bluuebunny/crossref_metadata_2025 huggingface dataset:
L’imagerie cérébrale systématique du nouveau-né prématuré
Authors: Guillot Mireille , Chau Vann , Lemyre Brigitte
Published: June 2020

L’imagerie cérébrale systématique pour déceler les lésions touchant les nouveau-nés prématurés est utilisée pour prédire le pronostic à long terme et déterminer les complications susceptibles de nécessiter une intervention. Même si l’imagerie par résonance magnétique peut être indiquée dans des situations particulières, l’échographie cérébrale est la technique la plus utilisée et demeure la meilleure modalité d’imagerie systématique en raison de sa portabilité et de sa facilité d’accès. L’échographie cérébrale systématique est recommandée pour tous les nouveau-nés venus au monde à 31+6 semaines d’âge gestationnel ou auparavant. Chez les nouveau-nés prématurés venus au monde entre 32+0 et 36+6 semaines d’âge gestationnel l’échographie cérébrale systématique n’est recommandée qu’en présence de facteurs de risque d’hémorragie intracrânienne ou d’ischémie. Il est conseillé d’obtenir une imagerie cérébrale de quatre à sept jours après la naissance pour déceler la plupart des hémorragies de la matrice germinale et des hémorragies intraventriculaires. Il est recommandé de reprendre l’imagerie entre quatre et six semaines de vie pour déceler les lésions de la substance blanche. Chez les nouveau-nés prématurés venus au monde avant 26 semaines d’âge gestationnel, il est recommandé de reprendre l’échographie cérébrale à l’âge équivalant au terme.
Routine imaging of the preterm neonatal brain
Authors: Guillot Mireille , Chau Vann , Lemyre Brigitte
Published: June 2020

Routine brain imaging to detect injuries affecting preterm infants is used to predict long-term outcomes and identify complications that might necessitate an intervention. Although magnetic resonance imaging may be indicated in some specific cases, head ultrasound is the most widely used technique and, because of portability and ease of access, is the best modality for routine imaging. Routine head ultrasound examination is recommended for all infants born at or before 31+6 weeks gestation. For preterm neonates born between 32+0 to 36+6 weeks gestation, routine head ultrasound is recommended only in presence of risk factors for intracranial hemorrhage or ischemia. Brain imaging in the first 4 to 7 days postbirth is advised to detect most germinal matrix and intraventricular hemorrhages. Repeat imaging at 4 to 6 weeks of age is recommended to detect white matter injury. In preterm neonates born before 26 weeks gestation, a repeat HUS at term-equivalent age is recommended.
The Origins of Violence in Rwanda
Authors: Heldring Leander
Published: June 2020

This article shows that the intensity of violence in Rwanda’s recent past can be traced back to the initial establishment of its pre-colonial state. Villages that were brought under centralized rule one century earlier experienced a doubling of violence during the state-organized 1994 genocide. Instrumental variable estimates exploiting differences in the proximity to Nyanza—an early capital—suggest that these effects are causal. Before the genocide, when the state faced rebel attacks, with longer state presence, violence is lower. Using data from several sources, including a lab-in-the-field experiment across an abandoned historical boundary, I show that the effect of the historical state is primarily sustained by culturally transmitted norms of obedience. The persistent effect of the pre-colonial state interacts with government policy: where the state developed earlier, there is more violence when the Rwandan government mobilized for mass killing and less violence when the government pursued peace.
Association Between Circulating Lipids and Future Weight Gain in Individuals With an At-Risk Mental State and in First-Episode Psychosis
Authors: Lamichhane Santosh , Dickens Alex M , Sen Partho , Laurikainen Heikki , Borgan Faith , Suvisaari Jaana , Hyötyläinen Tuulia , Howes Oliver , Hietala Jarmo , Orešič Matej
Published: June 2020

Patients with schizophrenia have a lower than average life span, largely due to the increased prevalence of cardiometabolic comorbidities. There is an unmet public health need to identify individuals with psychotic disorders who have a high risk of rapid weight gain and who are at risk of developing metabolic complications. Here, we applied mass spectrometry-based lipidomics in a prospective study comprising 48 healthy controls (CTR), 44 first-episode psychosis (FEP) patients, and 22 individuals at clinical high risk (CHR) for psychosis, from 2 study centers (Turku, Finland and London, UK). Baseline serum samples were analyzed using lipidomics, and body mass index (BMI) was assessed at baseline and after 12 months. We found that baseline triacylglycerols (TGs) with low double-bond counts and carbon numbers were positively associated with the change in BMI at follow-up. In addition, a molecular signature comprised of 2 TGs (TG[48:0] and TG[45:0]) was predictive of weight gain in individuals with a psychotic disorder, with an area under the receiver operating characteristic curve (AUROC) of 0.74 (95% CI: 0.60–0.85). When independently tested in the CHR group, this molecular signature predicted said weight change with AUROC = 0.73 (95% CI: 0.61–0.83). We conclude that molecular lipids may serve as a predictor of weight gain in psychotic disorders in at-risk individuals and may thus provide a useful marker for identifying individuals who are most prone to developing cardiometabolic comorbidities.
Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements
Authors: Smart Hiske , Opinion Francis Byron , Darwich Issam , Elnawasany Manal Aly , Kodange Chaitanya
Published: June 2020

OBJECTIVE

To determine if a repurposed silicone-based dressing used underneath an N95 mask is a safe and beneficial option for facial skin injury prevention without compromising the mask’s seal.

METHODS

Since February 21, 2020, staff in high-risk areas such as the ED and ICU of King Hamad University Hospital have worn N95 masks when performing aerosol-generating procedures to protect against the novel coronavirus 2019. At that time, without education enablers or resources that could be directly translated into practice, the hospital’s Pressure Injury Prevention Committee explored, created, and tested a stepwise process to protect the skin under these masks while ensuring that it did not interfere with the effectiveness of the N95 mask seal.

RESULTS

Skin protection was achieved by repurposing a readily available silicone border dressing cut into strips. This was tested on 10 volunteer staff members of various skin types and both sexes. Oxygen saturation values taken before and after the 4-hour wear test confirmed that well-fitted facial protection did not compromise the mask seal, but rather improved it. Staff also self-reported increased comfort with less friction. An educational enabler to prevent MDRPI from N95 mask wear was an important additional resource for the staff.

CONCLUSIONS

This creative and novel stepwise process of developing a safe skin protection method enabling staff to apply a repurposed silicone border dressing beneath an N95 mask was largely effective and aided by the creation of the enabler.
Association of Living in a Food Desert With Pregnancy Morbidity
Authors: Tipton Matthew J. , Wagner Sarah A. , Dixon Alison , Westbay Lauren , Darji Himani , Graziano Scott
Published: June 2020

OBJECTIVE:

To evaluate whether women living in areas deemed food deserts had higher rates of pregnancy morbidity, specifically preeclampsia, gestational hypertension, gestational diabetes, prelabor rupture of membranes, preterm labor, than women who did not live in food deserts at the time of their pregnancy and delivery.

METHODS:

This was a retrospective observational study in which we reviewed electronic medical records of all patients who delivered at Loyola University Medical Center in Maywood, Illinois in 2014. The Economic Research Service of the U.S. Department of Agriculture publishes the Food Access Research Atlas, which presents a spatial overview of food access indicators for low-income and other Census tracts using different measures of supermarket accessibility. A spatial join between the Food Access Research Atlas and patient coordinates was performed to identify patient point locations and determine whether each patient was located within or outside of a food desert.

RESULTS:

Data for 1,003 deliveries at Loyola University Medical Center in 2014 were provided by the Loyola University Chicago Clinical Research Database. Two deliveries were excluded owing to inability to map address coordinates; thus 1,001 deliveries were analyzed. Of the 1,001 patients, 195 (19.5%) women were designated to food deserts. Multivariable analysis was done by adjusting for age, race, and medical insurance class. Having at least one morbid condition was the only variable that demonstrated a significant association with the food desert in multivariable analyses (47.2% vs 35.6%) (odds ratio [OR] 1.62, 95% CI 1.18–2.22) (adjusted OR 1.64, 95% CI 1.18–2.29).

CONCLUSION:

The odds of having at least one of the studied morbid conditions in pregnancy were greater for patients living in a food desert. As there is an association of morbidity in pregnancy with living in a food desert, intervention trials to improve the built food environment or mitigate the effect otherwise are needed.
Racial and Ethnic Disparities in Maternal and Neonatal Adverse Outcomes in College-Educated Women
Authors: Tanner Lisette D. , Chen Han-Yang , Sibai Baha M. , Chauhan Suneet P.
Published: June 2020

OBJECTIVE:

To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups.

METHODS:

This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live singleton neonate at 24–40 weeks. The primary outcome, composite maternal adverse outcome, included admission to intensive care unit, maternal transfusion, ruptured uterus, unplanned hysterectomy, or unplanned operating room procedure after delivery. The secondary outcome, composite neonatal adverse outcome, included 5-minute Apgar score less than 5, assisted ventilation for more than 6 hours, neonatal seizure, birth injury, or neonatal death. Multivariable regression models were used to estimate the association between maternal race and adverse outcomes.

RESULTS:

Of 11.8 million live births, 2.2 million (19%) met the inclusion criteria; 81.5% were to non-Hispanic white women, 8.5% to non-Hispanic black women, and 10% Hispanic women. The overall rate of composite maternal adverse outcome was 5.3 per 1,000 live births. Compared with non-Hispanic white women, the risk of the composite maternal adverse outcome was significantly higher among non-Hispanic black women (adjusted relative risk [aRR] 1.20; 95% CI 1.13–1.27), but lower among Hispanic women (aRR 0.69; 95% CI 0.64–0.74), a pattern which varied among different gestational age groups. The overall rate of composite neonatal adverse outcome was 11.6 per 1,000 live births. The risk of composite neonatal adverse outcome was significantly higher among neonates with non-Hispanic black mothers (aRR 1.25; 95% CI 1.20–1.30), but lower among neonates with Hispanic mothers (aRR 0.71; 95% CI 0.68–0.75), compared with neonates delivered by non-Hispanic white mothers and varied across gestational age.

CONCLUSION:

Among women with at least a bachelor’s degree, small but measurable racial and ethnic disparities in composite maternal and neonatal adverse outcomes.
Where are the theca cells from: the mechanism of theca cells derivation and differentiation
Authors: Liu Tao , Qin Qing-Yuan , Qu Jiang-Xue , Wang Hai-Yan , Yan Jie
Published: June 2020

Mammalian follicles are composed of oocytes, granulosa cells, and theca cells. Theca cells form in the secondary follicles, maintaining follicular structural integrity and secreting steroid hormones. Two main sources of theca cells exist: Wilms tumor 1 positive (Wt1

+
) cells native to the ovary and Gli1

+
mesenchymal cells migrated from the mesonephros. Normal folliculogenesis is a process where oocytes, granulosa cells, and theca cells constantly interact with and support each other through autocrine and paracrine mechanisms. The proliferation and differentiation of theca cells are regulated by oocyte-derived factors, including growth development factor 9 and bone morphogenetic protein 15, and granulosa cell-derived factors, including desert hedgehog, Indian hedgehog, kit ligand, insulin-like growth factor 1, as well as hormones such as insulin and growth hormones. Current research on the origin of theca cells is limited. Identifying the origin of theca cells will help us to systematically elaborate the mechanisms of follicular formation and development.
Therapeutic challenges in the management of osmotic demyelination syndrome
Authors: Elshafei Mohamed , Danjuma Mohammed I. , Tahir Rania El
Published: June 2020

Rationale:

There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late.

Patient concerns:

A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction.

Diagnosis:

Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS.

Intervention:

Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration.

Outcomes:

Significant improvement in patients’ conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home.

Lessons:

Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers.
Analysis of recurrence after resection of well-differentiated non-functioning pancreatic neuroendocrine tumors
Authors: Tan Qing-quan , Wang Xing , Yang Le , Chen Yong-Hua , Tan Chun-lu , Zhu Xiao-mei , Ke Neng-wen , Liu Xu-Bao
Published: June 2020

Although pancreatic neuroendocrine tumors (PNETs) are generally considered to have a favorable overall prognosis after resection, disease recurrence has been observed. Few studies have specifically addressed recurrence after resection of PNETs, especially for non-functioning PNETs (NF-PNETs). The aim of our study is to analyze the recurrence of resected well-differentiated NF-PNETs.

Patients who underwent surgical resection for grade 1 and 2 NF-PNETs without synchronous metastasis were identified for analysis. Patients were treated from January 2009 to December 2017 in our institution. Univariate and multivariate cox regression analysis were conducted to identify prognostic factors.

Of the 88 patients, 46 were men (52%) and the mean age was 52 years. With a median follow-up of 49.1 months (range, 8–122 months), there were 12 recurrences (14%). Liver was the most common recurrence site (7/12, 58%). The 1-, 3-, and 5-year recurrence-free survival was 99%, 90%, and 88%, respectively. Univariate analysis identified that age >52 years, positive lymph nodes, tumor grade 2, and Ki67 index ≥5% were statistically significant. Multivariate analysis identified that Ki67 index ≥5% (hazard ratio [HR], 4.69; 95% confidence interval [CI], 1.36–16.75, P = .015), positive lymph nodes (HR, 6.75; 95% CI, 1.73–24.43, P = .006) were independently associated with recurrence. The 5-year disease-free survival rate was 53% (95% CI, 14.20–91.81%) for patients with Ki-67 ≥5% or (and) positive lymph nodes, while 95% (95% CI, 82.26–100%) for the patients without these 2 factors.

Ki67 index and lymph node status are independently associated with recurrence after resection of well-differentiated NF-PNETs in this study.
Analgesic impact of buprenorphine transdermal patch in total hip arthroplasty
Authors: Li Wen-Min , Li Feng-Dao , Xu Hua , Sun Li-Chen
Published: June 2020

Background:

The efficacy and safety of buprenorphine transdermal patch (BTP) has been well established in chronic pain, but data regarding acute postoperative pain relief is still very limited. Therefore, we design a prospective, randomized, controlled study to evaluate the effectiveness and safety of the BTP for postoperative analgesia in total hip arthroplasty.

Methods:

This study is designed as a single-center, prospective, double-blind, randomized controlled trial. Group A receives a 10 mg patch of buprenorphine at the conclusion of surgery which is continued for 14 days. Group B receives a conventional analgesic regimen, that is, IV paracetamol 1 mg every 8 hours alternating with parenteral tramadol 50 mg every 8 hours for the first 2 postoperative days followed by oral administration of the same drug still the end of 2 weeks. A total of 160 patients are needed with an allowance for 10% drop-out. The primary outcome of this noninferiority study is opioid consumption within the first 24 hours following surgery. The secondary outcomes included numerical rating scale scores at rest, postoperative complications, length of hospital stay, and patient satisfaction.

Results:

This trial is expected to be the largest randomized trial assessing the efficacy of BTP after primary total hip arthroplasty and powered to detect a potential difference in the primary outcome.

Trial registration number:

This study protocol was registered in Research Registry (researchregistry5524).
Real-world treatment efficacy of anti-programmed death-1 combined with anti-angiogenesis therapy in non-small cell lung cancer patients
Authors: Qiu Lupeng , Zhao Xiao , Shi Weiwei , Sun Shengjie , Zhang Guoqing , Sun Qiong , Meng Jing , Xiong Qi , Qin Boyu , Jiao Shunchang
Published: June 2020

Anti-programmed death-1 (PD-1) therapy has been extensively used to treat cancer. Recently, the combination of immunotherapy and anti-angiogenic therapy has emerged as a novel treatment approach. Therefore, we designed a study to evaluate the real-world benefit of the combination of anti-PD-1 and anti-angiogenesis therapy in patients with non-small cell lung cancer (NSCLC).

We obtained the medical records of patients at the Chinese People's Liberation Army General Hospital who received either nivolumab or pembrolizumab combined with anti-angiogenesis therapy from January 2015 to December 2018. The overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated for all patients.

Sixty-nine patients with NSCLC were included in our study. The ORR was 31.9% (95% CI: 20.6–43.2%) and the median PFS was 8.37 months (95% CI: 6.5–10.0 months). The subgroup analysis statistically revealed a significant difference in ORR for patients receiving first-line treatment vs other lines, and the values were 58.8% (95% CI: 32.7–84.9%) compared with 23.1% (95% CI: 11.2–34.9%). We also observed a significant improvement in PFS, with a median value of 10.5 months (95% CI: 7.4–13.1 months) for patients without EGFR mutations and 5.4 months (95% CI: 4.0–6.3 months) for patients with EGFR mutations.

The real-world ORR, PFS, and OS were comparable to previous clinical trials, despite the patients’ different baseline characteristics. Importantly, compared with patients having identified EGFR mutations, patients without EGFR mutations had a better PFS. Furthermore, these data support the use of anti-PD-1 combined with anti-angiogenesis therapy as a novel treatment approach for patients with NSCLC.
Correlation between Body Mass Index and Periprosthetic Joint Infection following Total Joint Arthroplasty
Authors: Xu Jing-Li , Liang Zheng-Rong , Xiong Bing-Lang , Zou Qi-Zhao , Lin Tian-Ye , Yang Peng , Chen Da , Zhang Qing-Wen
Published: June 2020

Background:

Despite rapid reports on the correlation between body mass index (BMI) and periprosthetic joint infection (PJI) after total joint arthroplasty, some have conducted regression tests or meta-analyses with controversial results. In this study, we systematically meta-analyzed relevant trials and carefully evaluated the correlation for verification.

Methods:

Literature on the correlation between BMI and PJI following total joint arthroplasty was retrieved in PubMed, Embase and Cochrane Library due September 2019. Stata 13.0 software was adopted for data synthesis and analyses of publication bias and sensitivity. Random-effect models were used to summary the overall estimate of the multivariate adjusted odds ratio (OR)/hazard ratio/rate ratio with 95% confidence intervals (CIs).

Results:

A total of 29 observational studies representing 3,204,887 patients were included. The meta-analysis revealed that the risk of postoperative PJI significantly increased by 1.51 times in the obese group (OR = 1.51; 95% CI = 1.30–1.74 for the obese group vs. the non-obese group), and by 3.27 times in the morbid obese group (OR = 3.27; 95% CI = 2.46–4.34 for the morbid obese group vs the non-morbid obese group). A significant association remained consistent, as indicated by subgroup analyses and sensitivity analyses.

Conclusion:

Our findings demonstrate that postoperative PJI is positively correlated with BMI, with obese patients showing a greater risk of developing PJI than non-obese patients. Similarly, morbid obese patients present a higher risk of PJI than non-morbid obese patients. However, this conclusion needs to be corroborated by more prospective studies.
Efficacy of paclitaxel, carboplatin, and bevacizumab for cervical cancer
Authors: Zhang Li , Zheng Chun-yan , Cao Jin-hui , Luo Shu-ling
Published: June 2020

Background:

Cervical cancer (CC) is a very common and malignant tumor in female population. Although a variety of single medications are reported to treat this condition, they all have limited efficacy. Previous studies have reported the combination of paclitaxel, carboplatin, and bevacizumab (PCB) can be used for the treatment of patients with CC effectively. However, no systematic review has explored its efficacy and safety. This study will address its efficacy and safety systematically and comprehensively.

Methods:

The following electronic databases will be retrieved from their inceptions to the January 1, 2020 to identify all potential associated studies: MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science, CINAHL, Google scholar, and Chinese Biomedical Literature Database. We will include randomized controlled trials (RCTs) of adult women (≥18 years) with CC globally. Eligible interventions will target any forms of PCB. The study methodological quality of all included studies will be appraised using Cochrane risk of bias tool. Statistical analysis will be undertaken using RevMan 5.3 software. In addition, we will perform a narrative synthesis to describe quality and content of the evidence.

Results:

This study will summarize recent evidence and provide quality evidence for the efficacy and safety of PCB on CC.

Conclusion:

The findings of this study will seek to identify the efficacy and safety of PCB and suggest future directions for research efforts targeting CC among this population.

Systematic review registration:

INPLASY202040195.
Effects of Jianpi Yiqi method for chronic obstructive pulmonary disease
Authors: Wang Yuxi , Jiang Yihui , Ge Junchen , Zhang Zhiwei , Dong Jia
Published: June 2020

Background:

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease with high morbidity and mortality worldwide. Jianpi Yiqi method (JYM) is a classical Chinese therapy in the treatment of COPD. However, there is no systematic review related to JYM for COPD. In this study, we aim to systematically examine the efficacy and safety for clinical use of JYM.

Methods and analysis:

We will conduct a comprehensive retrieval in the following electronic databases: PubMed, Embase, MEDLINE, Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI) database, Wanfang Data Knowledge Service Platform, Chinese Scientific Journals Database (VIP), Chinese Biomedical Literature Service System (SinoMed), and other sources. Two trained reviewers will identify relevant studies, extract data information, and then assess the methodical quality by the Cochrane risk of bias assessment tool, independently. Then the meta-analyses will be conducted by using the RevMan 5.2. Based on the heterogeneity test, data integration is performed using a fixed effect model or a random effects model. A sensitivity analysis will be performed to evaluate the stability of the results. Then publication bias assessment will be conducted by funnel plot analysis and Egger test. Finally, the quality of evidence will be assessed by the GRADE system.

Results:

The results of our research will be published in a peer-reviewed journal.

Conclusion:

The conclusion of our systematic review will provide evidence to judge whether JYM is an effective intervention for patients with COPD.

OSF registration number:

10.17605/OSF.IO/JKQYV.
The maintenance effect of acupuncture on the side effects of breast cancer endocrine therapy
Authors: Shi Kejin , Tang Ying , He Fengyi , Xiao Xiao , Zhang Jiayuan , Jin Yuxia , Wang Yunxia , Zhang Qi
Published: June 2020

Background:

Breast cancer is common among women throughout the world and endocrine therapy is an established part of its treatment. But, unfortunately, this has also resulted in intolerable side effects affecting the quality of life. Acupuncture has been widely used to treat endocrine-related side effects in patients with breast cancer, but how long its effect can be maintained has not been published. The systematic review is designed to evaluate the maintenance efficacy of acupuncture for related side effects after breast cancer endocrine therapy.

Methods and analysis:

We will search for the following databases: PubMed, Embase, Cochrane Library, Web of Science, including China National Knowledge Infrastructure (CNKI), WanFang Data, Technology Periodical Database (VIP), and China Biology Medicine (CBM) from inception to May 2020. Two reviewers will search these databases, collect all articles, and assess the quality of studies separately, and there will be no limitations on language. The primary outcomes will be assessed using acupuncture for endocrine-related hot flashes and joint pain duration (1 month, 3 months, 6 months). Measurement tools include the Kupperman index, Brief Pain Inventory Short Form (BPI-SF), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Brief Pain Inventory-Short (BPI-SF). We will use RevMan V.5.3 for meta-analysis and employ the Grading of Recommendations Assessment, Development and Evaluation System to assess the quality of evidence.

Results:

This systematic review will evaluate the maintenance efficacy of acupuncture on the side effects of breast cancer endocrine therapy.

Conclusion:

This study will provide high-quality current evidence of how long its effect can be maintained after acupuncture for related side effects after breast cancer endocrine therapy.

Ethics and dissemination:

Ethical committee approval is not required for this systematic review as patient data will not be collected. This study will help to inform doctors and researchers on the duration of acupuncture treatment for endocrine-related hot flashes and joint pain. The results will be published in a peer-reviewed journal and will be disseminated in relevant conferences.

INPLASY registration number:

INPLASY202040024
Photochemical Retinopathy induced by blue light emitted from a light-emitting diode Face Mask
Authors: Kim Tae Gi , Chung Junkyu , Han Jisang , Jin Kyung Hyun , Shin Jae-Ho , Moon Sang Woong
Published: June 2020

Rationale:

Skin photobiomodulation involves the use of low doses of light of a specific wavelength to reduce skin inflammation and promote tissue repair. Recently, a face mask using a light-emitting diode (LED) to induce photobiomodulation has been widely introduced in the market. However, a short wavelength of high-energy blue light can cause retinal damage. We would like to report a rare case of photochemical retinopathy after using a blue LED face mask.

Patient concerns:

A 37-year-old woman presented with complaints of distorted vision. The patient was exposed to blue light from an LED face mask 1 month before presentation.

Diagnosis:

Color fundus photography revealed a yellowish chorioretinal lesion and optical coherence tomography revealed retinal pigment epithelium destruction in the parafoveal area. Fluorescein angiography revealed leakage from the lesion at the parafovea. The patient was diagnosed with blue LED-induced photochemical retinopathy.

Interventions:

Intravitreal bevacizumab was injected in the right eye.

Outcomes:

After 4 weeks, dysmorphopsia was improved.

Lessons:

This case report demonstrates that retinal damage can occur in humans due to prolonged exposure to blue light. Therefore, it is important to be wary of eye exposure and ensure the eyes are covered during LED face mask use.
Fat embolism syndrome with cerebral fat embolism through a patent foramen ovale
Authors: Yang Lijuan , Wu Jiafang , Wang Baojun
Published: June 2020

Rationale:

Fat embolism syndrome with cerebral fat embolism, rarely observed at our neurology department, is often associated with long bone fractures. Its diagnosis is based on medical history and supportive imaging data and is usually not difficult. However, its pathogenesis remains poorly understood.

Patient concerns:

A 46-year-old woman was urgently presented to a nearby hospital because of a femur fracture caused by an accident. She rapidly developed somnolence and was suspected to have fat embolism syndrome.

Diagnoses:

Due to patients history of trauma and supportive imaging data, she was diagnosed with fat embolism syndrome obviously. However, severe brain damage confused our understanding of the pathogenesis. The subsequent diagnosis of fat embolism syndrome with patent foramen ovale provided a reasonable explanation.

Interventions:

Initially, we did not consider the fact that the patient had developed fat embolism syndrome and thus designed a comprehensive treatment program for fat embolism syndrome. Then the routine cardiac and vascular ultrasound screening were followed up, but patent foramen ovale was diagnosed unexpectedly, which led to a more aggressive treatment of brain injury.

Outcomes:

After relevant symptomatic treatment continued for nearly 3 months, an overall improvement was observed. Patients consciousness was restored but language disorders were left.

Lessons:

Clinicians should consider patent foramen ovale as the embolization pathway, particularly in young and middle-aged patients with cerebral embolism because it is often mistaken for a rare situation.
Incidence, predictors, and outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement
Authors: He Shixin , Fang Zhenfei
Published: June 2020

Background:

Prosthesis-patient mismatch (PPM) following transcatheter aortic valve replacement (TAVR) is common, but the incidence, predictors and outcome of PPM are still controversial.

Methods:

A total of 18 articles incorporating 72,016 patients were identified form PubMed and Embase online database.

Results:

The pooled incidences of overall, and severe PPM following TAVR were 32.0% and 10.0% separately. Comparing to surgical aortic valve replacement (SAVR), TAVR had lower incidence of overall (OR, 0.31, 95% CI, 0.20–0.50) and severe PPM (OR, 0.38, 95% CI, 0.28–0.52). PPM was associated with a larger body surface area (BSA), larger body mass index (BMI) and previous myocardial infarction in comparison with those patients without PPM. Although PPM was not rare after TAVR, no significant differences were observed both in short- and mid-term all-cause mortality (30 day: OR: 1.51, 95% CI, 0.79–2.87, 1 year: OR: 1.02, 95% CI, 0.96–1.08, and 2 years: OR: 0.99, 95% CI, 0.79–1.24) between patients with PPM and those without PPM.

Conclusions:

Despite the fact that the incidence of PPM was lower than that of SAVR, PPM was not seen to have an impact on short- and mid-term survival.
Transparent cap-assisted endoscopic injection sclerotherapy for the treatment of patients with esophageal varices
Authors: Wang Jing , Zhang Xiaohua , Zhao Shulei
Published: June 2020

The aim of this study was to compare the efficacy and safety of cap-assisted endoscopic injection sclerotherapy (EIS) versus direct EIS in the management of esophageal variceal bleeding in patients with cirrhosis.

This retrospective study included patients with cirrhosis and esophageal variceal bleeding who underwent EIS with or without the use of a transparent cap at Shandong Provincial Hospital between December 2014 and April 2017. Patients were divided into two groups: Group A (EIS with transparent cap, n = 50) and Group B (direct EIS, n = 45). Data collected included patients’ demographics, procedure details, and rates of variceal eradication, variceal rebleeding, variceal recurrence, and survival during the follow-up period. All data were expressed as mean ± SD. Quantitative variables were compared with Student t test; qualitative variables were compared with the Fisher exact test or chi-square test. P values less than .05 were considered significant.

The mean follow-up duration was similar in both groups (16.3 ± 10.2 mo in Group A and 15.5 ± 9.5 mo in Group B). The volume of sclerosant (64.86 ± 10.62 vs 104.73 ± 21.25 ml, P = .044), mean number of sessions (2.37 ± 1.15 vs 5.70 ± 1.57, P = .042), time required to perform endoscopic treatment (6.57 ± 1.50 vs 11.22 ± 2.29 minutes, P = .049), and time to initial esophageal varices eradication (5.43 ± 1.38 vs 8.93 ± 1.5 wk, P = .041) were significantly smaller in the cap-assisted EIS group than in the direct EIS group. The probability of variceal recurrence and rebleeding was significantly higher in the direct EIS group than in the cap-assisted EIS group (14% versus 35.6% and 20% versus 40%). Only 22 patients (44%) developed complications in the cap-assisted group versus 30 patients (66.7%) in the EIS group (P = .039). The probability of survival was similar in both groups (86% versus 75.6%, P = .133).

Modified EIS with the use of a transparent cap resulted in lower rates of esophageal variceal recurrence, rebleeding, and complications, compared with direct EIS.
The association of gene rearrangement and lymphoma diagnosis
Authors: He Xiaoyan , Xu Pei , Wang Xianwei , Jiang Shuming , Gong Daoyin , Wu Ning
Published: June 2020

Introduction:

To investigate the gene rearrangement and mutation of lymphoma biomarkers including (Immunoglobulin H (IgH), Immunoglobulin kappa (IGK), Immunoglobulin lambda (IGL), and TCR) in the lymphoma diagnosis.

Methods and analysis:

Paraffin tissue samples from 240 cases diagnosed as suspected lymphoma in the department of pathology, Deyang City People's Hospital from June 2020 to June 2021 will be enrolled. Deoxyribonucleic acid extraction and Polymerase Chain Reaction (PCR) amplification will be performed in these paraffin tissue samples. Immunoglobulin and T cell receptor (TCR) rearrangement will be analyzed by hetero-double chain gel electrophoresis and BioMed-2 standardized immunoglobulin gene rearrangement detection system. In this study protocol IGH gene rearrangement, IGK gene rearrangement, both IGH and IGL gene rearrangement, both IGH and IGK gene rearrangement, both IGK and IGL gene rearrangement, both IGH, IGK and IGL gene rearrangement, TCR gene rearrangement and positive Ig/TCR rearrangement will be analyzed.

Discussion:

In this study, we will use B and T cell lymphoma analysis focusing on IgH, IGK, IGL, and TCR gene rearrangement, so as to provide early guidance for the diagnosis of lymphoma. Second generation sequencing technology is helpful in the differential diagnosis of lymphoma.

Trial registration:

Chinese Clinical trial registry: ChiCTR2000032366.
Dose–response of rPMS for upper Limb hemiparesis after stroke
Authors: Kinoshita Shoji , Ikeda Kumi , Yasuno Shinji , Takahashi Sho , Yamada Naoki , Okuyama Yumi , Sasaki Nobuyuki , Hada Takuya , Kuriyama Chiaki , Suzuki Shin , Hama Midori , Ozaki Naoto , Watanabe Shu , Abo Masahiro
Published: June 2020

Introduction:

Repetitive peripheral magnetic stimulation (rPMS) therapy is an innovative and minimally invasive neurorehabilitative technique and has been shown to facilitate neural plasticity. However, there is at present no research that clarifies the dose–response of rPMS therapy on the recovery of upper limb hemiparesis after stroke. This trial aims to clarify the dose–response of rPMS therapy combined with intensive occupational therapy (OT) for chronic stroke patients with moderate to severe upper limb hemiparesis.

Methods and analysis:

This multicenter, prospective, assessor-blinded, randomized controlled study with 3 parallel groups will be conducted from January 20, 2020 to September 30, 2022. Fifty patients will be randomly assigned in a ratio of 1:2:2 to the control group, the group receiving daily 2400 pulses of rPMS, or the group receiving daily 4800 pulses of rPMS, respectively. From the day after admission (Day 1), rPMS therapy and intensive OT will be initiated. The primary outcome is the change in the motor function of the affected upper extremity (Fugl-Meyer Assessment) between the time of admission (Day 0) and the day after 2 weeks of treatment (Day 14). Secondary outcomes will include the changes in spasticity, active range of motion, motor evoked potential, and activity of daily living.

Ethics and dissemination:

The study was approved by the Jikei University Certified Review Board for all institutions (reference number: JKI19–020). Results of the primary and secondary outcomes will be published in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients.

Trial registration number:

jRCTs032190191.
Nursing Students’ Academic Success Factors
Authors: Brown Janine , McDonald Meghan , Besse Cheryl , Manson Patti , McDonald Reid , Rohatinsky Noelle , Singh Madeline
Published: June 2020

Background

Attrition from nursing programs is an ongoing concern. Capitalizing on nursing students' strengths and supporting areas for remediation will maximize student success.

Purpose

This study explored undergraduate nursing student strengths and areas for remediation at program entry and across all years of nursing education study.

Methods

We used a cross-sectional design and collected data via the Academic Success Inventory for College Students survey tool. Baseline data were collected on first-year students after program start, and data were collected for all years of study at the end of the academic terms.

Results

Compared with other undergraduate students, nursing students exhibited strengths in study skills, in self-organization strategies, in their certainty of progress toward career goals, in recognizing the importance of their studies, and in levels of socializing that did not hinder academic performance. At some data collection points, they had strengths in motivation, confidence, and concentration. Nursing students indicated areas for remediation in studying or test-taking anxiety and their perception of the educator's ability to organize, teach, and assess student progress.

Conclusion

Nurse educators' pedagogical approaches should augment nursing student strengths. Remediation is required to support student success relative to anxiety, and students need orientation to the process of learning.
Complementary and Alternative Medicine Use Among Pediatric Emergency Department Patients in Singapore
Authors: Sathiyan Jayapriya , Faeyza Noorul , Ramasamy Krishnapriya , Ng Wei Sheng , Ganapathy Sashikumar
Published: June 2020

Objective

The aim of the study was to determine the prevalence and types of complementary and alternative medicine (CAM) use among pediatric emergency department (ED) patients and perceptions of CAM among the caregivers who administer CAM in Singapore.

Methods

A survey was administered in a Singapore ED (June 2016–June 2017). A convenience sample of parents/carers accompanying pediatric patients completed a self-administered questionnaire. The primary outcome measures were prevalence of CAM use and perceptions of CAM.

Results

Parents/carers of 610 patients participated. Four hundred seventy-five (78.0%, 95% confidence interval, 74.5–81.0) had taken a CAM within the previous 12 months and 110 (18.1%; 95% confidence interval, 14.8–21.0) had taken a CAM on the day of presentation. There were no sex differences between CAM users and nonusers (P = 0.691). The use of CAM was more common among preschool children and younger (62.9%). There was no difference in CAM use among those with and without chronic disease (P = 0.878). Vitamins/supplements, cod liver oil, and probiotics were the most commonly used CAM. A total of 0.7% of CAM use was reported to the ED doctor. There were no adverse effects reported. The perception that CAMs are safe was more common among parents or caregivers who had administered CAM (P = 0.008).

Conclusions

Complementary and alternative medicine use is very common among pediatric ED patients in Singapore and is more prevalent than in Australia and the United Kingdom. However, it is not always reported to the doctor. Parents or caregivers who administer CAM are more likely to perceive CAMs to be safe.
Simultaneous Dual-Contrast Imaging of Small Bowel With Iodine and Bismuth Using Photon-Counting-Detector Computed Tomography
Authors: Ren Liqiang , Rajendran Kishore , Fletcher Joel G. , McCollough Cynthia H. , Yu Lifeng
Published: June 2020

Objectives

Dual-energy and multienergy computed tomography (DECT/MECT) has the potential to simultaneously visualize two contrast agents in the small bowel: arterial enhancement of iodine in the bowel wall and enteric enhancement of bismuth in the bowel lumen. The purpose of this study was to explore its feasibility in a swine study using a research whole-body photon-counting-detector (PCD) computed tomography (CT) system.

Materials and Methods

A phantom study was initially performed to evaluate the quantification accuracy of iodine and bismuth separation from a single PCD-CT scan, which also served as the calibration reference for material decomposition of in vivo swine PCD-CT data. In the animal study, a test bolus scan was first performed to determine the time-attenuation curve for the arterial enhancement, based on which the timing of the PCD-CT dual-contrast scan was determined. A 600 mL homogeneous bismuth-saline solution (180 mL Pepto-Bismol + 420 mL normal saline) was orally administered to the pig using esophageal intubation. Approximately 1 hour after bismuth administration, 40 mL iodine contrast (Omnipaque 350, 5 mL/s) was injected intravenously. A PCD-CT scan was performed 13 seconds after the initiation of the contrast injection to simultaneously capture the arterial enhancement of iodine and the enteric enhancement of bismuth. To provide optimal material separation and quantification, all PCD-CT scans in both phantom and animal studies were operated at 140 kV with 4 energy thresholds of 25, 50, 75, and 90 keV.

Results

Using a generic image-based material decomposition method, the iodine and bismuth samples were successfully delineated and quantified in the phantom images with a root-mean-square-error of 1.32 mg/mL in iodine measurement and 0.64 mg/mL in bismuth measurement. In the pig study, the enhancing bowel wall containing iodine and the small bowel loop containing bismuth were not differentiable in the original PCD-CT images. However, they were clearly distinctive from each other in the iodine- and bismuth-specific images after material decomposition, as reviewed by an abdominal radiologist. In addition, quantitative analysis showed that the misclassification between the two contrast materials was less than 1.0 mg/mL.

Conclusions

Our study demonstrated the feasibility of simultaneous imaging of iodine and bismuth in small bowel of swine using PCD-CT.
The influence of environmental setting on the community ecology of Ediacaran organisms
Authors: Mitchell Emily G. , Bobkov Nikolai , Bykova Natalia , Dhungana Alavya , Kolesnikov Anton V. , Hogarth Ian R. P. , Liu Alexander G. , Mustill Tom M. R. , Sozonov Nikita , Rogov Vladimir I. , Xiao Shuhai , Grazhdankin Dmitriy V.
Published: June 2020

The broad-scale environment plays a substantial role in shaping modern marine ecosystems, but the degree to which palaeocommunities were influenced by their environment is unclear. To investigate how broad-scale environment influenced the community ecology of early animal ecosystems, we employed spatial point process analyses (SPPA) to examine the community structure of seven late Ediacaran (558–550 Ma) bedding-plane assemblages drawn from a range of environmental settings and global localities. The studied palaeocommunities exhibit marked differences in the response of their component taxa to sub-metre-scale habitat heterogeneities on the seafloor. Shallow-marine (nearshore) palaeocommunities were heavily influenced by local habitat heterogeneities, in contrast to their deeper-water counterparts. The local patchiness within shallow-water communities may have been further accentuated by the presence of grazers and detritivores, whose behaviours potentially initiated a propagation of increasing habitat heterogeneity of benthic communities from shallow to deep-marine depositional environments. Higher species richness in shallow-water Ediacaran assemblages compared to deep-water counterparts across the studied time-interval could have been driven by this environmental patchiness, because habitat heterogeneities increase species richness in modern marine environments. Our results provide quantitative support for the ‘Savannah’ hypothesis for early animal diversification—whereby Ediacaran diversification was driven by patchiness in the local benthic environment.
Reconciling proxy records and models of Earth's oxygenation during the Neoproterozoic and Palaeozoic
Authors: Tostevin Rosalie , Mills Benjamin J. W.
Published: June 2020

A hypothesized rise in oxygen levels in the Neoproterozoic, dubbed the Neoproterozoic Oxygenation Event, has been repeatedly linked to the origin and rise of animal life. However, a new body of work has emerged over the past decade that questions this narrative. We explore available proxy records of atmospheric and marine oxygenation and, considering the unique systematics of each geochemical system, attempt to reconcile the data. We also present new results from a comprehensive COPSE biogeochemical model that combines several recent additions, to create a continuous model record from 850 to 250 Ma. We conclude that oxygen levels were intermediate across the Ediacaran and early Palaeozoic, and highly dynamic. Stable, modern-like conditions were not reached until the Late Palaeozoic. We therefore propose that the terms Neoproterozoic Oxygenation Window and Palaeozoic Oxygenation Event are more appropriate descriptors of the rise of oxygen in Earth's atmosphere and oceans.