bluuebunny/crossref_metadata_2025 huggingface dataset:
Japanese Literati Painting and Calligraphy
Authors: Graham Patricia J. , Chance Frank L.
Published: February 2021

Literati painting in Japan is generally referred to as Bunjinga (literati painting; Ch. Wen ren hua) or Nanga (Southern School painting; Ch. nan zong hua), both terms borrowed from China. Wen ren hua refers to the status of artists who belonged to the scholar-gentleman class. Nan zong hua was coined by the Chinese painter and theorist Dong Qichang (b. 1555–d. 1636), who used it to describe art by literati, ostensibly amateurs, whose paintings were indebted to their mastery of calligraphy, expressed their inner feelings, and sought to capture the spiritual essence of their subjects. He deemed Nan zong hua superior to that of another so-called “school” of painters he invented, the “northern school,” professionals whose work he declared to be superficial and decorative. In relation to Japanese literati painters, however, this distinction between the southern and northern schools is largely irrelevant. The diverse and very large group of artists defined as literati painters were variously amateurs and professionals who worked in styles inspired by a wide range of Chinese pictorial approaches, which the Japanese learned from imported woodblock-printed painting books, actual paintings, and Chinese and Korean artists and calligraphers who visited or emigrated to Japan, including professional painters, Confucian scholars, and Chan (Zen) Buddhist monks. Some Japanese literati painters were samurai, others commoners. Their commonality is a dedication to and deep knowledge of Sinophile literati culture—particularly Chinese poetry—and their use of Chinese literati painting subjects, especially ink landscapes and themes, such as bamboo, in response to the market demands of Japanese consumers fascinated by Chinese culture. Many also brushed polished and colorful bird-and-flower paintings modeled after the work of Chinese professional painters, and their art was also impacted by native styles then in vogue and by naturalistic rendering drawn from exposure to imported Western art. Some literati artists earned their living as Confucian scholars or writers and painted as an avocation; others worked as professional painters, presiding over independent ateliers with legions of disciples. Although the literati painting movement began in the Kyoto region, it was quickly embraced by artists throughout the country who often traveled and shared ideas. The first writings on the subject date to the early 20th century, but the heyday of scholarship occurred in the 1970s and 1980s, and resulted, in the West, in a large number of dissertations, with the majority dating from the late 1970s through early 1990s. Those that were subsequently revised as published monographs have been omitted from this bibliography.
Role of VVZ-149, a Novel Analgesic Molecule, in the Affective Component of Pain: Results from an Exploratory Proof-of-Concept Study of Postoperative Pain following Laparoscopic and Robotic-Laparoscopic Gastrectomy
Authors: Song Inkyung , Cho Sunyoung , Nedeljkovic Srdjan S , Lee Sang Rim , Lee Chaewon , Kim Jina , Bai Sun Joon
Published: February 2021

Objective

VVZ-149 is a small molecule that both inhibits the glycine transporter type 2 and the serotonin receptor 5 hydroxytryptamine 2 A. In a randomized, parallel-group, and double-blind trial (NCT02844725), we investigated the analgesic efficacy and safety of VVZ-149 Injections, which is under clinical development as a single-use injectable product for treating moderate to severe postoperative pain.

Methods

Sixty patients undergoing laparoscopic and robotic-laparoscopic gastrectomy were randomly assigned to receive a 10-hour intravenous infusion of VVZ-149 Injections or placebo, initiated approximately 1 hour before completion of surgical suturing. Major outcomes included pain intensity and opioid consumption via patient-controlled analgesia and rescue analgesia provided “as needed.” The treatment efficacy of VVZ-149 was further examined in a subpopulation requiring early rescue medication, previously associated with the presence of high levels of preoperative negative affect in a prior Phase 2 study (NCT02489526).

Results

Pain intensity was lower in the VVZ-149 (n = 30) than the placebo group (n = 29), reaching statistical significance at 4 hours post-emergence (P < .05), with a 29.5% reduction in opioid consumption for 24 hours and fewer demands for patient-controlled analgesia. In the rescued subgroup, VVZ-149 further reduced pain intensity (P < .05) with 32.6% less opioid consumption for 24 hours compared to placebo patients.

Conclusions

VVZ-149 demonstrated effective analgesia with reduced postoperative pain and opioid requirements. Consistent with the results from the previous Phase 2 study, patients with early rescue requirement had greater benefit from VVZ-149, supporting the hypothesis that VVZ-149 may alleviate the affective component of pain and mitigate excessive use of opioids postoperatively.
Income and Wealth Distribution in Macroeconomics: A Continuous-Time Approach
Authors: Achdou Yves , Han Jiequn , Lasry Jean-Michel , Lions Pierre-Louis , Moll Benjamin
Published: February 2021

We recast the Aiyagari–Bewley–Huggett model of income and wealth distribution in continuous time. This workhorse model—as well as heterogeneous agent models more generally—then boils down to a system of partial differential equations, a fact we take advantage of to make two types of contributions. First, a number of new theoretical results: (1) an analytic characterization of the consumption and saving behaviour of the poor, particularly their marginal propensities to consume; (2) a closed-form solution for the wealth distribution in a special case with two income types; (3) a proof that there is a unique stationary equilibrium if the intertemporal elasticity of substitution is weakly greater than one. Second, we develop a simple, efficient and portable algorithm for numerically solving for equilibria in a wide class of heterogeneous agent models, including—but not limited to—the Aiyagari–Bewley–Huggett model.
Exposure–response analysis for selection of optimal dosage regimen of anifrolumab in patients with systemic lupus erythematosus
Authors: Chia Yen Lin , Santiago Linda , Wang Bing , Kuruvilla Denison , Wang Shiliang , Tummala Raj , Roskos Lorin
Published: February 2021

Objectives

The randomized, double-blind, phase 2 b MUSE study evaluated the efficacy and safety of the type I IFN receptor antibody anifrolumab (300 mg or 1000 mg every 4 weeks) compared with placebo for 52 weeks in patients with chronic, moderate to severe SLE. Characterizing the exposure–response relationship of anifrolumab in MUSE will enable selection of its optimal dosage regimen in two phase 3 studies in patients with SLE.

Methods

The exposure–response relationship, pharmacokinetics (PK) and SLE Responder Index (SRI(4)) efficacy data were analysed using a population approach. A dropout hazard function was also incorporated into the SRI(4) model to describe the voluntary patient withdrawals during the 1-year treatment period.

Results

The population PK model found that type I IFNGS–high patients, and patients with a higher body weight, had significantly greater clearance of anifrolumab. Stochastic clinical simulations demonstrated that doses <300 mg would lead to a greater-than-proportional reduction in drug exposure owing to type I IFN alpha receptor-mediated drug clearance (antigen-sink effect, more rapid drug clearance at lower concentrations) and suboptimal SRI(4) responses with wider confidence intervals.

Conclusions

Based on PK, efficacy and safety considerations, anifrolumab 300 mg every 4 weeks was recommended as the optimal dosage for pivotal phase 3 studies in patients with SLE.
Early NMDA Receptor Ablation in Interneurons Causes an Activity-Dependent E/I Imbalance in vivo in Prefrontal Cortex Pyramidal Neurons of a Mouse Model Useful for the Study of Schizophrenia
Authors: Pafundo Diego E , Pretell Annan Carlos A , Fulginiti Nicolas M , Belforte Juan E
Published: February 2021

Altered Excitatory/Inhibitory (E/I) balance of cortical synaptic inputs has been proposed as a central pathophysiological factor for psychiatric neurodevelopmental disorders, including schizophrenia (SZ). However, direct measurement of E/I synaptic balance have not been assessed in vivo for any validated SZ animal model. Using a mouse model useful for the study of SZ we show that a selective ablation of NMDA receptors (NMDAr) in cortical and hippocampal interneurons during early postnatal development results in an E/I imbalance in vivo, with synaptic inputs to pyramidal neurons shifted towards excitation in the adult mutant medial prefrontal cortex (mPFC). Remarkably, this imbalance depends on the cortical state, only emerging when theta and gamma oscillations are predominant in the network. Additional brain slice recordings and subsequent 3D morphological reconstruction showed that E/I imbalance emerges after adolescence concomitantly with significant dendritic retraction and dendritic spine re-localization in pyramidal neurons. Therefore, early postnatal ablation of NMDAr in cortical and hippocampal interneurons developmentally impacts on E/I imbalance in vivo in an activity-dependent manner.
Gliotoxin Is an Important Secondary Metabolite Involved in Suppression of Sclerotium rolfsii of Trichoderma virens T23
Authors: Hua Lixia , Zeng Hualan , He Lian , Jiang Qiuping , Ye Pengsheng , Liu Yong , Sun Xiaofang , Zhang Min
Published: February 2021

Sclerotium rolfsii causes destructive soilborne disease in numerous plant species, and biological control may be a promising and sustainable approach for suppressing this widespread pathogen. In this study, the antagonistic effect against S. rolfsii of 10 Trichoderma strains was tested by the dual culture method, and a gliotoxin-producing strain, T. virens T23, was shown to be the most effective, inhibiting growth of S. rolfsii in vitro by 70.2%. To clarify the antagonistic mechanism and gliotoxin biosynthesis regulation of T23, a gliotoxin-deficient mutant was constructed via Agrobacterium tumefaciens-mediated gene knockout in vivo. As expected, disruption of the gene located in the putative gliotoxin biosynthesis gene cluster, gliI-T, resulted in gliotoxin deficiency and attenuation of the antagonistic effect against S. rolfsii, indicating that gliotoxin biosynthesis is regulated by gliI-T and that gliotoxin is an important antifungal metabolite of T23. Transmission electron microscopy revealed that gliotoxin treatment caused marked alterations of the hyphal cells of S. rolfsii depending on the drug concentration, whereby one of the prominent structural alterations was a reduction in the number and length of mitochondrial cristae. When S. rolfsii was exposed to 30 μg/ml of gliotoxin for 12 h, striking plasmolysis and ultrastructural changes were induced. The results demonstrated that gliotoxin is an important secondary metabolite of T. virens T23 in its antagonism against S. rolfsii.
Autologous osteochondral graft as treatment for gouty tophus in the talus
Authors: Mei Sheng , Zheng Xin , Kong Jingsong , Huang Yang , Tao Chen
Published: February 2021

Rationale:

Gout can cause redness, swelling, local heat, severe pain, and limitation of function of the affected joints and surrounding tissues. Gouty tophi are commonly found in the auricle, joints, Achilles tendon and tarsal bursa. However, gouty tophi rarely affect the talus.

Patient concerns:

We report a case of a 35-year-old man with a history of a sprained left ankle (six years before presentation), who presented with atraumatic and progressive pain, which the patient has been experiencing for a year.

Diagnosis:

The patient was diagnosed with ankle pain with a gouty stone in the talus.

Interventions:

The patient was treated with autologous osteochondral transplantation.

Outcomes:

During the two-year follow-up period, the patient's ankle joint underwent functional recovery and pain relief. Furthermore, the patient's Baird-Jackson ankle score improved from 80 to 95.

Lessons:

The gold standard for the diagnosis of gouty tophus in the talus is intraoperative arthroscopy and pathology. The presented case achieved satisfactory clinical effects with autologous osteochondral transplantation as the treatment for gouty tophus in the talus, and obtained an ideal hyaline cartilage repair with restored ankle joint function.
A multicenter, randomized controlled trial of massage in children with pediatric cerebral palsy
Authors: Zhang Can , Xiong Guangyi , Wang Jian , Shi Xinan , Guo Taipin , Jin Yaju , Zhao Yan , Tai Xiantao
Published: February 2021

Background:

Cerebral palsy is 1 of the diseases critically affecting the health of children. The spasmodic type is the most common, characterized by the increased muscular tension. It often leads to lifelong disability, bringing a heavy economic burden to families and society. As a key treatment in traditional Chinese medicine, pediatric massage has a significant clinical effect on cerebral palsy in children; however, high-quality randomized controlled studies are lacking. The main objective of this study was to evaluate the efficacy of pediatric massage for children with spastic cerebral palsy.

Methods/Design:

The study will be a multicenter, single-blinded, randomized-controlled pilot trial. During the period from June 2019 to December 2020, 182 children with spastic cerebral palsy will be randomly divided into experimental and control groups in a 1:1 ratio. The experimental group will undergo the modified selective spinal massage method combined with the basic rehabilitation treatment, while only the basic rehabilitation treatment would be performed for the control group. The intervention period of the study will last 12 weeks, 5 days weekly on weekdays. The primary outcomes include a modified Ashworth scale assessment and gross motor function test. The secondary outcomes include the 4-diagnostic scale of Chinese medicine and children's intelligence. The observation index will be measured during the complete 12 weeks duration after the treatment of the child, that is, before treatment, after 4 weeks of treatment, after 8 weeks, and after 12 weeks of treatment.

Discussion:

This study aims to evaluate the efficacy of pediatric massage on children with spastic cerebral palsy; if the outcome is positive, it can provide a reference for the further promotion and application of pediatric massage in the treatment of spastic cerebral palsy.

Trial registration:

Chinese ClinicalTrials.gov, ID: ChiCTR1900021666. Acupuncture-Moxibustion Clinical Trial Registry, AMCTR: (AMCTR-IPR-19000260) Registered on 04 March 2019.
The difference in heat transport characteristics of the heart and lung meridians
Authors: Li Xiaoyu , Jiang Yongliang , Hu Hantong , Zhang Yajun , Lou Jiali , He Xiaofen , Sun Jing , Wu Yuanyuan , Fang Junfan , Shao Xiaomei , Fang Jianqiao
Published: February 2021

Background:

The vast majority of previous studies focused on the relationship between 1 meridian and 1 organ, and the comparison and specificity between 2 meridians is rarely explored. Thus, the aim of this study is to compare the heat transport characteristics between 2 different meridians and the specificity between them will also be investigated.

Methods:

The Lung and Heart meridians are chosen for comparison of 2 different meridians. We will enroll 120 subjects and divide them into the healthy control group, chronic obstructive pulmonary disease (COPD) group and healthy intervention group, in a 1:1:1 ratio. Infrared thermography (IRT) will be used to assess the heat transport characteristics of the Heart and Lung meridians. The specificity for the meridian-visceral association will be investigated by comparing the difference in heat transport characteristic between the Heart and Lung meridians in the healthy control group and COPD group. Meanwhile, moxibustion will be given to subjects in the Heart meridian and Lung meridian respectively in the healthy intervention group to verify the specificity for the surface-surface association.

Results:

The primary outcomes will be the temperature of corresponding sites along the Heart and Lung meridians.

Conclusion:

This study will verify the specificity between different meridians by comparing the difference in heat transport characteristic. The findings will guide the selection of acupoints to optimize the therapeutic effect of acupuncture and help determine whether IRT could be used to assist in the diagnosis of COPD.

Ethics and dissemination:

The study has been approved by the Third Affiliated Hospital of Zhejiang Chinese Medical University (Approval No. ZSLL-KY-2019-001G-01).

Trial registration numbers:

NCT04046588.
Arthroscopic treatment of Mycobacterium massiliense septic arthritis outbreak after intra-articular injection
Authors: Lee Byung Ill , Jang Byung-Woong , Choi Hyung Suk , Lee Jeong Seok , Kim Yong Beom
Published: February 2021

Non-tuberculous mycobacteria (NTM) comprise mycobacteria, with the exceptions of Mycobacterium (M.) leprae and the M. tuberculosis complex. Septic arthritis caused by NTM is so rare that there is no standardized treatment.

Between April and September 2012, 27 patients were infected with M. massiliense in a single clinic following injection of steroid in the knee joint. Clinical data of 9 patients who received arthroscopic treatment in Seoul Hospital of Soonchunhyang University were analyzed retrospectively.

Arthroscopic irrigation and debridement were performed average 2.6 times (1–3 times). As 6 out of 9 cases (67%) had joint contracture of the knee joint, arthroscopic adhesiolysis, and brisement were performed. After surgical procedures, Hospital for Special Surgery and Lysholm knee score showed improvement compared before the surgery, but a radiographic result evaluated by Kellgren-Lawrence revealed that 6 cases got deteriorated to stage 4 in the 4-year follow-up.

NTM septic arthritis had a higher recurrence and a higher contracture incidence than septic arthritis caused by tuberculous mycobacteria or other bacteria. Treatment was possible with repeated arthroscopic debridement and intravenous antibiotics.
Effect of Kangfuxin Liquid enema combined with mesalazine on gestational outcomes and quality of life in child-bearing female with active ulcerative colitis
Authors: Wang Tong , Lu Hua , Li Fangyuan , Zhang Qi
Published: February 2021

Background:

In recent years, the incidence of ulcerative colitis (UC) is on the rise, and most of them are young adults. As the peak of the disease overlaps with the childbearing age, it has a great impact on the fertility of female patients. We, therefore, conduct a randomized and controlled trial to evaluate the efficacy and safety of mesalazine enteric-coated tablets combined with Kangfuxin Liquid (KFX) enema for the child-bearing period female with active UC.

Methods:

In this randomized controlled study, a total of 236 eligible patients will be assigned to the experimental group (n = 118) or the control group (n = 118) in a 1:1 ratio. The control group will be taken mesalazine enteric-coated tablets combined with placebo enema and the experimental group will be taken mesalazine enteric-coated tablets combined with KFX enema. Participants will receive 8 weeks of intervention treatment and 3 months of maintenance treatment before pregnancy. The primary assessment is the Mayo score. Secondary outcomes include mucosal healing, faecal calprotectin (FC), Inflammatory Bowel Disease Quality (IBDQ), and pregnancy outcome.

Discussion:

This study will provide evidence regarding the efficacy and safety of KFX enema used before pregnancy on halting active UC, reducing the relapse rate during pregnancy, improving pregnancy outcome, and the quality of life.

Trial registration:

Chinese Clinical Trials Register identifier, ChiCTR2000039161, registered on October 20, 2020.
The effectiveness and safety of recombinant human growth hormone combined with alginate dressing in the treatment of diabetic foot ulcer
Authors: Zhou Deng-Rong , Deng Hai-Yan , Pu Lin-Li , Lin Shao-Lan , Gou Rong , Wang Feng-Ling
Published: February 2021

Background:

Diabetic foot ulcer (DFU) is one of the serious complications of diabetes. It is the result of a joint effect of lower extremities vascular lesions, neuropathy, and infection, which require amputation and even threaten the life of the patient. At present, the conventional treatment for DFU includes infection control, wound care, wound reduction, reduction of foot pressure, use of dressings that are beneficial to wound surface healing, etc, but the effectiveness is not satisfactory. Recombinant human growth hormone and alginate dressing have been used in clinical, but there is lack of the relevant evidence of its effectiveness and safety, so this study evaluates the clinical effectiveness and safety of recombinant human growth hormone combined with alginate dressing in the treatment of DFU by systematic evaluation, the purpose is to provide a theoretical basis for the treatment of diabetic foot ulcer.

Methods:

This study mainly retrieves the randomized controlled trial of recombinant human growth hormone combined alginate dressing in the treatment of DFU in 7 electronic databases, such as PubMed, EMbase, Cochrane Library, SinoMed, CNKI, WANGFANG database, and VIP database. All the retrieval dates of database are from the establishment of the database until May 31, 2020. At the same time, searching the related degree papers, conference papers, and other gray literature by manual. The original literature data are independently screened and extracted by 2 researchers on the basis of inclusion and exclusion criteria and literature information sheets, and cross-checked and resolved through group discussions and consultations when there are differences of the opinion. Assessing the methodological quality of inclusion in the study based on the “Bias Risk Assessment Form” of the Cochrane Collaboration Network. Using the software of RevMan 5.3.3 and STATA 13.0 for statistical analysis.

Results:

This study compares the main and secondary outcome indicators by systematic evaluation and it will provide strong evidence of recombinant human growth hormone combined alginate dressing in the treatment of DFU.

Ethics and dissemination:

All data in this study are obtained through the web database and do not involve humans, so ethical approval is not suitable for this study.

OSF registration number:

DOI 10.17605/OSF.IO/W6P24.

Conclusion:

This study will give positive conclusions about the effectiveness and safety of recombinant human growth hormone combined alginate dressing in the treatment of DFU.
Effect of traditional Chinese manipulation on ankle sprains
Authors: Wang Baojian , Yin Xunlu , Zhang Ping , Yang Kexin , Sun Wu , Jin Zhefeng , Li Jianguo , Gao Chunyu , Gao Jinghua
Published: February 2021

Background:

This systematic review and meta-analysis was performed to evaluate the clinical efficacy and safety of traditional Chinese manipulation in treating ankle sprains.

Methods:

Seven databases were searched from inception to July 2020. A meta-analysis of randomized controlled trials comparing traditional Chinese manipulation and other conservative therapy for ankle sprains was conducted. The Cochrane Handbook tool was applied to access the quality and risk of bias of each study. The meta-analysis was performed with Review Manager 5.3 software (Nordic Cochrane Centre, Copenhagen, Denmark).

Results:

In total, 14 articles and 1112 patients were included. The total effective rate of ankle manipulation was much higher than that of other conservative therapy (risk ratio [RR], 1.23; 95% confidence interval [CI], 1.17–1.30; P < .00001). The Baird–Jackson score (RR, 10.14; 95% CI, 5.57–14.70; P < .0001), visual analog scale score (RR, −1.78; 95% CI, −3.14 to −0.43; P = .01), and American Orthopaedic Foot and Ankle Society ankle-hindfoot score (RR, 15.70; 95% CI, 12.72–18.68; P < .00001) were significantly lower in the manipulation group than in the control group. Further subgroup analysis showed that the visual analog scale score of the rotating-traction-poking manipulation was significantly lower than that of the control group (RRRTPM, −2.56; 95% CI, −4.54 to −0.58; P = .01), while there were no significant differences between the effects of other manipulations and the control group (RRother manipulation, −0.62; 95% CI, −1.52 to 0.28; P = .18).

Conclusion:

Traditional Chinese manipulation might have a better effect on ankle sprains than other types of conservative treatment. The rotating-traction-poking manipulation might achieve better effects than other manipulation techniques in terms of alleviating pain intensity. However, considering the overall high or unclear risk of bias, the evidence identified does not allow for a robust conclusion concerning the efficacy and safety of traditional Chinese manipulation for treating ankle sprains. High-quality randomized controlled trials are needed to confirm these findings.
The effect of Gegen Qinlian Decoction on clinical prognosis and islet function for type 2 diabetic mellitus
Authors: Ren Yuhang , Xiong Peiyu , Zhong Chun , Zhang Peixu , Jia Bo
Published: February 2021

Background:

With the development of social economy, people's lives are improving day by day. Chronic diseases represented by diabetes have gradually entered people's field of vision. At present, about 415 million people in the world suffer from diabetes, of which more than 90% are Type 2 diabetic mellitus (T2DM), which causes severe physical and mental pain to patients and their families, and also imposes a huge burden on the health care system. Animal experiments and clinical studies both show that Gegen Qinlian Decoction (GQD) cannot only reduce the blood glucose of T2DM, but also improve the islet function of patients, reduce the insulin resistance index and insulin secretion index, and have no adverse reactions. Therefore, we designed this protocol to evaluate the effect of GQD on clinical Prognosis and islet function for T2DM.

Methods:

This review was conducted from January 1, 2000 to October 1, 2020, sourced from the Cochrane Library, Pubmed, Excerpt Medica Database, Science Direct, World Health Organization, International Clinical Trials Registration Platform, Web of Science, Chinese Biomedical Literature, the China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database. In this study clinical randomized controlled trial is used and we set inclusion criteria and exclusion criteria for screening. The primary outcomes include Fasting plasma glucose,2 h plasma glucose, Hemoglobin A1c, fasting plasma insulin, insulin resistance index and insulin secretion index. Review Manager 5.3 software will be used for data analysis.

Results:

This study will provide the systematic evidence of the effect of GQD on Clinical Prognosis and islet function for T2DM.

Conclusion:

The findings of this meta-analysis will provide evidence to evaluate the effect of GQD on Clinical Prognosis and islet function for type 2 diabetic mellitus.

INPLASY registration number:

INPLASY2020110083.
Long-term progression-free survival in a patient with advanced non-small-cell lung cancer treated with low-dose gefitinib and traditional herbal medicine
Authors: Lee Beom-Joon , Kim Kwan-Il , Choi Cheong-Woon , Kim Jong Yeol , Lee Jun-Hwan
Published: February 2021

Rationale:

Gefitinib is a first-line palliative chemotherapy drug used to treat advanced non-small-cell lung cancer (NSCLC) in patients who have an epidermal growth factor receptor (EGFR) mutation. However, approximately two-thirds of NSCLC patients with EGFR-tyrosine kinase inhibitor experience dermatological toxicity. Cutaneous toxicity is usually not life threatening but can necessitate modification or discontinuation of medication in severe cases. In this case, despite a reduction in the dose of gefitinib due to side effects, combined treatment with modified Bojungikki-tang (BJKIT) increased progression-free survival (PFS) in an advanced NSCLC patient.

Patient concerns:

An 83-year-old Asian woman presented with chief complaints of chronic cough, dyspnea, weight loss, and anorexia.

Diagnoses:

The patient was diagnosed with stage IV NSCLC (T2aN3M1), adenocarcinoma with metastasis to the lymph node, brain, and bone based on image scan and biopsy. An EGFR deletion was detected in exon 19.

Interventions:

The patient was treated with gefitinib (250 mg/d) and traditional herbal medicine, modified Bojungikki-tang (BJIKT). However, after 1 year of combination therapy, gefitinib was tapered down to once per week while modified BJIKT was maintained.

Outcomes:

A partial response was achieved, but after 3 months severe papulopustular skin rashes developed and became aggravated with time. Thus, the gefitinib dose was reduced. However, the PFS has been maintained for approximately 78 months.

Lessons:

Despite the reduction in gefitinib dose due to side effects, the combined treatment of gefitinib and the modified BJIKT has maintained a PFS of over 78 months, indicating that modified BJIKT enhanced the anti-cancer effect of gefitinib in a patient with advanced NSCLC harboring the EFGR mutation, and may have delayed acquired resistance, the main limitation on the efficacy of gefitinib. Further investigations including clinical trials are needed to confirm these effects.
A comprehensive program for enhanced management of femoral neck fractures including an enhanced recovery after surgery program
Authors: Huang Zheyu , Zhang Junhui , Di Zhenglin , Zeng Zhimin
Published: February 2021

To retrospectively analyze the functional outcomes and complications in patients who underwent hip arthroplasty with enhanced recovery after surgery (ERAS) program for femoral neck fractures.

Between June 2015 and May 2019, 1138 patients with femoral neck fractures were treated in our department. According to the Garden classification system, 467 cases were type III and 671 cases were type IV with an average age of 74.9 ± 8.8 years (range, 59–96 years). All patients underwent hip arthroplasty with ERAS. The clinical outcomes of these patients were retrospectively analyzed at the final follow-up using the Harris hip score (HHS).

The median follow-up was 21.2 months (range, 6–36 months). The mean time to surgery and the length of hospitalization after surgery were 2.4 and 2.2 days, respectively. Eight hundred and fifty-two patients (74.9%) were operated within 48 hours from admission, 1052 cases (92.4%) were discharged within 48 hours after surgery. Twelve patients (1.05%) were readmitted for prosthetic dislocation. None of the patients suffered from infection, periprosthetic fractures, and/or prosthetic loosening. The HHS at the final follow-up was 92.7 ± 7.6, with an excellent or good rate of 90.2%.

Patient-oriented ERAS optimizes the interventional measures during the perioperative period for geriatric patients with femoral neck fractures and can improve their short-term clinical outcomes without increased readmission rates.
Computed tomography-guided coil localization for scapula-blocked pulmonary nodules
Authors: Liu Xia , Cao Wei , Xu Qing-Song
Published: February 2021

To evaluate the clinical efficiency, feasibility, and safety of computed tomography (CT)-guided trans-scapular coil localization (TSCL) approach to treating scapula-blocked pulmonary nodules (SBPNs).

In total, 105 patients with pulmonary nodules underwent CT-guided CL and subsequent video-assisted thoracoscopic surgery (VATS)-guided wedge resection (WR) between January 2016 and July 2020. Six of these patients (5.7%) had SBPNs that led them to undergo CT-guided TSCL. Rates of technical success and localization-related complications were then recorded and analyzed.

CT-guided TSCL was associated with a 100% technical success rate, with one coil being placed per patient. The median CT-guided TSCL duration was 15 min. No patients experienced any complications associated with this procedure, and subsequent VATS-guided WR of SBPNs was 100% technically successful. In two patients with invasive adenocarcinoma, additional lobectomy was performed. Median VATS duration and intraoperative blood loss were 120 min and 150 mL, respectively.

In summary, these results indicate that CT-guided TSCL could be easily and safely implemented to achieve high success rate when performing the VATS-guided WR of SBPNs.
Effect of robot-assisted gait training on gait automaticity in Parkinson disease
Authors: Yun Seo Jung , Lee Hyun Haeng , Lee Woo Hyung , Lee Seung Hak , Oh Byung-Mo , Seo Han Gil
Published: February 2021

Gait automaticity is reduced in patients with Parkinson disease (PD) due to impaired habitual control. The aim of this study was to investigate the effect of robot-assisted gait training (RAGT) on gait automaticity as well as gait speed and balance in patients with PD.

This study was a prospective, open-label, single-arm, pilot study. We planned to recruit 12 patients with idiopathic PD. Participants received 12 sessions of RAGT using exoskeleton-type robotic device. Sessions were 45-minute each, 3 days a week, for 4 consecutive weeks using an exoskeleton-type gait robot. The primary outcome was the percentage of dual-task interference measured by the 10-Meter Walk Test (10MWT) under single and dual-task (cognitive and physical) conditions. Secondary outcomes were the Berg Balance Scale and Korean version of the Falls Efficacy Scale-International. All measures were evaluated before treatment (T0), after treatment (T1), and 1-month post-treatment (T2).

Twelve patients were enrolled and 1 dropped out. Finally, 11 patients with idiopathic PD were analyzed. The mean age of 11 patients (5 males) was 66.46 ± 5.66 years, and disease duration was 112.91 ± 50.19 months. The Hoehn and Yahr stages were 2.5 in 8 patients and 3 in 3 patients. Linear mixed-effect model analysis showed a significant change over time only in single-task gait speed of the 10MWT (P = .007), but not in dual-task gait speed, dual-task interferences, and Korean version of the Falls Efficacy Scale-International. Cognitive dual-task interference significantly increased (P = .026) at T1, but not at T2 (P = .203). No significant changes were observed for physical dual-task interference at T1 and T2. Single-task gait speed of the 10MWT was significantly increased at T1 (P = .041), but not at T2 (P = .445). There were no significant changes in the dual-task gait speed of 10MWT. A significant improvement was observed in Berg Balance Scale score at T1 and T2 (P = .004 and P = .024, respectively).

In this pilot study, despite improvement in walking speed and balance, gait automaticity in patients with PD was not improved by RAGT using an exoskeleton-type robot. Additional therapeutic components may be needed to improve gait automaticity using RAGT in patients with PD.
The efficacy of artificial dermis combined with continuous vacuum sealing drainage in deep neck multiple spaces infection treatment
Authors: Gu Xiang , Chen Wei , Yuan Kun , Tan Jian , Sun Suguang
Published: February 2021

Deep neck abscesses are dangerous. Artificial dermis combined with seal negative pressure drainage is a new technique for treating refractory wounds.

To compare the efficacy of vacuum sealing drainage (VSD) with that of traditional incision drainage approaches for treating deep neck multiple spaces infections.

This retrospective analysis includes patient data from our hospital collected from January 2010 to March 2020. A total of 20 cases were identified. Based on the treatment methods, the patients were divided into the VSD group and the traditional group. Inflammation indicators (white blood count, WBC), duration of antibiotic use, hospitalization time, doctors’ workload (frequency of dressing changes) and treatment cost were analyzed and compared between the two groups.

Of the 20 patients, 11 patients underwent treatment with VSD, while the other 9 underwent traditional treatment. All patients were cured after treatment. Compared with the traditional group, the VSD group had a slower decline in the inflammation index, shorter duration of antibiotic use, shorter hospital stay, and lower doctor workloads (P < .001). There was no significant difference in treatment cost between the two groups (P > .05).

VSD technology can markedly improve the therapeutic effect of deep neck multiple spaces infection. This treatment method can be used to rapidly control infections and is valuable in the clinic (P > .05).
Transformation from acute promyelocytic leukemia to acute myeloid leukemia with a CEBPA double mutation
Authors: Sun Ye , Wang Chong , Sun Yongcheng , Wang Jiaping , Rong Chunmeng , Wu An , Ouyang Guifang , Sheng Lixia
Published: February 2021

Introduction:

The transformation of acute promyelocytic leukemia (APL) to acute mononuclear leukemia during treatment is a rare clinical phenomenon, and no CCAAT/enhancer-binding protein alpha (CEBPA) double mutations have been reported.

Patient concerns:

A 42-year-old male was hospitalized for ecchymosis of the left lower limb for more than 1 month, gingival bleeding, and fatigue for 10 days, with aggravation of symptoms for 2 days.

Diagnosis:

A diagnosis of APL was based on bone marrow (BM) morphology, immunophenotyping, fusion gene analysis, and fluorescence in situ hybridization. At a 1-year follow-up of maintenance treatment, he developed thrombocytopenia and was diagnosed with acute myeloid leukemia (AML) with a CEBPA double mutation by BM morphology, immunotyping, chromosomal analysis, polymerase chain reaction, and next generation sequencing.

Interventions:

Complete remission of APL was achieved after all-trans retinoic acid and arsenic trioxide double induction therapy, followed by 2 cycles of mitoxantrone and cytarabine, and 1 cycle of idarubicin and cytarabine. Thereafter, sequential maintenance therapy of arsenic trioxide + all-trans retinoic acid + methotrexate was started. In the fourth cycle of maintenance therapy, APL was transformed into AML with a CEBPA double mutation. After 1 cycle of idarubicin and cytarabine, the patient achieved complete remission and received 3 cycles of idarubicin and cytarabine and three cycles of high-dose cytarabine as consolidation therapy.

Outcomes:

At present, the patient is in continuous remission with minimal residual disease negative for both of APL and AML.

Conclusion:

AML with a CEBPA double mutation after APL treatment is very rare, thus the prognosis of this event will require further observation.
Mental health status among Chinese healthcare-associated infection control professionals during the outbreak of coronavirus disease 2019
Authors: Zhang Ying , Tian Lingyun , Li Wan , Wen Ximao , Wu Hongman , Gong Ruie , Zeng Lanman , Zhou Feng , Liu Zhenru , Tang Ziyuan , Wu Anhua , Huang Xun
Published: February 2021

Recently, the coronavirus disease 2019 (COVID-19) epidemic has greatly threatened global public health. The responsibility of healthcare-associated infection control professionals (ICPs) is to prevent and control the nosocomial infections. The mental health status of ICPs deserves more attention, however, the correlational research is still lacking. This study aims to investigate the incidence and risk factors of mental health status among ICPs in China during the outbreak of COVID-19.

A national cross-sectional survey was performed. The online questionnaire was completed by 9228 ICPs from 3776 hospitals throughout China. Data collection tools were used, including demographics data questionnaire, the Chinese version of the 12-item general health questionnaire (GHQ-12) and the Chinese version of the psychological capital questionnaire (PCQ) for medical staff. Univariate and multivariable analyses were conducted.

The total score of mental health of Chinese ICPs was 3.45 ± 2.57. 5608 (60.77%) ICPs might have mental health problems. The psychological capital was in the upper-middle level with an average score of 3.72 ± 0.38. An increased mental health problem risk was associated with the greater self-efficacy and working in the public hospital; a significantly lower risk was obtained by working in the second-class hospital rather than in the third-class hospitals. Besides, mental health problem risk of ICPs working in hospitals of the western economic region or northeast economic region was more significant than that in hospitals of the central economic region. However, a lower risk was caused by the unmarried than married, and working years in department ≤1 year contributed to the lower risk than that >20 years. Moreover, fewer working hours per week, higher values of hope, and optimism each were contributed to a lower risk.

Chinese healthcare-associated ICPs were under different levels of mental health problems in fighting against COVID-19. More importantly, we should actively deal with the mental health problem of ICPs and help them get rid of psychological disorders.
Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department
Authors: Chen Wei-Lung , Hsu Chan-Peng , Wu Po-Han , Chen Jiann-Hwa , Huang Chien-Cheng , Chung Jui-Yuan
Published: February 2021

Point-of-care ultrasonography (POCUS) is a prompt and simple tool for the urgent diagnosis and treatment of patients in the emergency department (ED). We developed a comprehensive residency-based POCUS training program for ED residents and determined its effect on ultrasound utilization in the ED.

We conducted a retrospective cohort study in the ED of a university-affiliated medical center, to evaluate a centralized residency-based POCUS training course for ED residents, which included 12 core ultrasound applications, from July 2017 to June 2018. Each application comprised a combined lecture and hands-on practice session that lasted for 2 hours. Pre-tests and post-tests, including still image and video interpretation, were performed. The use of POCUS (number of ultrasound studies performed divided by the number of patients each resident saw in 1 year) among ED residents, before and after the POCUS training course (July 2016–June 2017 and July 2018–June 2019), was calculated and analyzed using the Wilcoxon signed-rank test.

Sixteen residents participated and completed the entire training course. The post-test score was significantly better than the pre-test score, by a median of 12 points (P = .04). Utilization of POCUS among the ED residents increased significantly, from 0.15 ultrasound studies per patient per year to 0.41 ultrasound studies per patient per year (P < .01), after completion of the entire training course. Increased POCUS scanning percentages over the cardiac tissue, soft tissue, abdominal region, vascular system, procedural guidance, and ocular regions were also noted after providing the curriculum.

Conducting a comprehensive POCUS education program may enhance POCUS utilization among residents in the ED.
Leading Through Chaos
Authors: Losty Lyn Stankiewicz , Bailey K. David
Published: February 2021

The COVID-19 crisis created unique and interesting challenges for health care systems and changed how health care professionals delivered care. Evidence suggests that leadership skills remain of utmost importance during crises as it is the leader who often determines the response of the follower. A descriptive qualitative approach was used to ascertain the essence of nurse executive leadership and innovation during the COVID-19 crisis. Nurse executives were recruited via personal invitations to participate in the study. Participants were asked about their current challenges of COVID-19 on health care delivery, their leadership style, and what innovative processes their teams deployed. Using a thematic analysis approach, 3 themes emerged and resonated from the interviews: the importance of communication; the need for leadership presence; and mental toughness. With any health care crisis, leadership is essential to guide followers. As demonstrated by these findings, communication, leadership presence, and mental toughness are 3 key components to promoting and providing quality care in an austere, complex, and changing health care environment. Further understanding of the roles of these key concepts may add insight into nurse leaders and leadership development.
Nurses Taking the Lead: A Look Back to Move Forward
Authors: Nelson-Brantley Heather V. , Bailey K. David , Batcheller Joyce , Caramanica Laura , Cherry Barbara , Snow Francine , Warshawsky Nora
Published: February 2021

In recognition of the Year of the Nurse and Midwife, the 2020 annual conference of the Association for Leadership Science in Nursing (ALSN) celebrated A Look Back to Move Forward in recognition of the 50th anniversary of ALSN. The ALSN began as the Council of Graduate Education for Administrative Nursing (CGEAN) in 1970. Today, ALSN maintains the goals of shaping graduate education and research to inform nursing leadership practice.
Using a Mentorship Approach to Address the Underrepresentation of Ethnic Minorities in Senior Nursing Leadership
Authors: Brown-DeVeaux Dewi , Jean-Louis Kimberly , Glassman Kimberly , Kunisch Judith
Published: February 2021

Healthcare organizations must be intentional and purposeful in creating diversity programs. A nursing leader mentorship program for racial and ethnic minority nurse managers was introduced at a large academic medical center to meet this need. The program design was based on the successful Leadership Institute for Black Nurses, first conducted at a university school of nursing. The participants in the 4-month program were 16 nurse managers from 2 city hospitals and their mentors.
A Novel Olfactory Self-Test Effectively Screens for COVID-19
Authors: Snitz Kobi , Honigstein Danielle , Weissgross Reut , Ravia Aharon , Mishor Eva , Perl Ofer , Karagach Shiri , Medhanie Abebe , Harel Nir , Shushan Sagit , Roth Yehudah , Iravani Behzad , Arshamian Artin , Ernst Gernot , Okamoto Masako , Poo Cindy , Bonacchi Niccolò , Mainen Zachary , Monteleone Erminio , Dinnella Caterina , Spinelli Sara , Mariño-Sánchez Franklin , Ferdenzi Camille , Smeets Monique , Touhara Kazushige , Bensafi Moustafa , Hummel Thomas , Lundström Johan N. , Sobel Noam
Published: February 2021

Key to curtailing the COVID-19 pandemic are wide-scale testing strategies1,2. An ideal test is one that would not rely on transporting, distributing, and collecting physical specimens. Given the olfactory impairment associated with COVID-193-7, we developed a novel measure of olfactory perception that relies on smelling household odorants and rating them online. We tested the performance of this real-time tool in 12,020 participants from 134 countries who provided 171,500 perceptual ratings of 60 different household odorants. We observed that olfactory ratings were indicative of COVID-19 status in a country, significantly correlating with national infection rates over time. More importantly, we observed remarkable indicative power at the individual level (90% sensitivity and 80% specificity). Critically, olfactory testing remained highly effective in participants with COVID-19 but without symptoms, and in participants with symptoms but without COVID-19. In this, the current odorant-based olfactory test stands apart from symptom-checkers (including olfactory symptom-checkers)3, and even from antigen tests8, to potentially provide a first line of screening that can help halt disease progression at the population level.