM) is a chronic disease that is increasing the number of cases worldwide. The treatments currently used have not worked as expected. Alternative and complementary medicines were inserted in health services, especially in primary care, as an attempt to minimize risks and help control diseases such as diabetes. Among the herbal medicines used stands out cinnamon, which can serve as an adjuvant in the control of diabetes.

Objective:

To analyze the effectiveness of 3 grams of cinnamon (Cinnamomum verum) per day for 90 days in reducing glycemic and lipid levels in adults with T2DM compared with placebo

Methods:

A randomized, double-blind, placebo-controlled, phase II trial, which will be conducted at basic health units in the city of Parnaíba, state of Piauí, Brazil. In total, 130 people diagnosed with T2DM, followed at health units, with hemoglobin A1c > 6.5%, and using oral antidiabetic medicines, are expected to participate in the study. The intervention will last for 3 months, and each participant will receive a total of 3 bottles containing 120 capsules in each bottle of cinnamon or placebo. Each person should take 4 capsules daily, for 90 days. The patients will be distributed into the 2 groups by performing block randomization (n = 6) at a ratio of 1:1 according to a code generated by a software. Assessments of socioeconomic, clinical, lifestyle, anthropometric, and laboratory variables will be performed in 2 separate visits.

Discussion:

This study will be the first to investigate cinnamon to reduce glycemic, lipid, and anthropometric levels in Brazil. In case of favorable results, this therapy may be used as an alternative or additional medicine in cases where only oral antidiabetic agents are used and can promote the use of the product to minimize future complications of patients with diabetes and people who do not have the disease.

Trial registration:

RBR-2KKB6D, registered on December 11th, 2018.
Different types of acupuncture and moxibustion therapy for neurogenic bladder after spinal cord injury
Authors: Lei Hanzhou , Fu Yanan , Xu Guixing , Yin Zihan , Zhao Ling , Liang Fanrong
Published: January 2020

Background:

The invasive surgical intervention for neurogenic bladder dysfunction (NBD) following spinal cord injury (SCI) involves permanently altering one's body system and carries many surgical related risks and medication side effects are often seen in long term usage of pharmaceutical medications. Therefore, acupuncture and moxibustion therapies have been recommended due to their efficacy, simplicity of operation, cost effectiveness and safety. This protocol is designed for systematic review and network meta-analysis, which will perform comparisons or rankings of efficacy among the currently available acupuncture and moxibustion techniques and provide evidence to guide the best practice in acupuncture and moxibustion treatments of NBD due to SCI.

Methods/Design:

The Cochrane Library, EMBASE, PubMed, Web of Science, CENTRAL, CNKI, The VIP Database, The Wanfang database, CDFD, CMFD will be searched from inception to November 1, 2019. All randomized controlled trials containing eligible interventions(s) and outcome(s) will be included. The quality of included trials will be assessed using the “Risk of bias” tool from the Cochrane Handbook (V.5.1.0). Data analysis will be conducted by using STATA software (Version 13.0). Continuous outcome will be indicated as mean difference (MD) or standard mean difference (SMD), and enumeration data will be presented with odds risk (OR) or relative risk (RR).

Results:

This systematic review and network meta-analysis study aims to determine the most effective and safe approach in relieving urinary symptoms, and whether it produces better results in urodynamic examination. And a high-quality ranking of the therapeutic classes will be presented. The report will follow the PRISMA checklist for network meta-analysis. Results of the search strategy and the study selection will be presented in a PRISMA compliant flow chart.

Conclusion:

This study aims to propose a standard clinical decision-making guideline for acupuncture and moxibustion treatment of NBD after SCI.
Prognostic impact of elevated pre-treatment systemic immune-inflammation index (SII) in hepatocellular carcinoma
Authors: Wang Bolin , Huang Yan , Lin Tao
Published: January 2020

Background:

There is a growing literature on the significance of systemic immune-inflammation index in hepatocellular carcinoma. However, the results were inconsistent due to the small sample size and different study endpoints. Therefore, the purpose of this study was to further systematically and comprehensively verify the prognostic role of the SII in HCC.

Methods:

Several databases were searched systematically, and relevant papers were selected. The main outcome measure was overall survival (OS); the secondary outcome measure was a composite of time to recurrence (TTR), progression-free survival (PFS), and recurrence-free survival (RFS).

Results:

Ten published retrospective studies involving 2796 HCC patients were included. The results revealed that elevated pre-treatment SII was related to lower OS (HR:1.54, P < .001) and earlier TTR (HR:1.77, P < .001).

Conclusions:

Elevated SII is a poor prognostic factor for patients with hepatocellular carcinoma. The clinical application of SII is encouraged to evaluate the progress of hepatocellular carcinoma.
Gene expression-based analysis identified NTNG1 and HGF as biomarkers for diabetic kidney disease
Authors: Tang Yun-Liang , Dong Xiao-Yang , Zeng Zhen-Guo , Feng Zhen
Published: January 2020

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease. Because the molecular mechanisms of DKD are not fully understood, exploration of hub genes and the mechanisms underlying this disease are essential for elucidating the pathogenesis and progression of DKD. Accordingly, in this study, we performed an analysis of gene expression in DKD. The differentially expressed genes (DEGs) included 39 upregulated genes and 113 downregulated genes in the GSE30528 dataset and 127 upregulated genes and 18 downregulated genes in the GSE30529 dataset. Additionally, functional analyses were performed to determine the roles of DEGs using glomeruli samples from patients with DKD and healthy controls from the GSE30528 dataset and using tubule samples from patients with DKD and healthy controls from the GSE30529 dataset. These DEGs were enriched in pathways such as the Wnt signaling pathway, metabolic pathways, and the mammalian target of rapamycin signaling pathway in the GSE30528 dataset and the longevity regulating pathway and Ras signaling pathway in the GSE30529 dataset. Moreover, a protein-protein interaction network was constructed using the identified DEGs, and hub gene analysis was performed. Furthermore, correlation analyses between key genes and pathological characteristics of DKD indicated that CCR4, NTNG1, HGF and ISL1 are related to DKD, and NTNG1 and HGF may server as diagnostic biomarkers in DKD using the receiver–operator characteristic (ROC) curve. Collectively, our findings established 2 reliable biomarkers for DKD.
Metabolic syndrome risk in relation to posttraumatic stress disorder among trauma-exposed civilians in Gansu Province, China
Authors: LIhua Ma , Tao Zhang , Hongbin Ma , Hui Wang , Caihong Jiao , Xiaolian Jiang
Published: January 2020

This study included 1456 men and 1411 women who were trauma-exposed and underwent routine health examinations in a community epidemiological investigation. The participants completed the posttraumatic stress disorder (PTSD) Check List-Civilian Version (PCL-C) for PTSD and medical examinations to detect metabolic syndrome. Adjustments for age, marriage, exercise, education, cigarette smoking, cancer, stroke, angina, and thyroid disease were performed. The relationship between PTSD and metabolic syndrome and each of its components was analyzed by multiple logistic regression.

In women, PTSD was associated with metabolic syndrome (OR = 1.53, 95% CI = 1.01–1.95, P = .047) and the high-density lipoprotein cholesterol component (OR = 1.98, 95% CI = 1.04–2.12, P = .002). In men, PTSD was related to the hypertension component of metabolic syndrome (OR = 0.54, 95% CI = 0.31–0.92, P = .023). There was also a relationship between PTSD severity and metabolism (OR = 1.141, 95% CI = 1.002–1.280, P = 0.037) in women, and PTSD was inversely associated with the hypertension component (OR = 0.54, 95% CI = 0.31–0.92, P = .023) in men.

PTSD was related to metabolic syndrome only in women. We plan to further research the mechanism of sex differences and dyslipidemia.
Laparoscopic resection of abdominal cystic lymphangioma derived from lesser omentum
Authors: Hamaguchi Yuhei , Arita So , Sugimoto Naoko , Inamoto Osamu , Takagi Hidekazu , Kogire Masafumi , Kitai Toshiyuki
Published: January 2020

Rationale:

Cystic lymphangiomas are uncommon congenital malformations that originate from lymphatic channels. Lymphangiomas frequently appear in the head, neck, and axillary regions of children. Abdominal cystic lymphangiomas are extremely rare, having a reported incidence of 1 in 20,000 to 250,000.

Patient concerns:

A 50-year-old female patient was admitted to our hospital with a cough that had persisted for several weeks. Abdominal ultrasonography incidentally revealed a multilocular cystic lesion in the lesser curvature of the stomach.

Diagnosis:

Preoperative findings indicated that the lesion was cystic lymphangioma. However, the possibility of a pancreatic tumor could not be completely excluded.

Interventions:

Laparoscopy revealed a multilocular cyst in the lesser curvature of the stomach. The gastrocolic ligament was divided, and the body and tail of the pancreas was exposed in the omental bursa, showing that the cystic lesion was not derived from the pancreas but from the lesser omentum. Although it was located directly beside the left gastric artery, the cyst was enucleated and totally resected laparoscopically without sacrificing the artery.

Outcomes:

The cystic lesion was histopathologically diagnosed as an abdominal cystic lymphangioma originating from the lesser omentum. The patient was discharged on the postoperative day 4 without complications.

Lessons:

Preoperative imaging cannot completely distinguish abdominal cystic lymphangiomas from other types of cystic tumors. Because cystic lymphangiomas have the potential to grow, invade vital structures, and develop life-threatening complications, laparoscopic assessment followed by total resection is considered a useful treatment strategy for peripancreatic cystic lesions.
Clinical outcomes of laparoscopic versus open right hepatectomy for liver tumors
Authors: Hong Qiang , Wang Jianjun , Wang Yong , Fu Baojuan , Fang Yuejun , Tong Qin , Liu Tao , Wu Zhangqiang , Zhou Junchao
Published: January 2020

Background:

Laparoscopic right hepatectomy (LRH) is one of the most challenging procedures. Right liver resections have been always performed in open procedure and open right hepatectomy (ORH) was initially considered as routine way. Moreover, it is unclear how beneficial the minimally invasive technique is to patients; thus, we conducted a meta-analysis to acquire a more reliable conclusion about the feasibility and safety of LRH compared with ORH.

Methods:

We comprehensively searched the electronic databases of PubMed, Embase, and the Cochrane Library using the key words. Meta-analysis was performed using the Review Manager, with results expressed as odds ratio and weighted mean difference with 95% confidence intervals. The fixed-effect model was selected initially if high heterogeneity was not present between the studies; otherwise, the randomized-effect model was used. Subgroup analysis was performed based on different surgical methods of pure laparoscopic operation or hand-assisted operation.

Results:

Seven studies with 467 patients were included. In the overall analysis, less intraoperative blood loss (MD = –155.17; 95% CI, –238.89, –71.45; P = .0003) and a shorter length of stay (MD = –4.45; 95% CI, –5.84, –3.07; P < .00001) were observed in the LRH group compared to the ORH group. There were fewer overall complications (OR = 0.30; 95% CI, 0.10, 0.90; P = 0.03) and severe complications (OR = 0.24; 95% CI, 0.10, 0.58; P = .002;) in the LRH group than in the ORH group. The disadvantage of LRH was the longer operative time (MD = 49.39; 95% CI, 5.33, 93.45; P = .03). No significant difference was observed between the 2 groups in portal occlusion, rate of R0 resection, transfusion rate, mild complications, and postoperative mortality. In the subgroup analysis, intraoperative blood loss was significantly lower in the pure LRH group and hand-assist LRH group compared with ORH group. Length of stay was shorter by use of pure LRH and hand-assisted LRH manners than ORH. The incidence rate of complications was lower in the pure LRH group than in the ORH group. In contrast, there was no significant difference between hand-assisted LRH group and ORH group.

Conclusion:

Compared to ORH, LRH has short-term surgical advantages and leads to a shorter recovery time in selected patients. We speculate that the operative time of LRH is closer with ORH. Overall, LRH can be considered a feasible choice in routine clinical practice with experienced surgeons, although more evidence is needed to make a definitive conclusion.
Antidepressant-induced reduction in betel-quid use in patients with depression
Authors: Hung Chung-Chieh , Lee Chien-Hung , Chung Chia-Min , Nithiyanantham Srinivasan , Lane Hsien-Yuan , Ko Ying-Chin
Published: January 2020

Betel-quid is commonly used around the world and is listed as a Group I carcinogen. Prior research has suggested a possible association between antidepressants and betel-quid use. We aimed to clarify the effects of antidepressant therapy in betel-quid chewers in the population of patients with depression.

We enrolled 204 patients with depressive disorders, collected their demographic information, and administered the Substance Use Severity Rating Scale for alcohol, cigarettes, and betel-quid and the Hamilton Depression Rating Scale. We compared betel-quid and non-betel-quid chewers and examined the effects of antidepressant therapy on betel-quid abstinence after previous exposure to betel-quid.

Patients with depression were reported a higher prevalence of 26% betel-quid chewing habits and patients who chewed betel-quid showed more severe depressive symptoms. After antidepressant therapy, the addictiveness of betel-quid was significantly reduced by 4 times.

This was a pioneering study showing that antidepressants could be a candidate for betel-quid cessation therapy. Future clinical trials are needed to verify their efficacy in reducing consumption for betel-quid addiction treatment.