bluuebunny/crossref_metadata_2025 huggingface dataset:
Policy support for expanding the adolescent vaccine school mandate in Pennsylvania to include the human papillomavirus (HPV) vaccine
Authors: Falik Rachel B. , Albrecht Susan A. , Cassidy Brenda L.
Published: February 2019

Approximately 27,000 men and women are affected by human papillomavirus (HPV)–related cancer every year. The Advisory Committee for Immunization Practices and the Centers for Disease Control and Prevention (CDC) routinely recommend that adolescents receive HPV, tetanus, diphtheria, and acellular pertussis (tetanus–diphtheria–acellular pertussis [Tdap]) and meningococcal (MCV) vaccines at age 11–12 years. Although the CDC and professional organizations such as the American Academy of Pediatrics make national vaccine recommendations, according to the National Vaccine Information Center, it is the responsibility of “state health departments to make and enforce vaccine mandates for school entry.” The Pennsylvania Department of Health has only mandated two of the recommended three vaccinations: Tdap and MCV. As of 2016, 92% of adolescents aged 13–17 years in Pennsylvania received the Tdap vaccine and 92.7% received the MCV. However, only 58% of females and 44.4% of males aged 13–17 years received all three doses of the HPV vaccine. A comparison of HPV vaccine rates in states with school mandates was compared with Pennsylvania rates. Human papillomavirus vaccination rates were found to be significantly higher in the District of Columbia and Rhode Island, which have HPV vaccine school-entry requirements, supporting the need for a statewide HPV mandate in Pennsylvania.
Duodenoscope combined with laparoscopy in treatment of biliary stones for a patient with situs inversus totalis
Authors: Hu Liangshuo , Chai Yichao , Yang Xue , Wu Zheng , Sun Hao , Wang Zheng
Published: February 2019

Rationale:

Although endoscopic and laparoscopic techniques in situs inversus totalis (SIT) have been reported respectively, endo-laparoscopic combination therapy due to biliary lithiasis remains infrequent. We shared the experience regarding the operations with a video report and discussed the similarities and differences with the usual procedures, which proved to be challenging to some extent for SIT.

Patient concerns:

Herein we present a 72-year-old man with SIT who underwent endo-laparscopic combination therapy due to choledocholithiasis and gallbladder stone.

Diagnosis:

Choledocholithiasis; Gallbladder stone; SIT

Interventions:

The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) first. He was placed in the left lateral decubitus position with basal anesthesia. As a result of the anatomical abnormality, the endoscope was rotated 180° in the 2nd portion of the duodenum. The ampulla was identified with difficulty because of a giant duodenal diverticulum nearby. After double-wire-guided cannulation, cholangiogram demonstrated filling defects and sphincterotomy was performed. This was followed by balloon ampulla dilation, sludge sweepage and nasobiliary drainage. The patient underwent standard laparoscopic cholecystectomy (LC) the next day.

Outcomes:

No complications such as bleeding, pancreatitis, perforation (after ERCP) or bile leakage (after LC) was detected. The patient was discharged after 4 days and recovered well after 3 months follow-up.

Lessons:

We found that patients were not required to make changes in position; the medical staff should adapt to mirror symmetrical anatomy and operate carefully. The surgical outcomes were not affected despite the extended operation time. In addition, operators can amend usual operating habits with modified techniques for patients with SIT.
Recovery of an injured corticospinal tract via an unusual pathway in a stroke patient
Authors: Jang Sung Ho , Chang Chul Hoon , Jung Young Jin , Seo You Sung
Published: February 2019

Rationale:

A few mechanisms of recovery from an injured corticospinal tract (CST) in stroke patients have been reported: recovery of an injured CST through (1) normal CST pathway, (2) peri-lesional reorganization, and (3) shifting of the cortical origin area of an injured CST from the other areas to the primary motor cortex. However, it has not been clearly elucidated so far.

Patient concerns:

A 57-year-old male patient presented with complete weakness of the right extremities due to an intracerebral hemorrhage (ICH) in the left basal ganglia. At three weeks after onset, the patient showed severe weakness of his right upper and lower extremities (Motricity Index [MI]: 28/100, finger extensor: 0/5). At 6 months after onset, his weakness showed some recovery, however, right finger extensor did not show any recovery (MI: 51/100, finger extensor: 0/5). At 9 months after onset, weakness showed significant recovery, particularly right finger extensor (MI: 64/100, right finger extensor: 3/5) and similar motor function persisted until 11 months after onset (MI: 67/100, right finger extensor: 3/5).

Diagnoses:

The patient was diagnosed as the right hemiplegia due to ICH in the left corona radiata and basal ganglia.

Interventions:

Clinical assessment, transcranial magnetic stimulation (TMS), and diffusion tensor tractography (DTT) were performed at 1, 6, 9, and 11 months after onset.

Outcomes:

Discontinuation of the left CST at the midbrain level was observed on 1-month DTT and the corona radiata on 6-month DTT. However, on 9-month DTT, we observed a CST branch originating from the left posterior parietal cortex and then connecting to the main truck to the CST at the thalamic level and thickened on 11-month DTT. On 1-month TMS, no MEP was evoked from the left hemisphere; on 6-month TMS study, MEPs were obtained at a right hand muscle (latency: 22.8 ms, amplitude: 130 μV) and its amplitude was increased as 300 μV with similar latencies on 9- and 11-month TMS studies.

Lessons:

Recovery of an injured CST via an unusual pathway was demonstrated in a hemiparetic patient with ICH, using DTT and TMS. We believe that our results suggest that precise evaluation for an injured CST using TMS and DTT might be necessary, particularly in young patients, even after 6 months from onset even though the stroke patients show clinical characteristics of severe injury of the affected CST.
Implementing a perioperative efficiency initiative for orthopedic surgery instrumentation at an academic center
Authors: Capra Richard , Bini Stefano A. , Bowden Dawn E. , Etter Katherine , Callahan Matt , Smith Richard T. , Vail Thomas Parker
Published: February 2019

Optimizing surgical instrumentation may contribute to value-based care, particularly in commonly performed procedures. We report our experience in implementing a perioperative efficiency program in 2 types of orthopedic surgery (primary total-knee arthroplasty, TKA, and total-hip arthroplasty, THA).

A comparative before-and-after study with 2 participating surgeons, each performing both THA and TKA, was conducted. Our objective was to evaluate the effect of surgical tray optimization on operating and processing time, cost, and waste associated with preparation, delivery, and staging of sterile surgical instruments. The study was designed as a prospective quality improvement initiative with pre- and postimplementation operational measures and a provider satisfaction survey.

A total of 96 procedures (38 preimplementation and 58 postimplementation) were assessed using time-stamped performance endpoints. The number and weight of trays and instruments processed were reduced substantially after the optimization intervention, particularly for TKA. Setup time was reduced by 23% (6 minutes, P = .01) for TKA procedures but did not differ for THA. The number of survey respondents was small, but satisfaction was high overall among personnel involved in implementation.

Optimizing instrumentation trays for orthopedic procedures yielded reduction in processing time and cost. Future research should evaluate patient outcomes and incremental/additive impact on institutional quality measures.
The effects of perioperative intravenous fluid administration strategy on renal outcomes in patients undergoing cardiovascular surgery
Authors: Lee Eun-Ho , Yun Sung-Cheol , Lim Ye-Ji , Jo Jun-Young , Choi Dae-Kee , Choi In-Cheol
Published: February 2019

We assessed whether perioperative fluid management with balanced solutions and a limited volume of hydroxyethyl starch (renal-protective fluid management [RPF] strategy) could improve renal outcomes after cardiovascular surgery.

For this retrospective observational study, we evaluated 2613 patients who underwent cardiovascular surgery from January 1, 2010 to December 31, 2013. The control group were given intravenous fluids with saline-based solutions and unlimited volumes of hydroxyethyl starch solutions and the RPF group were given intravenous fluids with RPF. The primary outcome was the incidence of acute kidney injury (AKI) and chronic dialysis within 12 months after cardiovascular surgery. Multivariable regression and propensity analyses were performed to evaluate the association between perioperative fluid management strategy and postoperative renal outcomes.

Postoperative AKI and chronic dialysis occurred in 213 (21.2%) and 5 (0.5%) patients in the RPF group compared with 696 (43.2%) and 38 (2.4%) patients in the control group, respectively. After adjustment, the RPF group was linked to a decreased risk of postoperative AKI, severe AKI, persistent AKI, use of renal replacement therapy, chronic kidney disease, chronic dialysis, and a shorter postoperative extubation time and intensive care unit, and hospital stay duration.

The perioperative fluid management strategy with balanced solutions and a limited volume of hydroxyethyl starch was related to improved acute and 1-year renal and clinical outcomes after cardiovascular surgery. These findings indicate the need for further definitive clinical trials on perioperative fluid management strategy.
High dose dual therapy versus bismuth quadruple therapy for Helicobacter pylori eradication treatment
Authors: Yang Xue , Wang Jin-Xia , Han Sheng-Xi , Gao Cai-Ping
Published: February 2019

Aim:

The aim of this study was to perform a systematic review and meta-analysis on high-dose dual therapy (HDDT) versus bismuth quadruple therapy (BQT) for Helicobacter pylori infection.

Methods:

Comparing HDDT to BQT were identified from PubMed, EMBASE, Cochrane library, CNKI, and Wanfang databases in Chinese up to March 2018. Statistical analyses were conducted using Review Manager 5.3 to compare the efficacy and side effects of these 2 therapies for H pylori infection. Dichotomous data were pooled to score the relative risk (RR) with 95% confidence intervals (CIs).

Results:

Four randomized clinical trials (RCTs) including 829 patients with a diagnosis of H pylori infection were assessed. Overall the meta-analysis showed that both HDDT and BQT achieved similar efficacy of intention-to-treat (ITT) eradication rate, 85.5% versus 87.2%, RR 1.01 (95% CI: 0.96–1.06), P = .63, and of per-protocol (PP) eradication rate, 88.4% versus 91.5%, RR 1.00 (95% CI: 0.96–1.04), P = .99, and adherence 97.8% versus 95.0%, RR 1.01 (95% CI: 0.99–1.04), P = .32, but side effects were more likely in BQT (14.4% vs 40.4%, RR 0.42 (95% CI: 0.32–0.54), P <.00001).

Conclusion:

Both HDDT and BQT can achieve similar eradication rate for H pylori infection and adherence, and generally HDDT causes fewer side effects.
A case report of application of posterior pharyngeal flap in resection and reconstruction of posterior pharyngeal wall carcinomas located at the level of the cricoid cartilage
Authors: Li Lianhe , Zou Liangyu , Fang Jugao
Published: February 2019

Rationale:

posterior pharyngeal wall carcinomas located at the level of the cricoid cartilage is a rare occurrence. Surgical treatment is a dilemma owing to the retention of laryngeal function

Patient concerns:

A 56-year-old man underwent a “resection of left cervical tumor” at another hospital. Postoperative pathological report noted a left metastatic squamous cell carcinoma of the neck. Neck-enhanced computed tomography (CT) revealed thickening of the right posterior pharyngeal wall, and an image of soft tissue density was present on the posterior pharyngeal wall with a size of approximately 1.0 × 1.5 cm.

Diagnosis:

Hypopharyngeal carcinoma (T1N2M0).

Interventions:

We performed operation on a patient who suffered from posterior pharyngeal wall carcinomas at the level of the cricoid cartilage. The postoperative defects were repaired with posterior pharyngeal flaps.

Outcomes:

The patient with posterior pharyngeal flap after operation survived without necrosis, the neck wounds of patient healed in 1 stage, and the phonation, swallowing and respiratory function was good.

Lessons:

The application of posterior pharyngeal flap to repair defects due to posterior pharyngeal wall carcinomas that were located at the level of the cricoid cartilage after resection is an effective reconstruction method that is easy to use and has excellent repair effects.
Proton pump inhibitor use and risk of dementia
Authors: Li Min , Luo Zheng , Yu Sisi , Tang Zhenyu
Published: February 2019

Background:

Proton pump inhibitors (PPIs) are an established kind of drugs used to the treatment of most acid-related diseases. Some prospective studies have noticed that PPI use was associated with increased dementia risk. However, the results of those studies were inconsistent and controversial. This meta-analysis aims to determine the association of PPI use and risk of dementia among older people.

Methods:

Relevant articles were systematically identified by searching the PubMed, EMBASE, and Cochrane Library databases from inception to February 2018. Cohort studies that reported the risk of dementia or Alzheimer's disease (AD) among PPI users compared with non-PPI users were included. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS). The publication bias was detected by a funnel plot and Egger test. The meta-analysis will abstract risk estimates including relative risks (RRs), hazard ratios (HRs), and odds ratios (ORs) with a 95% confidence interval (CI) for the associations between PPI use and dementia or Alzheimer's risk. Study-specific results were pooled using a random-effects model.

Results:

Six cohort studies were selected finally. The pooled RRs of dementia and AD were 1.23 (95% CI: 0.90–1.67) and 1.01 (95% CI: 0.78–1.32), respectively, compared with those of non-PPI use. The Egger test and funnel plot showed no existence of publication bias. Overall, there was no statistically significant association between PPI use and risk of dementia or AD (P >.05).

Conclusions:

This meta-analysis suggests that there was no statistical association between PPIs use and increased risk of dementia or AD.
The association between human papillomavirus infection and head and neck cancer
Authors: Tsai Stella Chin-Shaw , Huang Jing-Yang , Lin Chuck , Liaw Yung-Po , Lin Frank Cheau-Feng
Published: February 2019

Human papillomavirus (HPV) has been linked with development of oropharyngeal squamous cell carcinoma, a subset of head and neck cancer (HNC). This study aimed to evaluate the association between HPV infection and subsequent development of HNC and to report epidemiological information in Taiwan.

This population-based cohort study retrieved patient data from the longitudinal health insurance database (LHID) of Taiwan's National Health Insurance Research Database (NHIRD) from 2005 to 2010 and analyzed it retrospectively. The crude incidence rate and incidence rate ratios with 95% confidence intervals of HNC were estimated in patients with and without HPV infection. A time-to-event analysis was conducted and multiple regression analysis was performed to identify factors associated with HNC in HPV-infected patients, including age at baseline, sex, and comorbidities.

This study included the data of 25,520 HPV-infected and 1,061,817 noninfected patients. The HPV-infected group had a significantly higher proportion of females than the noninfected group (55.80% vs 50.66%, respectively; P < .0001). The incidence rate of HNC was 11.49 (males) and 5.83 (females) per 105 person-months versus 11.38 (males) and 3.90 (females) per 105 person-months in the infected and noninfected groups, respectively. HPV was significantly associated with cancer in females (hazard ratio = 1.520, 95% confidence interval 1.166–1.981), but not in males (hazard ratio = 1.000, 95% confidence interval 0.815–1.228). No significant differences were found in age between the HPV-infected and noninfected patients (49.20 ± 14.34 years vs 49.09 ± 13.82 years, respectively); and a slightly higher percentage of HPV-infected patients had a specific comorbidity than did noninfected patients 12.54% versus 9.43%, ischemic heart disease 14.22% versus 10.51%, hypertension 22.40% versus 19.54%, liver disease 22.88% versus 16.17%, and renal disease 7.14% versus 5.39%, respectively.

Results of this study may help clinicians in the diagnosis, prognosis, and treatment of head and neck cancer.
Effects of aging and menopause on pancreatic fat fraction in healthy women population
Authors: Yang Wenjuan , Xie Yi , Song Bin , Xia Chunchao , Tang Chengwei , Li Jing
Published: February 2019

Pancreatic fat fraction has been shown to increase in many pathological situations. However, pancreatic fat fraction and its physiological changes in healthy women are still unclear. The aim of this study is to investigate the effect of aging and menopause on pancreatic fat fraction in healthy female population.

This was a cross-sectional study. A phantom of fat–water mixtures was established. One hundred sixty-seven healthy women (20–70 years) were recruited. Fat fraction was quantified with double-echo chemical shift magnetic resonance imaging with T1 and T2∗ correction. The association between measured and actual fat fractions was determined with Pearson correlation. Linear regression analysis was used to establish the calibration curve. Fat fractions were analyzed via analysis of variance.

A significant positive linear correlation was revealed between the measured and actual fat fractions on the phantom (r
2 = 0.991, P < .001). There was no significant difference in fat fractions among caput, corpus, and cauda of the pancreas. Pancreatic fat fraction remained constant during the age of 20 to 40 years (4.41 ± 0.79%) but significantly increased during the ages of 41 to 50 and 51 to 70 years (7.49 ± 1.10% and 9.43 ± 1.51%, respectively, P < .001). Moreover, pancreatic fat fractions of the healthy women aged 41 to 70 years were still significantly higher than these in the groups aged 20 to 40 years when postmenopausal healthy women were removed (P < .001). For volunteers aged 46 to 49 years, pancreatic fat fraction of the postmenopausal women was significantly increased compared with that of their premenopausal counterparts (P < .001).

We found that an even distribution of pancreatic fat in healthy women, aging and menopause as 2 independent risk factors for pancreatic steatosis, a fatty infiltration in the pancreas beginning in the fifth decade in women.
Head trauma complicated with primary cranial vault lymphoma
Authors: Huang Jie , Tang Dong , Xu Yan , Wang Xuna , Yu Chuanwen , Dong Yang
Published: February 2019

Rationale:

Primary cranial vault lymphoma (PCVL) is an extremely rare extranodal lymphoma in the skull. This case study investigates the clinical features, so as to improve the understanding of the diagnosis and therapy.

Patient concerns:

A 31-year-old male presented painful scalp mass at the site of 1-month-old head trauma.

Diagnosis:

The final diagnosis was plasma cell lymphoma, which is a rare subtype of diffuse large B-cell lymphoma based on biopsy and immunohistochemistry findings.

Interventions:

The patient received total tumor resection in combination with chemotherapy

Outcomes:

The patient survived without signs of systemic dissemination for 12 months after surgery at the time of last follow-up.

Lessons:

Trauma may be one of the factors that induce PCVL. The final diagnosis of PCVL depends on pathology and immunohistochemistry findings. A combined treatment of surgery, chemotherapy, and radiotherapy can achieve favorable outcomes.
Aggravation of atrial arrhythmia by amiodarone during the perinatal period
Authors: Ye Fanhao , Jiang Wenbing , Wang Yi , Lin Wei , Chen Hao , Pan Binglin
Published: February 2019

Rationale:

Amiodarone, a broad-spectrum antiarrhythmic drug, is widely used for the clinical treatment of tachyarrhythmias because of its safety and efficacy.

Patient concerns:

A 30-year-old woman presented with known paroxysmal atrial tachycardia and severe preeclampsia. Two days before admission, she had given birth to twins. She described her symptoms as a sudden palpitation at 10:20 accompanied by chest tightness and shortness of breath. Diagnosis: Cardiac arrhythmia and acute left heart failure.

Interventions:

Furosemide and sodium nitroprusside were administered to control the heart failure. At 16:20, 150 mg amiodarone (15 mg/min) was injected intravenously and continued at 1 mg/min. At 16:50, her electrocardiogram showed possible atrial tachycardia or atrial flutter with a ventricular rate of 206 beats/min. Administration of amiodarone was stopped at 17:23, and the medication was changed to esmolol.

Outcomes:

After 3 minutes, the palpitations stopped, the heart rate changed to a sinus rhythm, and the ventricular rate was 100 beats/min. Four days later, the patient underwent an electrophysiologic study and radiofrequency ablation.

Lessons:

When amiodarone is used to treat atrial arrhythmia, the ventricular rate may accelerate, which can cause patients with borderline heart failure to develop acute heart failure or further deterioration of acute heart failure. For heart failure induced or mediated by atrial arrhythmias, short-term β-blockers may be used to control the ventricular rate more quickly and effectively and to prevent the progression of heart failure.
The correlation between oxidative stress level and intra-abdominal fat in obese males
Authors: Jia Xiao-Jiao , Liu Lan-Xiang , Tian Yi-Ming , Wang Rui , Lu Qiang
Published: February 2019

This study aims to investigate the correlation between oxidative stress and intra-abdominal fat (IAF) in obese young and middle-aged males.

The present study included 136 male examinees in the Examination Center of the First Hospital of Qinhuangdao from October 10, 2015 to December 10, 2015. Then, clinical data, oxidative stress indices (8-iso-prostaglandin F2α [8-iso-PGF2α], malondialdehyde [MDA], and superoxide dismutase [SOD]), and IAF area were recorded. All subjects were assigned into 3 groups according to body mass index (BMI): obese group (BMI ≥ 28 kg/m2, 43 subjects), overweight group (24 ≤ BMI < 28 kg/m2, 46 subjects), and control group (BMI < 24 kg/m2, 47 subjects). Then, statistical analysis was performed.

There were significant differences in IAF area, leptin, adiponectin, 8-iso-PGF2α, MDA, SOD, fasting insulin (FINS), fasting blood glucose (FBG), and homeostasis model assessment-insulin resistance (HOMA-IR) among these 3 groups (P < .05). Male subjects in the obese group had higher leptin, 8-iso-PGF2α, MDA, FINS, and HOMA-IR levels, compared to subjects in the overweight and control groups. Furthermore, subjects in the overweight group had a larger IAF area and higher 8-iso-PGF2α, MDA, and FBG levels, when compared to controls. In addition, SOD was significantly lower in the obese and overweight groups than in the control group. However, there were no statistical differences in age, systolic and diastolic blood pressure, lipids, and islet β-cell secretion function (homeostasis model assessment-β) among these 3 groups (P ≥ .05). Moreover, the IAF area was positively correlated to 8-iso-PGF2α and MDA, and negatively correlated to SOD.

Oxidative stress is significantly associated with the IAF area in obese males, and abdominal obesity could increase oxidative stress level and insulin resistance.
A case report and review of literature of Dieulafoy's disease of bronchus
Authors: Zhou Pengcheng , Yu Wei , Chen Kelin , Li Xuelian , Xia Qianming
Published: February 2019

Rationale:

Dieulafoy's lesions are characterized by the presence of a dysplastic artery in the submucosa, most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive or fatal hemoptysis

Patient concerns:

The patient was a 62-year-old male farmer with intermittent hemoptysis of approximately 2 years duration and a definite diagnosis could not be established.

Diagnosis:

A thorax-computed tomography at our hospital revealed that the bronchus of left lower lobe was narrowed with associated local atelectasis, and lung cancer was suspected. A bronchoscopy showed a slit-like stenosis of the left lower lobe, swollen and smooth mucosa, and a significantly wider subsection carina.

Interventions:

A fatal hemorrhage occurred during biopsy and, rescue and resuscitation measures were immediately taken. A double-lumen endotracheal intubation was implanted and single-lung ventilation was started to maintain oxygenation. Hemoptysis completely stopped after bronchial artery embolization.

Outcomes:

The patient eventually died of disseminative intravascular coagulation and multiple organ failure. Bronchial arteriography and subsequent autopsy confirmed Dieulafoy's disease of the bronchus.

Lessons:

In cases with recurrent unexplained hemoptysis, where CT chest or thoracic radiography show no abnormalities, pulmonologist should suspect a bronchial Dieulafoy's disease and avoid blindly performing bronchoscopy guided biopsy, which may result in fatal hemoptysis.
A systematic review and network meta-analysis protocol of adjuvant chemotherapy regimens for resected gastric cancer
Authors: Ge Long , Hou Liangying , Yang Qingxia , Wu Yiting , Shi Xiue , Li Jiang , Yang Kehu
Published: February 2019

Background:

Gastric cancer is the third leading cause of cancer death in the world. The benefit of adjuvant chemotherapy has been demonstrated by published individual patient data meta-analysis and Cochrane systematic review. However, there is no consensus on which is the optimal adjuvant chemotherapy regimens. Present network meta-analysis aims to compare the differences of effect between all available adjuvant chemotherapy regimens in improving overall survival and disease-free survival, and to rate the certainty of evidence from present network meta-analysis.

Methods:

We will conduct this systematic review and network meta-analysis using Bayesian method and according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. We will search PubMed, EMBASE.com, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese National Knowledge Infrastructure (CNKI), and Chinese Biological Medical Database (CBM), and ClinicalTrials.gov (http://clinicaltrials.gov/) to identify randomized controlled trials (RCTs) comparing adjuvant chemotherapy to surgery alone. We will assess the risk of bias of individual RCTs using a modified version of Cochrane tool. We will also use the advance of GRADE to rate the certainty of network meta-analysis. Data analysis will be performed with R-3.4.1 and WinBUGS software.

Results:

The results of this study will be published in a peer-reviewed journal.

Discussion:

To the best of our knowledge, this systematic review and network meta-analysis will firstly use both direct and indirect evidence to compare the differences of all available adjuvant chemotherapy regimens for resected gastric cancer patients. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.
The disparities of healthcare access for adults with autism spectrum disorder
Authors: Calleja Shenae , Islam Fakir M. Amirul , Kingsley Jonathan , McDonald Rachael
Published: February 2019

Introduction:

Adults living with autism spectrum disorder (ASD) can experience many factors that may impact their everyday lives. Striving for optimal health and enduring a healthy lifestyle comes with the ability to access appropriate healthcare services, yet adults with ASD have unmet healthcare needs. The barriers and enablers of healthcare access for adults with ASD remain unclear. We will conduct a systematic review to explore what is currently known about healthcare access for adults with ASD, this will determine the level and appropriateness of access to healthcare services to better support the lives of adults with ASD.

Method and analysis:

The systematic review will report on all studies that include quantitative, qualitative, and mixed-methods designs that consider healthcare access for adults with ASD. We will search 5 databases: EBSCOhost, Scopus, PubMed, the Cochrane Library, and Web of Science. The Mixed Methods Appraisal Tool (MMAT) will be used to assess quality of articles and the Cochrane RoB 2.0 Tool will be used to assess for bias. Clarifying the evidence in this area will be important for future research directions when developing and piloting health interventions for researchers and healthcare clinicians in the field.

Ethics and dissemination:

There are no human participants, data, or tissue being directly studied for the purposes of the review; therefore, ethics approval and consent to participate is not applicable.

Registration and Status:

PROSPERO 2018 CRD42018116093.
Impact of a home health care program for disabled patients in Taiwan
Authors: Lee Yi-Hsuan , Lu Chia-Wen , Huang Chi-Ting , Chang Hao-Hsiang , Yang Kuen-Cheh , Kuo Chia-Sheng , Chang Yu-Kang , Hsu Chih-Cheng , Huang Kuo-Chin
Published: February 2019

The aim of this study was to evaluate the impact of home health care (HHC) for disabled patients.

We conducted a nationwide population-based retrospective cohort study. A total of 5838 disabled patients with HHC were identified to match by propensity score with 15,829 disabled patients without HHC receiving tube or catheter care (tracheostomy tube, nasogastric tube, urinary catheter, cystostomy tube, nephrostomy tube) or stage 3 or 4 pressure sore care from the Taiwanese National Health Insurance Research Database between 2005 and 2009. After 1:1 matching, 2901 subjects in the HHC group and 2901 subjects in the non-HHC group were selected and analyzed. Generalized estimating equations (GEEs) were used to compare the risk of health outcomes (rate of hospitalization and emergency services use) and the healthcare expenditure between the 2 groups.

Compared to those in the non-HHC group, the patients in the HHC group had significantly higher risk for hospitalization (odds ratio [OR] = 18.43, 95% confidence interval [CI]: 15.62–21.75, P < .001) and emergency services use (OR = 3.72, 95% CI: 3.32–4.17, P < .001) 1 year before the index date. However, 1 year after the index date, the risk for hospitalization (OR = 1.6, 95% CI: 1.41–1.83, P < .001) and emergency services use (OR = 1.16, 95% CI: 1.04–1.30, P < .05) attenuated significantly. Regarding the comparison of total healthcare expenditure 1 year before and after the index date, our study showed an insignificant decrease of US$1.5 per person per day and a significant increase of US$5.2 per person per day (P < .001) in the HHC and non-HHC groups, respectively.

The HHC for disabled patients has a potential role to reduce hospitalization and emergency services use. Besides, the improvement of healthcare quality through HHC was not accompanied by increased healthcare expenditure. The clinical impact of HHC emphasizes the importance for public health officials to promote HHC model to meet the needs of disabled patients.
Clinical efficacy and safety of thread-embedding acupuncture for treatment of the sequelae of Bell's palsy
Authors: Goo Bonhyuk , Jeong Seong-Mok , Kim Jong-Uk , Park Yeon-Cheol , Seo Byung-Kwan , Baek Yong-Hyeon , Yook Tae-Han , Nam Sang-Soo
Published: February 2019

Background:

The sequelae of Bell's palsy cause critical problem in facial appearance, as well as social and psychological problems in the patient's life. The aim of the present study is to establish clinical evidence of thread-embedding acupuncture (TEA) in the treatment of sequelae of Bell's palsy.

Method/Design:

This is a patient-assessor blinded, randomized, sham-controlled trial with two parallel arms. Fifty-six patients aged 19–65 years, who have experienced sequelae of Bell's palsy for >3 months, will be recruited and screened using the eligibility criteria. After screening, they will be randomly allocated to a TEA group or a sham TEA (STEA) group. Both groups will receive TEA or STEA treatment on ten predefined acupoints once a week for 8 weeks. Additionally, both groups will receive the same acupuncture treatment twice a week for 8 weeks as a concurrent treatment. Changes in the Facial Disability Index over 8 weeks will be assessed as the primary outcome. Furthermore, the House-Brackmann Grade, Facial Nerve Grading System 2.0, Sunnybrook Facial Grading System, facial stiffness score, lip mobility score, and treatment satisfaction score will be measured and analyzed as secondary outcomes. All outcomes will be assessed at baseline and at 4 and 8 weeks after screening.

Discussion:

The results from this trial will help establish clinical evidence regarding the efficacy and safety of TEA in the treatment of patients with sequelae of Bell's palsy.

Trial registration number:

KCT0002557 (Clinical Research Information Service of the Republic of Korea).
Spontaneous regression of cervical discs
Authors: Turk Okan , Yaldiz Can
Published: February 2019

Cervical disc herniation is a condition which arises from compression of cervical spinal nerve root by the degenerated disc and vast majority of the patients are aged between 30 and 40 years. Spontaneous regression of cervical disc was first reported by Kriegerand Maniker in 1992. Our study is the second large series in literature. Besides, 4 patients are the first who were shown to have resorption in C 4-5.

The records of patients diagnosed with cervical disc herniation who applied to the Spine Polyclinic between 2014 and 2018 were reviewed retrospectively. The files of the patients who were recommended surgery with the diagnosis of cervical disc herniation were examined. Patients who did not accept surgery on their own initiative, but who attended our outpatient clinic for a check-up were included in the study.

Of a total of 14 patients, 28.57% (n = 4) were male and 71.43% (n = 10) were female. Mean age of the patients was 40.79 (range 25–60).

The results of the study indicate that likelihood of spontaneous regression is higher in para-central or foraminal disc compared to central disc hernias. Although there are a limited number of case reports in the literature, conservative treatment seems to be a good option in patients without neurological deficits, with foraminal disc hernias and not requiring emergency surgery.
Efficacy of tolvaptan for chronic heart failure
Authors: Gao Wei-qin , Meng Xiang-dong , Sun Ze
Published: February 2019

Background:

The protocol of this study will be proposed for systematic evaluation of the efficacy and safety of tolvaptan in the treatment of chronic heart failure (CHF).

Methods:

We will retrieve the following electronic databases for randomized controlled trials assessing the efficacy of tolvaptan in patients with CHF: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data. Each database will be retrieved from inception to February 1, 2019 without any limitations. The entire process of study selection, data extraction, and methodological quality evaluation will be conducted by 2 independent authors.

Results:

The protocol of this proposed study will compare the efficacy and safety of tolvaptan in the treatment of patients with CHF. The outcomes will include all-cause mortality, change in body weight, urine output, change in serum sodium; and incidence of all adverse events.

Conclusion:

The findings of this proposed study will summarize the current evidence of tolvaptan for CHF.

Ethics and dissemination:

All data used in this systematic review will be collected from the previous published trials. Thus, no research ethics approval is needed for this study. The findings of this study will be published at a peer-reviewed journal.

PROSPERO registration number:

PROSPERO CRD42019120818.
A novel computer navigation method for accurate percutaneous sacroiliac screw implantation
Authors: Yu Tong , Zheng Shuang , Zhang Xiwen , Wang Dongsheng , Kang Mingyang , Dong Rongpeng , Qu Yang , Zhao Jianwu
Published: February 2019

The purpose of this study was to assess the accuracy of percutaneous sacroiliac screw (PSS) placement assisted by screw view model of navigation system for treatment of sacroiliac fractures.

Data pertaining to 18 consecutive patients with posterior pelvic ring fracture who received sacroiliac screw fixation between January 2015 and July 2018 at the Second Hospital of Jilin University were retrospectively analyzed. Kirschner wires were placed under the guidance of navigation's screw view mode. The position of the screws was evaluated by computed tomography (CT) scan postoperatively. Fracture dislocation of sacroiliac joint was measured in axial, sagittal, and coronal views of 3 dimensional (3D) CT images preoperatively, postoperatively and at the last follow-up visit. The duration of trajectory planning, guide wire implantation time, screw placement time, intraoperative blood loss, and incidence of screw loosening and clinical complications were also assessed.

A total of 27 screws were placed unilaterally or bilaterally into segments S1 or S2. Screw placement was rated as excellent for 88.9% of screws (n = 24), good for 7.4% (n = 2), and poor for 3.7% (n = 1). Preoperatively, the average fracture dislocation of sacroiliac joint on axial, sagittal, and coronal views was 14.3 mm, 9.6 mm, and 7.4 mm, respectively, and the corresponding postoperative figures were 5.6 mm, 3.2 mm, 4.1 mm, respectively. The corresponding correction rates were 60.8%, 66.7%, and 44.6%, respectively. The mean duration of trajectory planning was 6.5 min (2.7–8.9 min). Mean screw implantation time was 32 min (range, 20–53 min), and the mean guide wire implantation time was 3.7 min (range, 2.1–5.3 min). No clinical complications such as neurovascular injury, infection or screw loosening were observed on follow-up.

The PSS placement under guidance of screw view model of navigation is a convenient, safe and reliable method.
Dual anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody-positive crescent glomerulonephritis in a patient with monoclonal gammopathy of undetermined significance
Authors: Li Xiaoli , Hao Yunfei , Xue Rong , Qi Xueting , Ma Zhigang
Published: February 2019

Rationale:

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and anti-glomerular basement membrane (GBM) antibody disease are both rare autoimmune diseases. Monoclonal gammopathy of undetermined significance (MGUS) is one of the most common causes of plasma cell dyscrasias (PCD). The three entities can cause renal lesions via different mechanisms and, however, they have not been reported in a single patient with renal lesion.

Patient concerns:

Here, we describe a patient with half-year fatigue and 40-day nausea and vomiting. Laboratory workup displayed increased serum creatinine, proteinuria, and mild microscopic hematuria. Serological tests were positive for anti-nuclear antibody (titer 1:100), anti-GBM antibodies (not quantified), and myeloperoxidase (MPO)-ANCA (228 RU/ml). Serum immunofixation electrophoresis found monoclonal immunoglobulin (MIg) G κ-light chain in the serum. Renal biopsy displayed crescentic formation in glomerule by microscopy and staining for liner IgG (+), sparse C3 (+-) and light chain (κ and λ) (+-) by immunofluorescence. The bone marrow examination indicated basically normal myelogram and sporadic plasma cells positive for CD38, CD138 staining, and κ light-chain restriction.

Diagnosis:

Crescentic glomerulonephritis and MGUS.

Interventions:

The patient was treated with plasmapheresis, pulse methylprednisolone therapy in combination with cyclophosphamide.

Outcomes:

The patient still became hemodialysis-dependent.

Lessons:

The present study discusses, to the best of our knowledge, first case of crescentic glomerulonephritis seropositive for ANCA anti-GBM antibody in MGUS. The rare concurrence highlights it as a clinical concern.
Pneumocystis jirovecii pneumonia as an initial manifestation of hyper-IgM syndrome in an infant
Authors: Kim Danbi , Shin Ju Ae , Han Seung Beom , Chung Nack-Gyun , Jeong Dae Chul
Published: February 2019

Rationale:

Pneumocystis jirovecii causes severe pneumonia in immunocompromised hosts. Human immunodeficiency virus infection, malignancy, solid organ or hematopoietic cell transplantation, and primary immune deficiency compose the risk factors for Pneumocystis pneumonia (PCP) in children, and PCP can be an initial clinical manifestation of primary immune deficiency.

Patient concerns:

A 5-month-old infant presented with cyanosis and tachypnea. He had no previous medical or birth history suggesting primary immune deficiency. He was diagnosed with interstitial pneumonia on admission.

Diagnoses:

He was diagnosed with PCP, and further evaluations revealed underlying X-linked hyper-IgM syndrome.

Interventions:

He was treated with trimethoprim/sulfamethoxazole for PCP, and eventually received allogeneic hematopoietic cell transplantation for hyper-IgM syndrome.

Outcomes:

Twenty months have passed after transplantation without severe complications.

Lessons:

PCP should be considered in infants presenting with severe interstitial pneumonia even in the absence of evidence of immune deficiency. Primary immune deficiency should also be suspected in infants diagnosed with PCP.
Properties of spoof plasmon in thin structures
Authors: Joy Soumitra Roy , Yu Hao , Mazumder Pinaki
Published: February 2019

Spoof surface plasmon polariton (SSPP) is an exotic electromagnetic state that confines light at a subwavelength scale at a design-specific frequency. It has been known for a while that spoof plasmon mode can exist in planar, thin structures with dispersion properties similar to that of its wide three-dimensional structure counterpart. We, however, have shown that spoof plasmons in thin structures possess some unique properties that remain unexplored. Our analysis reveals that the field interior to SSPP waveguide can achieve an exceptional hyperbolic spatial dependence, which can explain why spoof plasma resonance incurs red-shift with the reduction of the waveguide thickness, whereas common wisdom suggests frequency blue-shift of a resonant structure with its size reduction. In addition, we show that strong confinement can be achieved over a wide band in thin spoof plasmon structure, ranging from the spoof plasma frequency up to a lower frequency considerably away from the resonant point. The nature of lateral confinement in thin SSPP structures may enable interesting applications involving fast modulation rate due to enhanced sensitivity of optical modes without compromising modal confinement.
The mathematics of asymptotic stability in the Kuramoto model
Authors: Dietert Helge , Fernandez Bastien
Published: February 2019

Now a standard in Nonlinear Sciences, the Kuramoto model is the perfect example of the transition to synchrony in heterogeneous systems of coupled oscillators. While its basic phenomenology has been sketched in early works, the corresponding rigorous validation has long remained problematic and was achieved only recently. This paper reviews the mathematical results on asymptotic stability of stationary solutions in the continuum limit of the Kuramoto model, and provides insights into the principal arguments of proofs. This review is complemented with additional original results, various examples, and possible extensions to some variations of the model in the literature.
Proposal of new combination, Cutibacterium acnes subsp. elongatum comb. nov., and emended descriptions of the genus Cutibacterium, Cutibacterium acnes subsp. acnes and Cutibacterium acnes subsp. defendens
Authors: Dekio Itaru , McDowell Andrew , Sakamoto Mitsuo , Tomida Shuta , Ohkuma Moriya
Published: February 2019

In 2016, division of the genus

Propionibacterium

into four distinct genera was proposed. As a consequence, the species

Propionibacterium acnes

was transferred to

Cutibacterium

gen. nov. as

Cutibacterium acnes

comb. nov. The three recently proposed subspecies of

P. acnes

were not, however, accommodated in this proposal. Following a very recent validation of a new combination for

C. acnes

subsp.

defendens

and an automatically created

C. acnes

subsp.

acnes

, we now propose the new combination,

C. acnes

subsp. elongatum comb. nov. The type strain of

Cutibacterium acnes

subsp. elongatum is JCM 18919T (=NCTC 13655T). On the basis of further genomic and phenotypic (haemolysis and MALDI-TOF mass spectrometry) analyses of these subspecies, we also provide emended descriptions of the genus

Cutibacterium

Scholz and Kilian 2016,

C. acnes

subsp.

acnes

(Gilchrist 1900) Nouioui et al. 2018, and

C. acnes

subsp.

defendens

(McDowell et al. 2016) Nouioui et al. 2018.
The quality characteristics of aronia by cultivation region
Authors: Jeon Jin-Ah , Choi Jeong-Sil , Jung Eui-Hyoun , Kim Chan-Woo , Bae Eun-Jung , Jeong Seok-Tae
Published: February 2019

The aim of the present study was to investigate the quality characteristics of the aronia cultivar ‘Viking’ as affected by cultivation region. Aronia cultivated in 5 different regions (Danyang, Geochang, Gangjin, Gochang, and Ganghwa) was collected. pH, total acid, soluble solid, redness, total anthocyanin, total polyphenol, tannin, and organic acids were analyzed. Correlation analysis was also performed to determine the relationship between the quality characteristics of aronia and meteorological factors in each cultivation region. All variable assessed differed significantly among samples. pH ranged between 3.86-4.06. The highest pH was recorded in aronia cultivated in Gochang. Aronia grown in Ganghwa had the highest total acid, soluble solid, and total anthocyanin content and the highest redness. Malic acid, tartaric acid, and citric acid were detected in all aronia samples, with malic acid being the predominant organic acid in the aronia cultivars. Correlation analysis revealed pH and soluble solid content to have significant positive correlations with sunshine duration. However, redness showed a significant negative correlation with precipitation. Therefore, it can be confirmed that cultivation region play an important role in determining the quality characteristics of aronia ‘Viking’ from the results of this study.