bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovation in Large-Scale Research Programs: Elevating Research Participants to Governance Roles Through the All of Us Research Program Engagement Core
Authors: Fair Alecia , Watson Karriem S. , Cohn Elizabeth G. , Carpenter Selena M. , Richardson-Heron Dara , Wilkins Consuelo H.
Published: November 2022

Problem

Despite the successes of community-engaged research in advancing research relevance and health equity for diverse communities, the impact of this research has been limited to local and regional programs. Engaging diverse community voices in large-scale, national research programs represents a paradigm shift in biomedical research. Still, disconnects remain between research decision makers and the communities they serve, impeding richer, bidirectional engagement.

Approach

An engagement core team was established within National Institutes of Health All of Us Research Program (AoURP) in 2018 to synthesize community-engaged research practices and establish infrastructure that operationalizes diverse research participant engagement. The authors integrated research participants as “participant partners” within the AoURP governance, an approach that is embedded into the engagement core’s 3 aims: (1) integrate a diverse pool of participants into the program, (2) identify and meaningfully engage a cadre of diverse participants into program governance, and (3) assess the impact of such engagement on research. Participant partners are compensated as consultants at approximately $50/hour.

Outcomes

As of August 2022, more than 515,000 individuals consented to participate in the AoURP, with more than 49% representing racial/ethnic minorities. The authors invited participants to self-nominate if interested in engaging in research working groups, decision making, and governance. Also, consortium partners nominated individuals on AoURP community advisory and/or participant advisory boards to serve as participant ambassadors. Ten individuals were selected as participant partners for the 2022–2025 term. Eight serve on the steering committee; of those, 4 serve on the executive committee; 2 more serve on the advisory panel. An additional 23 serve as participant ambassadors.

Next Steps

The authors continue to increase the number of research participants serving as engaged partners in the program. Engagement approaches will be systematically evaluated with the goal of adoption by other large-scale research programs.
Technical Nuances of Cervical Laminoplasty
Authors: Ambati Vardhaan S. , Morshed Ramin , Park Christine , Salha Diana M. , Chryssikos Timothy , Mummaneni Praveen V.
Published: November 2022

Study Design:

Operative video and supplemental manuscript.

Objective:

The technical nuances of open-door laminoplasty are described. Potential complications of open-door laminoplasty and strategies for their minimization are discussed.

Summary of Background Data:

Cervical laminoplasty may be indicated in patients with cervical myelopathy due to cervical stenosis in the setting of spondylosis, ossification of the posterior longitudinal ligament, congenital stenosis, and traumatic central cord syndrome.

Methods:

A video illustrates the nuances of the surgical technique for cervical laminoplasty.

Results:

Myelopathic patients with preserved lordotic sagittal profile, central stenosis involving several levels, and minimal to no axial neck pain are ideal candidates for laminoplasty.

Conclusions:

Cervical laminoplasty provides more stability compared with laminectomy alone and a better range of motion compared with laminectomy with posterior spinal fusion. Understanding the nuances of laminoplasty may help surgeons to avoid complications.
A Novel Macrophage-Activating Gel Improves Healing and Skin Quality After CO2 Laser Resurfacing of the Chest
Authors: Wu Douglas C , Kollipara Ramya , Carter Marissa J. , Goldman Mitchel P.
Published: November 2022

BACKGROUND

After laser resurfacing, it is imperative that an appropriate postoperative regimen is followed for optimal wound healing. There is currently no consensus about which agents should be used.

OBJECTIVE

To evaluate the safety and efficacy of a novel macrophage-activating gel in a Phase 2B trial to be used after fractionated ablative laser resurfacing of the chest.

MATERIALS AND METHODS

Forty-two adults who received fractionated CO2 laser resurfacing of the chest were randomized (active or placebo) for 5 consecutive days after procedure. Skin quality at baseline and follow-up was assessed by a blinded evaluator using the Fitzpatrick–Goldman Wrinkle Scale. Subject satisfaction with skin healing and quality was also assessed.

RESULTS

At 28 days according to the Fitzpatrick–Goldman Wrinkle Scale, 85% of subjects achieved an improvement of at least 33% for the active group versus 50% in the placebo group (absolute difference 35%; p = .04). Similarly, 75% of subjects achieved an improvement score of at least 33% in elastosis in the active group versus 35% in the placebo group at 28 days (40% absolute difference; p = .011).

CONCLUSION

This study confirms the potent effects of the novel macrophage-activating gel for optimization of skin healing and quality after laser resurfacing of the chest.
Quantification of Erythema Associated With Varying Suture Materials in Facial Surgery Repair: A Randomized Prospective Study
Authors: Majd Ali , Lim Catherine , Zloty David
Published: November 2022

BACKGROUND

A common concern among patients following Mohs micrographic surgery (MMS) is scar appearance and residual erythema. However, few studies have quantitatively compared scar erythema between different suture materials.

OBJECTIVE

To quantify erythema intensity (EI) associated with use of percutaneous nylon, irradiated polyglactin-910 (IPG) and fast-absorbing gut (FG) sutures on facial sites.

METHODS

After undergoing MMS, 210 patients were randomized to one of 2 groups. Patients in the first group (n = 105) had their defects repaired half with continuous IPG sutures and the other half with nylon sutures; the second group (n = 105) received IPG and FG sutures. Standardized photographs of scars were taken at 1 week, 2 months, and 6 months postoperatively and computer-assisted image analysis was used to quantify EI.

RESULTS

The average EI was comparable between all 3 suture materials at 1 week, 2 months, and 6 months. From 1 week to 2 months, EI in nylon, IPG, and FG sutures decreased by 24.8%, 12.8%, and 17.9% (p < .05), respectively. There was no statistically significant difference in EI among suture types between 2 and 6 months.

CONCLUSION

Erythema decreased significantly during early scar maturation in all groups and was comparable between all suture materials at 1 week, 2 months, and 6 months.
Dermatology Match Preference Signaling Tokens: Impact and Implications
Authors: Dirr McKenzie A. , Brownstone Nicholas , Zakria Danny , Rigel Darrell
Published: November 2022

BACKGROUND

The dermatology residency application process implemented a new system of preference signaling tokens (PSTs) in the 2021-2022 cycle to allow applicants to express a higher level of interest in specific programs. Limited data are available on the utilization and impact of these tokens.

OBJECTIVE

To determine the impact of PSTs on the application process and where in the process PSTs had the greatest influence.

MATERIALS AND METHODS

A 14-question survey was sent to 62 ACGME-accredited dermatology residency programs. Primary outcomes were PST impact on 2021-2022 applications. Variables were evaluated using open-ended questions, yes/no responses, and importance ratings from 0 to 100.

RESULTS

An average of 7.1% of applicants were offered interviews, but 21.1% of applicants that submitted PSTs were interviewed versus 3.7% of nonsubmitters. 22.5% of ranked applicants and 19% of matched applicants submitted a PST to that program.

Limitations

Not all programs responded, and PST submission restrictions could not be assessed.

CONCLUSION

The greatest PST impact was on the interview decision but had minimal subsequent impact. Given PSTs cannot be submitted to home programs or in-person away rotations, the actual impact was probably greater than found. Programs will continue to implement PSTs in future cycles.
LncRNA TUG1 Exacerbates Myocardial Fibrosis in Diabetic Cardiomyopathy by Modulating the microRNA-145a-5p/Cfl2 Axis
Authors: Wang KunWei , Lin Yingnan , Shen Honghui , Yu Shushu , Xu Jiahong
Published: November 2022

Nowadays, there is limited prevention and treatment for myocardial fibrosis in diabetic cardiomyopathy (DCM). Our study aimed to depict the mechanism of the lncRNA TUG1/miR-145a-5p/Cfl2 axis in DCM and to provide a molecular basis for the study of this disease. Male C57BL/6J mice were intraperitoneally injected with streptozotocin to establish DCM mouse models. The expression levels of lncRNA TUG1, miR-145a-5p, and Cfl2 in myocardial tissues of mice were tested by RT-qPCR or Western blot. Cardiac function was assessed by echocardiography. The contents of Ang-II, TNF-α, and IL-1β were measured using ELISA. The histopathological observation was performed by HE staining and Masson staining. The expression levels of myocardial fibrosis–related genes COL1A1, MMP2, and FN1 were determined by RT-qPCR. In addition, bioinformatics website, RIP assay, pull-down assay, and luciferase activity assay were conducted to verify the relationships of lncRNA TUG1, miR-145a-5p, and Cfl2. In the DCM mouse model, lncRNA TUG1 and Cfl2 expression levels were upregulated and miR-145a-5p expression was downregulated. Downregulation of lncRNA TUG1 improved cardiac function and myocardial fibrosis; decreased COL1A1, MMP2, and FN1 expression levels; as well as TNF-α, IL-1β, and Ang-II contents in myocardial tissues of DCM mice. Upregulation of miR-145a-5p showed the same trend as downregulation of lncRNA TUG1. In addition, upregulating miR-145a-5p reversed the promotion roles of lncRNA TUG1 on myocardial fibrosis in DCM mice, and upregulating Cfl2 compromised the improvement effect of downregulated lncRNA TUG1 on myocardial fibrosis in DCM mice. Mechanistically, there was a binding site between lncRNA TUG1 and miR-145a-5p, and miR-145a-5p had a targeting relationship with Cfl2. This study highlights that lncRNA TUG1 sponges miR-145a-5p to aggravate myocardial fibrosis in DCM mice by promoting Cfl2.
Implant Attributes or Patient Characteristics? Factors Affecting Outcome after Breast Augmentation in Transgender Women
Authors: Kamali Alexander , Sackey Helena , Gran Isak , Sigurjónsson Hannes , Farnebo Filip , Lundgren Kalle , Granath Fredrik , Sommar Pehr
Published: November 2022

Background:

Implant-based breast augmentation is a valuable tool for treatment of gender dysphoria in transgender women. The aim was to assess whether implant attributes, plane selection, and patient characteristics had an impact on the surgical outcome, and to compare these parameters between transgender and cisgender breast augmentations.

Methods:

A cohort of transgender women who underwent breast augmentation at our department during 2009–2018 were retrospectively studied. The cohort was also compared with a cohort of 12,884 mainly cisgender women registered in the Swedish breast implant registry (BRIMP) during 2014–2019.

Results:

A total of 143 transgender individuals were included, with a median follow-up of 5.7 years. Complications occurred in 20 patients (14.0%), four patients (2.8%) underwent acute reoperation, and 20 patients (14.0%) had secondary corrections. No differences were seen in complication rates when comparing prepectoral with subpectoral placement (15.1% versus 12.9%; P = 0.81); size, less than 400 mL versus greater than or equal to 400 mL (14.7% versus 13.3%; P = 0.81), or the shape of the implants, round versus anatomic (10.7% versus 22.2%; P = 0.10). In comparison with the cohort from BRIMP, the transgender cohort had more round implants (72.0% versus 60.7%; P < 0.01), larger implants (44.1% had volumes of 400–599 mL, compared with 25.4%; P < 0.0001), and more prepectoral placement (51.0% versus 7.3%; P < 0.0001). The risk of reoperation less than 30 days was 1.2% in BRIMP and 2.8% in the transgender cohort (P = 0.08).

Conclusions:

In transgender women, implants are often larger, round, and placed prepectoral‚ compared with cisgender women. Despite these differences, complication rates were equivalent. Implant attributes, surgical techniques, and patient characteristics were not independently associated with the rate of complications
Corneal endothelium protection provided by ophthalmic viscosurgical devices during phacoemulsification: experimental study in rabbit eyes
Authors: Park Sally S.E. , Wilkinson Samuel W. , Ungricht Emilie L. , Trapnell Michael , Nydegger Jacob , Brintz Ben J. , Mamalis Nick , Olson Randall J. , Werner Liliana
Published: November 2022

Purpose:

To compare the protection of the corneal endothelium provided by a cohesive and a dispersive ophthalmic viscosurgical device (OVD) against damage from torsional ultrasound and simulated lenticular debris during phacoemulsification.

Setting:

University setting, Salt Lake City, Utah.

Design:

Experimental study.

Methods:

15 New Zealand rabbits were included. After incision, each eye received cohesive or dispersive OVD (ProVisc or Viscoat). 10 1.0 mm beads were injected to simulate lenticular debris. The Intrepid Balanced tip (Centurion Ozil handpiece) was inserted into the anterior chamber, and 60% torsional ultrasound with 50 mL/min flow, 70 mm Hg intraocular pressure, and 600 mm Hg vacuum was applied (20 seconds). Cumulative dissipated energy (CDE) was noted. After euthanasia and enucleation, corneas were removed, stained with trypan blue/alizarin red, and photographed (5 ×400 magnification photos and 1 overview photograph from each cornea). ImageJ was used to evaluate cell damage and loss.

Results:

CDE was 4.70 ± 0.26 and 4.64 ± 0.10 in the cohesive and dispersive OVD groups, respectively (P = .8647). The analysis of the ×400 photographs showed that the percentage of intact cells was statistically higher in the dispersive OVD group (P = .0002), whereas the percentages of damaged and lost cells were statistically higher in the cohesive OVD group (P = .0002 and .0059, respectively). Overview photographs revealed the presence of residual OVD on the endothelium, especially in the dispersive group.

Conclusions:

In this experimental study using a rabbit model, the corneal endothelium protection provided by the dispersive OVD was superior to that provided by the cohesive OVD.
Early LASIK flap displacement without signs of infection
Authors: Pinto Germana M.Q.V. , Sampaio Lycia P. , Santhiago Marcony R.
Published: November 2022

A 37-year-old woman was referred for refractive surgery evaluation. Poor visual quality in her left eye is her chief concern. The patient had undergone laser in situ keratomileusis (LASIK) in both eyes 3 days previously.

Detailed history revealed that the patient underwent surgery to correct low myopia and astigmatism (−2.50 −2.75 × 180 in the right eye and −1.25 −2.75 × 180 in the left eye). The preoperative evaluation corrected distance visual acuity (CDVA) was 20/20 in the right eye and 20/20 in the left eye. The surgery was performed with a mechanical microkeratome and was uneventful. The patient reports that after her vision improved on the first day, she woke up with blurry vision in her left eye on the second day and it remained that way until the third day when she sought medical help.

The slitlamp examination showed LASIK flap displacement without signs of infection (Figure 1

JOURNAL/jcrs/04.03/02158034-202212000-00023/figure1/v/2023-08-19T002644Z/r/image-tiff

). The patient was using topical corticosteroids and topical antibiotics every 6 hours. Considering the likely stromal exposure time, what would be the best approach for this case? Does the probable time of displacement of this flap change its behavior? In what way? If you decide to reposition the flap, would it be interesting to use fibrin glue or suture? Considering that there was no major trauma in the patient's report, what is the importance of the LASIK flap having been created by a mechanical microkeratome and not by a femtosecond laser in the displacement of the flap?
Consensus elements for observational research on COVID-19-related long-term outcomes
Authors: Admon Andrew J. , Wander Pandora L. , Iwashyna Theodore J. , Ioannou George N. , Boyko Edward J. , Hynes Denise M. , Bowling C. Barrett , Bohnert Amy S.B. , O’Hare Ann M. , Smith Valerie A. , Pura John , Hebert Paul L. , Wong Edwin S. , Niederhausen Meike , Maciejewski Matthew L.
Published: November 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its long-term outcomes may be jointly caused by a wide range of clinical, social, and economic characteristics. Studies aiming to identify mechanisms for SARS-CoV-2 morbidity and mortality must measure and account for these characteristics to arrive at unbiased, accurate conclusions. We sought to inform the design, measurement, and analysis of longitudinal studies of long-term outcomes among people infected with SARS-CoV-2. We fielded a survey to an interprofessional group of clinicians and scientists to identify factors associated with SARS-CoV-2 infection and subsequent outcomes. Using an iterative process, we refined the resulting list of factors into a consensus causal diagram relating infection and 12-month mortality. Finally, we operationalized concepts from the causal diagram into minimally sufficient adjustment sets using common medical record data elements. Total 31 investigators identified 49 potential risk factors for and 72 potential consequences of SARS-CoV-2 infection. Risk factors for infection with SARS-CoV-2 were grouped into five domains: demographics, physical health, mental health, personal social, and economic factors, and external social and economic factors. Consequences of coronavirus disease 2019 (COVID-19) were grouped into clinical consequences, social consequences, and economic consequences. Risk factors for SARS-CoV-2 infection were developed into a consensus directed acyclic graph for mortality that included two minimally sufficient adjustment sets. We present a collectively developed and iteratively refined list of data elements for observational research in SARS-CoV-2 infection and disease. By accounting for these elements, studies aimed at identifying causal pathways for long-term outcomes of SARS-CoV-2 infection can be made more informative.
Mixed ganglioneuroma and cortical adenoma in adrenal gland: A case report
Authors: Kang Yoo Na
Published: November 2022

Rationale:

Adrenal mixed corticomedullary tumors (MCMTs) are single tumor masses composed of an intimately admixed population of both adrenal cortical cells and medullary components. Most medullary tumor components are pheochromocytomas; however, MCMTs composed of ganglioneuroma and adrenal cortical adenoma are extremely rare. The current case is a rare case of adrenal MCMT composed of ganglioneuroma and adrenal cortical adenoma with primary aldosteronism.

Patient concerns:

A 49-year-old male was admitted because of hypokalemia and an adrenal mass. He was diagnosed with hypertension in his 20s and was taking blood pressure medications.

Diagnosis:

Plasma aldosterone concentration 376.5 pg/dL (normal 37.8~233.0 pg/mL) and potassium 2.8 mmol/L (normal 3.4~4.9 mmol/L) were detected. The aldosterone-to-renin ratio [the ratio of plasma aldosterone concentration (ng/dL) to PRA (ng/mL/hour)] was 38. The saline loading test showed that serum aldosterone (49.4 ng/dL) was not suppressed, compared with the basal level (28.4 ng/dL). The adrenal venous sampling test showed that the aldosterone level markedly increased to 1521.2 pg/mL. Abdominal computed tomography revealed an enlarged relatively well-circumscribed multinodular mass (35 × 13 × 30 mm) in the right adrenal gland.

Interventions:

Laparoscopic right adrenalectomy was performed under the clinical diagnosis of a functioning adrenal cortical adenoma.

Outcomes:

After laparoscopic right adrenalectomy, the serum aldosterone and renin levels returned to normal. The patient maintained a normal aldosterone level without recurrence for 16 months.

Lessons:

Adrenal MCMTs of the ganglioneuroma and cortical adenomas in the ipsilateral adrenal gland are extremely rare. Adrenal MCMTs exhibit benign clinical behavior, with no metastasis or death due to the tumor. With the development of diagnostic imaging technology, it is possible to identify mixed tumors. However, surgical resection of adrenal gland is a common treatment and a final diagnosis should be made based on the pathological results after surgery. Because this is to rule out the occurrence of rare malignant tumors and confirm the pattern of mixed tumors.
Biosimilar erythropoietin in anemia treatment (BEAT)—Efficacy and safety of a 1:1 dose conversion from EPREX® to EPIAO® in patients with end-stage renal disease on hemodialysis: A prospective, randomized, double blind, parallel group study
Authors: Miao Bolong , Isachkina Alina Nikolaevna , Shutov Evgeny Viktorovich , Selyutin Alexander Alekseevich , Kvitkova Lyudmila Vladimirovna , Shilo Valery Yuryevich , Vetchinnikova Olga Nikolaevna , Alexandrov Ilya Vyacheslavovich , Perlin Dmitry Vladislavovich , Zuev Alexander Vasilievich , Davydkin Igor Leonidovich , Mironova Tatyana Pavlovna , Solovyova Olga Mikhailovna , Tutin Alexey Pavlovich , Omelchenko Alexey Mikhailovich , Vareesangthip Kriengsak , Khadikova Nadezhda Georgievna , Li Man , Li Xiang
Published: November 2022

Background:

EPREX®/ERYPO®/PROCRIT® (epoetin alfa, Janssen-Cilag GmbH) was the first available recombinant human erythropoietin (rHuEPO) and was universally reference product as per the recommendation provided by European Medicines Agency. EPIAO® is a biosimilar formulation of EPREX®, and making it a 1:1 dose conversion from EPREX® according to recommendation of European Medicines Agency. This study evaluated the clinical efficacy and safety of EPIAO® in subjects with end-stage renal disease receiving hemodialysis after intravenous administration.

Methods:

This study was a multicenter, prospective, randomized, double-blind, parallel-group, 2-cohort, maintenance phase, therapeutic equivalence study to evaluate a 1:1 dose conversion from EPREX® to EPIAO® in terms of clinical efficacy and safety that was conducted at 20 sites in 2 countries in patients with end-stage renal disease on hemodialysis. Eligible subjects were treated with EPREX® (reference product of epoetin) for a period of at least 3 months before the treatment period, and then were randomly assigned to the group of EPREX® or EPIAO®. Primary endpoints were mean absolute change in hemoglobin level and mean absolute change in weekly epoetin dosage from baseline to 6 months after treatment with EPIAO®/EPREX® in parallel groups.

Results:

A total of 200 people received the random intervention and were included in the safety set. After 6, 9, and 12 months of treatment with EPIAO® or EPREX®, there were no significant differences in the hemoglobin levels of the 2 groups compared with baseline. The 95% confidence interval for the treatment difference was within the predetermined acceptable range: ±0.5 g/dL. There were no significant differences in the epoetin dosage of the 2 groups compared with the baseline. The 95% confidence interval for the treatment difference was within the predetermined acceptable range: ± 45 IU/kg. There were no significant differences in the incidence of adverse events between the EPIAO® and EPREX® groups. Most adverse events were mild to moderate and were reverted/resolved.

Conclusion:

EPIAO® demonstrated promising effectiveness and manageable safety in patients with end-stage renal disease on hemodialysis.
The effect and safety of Bushen Huoxue Method combined with cyclophosphamide in the treatment of systemic lupus erythematosus: A protocol for systematic review and meta-analysis
Authors: Mao Huihui , Dai Fengming , Du Zonghua
Published: November 2022

Background:

Systemic lupus erythematosus (SLE) is an autoimmune disease that involves multiple systemic organs. Bushen Huoxue Method (BSHXM) is a traditional Chinese medicine treatment, which is used for the treatment of SLE combining with cyclophosphamide. However, no systematic review has been performed to describe its effectiveness. This study provides a protocol for systematic review and meta-analysis of currently published randomized controlled trials (RCTs) reporting the combination of BSHXM and cyclophosphamide for the treatment of SLE, thus providing evidences to support clinical practice.

Methods:

RCTs reporting the combination of BSHXM and cyclophosphamide for the treatment of SLE before October 2022 will be searched in the online databases, including the PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, VIP databases and CBM. The Cochrane Risk of Bias 2 (RoB2) tool will be used to evaluate the quality of included RCTs. Meta-analysis will be performed using Stata 14.0.

Results:

Results to be published in a peer-reviewed journal providing evidence for the efficacy and safety of the combination of BSHXM and cyclophosphamide on the treatment of SLE.

Conclusions:

This study will provide a strong basis for the effectiveness and safety of the combination of BSHXM and cyclophosphamide on the treatment of SLE.
Pharmacopuncture for nerve entrapment syndrome: A protocol for systematic review
Authors: Jeong Jin-Ho , Hwang Ji Hye
Published: November 2022

Background:

Nerve entrapment syndrome occurs when the nerves become compressed or entrapped and restricted. This study aims to evaluate the effectiveness and safety of pharmacopuncture in patients with nerve entrapment syndrome.

Methods:

A search will be conducted from inception to August 2022 using the following 11 electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database China National Knowledge Infrastructure, and 6 Korean databases. All randomized controlled trials (RCTs) evaluating pharmacopuncture treatment for various nerve entrapment syndromes will be considered, with no restrictions regarding the type of pharmacopuncture solution used. Two reviewers will perform the data extraction and quality assessment using a predefined data extraction form. The methodological quality of the included RCTs will be assessed using the Cochrane risk-of-bias tool.

Results:

This systematic review will provide high-quality evidence to determine the efficacy and safety of pharmacopuncture therapy for nerve entrapment syndrome.

Conclusion:

Our findings will be informative for patients with nerve entrapment syndrome, as well as clinicians, policymakers, and researchers.
Resolution of preeclampsia after selective termination in discordant twins: A case report and literature review
Authors: Liao Hua , Zeng Zhaomin , Liu Hongyan , Hu Qing , Yu Haiyan
Published: November 2022

Rationale:

Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Growth discordance is associated with an increased risk of preeclampsia in twin pregnancies. The management of preeclampsia combined with discordant twins is difficult and controversial because of severe maternal conditions and severe growth restriction in 1 twin.

Patient concerns:

A 34-year-old woman with dichorionic diamniotic twin pregnancy complicated by preeclampsia at 29 weeks of gestation, and 1 twin with severe growth restriction and fetal intracranial hemorrhage.

Diagnosis:

The patient developed severe preeclampsia with high blood pressure (>160/100 mm Hg) and proteinuria, hydrothorax and leg edema. Ultrasound examination confirmed growth restriction (weight estimation: 915 g, <1st percentile) and abnormal umbilical flow in 1 twin (twin B), with a normal co-twin (estimated weight: 1693 g) (twin A). Magnetic resonance imaging revealed intracranial hemorrhage in the germinal matrix of twin B.

Interventions:

Selective termination of twin B by intracardiac injection of potassium chloride was performed at 31 weeks and 2 days’ gestation.

Outcomes:

Symptoms of preeclampsia resolved after selective termination, allowing the pregnancy to be prolonged for nearly 4 weeks. A healthy female infant was delivered at 35 weeks of gestation.

Conclusion:

Delivery of both fetus is not the only choice for the management for twin pregnancy with severe preeclampsia and discordant twins. Selective termination of the fetus with poor prognosis could be a reasonable treatment choice in carefully selected cases.
Clinical use of thread embedding acupuncture for facial nerve palsy: A web-based survey
Authors: Kang Dahae , Goo Bonhyuk , Kim Jung-Hyun , Kim Joo-Hee , Nam Sang-Soo
Published: November 2022

Although thread embedding acupuncture (TEA) is widely used for facial nerve palsy (FNP) in Korea, it lacks clinical evidence. Therefore, a large-scale and long-term clinical trial is needed. It is necessary to standardize and optimize TEA treatment for clinical study. Hence, we collected information about how TEA in the facial region is performed in clinical practice using a web-based survey. A questionnaire was developed consisting of 22 essential items and 30 optional items including demographic characteristics, purpose of TEA, adverse events (AE), direct medical cost, required time, and current state of TEA treatment on FNP. The questionnaire was sent via e-mail to 23,910 traditional Korean medicine doctors (TKMD). A total of 427 respondents answered the questionnaire. The most common response for the purpose for TEA was cosmetic, followed by musculoskeletal disease and nervous system disease. The most common AE that resolved without medical treatment was bruising (90.4%). The most common AE that required medical treatment was dimple (30.5). Many respondents commonly used TEA for the sequelae of FNP (71.8%). The most frequent sequelae of FNP for which TEA was used as contracture around the mouth (75.3%). The most preferred treatment method was insertion of 6–10 monofilament threads using a 29-gauge needle at intervals of 2.2 ± 1.59 weeks in the sequelae period. The results of this survey can be used to standardize and optimize the procedure of TEA for FNP for further clinical research.
The combination of molecular docking and network pharmacology reveals the molecular mechanism of Danggui Niantong decoction in treating gout
Authors: Liu Yuan , Luo Di , Xu Bo
Published: November 2022

Background:

Due to unhealthy diet and living habits, the incidence of gout is on the rise and has become a common disease with a high incidence. Danggui Niantong decoction (DGNTD), as a classic formula composed of 15 common herbs, has been widely used in clinical practice since ancient times to prevent and treat gout. However, the pharmacological mechanism and target of DGNTD are not clear.

Methods:

The potential active compounds and targets of DGNTD were obtained by traditional Chinese medicine systems pharmacology (TCMSP) database, and the differential genes of gout patients and controls were analyzed in gene expression omnibus (GEO) database. GSEA analysis of differential genes with GSEA 4.1.0 software and then the differential genes were intersected with the gout-related disease targets searched by GeneCard, CTD and OMIM disease database to obtain the final disease target. The “Traditional Chinese medicine-Active compounds-Targets” network was constructed by Cytoscape3.7.2 software. The R packet is used for enrichment analysis. The molecular docking between the active compound of DGNTD and the core target was verified by AutoDockTools software.

Results:

Two hundred eighty six and 244 targets of DGNTD-related active components and 652 targets of gout were obtained, of which 13 targets were potential targets of DGNTD in the treatment of gout. GSEA analysis showed that the differential genes were mainly involved in apoptosis, inflammatory reaction, and receptor metabolism and so on. Gene ontology (GO) functional enrichment analysis shows that DGNTD regulates many biological processes, such as the response to purine-containing compound and response to lipopolysaccharide, positive regulation of acute inflammatory response and other cellular components. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis shows that DGNTD treatment of gout is mainly related to interleukin-17 (IL-17), Toll-like receptor, rheumatoid arthritis, tumor necrosis factor (TNF) and so on. The results of molecular docking showed that the five active compounds in DGNTD had strong binding activity to core protein receptors.

Conclusions:

The active compounds of DGNTD may achieve the purpose of treating gout by acting on the core target (CASP8, CXCL8, FOS, IL1B, IL6, JUN, PTGS2, STAT1, MMP1, TNF) to regulate cell metabolism, proliferation and apoptosis, and improve inflammatory response, which is the result of multi-component, multi-target and multi-pathway interaction. It provides an idea for the development of new combined drugs for gout.
The contribution of laparoscopic distal pancreatectomy videos on YouTube to the learning curve in the COVID-19 pandemic
Authors: Erözkan Kamil , Culcu Serdar , Tamam Selim , Unal Ali Ekrem
Published: November 2022

There is no standardization in videos uploaded to Youtube. Were the videos capable of contributing to adequate technical quality and surgical training? We are aiming to answer these questions in this paper. It is a cross-sectional study. In January 2022, we searched the Youtube platform using the keyword “distal pancreatectomy.” The substantiality, transparency, reliability, quality, popularity and educational values of the video content were evaluated after exclusion criteria. These parameters were evaluated using we the modified Journal of American Medical Association benchmark criteria, Global Quality Score (GQS), Video Power Index, modified laparoscopic pancreatectomy scoring system. The videos uploaded after the pandemic had a statistically significant higher GQS score (P < .001). Video Power Index, like GQS, had a statistically significant difference before and after the pandemic. (P = .046). There was no significant difference in the evaluation of the reliability and substantiality. Until the development of Youtube videos is completed, peer-reviewed, more reliable and content-rich online education platforms should be preferred in the first place. Care should be taken to watch selected videos on Youtube videos.
Paraoxonase 1 and atrial fibrillation: Is there a relationship?
Authors: Istratoaie Sabina , Boroş Bianca , Vesa Ştefan Cristian , Maria Pop Raluca , Cismaru Gabriel , Pop Dana , Vasile Milaciu Mircea , Ciumărnean Lorena , Văcăraş Vitalie , Dana Buzoianu Anca
Published: November 2022

Atrial fibrillation (AF) is associated with oxidative stress and inflammation. Paraoxonase-1 (PON1), circulates in blood bound to high-density lipoproteins and reduces systemic oxidative stress. The aim of this study was to evaluate PON1 serum concentration and PON1 arylesterase activity (AREase) in patients with AF. We studied a group of 67 patients with symptomatic paroxysmal or persistent AF admitted for cardioversion and a control group of 59 patients without AF. Clinical parameters, lipid profile, PON1 concentration and AREase were evaluated. A significant difference in serum PON1 concentration and in AREase was found among the two groups. In a multivariate linear regression model, the presence of AF was associated with low PON1 concentration (P = .022). The body mass index was also independently associated with PON1 values (P < .001). Only the high-density lipoproteins-cholesterol level was independently associated with AREase (P = .002). PON1 serum concentrations and AREase were diminished in patients with AF, and the presence of AF was independently associated with low PON1 values.
Radiation dose of prostatic artery embolization for benign prostatic hyperplasia: A protocol for systematic review
Authors: Liu Jinglei , Zhang Kai , Wu Xiaolong , Cui Bao , Liang Zhihui
Published: November 2022

Background:

Increasing evidence supports the efficacy and safety of prostatic artery embolization (PAE) in the treatment of benign prostatic hyperplasia. However, PAE relies on ionizing radiation, which has not been studied systematically so far. Therefore, the potential associated risks remain largely unknown and are subject to intense debate. We performed a protocol for systematic review and meta-analysis to evaluate the clinical benefits of different radiation doses in patients with benign prostatic hyperplasia undergoing PAE.

Methods:

A comprehensive search of several databases from 1966 to October 2022 was conducted. The databases include Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and PubMed. Risk of bias of the included studies was assessed by the “Risk of Bias Assessment Tool” of the Cochrane Handbook for randomized controlled trials. All data were analyzed using the Comprehensive Meta-Analysis software package (Biostat, Engelwood, NJ).

Results:

The results will be submitted to a peer-reviewed journal once completed.

Conclusion:

This review will provide reliable evidence for extensive application of PAE for benign prostatic hyperplasia and determine the most rational radiation dose for these patients.
Children with Hirschsprung disease in a developing country: A cohort study of the predictors of a positive rectal biopsy result
Authors: Al-Taher Raed , Daradkeh Hebah Tawfiq , Hadadin Hiba , Obiedat Abdelrahman , Hijazein Yazan , Hijazein Laith , Obiedat Sarah , Hadadin Yazeed , Al Manasra Abdel rahman , Alduraidi Hamza , Juweid Malik
Published: November 2022

Chronic constipation, which may be habitually or pathologically caused, is one of the most common complaints in children. One of the important pathological causes is Hirschsprung’s disease (HD), which is diagnosed via multiple modalities, mainly rectal biopsy. Our aim was to compare the presentation and different predictive factors for positive rectal biopsy results in a developing country in the Middle East, such as Jordan. This cohort study was conducted at the Jordan University Hospital (JUH). All consecutive children aged <14 years who presented with refractory constipation and underwent rectal biopsies between January 2014 and December 2019 were retrospectively enrolled in the study. In the entire cohort study, 79 patients were enrolled: 45 (57%) were males and 34 (43%) were females. Regarding the biopsy results, 51 (64.6%) cases of refractory constipation without HD and 28 (35.4%) patients with refractory constipation with HD were diagnosed with open rectal biopsies. The male-to-female ratio of HD patients was 3:1. Moreover, 3 (10.7%) children who passed the meconium within the first 24 to 48 hours showed features of HD, while 17 (60.7%) children with delayed passage of the meconium showed features of HD. Abdominal distension was found to be a positive predictor of positive biopsy results (odds ratio [OR] = 4.09, P = .011), and soiling was found to be a negative predictor of positive biopsy results (OR = 0.07, P = .024). In developing countries, children presenting with HD seem to have similar symptoms and signs to those observed with traditional sampling and staining techniques.
A novel biomechanical system to intrude the upper incisors and control overbite: Posterior miniscrew-assisted lever arm and 2 cases report
Authors: Zhang Chenghao , Ji Ling , Liao Wen , Zhao Zhihe
Published: November 2022

Rationale:

Overbite control is a key factor in orthodontic treatment. In some cases, incisor intrusion is essential and could be an optimal strategy for overbite control. The aim of this article was to introduce a biomechanical system called the posterior miniscrew-assisted lever arm, which is innovative in using existing posterior miniscrews to intrude the upper incisors and to control anterior overbite while simultaneously retracting the anterior teeth. Its efficiency in incisor intrusion has been proved with 2 cases.

Patient concerns:

Two adult women who came for orthodontic treatment with the chief complaint of convex profile were included in this study.

Diagnosis:

Both patients had similar malocclusions of Class II molar relationship, anterior deep overjet, and anterior deep overbite.

Interventions:

Their treatment plans were to extract 4 first premolars and insert 2 maxillary posterior buccal miniscrews. After teeth aligning and leveling, en masse retraction was started in both arches. During the space-closing stage, posterior miniscrew-assisted lever arms were placed in their upper arches so as to intrude upper incisors and control the overbite.

Outcomes:

After respectively 4 months and 3 months of incisor intrusion, the anterior overbite was successfully reduced to the normal range in each patient. Cephalometric analysis and superimposition also confirmed the treatment effect of this biomechanical system on incisor intrusion.

Lessons:

The posterior miniscrew-assisted lever arm is a valuable biomechanical system for intruding incisors and controlling anterior overbite.
Study on the awareness and its influencing factors of patients with pulmonary tuberculosis on preferential policies for tuberculosis prevention and treatment in Shandong, China
Authors: Jin Jin , Geng Hong , Li Yuan , Wang Maoshui , Yang Shulin , Bi Xiuli , Tao Wuwei
Published: November 2022

We investigated the awareness and its influencing factors of patients with pulmonary tuberculosis on preferential policies for tuberculosis prevention and treatment in Shandong, China. A total of 858 patients with pulmonary tuberculosis between January 1, 2018 and September 30, 2019 were surveyed with questionnaires. The basic information (age, sex, education level, family financial situation, disease and diagnosis and treatment, etc), policy awareness, and satisfaction survey status, etc of these 858 tuberculosis patients were collected and analyzed with SPSS software (Chicago, IL) The awareness of tuberculosis patients on preferential policies for tuberculosis prevention and treatment was acceptable with awareness rate of 75.17% (645/858), but their satisfaction with the current policies was not ideal. Debt status and total household assets were the influencing factors of awareness (P < .01). Patients with pulmonary tuberculosis expected to get more free items and lower-cost auxiliary drugs. Patients with pulmonary tuberculosis have different levels of awareness on preferential policies for tuberculosis prevention and treatment. Therefore, targeted promotion of preferential policies for tuberculosis prevention and treatment and different management methods for different patients are of great significance to the treatment of tuberculosis epidemics.
Whole-exome sequencing analysis of amniotic fluid cells in 5 pregnant women with thalassemia: Case report
Authors: Zhang Wei , Li Xiaokang , Wu Xiaoxia , Huang Xin , Zhang Xiao , Lu Yi , Niu Jianmin , Zhang Jian
Published: November 2022

Rationale:

While thalassemia is a monogenic disease that is relatively common worldwide, there is no recognized radical cure for thalassemia in current medical practice. Prenatal diagnosis is the most important contribution to thalassemia prevention, but due to its technical limitations, rare thalassemia mutations cannot be detected; and the birth of thalassemic babies cannot be completely circumvented. Whole-exome sequencing can, however, compensate for this shortcoming.

Patient concerns:

We report the results of whole exon sequencing of amniotic cells in 5 pregnant women with thalassemia.

Diagnosis:

Prenatal diagnosis revealed that 4 of them were α thalassemia carriers and 1 of them was β thalassemia carrier.

Interventions and Outcomes:

We collected amniotic fluid of 5 pregnant women (age range: 25–27 years, Mean ± SD: 28 ± 1.8) with thalassemia. The gestational ages ranged between 16 and 19 weeks. The cells were separated from the amniotic fluid and passaged until a sufficient number of cells were obtained for exome sequencing. We therefore employed whole-exome sequencing of amniotic fluid cells from thalassemic carriers to validate prenatal diagnostic results and to identify novel mutation sites. We found that 4 of 5 samples are SEA which is consistent with the clinical prenatal diagnosis. However, 2 of 5 samples were point mutations in the HBB gene, and were thus different from the clinical prenatal diagnosis.

Conclusion:

The identifications from this study showed that prenatal diagnosis has limitations. Whole-exome sequencing can compensate for this shortcoming. And this study would add new insights into understanding of molecular mechanisms in thalassemia.
Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report
Authors: Wang Chujun , Xiong Yipin , Liu Fengzhen , Qiu Lijuan , Zhang Chun-Quan
Published: November 2022

Rationale:

Rectal ectopic pregnancy is an extremely rare abdominal pregnancy. This article presents a female underwent an unsuccessful in vitro fertilization which was misdiagnosed by serum beta-human chorionic gonadotropin (β-hCG) test and transvaginal ultrasonography. Twenty days later, a ruptured rectal ectopic pregnancy was confirmed by laparoscopy then the gestational tissue removed successfully.

Patient concerns:

A 32-year-old Chinese female was admitted to our hospital with complaining of symptoms, like gradual worsening of lower abdominal pain and dysuria. The abdominal ultrasonography revealed a sac-like mass in the posterior area to the uterus and a moderate amount of free fluid in the pelvic cavity. Forty days ago, she underwent a frozen embryo transfer. Twenty days ago, her serum β-hCG level was <5 mIU/mL and neither intrauterine nor ectopic pregnancy was detected by transvaginal ultrasonography. Then the procedure was thought to have resulted in biochemical pregnancy failure.

Diagnosis:

The primary rectal ectopic pregnancy.

Interventions:

The mass was removed laparoscopic surgery.

Outcomes:

The patient recovered well.

Lessons:

When the history of in vitro fertilization combined with an inappropriate rise of serum β-hCG and no visible evidence of an intra-uterine pregnancy, physicians should consider the possibility of abdominal pregnancy. Early diagnosis of abdominal pregnancy can effectively save the life of the pregnant woman.
Unexpected cholinergic crisis caused by distigmine bromide: A case report
Authors: Sera Toshiki , Kusunoki Shinji , Shime Nobuaki
Published: November 2022

Rationale:

Distigmine bromide is a cholinesterase (ChE) inhibitor used to treat dysuria due to a hypotonic bladder. We encountered a case of cholinergic crisis caused by distigmine bromide, which resulted in a rapid decrease in serum ChE levels, hypothermia, respiratory failure, and circulatory failure within a short period of time.

Patient concerns:

A 51-year-old man was admitted to a psychiatric hospital to treat behavioral disorders due to irritability and violent behavior. The patient was referred to our hospital for septic shock secondary to urinary tract infection and respiratory failure. He had not defecated for 5 days before visiting our hospital. He had moderate intellectual disability. Immediately after admission, he developed hand tremors and drooling. The airway was obstructed by drooling due to vomiting of yellow clear gastric juice.

Diagnosis:

The patient’s high saliva volume, bradycardia, respiratory failure (54 breaths/min), constricted pupils (2.5/mm), poor oxygenation, and a history of oral medication were consistent with the diagnosis of cholinergic crisis due to distigmine bromide.

Interventions:

On admission, the patient was immediately intubated. He was treated with noradrenaline (0.1 µg/kg/min) to increase his blood pressure. He was admitted to the intensive care unit (ICU). Since he had circulatory failure, vasopressin (approximately 1 U/h) was administered. Continuous intravenous atropine sulfate (0.6 mg/h) was also administered for high saliva volume.

Outcomes:

On the 8th ICU day, the patient’s drooling and bradycardia improved. The patient was physically and mentally stable, and transferred to the referring hospital.

Lessons:

ChE levels and symptoms before onset may not be useful for the early detection and prevention of adverse effects of cholinergic crisis caused by distigmine bromide. In addition to known risks such as renal impairment and older age, constipation should be recognized and communicated as a risk factor.