bluuebunny/crossref_metadata_2025 huggingface dataset:
The Gaia spectrophotometric standard stars survey – V. Preliminary flux tables for the calibration of Gaia DR2 and (E)DR3
Authors: Pancino E , Sanna N , Altavilla G , Marinoni S , Rainer M , Cocozza G , Ragaini S , Galleti S , Bellazzini M , Bragaglia A , Tessicini G , Voss H , Carrasco J M , Jordi C , Harrison D L , De Angeli F , Evans D W , Fanari G
Published: March 2021

We present the flux tables of the spectrophotometric standard stars (SPSS) used to calibrate in flux the Gaia DR2 and (E)DR3 data releases. The latest SPSS grid version contains 112 stars, whose flux tables agree to better than 1 per cent with the CALSPEC spectra of 11 flux standards for the calibration of the Hubble Space Telescope. The synthetic magnitudes computed on the SPSS spectra also agree to better than 1 per cent with the Landolt magnitudes of 37 stars in common. The typical spreads in both comparisons are of the order of 1 per cent. These uncertainties already meet the initial requirements for the Gaia SPSS project, but further improvements are expected in the next SPSS versions, that will be used to calibrate future Gaia releases. We complement the SPSS flux tables with literature spectra of 60 additional stars that did not pass all the criteria to be SPSS, the Passband Validation Library (PVL). The PVL contains stars of extreme spectral types, such as bright O and B stars and late M stars and brown dwarfs, and was useful to investigate systematic effects in the previous Gaia DR2 release and to minimize them in the EDR3 one. The PVL literature spectra are recalibrated as accurately as possible on to the SPSS reference scale, so that the two sets together can be used in a variety of validation and comparison studies.
Les opioïdes par voie orale en remplacement de la codéine pour contrôler la douleur chez les enfants
Authors: Rieder Michael J , Jong Geert ’t
Published: March 2021

La douleur est un problème courant chez les enfants. Des mesures pharmacologiques et non pharmacologiques sont utilisées pour la prendre en charge. Depuis quelques décennies, les opioïdes par voie orale sont populaires pour soulager la douleur modérée à grave. La codéine a longtemps été l’opioïde par voie orale le plus connu pour les enfants. Pour des raisons de sécurité, elle est désormais nettement moins accessible et moins employée. Divers autres opioïdes la remplacent, mais les données sur leur efficacité et leur sécurité sont limitées chez les enfants. L’oxycodone par voie orale emprunte les mêmes voies métaboliques que la codéine, mais sa pharmacocinétique est très variable. Les données sur la sécurité et l’efficacité de l’hydromorphone et du tramadol par voie orale chez les enfants sont également limitées. Lorsqu’on y recourt au lieu de la codéine, la morphine par voie orale est l’opiacé dont la sécurité et l’efficacité sont les mieux démontrées chez les enfants. Des recherches devront être réalisées pour explorer d’autres approches relatives aux médicaments opioïdes et non opioïdes, afin d’orienter les traitements analgésiques fondés sur des données probantes qui soulageront la douleur modérée à grave chez les enfants.
Evolution of Intraplate Alkaline to Tholeiitic Basalts via Interaction Between Carbonated Melt and Lithospheric Mantle
Authors: Wang Ze-Zhou , Liu Sheng-Ao
Published: March 2021

Intraplate basaltic volcanism commonly exhibits wide compositional ranges from silica-undersaturated alkaline basalts to silica-saturated tholeiitic basalts. Possible mechanisms for the compositional transition involve variable degrees of partial melting of a same source, decompression melting at different mantle depths (so-called ‘lid effect’), and melt-peridotite interaction. To discriminate between these mechanisms, here we investigated major-trace elemental and Sr–Nd–Mg–Zn isotopic compositions of a suite of intraplate alkaline and tholeiitic basalts from the Datong volcanic field in eastern China. Specifically, we employed Mg and Zn isotope systematics to assess whether the silica-undersaturated melts originated from a carbonated mantle source. The alkaline basalts have young HIMU-like Sr and Nd isotopic compositions, lower δ26Mg (-0·42‰ to -0·38‰) and higher δ66Zn (0·40‰ to 0·46‰) values relative to the mantle. These characteristics were attributable to an asthenospheric mantle source hybridized by carbonated melts derived from the stagnant Pacific slab in the mantle transition zone. From alkaline to tholeiitic basalts, δ26Mg gradually increases from -0·42‰ to -0·28‰ and δ66Zn decreases from 0·46‰ to 0·28‰ with decreasing alkalinity and incompatible trace element abundances (e.g. Rb, Nb, Th and Zr). The Mg and Zn isotopic variations are significantly beyond the magnitude (<0·1‰) induced by different degrees of fractional crystallization and partial melting of a same mantle source, excluding magmatic differentiation, different degrees of partial melting and the ‘lid effect’ as possible mechanisms accounting for the compositional variations in the Datong basalts. There are strong, near-linear correlations of δ26Mg and δ66Zn with 87Sr/86Sr (R2=0·75 − 0·81) and 143Nd/144Nd (R2=0·83 − 0·90), suggesting an additional source for the Datong basalts. This source is characterized by pristine mantle-like δ26Mg and δ66Zn values as well as EM1-like Sr–Nd isotopic ratios, pointing towards a metasomatized subcontinental lithospheric mantle (SCLM). Isotope mixing models show that mingling between alkaline basaltic melts and partial melts from the SCLM imparts all the above correlations, which means that the SCLM must have been partially melted during melt-SCLM reaction. Our results underline that interaction between carbonated silica-undersaturated basaltic melts and the SCLM acts as one of major processes leading to the compositional diversity in intracontinental basaltic volcanism.
Partisan Bias in Bipartisan Places?
Authors: Guay Brian , Lopez Jesse
Published: March 2021

An extensive literature examines how partisanship divides public opinion on hot-button political issues, but little is known about its potential to polarize attitudes on bipartisan issues. Recent work shows that while Americans hold strong preferences for bipartisanship, their attitudes toward bipartisan issues quickly become polarized when associated with partisan identities. While prior research has examined the effect of these associations in lab settings, tests outside the lab are far more rare. In this research note, we aim to provide such a test by leveraging a bipartisan issue that became associated with partisan identities suddenly in 2018: the presidential alert. While the presidential alert—a product of bipartisan efforts to improve the government's capacity to send emergency communications in the wake of Hurricane Katrina—received little notice when signed into law, it gained widespread media attention during its inaugural test in 2018. We rapidly recruited a sample of US adults immediately before the alert was sent, such that participants in our study received the alert on their phones while completing a survey. We exploited the timing of the alert to randomize whether respondents answered questions about the alert moments before or after receiving it. Across two experiments we find little evidence that associating the alert with the Trump administration had any polarizing effect on attitudes, even when explicitly associated with a partisan cue, suggesting that at least some bipartisan attitudes are not as easily polarized as prior work implies.
Heel Rise and Non–Weight-Bearing Ankle Plantar Flexion Tasks to Assess Foot and Ankle Function in People With Diabetes Mellitus and Peripheral Neuropathy
Authors: Jeong Hyo-Jung , Mueller Michael J , Zellers Jennifer A , Yan Yan , Hastings Mary K
Published: March 2021

Objective

The objective of this study was to examine the effects of diabetes mellitus and peripheral neuropathy (DMPN), limited joint mobility, and weight-bearing on foot and ankle sagittal movements and characterize the foot and ankle position during heel rise.

Methods

Sixty people with DMPN and 22 controls participated. Primary outcomes were foot (forefoot on hindfoot) and ankle (hindfoot on shank) plantar-flexion/dorsiflexion angle during 3 tasks: unilateral heel rise, bilateral heel rise, and non–weight-bearing ankle plantar flexion. A repeated-measures analysis of variance and Fisher exact test were used.

Results

Main effects of task and group were significant, but not the interaction in both foot and ankle plantar flexion. Foot and ankle plantar flexion were less in people with DMPN compared with controls in all tasks. Both DMPN and control groups had significantly less foot and ankle plantar flexion with greater weight-bearing; however, the linear trend across tasks was similar between groups. The DMPN group had a greater percentage of individuals in foot and/or ankle dorsiflexion at peak unilateral heel rise compared with controls, but the foot and ankle position was similar at peak bilateral heel rise between DMPN and control groups.

Conclusion

Foot and ankle plantar flexion is less in people with DMPN. Less plantar flexion in non–weight-bearing suggests that people with DMPN have limited joint mobility. However, peak unilateral and bilateral heel rise is less than the available plantar flexion range of motion measured in non–weight-bearing, indicating that limited joint mobility does not limit heel rise performance. A higher frequency of people with DMPN are in foot and ankle dorsiflexion at peak unilateral heel rise compared with controls, but the position improved with lower weight-bearing.

Impact

Proper resistance should be considered with physical therapist interventions utilizing heel rise because foot and ankle plantar flexion position could be improved by reducing the amount of weight-bearing.
Cell Type-Specific Arousal-Dependent Modulation of Thalamic Activity in the Lateral Geniculate Nucleus
Authors: Molnár Benedek , Sere Péter , Bordé Sándor , Koós Krisztián , Zsigri Nikolett , Horváth Péter , Lőrincz Magor L
Published: March 2021

State-dependent thalamocortical activity is important for sensory coding, oscillations, and cognition. The lateral geniculate nucleus (LGN) relays visual information to the cortex, but the state-dependent spontaneous activity of LGN neurons in awake behaving animals remains controversial. Using a combination of pupillometry, extracellular, and intracellular recordings from identified LGN neurons in behaving mice, we show that thalamocortical (TC) neurons and interneurons are distinctly correlated to arousal forming two complementary coalitions. Intracellular recordings indicated that the membrane potential of LGN TC neurons was tightly correlated to fluctuations in pupil size. Inactivating the corticothalamic feedback to the LGN suppressed the arousal dependency of LGN neurons. Taken together, our results show that LGN neuronal membrane potential and action potential output are dynamically linked to arousal-dependent brain states in awake mice, and this might have important functional implications.
Complete Genome Sequence Resources for the Onion Pathogen, Pantoea ananatis OC5a
Authors: Asselin Jo Ann E. , Bonasera Jean M. , Helmann Tyler C. , Beer Steven V. , Stodghill Paul V.
Published: March 2021

Here, we report on the genomic sequence and annotation for Pantoea ananatis OC5a, a strain that was isolated from an onion bulb grown in New York and that is pathogenic to onion, causing center rot of onion. OC5a is the first P. ananatis strain pathogenic to onion from New York to be completely assembled and sequenced. Having been assembled using long PacBio reads and high-fidelity Illumina reads, this genome is closed, complete, and of high quality.
Increased Reimbursement for Surgical Fixation of Hip Fractures: The Difference Between the Hospital and the Surgeon
Authors: Chen Dennis Q. , Quinlan Nicole D. , Browne James A. , Werner Brian C.
Published: March 2021

Objectives:

To evaluate trends and variations in hospital charges and payments relative to surgeon charges and payments for surgical treatment of hip fractures in the US Medicare population.

Methods:

Hospital and surgeon charges and payments after treatment of hip fractures by closed reduction and percutaneous pinning (CRPP), open reduction internal fixation (ORIF), or intramedullary nail (IMN), along with corresponding patient demographics, 90-day and 1-year mortality, Charlson Comorbidity Index (CCI), and length of stay (LOS) from 2005 to 2014 were captured from the 5% Medicare Standard Analytic Files. The ratio of hospital to surgeon charges (CM: Charge Multiplier) and the ratio of hospital to surgeon payments (PM: Payment Multiplier) were calculated for each year and region of the United States and trended over time. Correlations between the CM and PM and LOS were evaluated using a Pearson correlation coefficient (r).

Results:

Three thousand twenty-eight patients who underwent CRPP and 25,341 patients who underwent ORIF/IMN were included. The CM for CRPP increased from 10.1 to 15.6, P < 0.0001. The CM for ORIF/IMN increased from 11.9 to 17.2, P < 0.0001. The PM for CRPP increased from 15.1 to 19.2, P < 0.0001. The PM for ORIF/IMN increased from 11.5 to 17.4, P < 0.0001.

Conclusions:

Hospital charges and payments have continually increased relative to surgeon charges and payments for treatment of hip fractures despite decreasing LOS.
Effective Reduction in Opioid Prescriptions for Ambulatory Lesion Excisions in Pediatric Patients
Authors: McKenna Rachel A. , Lee Alfred , Yan Chen , Vu Giap H. , Jantzen Ellen C. , Brennan Patrick J. , Watson Adam , Burlingame Caroline , Lin Ines C.
Published: March 2021

Background:

Childhood opioid consumption is potentially deleterious to cognitive development and may predispose children to later addiction. Opioids are frequently prescribed for outpatient surgery but may not be necessary for adequate pain control. We aimed to reduce opioid prescriptions for outpatient pediatric skin and soft tissue lesion excisions using quality improvement (QI) methods.

Methods:

A multidisciplinary team identified drivers for opioid prescriptions. Interventions were provider education, improving computer order set defaults, and promoting non-narcotic pain control strategies and patient-family education. Outcomes included percentage of patients receiving opioid prescriptions and patient-satisfaction scores. Data were retrospectively collected for 3 years before the QI project and prospectively tracked over the 8-month QI period and the following 18 months.

Results:

The percentage of patients receiving an opioid prescription after outpatient skin or soft tissue excision dropped significantly from 18% before intervention to 6% at the end of the intervention period. Patient-reported satisfaction with pain control improved following the QI intervention. Satisfaction with postoperative pain control was independent of closure size or receipt of a postoperative opioid prescription. Intraoperative use of lidocaine or bupivacaine significantly decreased the incidence of postoperative opioid prescription in both bivariate and multivariate analyses. Results were maintained at 18 months after the conclusion of the QI project.

Conclusion:

Raising provider awareness, educating patients on expected postoperative pain management options, and prioritizing non-narcotic medications postoperatively successfully reduced opioid prescription rates in children undergoing skin and soft tissue lesion excisions and simultaneously improved patient-satisfaction scores.
Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
Authors: Stoehr Jenna Rose , Chappell Ava G. , Dumanian Gregory A.
Published: March 2021

Abdominal wall pain can be challenging to diagnose and treat, as many etiologies can have similar presentations. Anterior cutaneous nerve entrapment syndrome has been reported to be a significant cause of AWP. Here, we report the case of a patient who was initially diagnosed with anterior cutaneous nerve entrapment syndrome and ultimately found to have intercostal neuromas-in-continuity. The patient was a healthy 36-year-old man who presented with debilitating, chronic abdominal wall pain. The pain began after a time period when the patient was regularly kiteboarding, and it impacted the ability to exercise and perform activities of daily living. The patient had undergone extensive testing and attempted many treatments, including medication, nerve blocks, and anterior cutaneous nerve entrapment syndrome surgery. Examination was significant for 2 near-symmetric areas that were persistently tender to palpation in the subcostal abdomen. The patient underwent excision and reconstruction with two 2-cm segments of processed nerve allograft. At 1-year follow-up, the patient reported complete alleviation of the pain, discontinuation of pain medication, and a return to all normal activities. While managing patients with abdominal wall pain, physicians must consider neuroma in their differential diagnoses and be aware of its treatment options, as the patient underwent a substantial delay in treatment. Kiteboarding is a unique mechanism of peripheral nerve injury that has not been previously reported in the literature. This report demonstrates the efficacy of processed nerve allograft in the management of neuromas-in-continuity of the abdominal wall, as well as the importance of being aware of unusual manners of nerve injury.
Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected children
Authors: Li Ying , Wang Haizhou , Wang Fan , Lu Xiaoxia , Du Hui , Xu Jiali , Han Feng , Zhang Liqiong , Zhang Maorong
Published: March 2021

Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to summarize and investigate the co-infection of SARS-CoV-2 in children.

We retrospectively reviewed the clinical manifestations, laboratory findings, and imaging characteristics of COVID-19 patients in co-infection group (CI, n = 27) and single infection group (SI, n = 54). Samples were tested for multiple pathogens.

A high incidence (27/81, 33%) of co-infection in children with COVID-19 was revealed. The most frequent co-infected pathogen was mycoplasma pneumoniae (MP, 20/81, 25%), followed by virus (6/81, 7%), and bacteria (4/81, 5%). No significant difference in clinical characteristics, laboratory examinations, or hospital stay was observed between the patients with co-infections and those with monomicrobial, only lower in white blood cell counts (CI: 5.54 ± 0.36 vs SI: 7.38 ± 0.37, P = .002), neutrophil counts (CI: 2.20 ± 0.20 vs SI: 2.92 ± 0.23, P = .024) and lymphocyte counts (CI: 2.72 ± 0.024 vs SI: 3.87 ± 0.28, P = .006). Compared with the patients with monomicrobial, chest imaging of those with co-infections showed consolidation in more cases (CI: 29.6% vs SI: 11.1%, P = .038) and duration of positive in nucleic acid was shorter (CI: 6.69 ± 0.82 vs SI: 9.69 ± 0.74, P = .015).

Co-infection was relatively common in children with COVID-19, almost 1/3 had co-infection, most commonly caused by MP. Co-infection did not cause a significant exacerbation in clinical manifestations.
Brain metastasis with subtype conversion in a patient with male breast cancer
Authors: Oh Byeong Ho , Woo Chang Gok , Lee Youn Joo , Park Young Seok
Published: March 2021

Rationale:

Brain metastasis of male breast cancer is extremely rare, and the pathological changes between the primary tumor and the metastatic brain tumor have not been reported. Herein, we report for the first time a case of male breast cancer with metastasis to the parietal lobe with subtype conversion after metastasis.

Patient concerns:

we describe a 45-year-old male patient admitted for an incidentally found brain tumor after a motorcycle accident. The patient had been treated for breast cancer 5 years previously. The primary tumor was an invasive ductal carcinoma classified as pT1N1M0 with hormone receptor positivity (estrogen receptor ++, progesterone receptor +++, human epidermal growth factor receptor-type2 (HER2) +) and was treated with surgery, adjuvant chemotherapy, radiation therapy and endocrine therapy (tamoxifen).

Diagnoses:

Magnetic resonance imaging revealed a well enhanced focal solid tumor in the right parietal lobe (5.0 × 4.2 cm in size), Immunohistochemical staining revealed cerebral metastases of breast cancer with HER2 subtype conversion (estrogen receptor +++, progesterone receptor +++, HER2 −).

Interventions:

The patient was successfully treated with surgery and whole brain irradiation (3 Gy × 10 fractions).

Outcomes:

There was no additional complication after the surgery and the patient transferred to oncology department for chemotherapy. 2 years later, he had gamma knife radiosurgery due to the recurred brain lesion and after that he discontinued the treatment and opted for hospice care.

Lessons:

Male breast cancer with metastasis to the brain is an extremely rare condition. Although a few similar cases have been reported, subtype conversion in similar cases has not been reported. Therefore, we report this case of a male patient with brain metastasis of invasive ductal carcinoma with HER2 status conversion after metastasis.
Prenatal and postnatal exposure to Tangshan earthquake and CRHR1 gene polymorphism influence risk of sleep disturbance in adulthood
Authors: Chen Ya-Nan , An Cui-Xia , Wang Ran , Wang Lan , Song Mei , Yu Lu-Lu , Sun Fei-Fei , Wang Xue-Yi
Published: March 2021

To determine the effect of earthquake on sleep quality of adults who had experienced Tangshan Earthquake either as infants or fetuses and also investigate whether CRHR1 polymorphism influenced sleep quality in subjects exposed to seismic stress.

Totally 556 subjects were enrolled in the current study and were divided into 3 groups, those who had experienced Tangshan Earthquake as infants (group I) or fetuses (group II), and those who had not experienced Tangshan Earthquake (group III). Sleep was evaluated using the Pittsburgh Sleep Quality Index (PQSI). Three single nucleotide polymorphisms of the CRHR1 gene were analyzed.

Fifty two (9.4%) subjects had sleep disturbance, including 17 (9.9%) subjects in group I, 24 (13.4%) subjects in group II, and 11 (5.3%) subjects in group III (χ2 = 7.373, P = .025). Moreover, subjects with CRHR1 genotype T/T had a significantly lower rate of sleep disturbance (7.8%) than subjects with genotype C/T and C/C (14.7%; χ2 = 4.845, P 
= .028). Furthermore, subjects with rs7209436 genotype C had an approximately 2-fold increase in the risk of sleep disturbance versus those who were not genotype C (OR = 1.978, 95% CI (1.045, 3.744).

Prenatal and postnatal exposure to seismic stress significantly increases subsequent risk of sleep disturbance in adulthood.
Lung adenocarcinoma organoids harboring EGFR 19Del and L643V double mutations respond to osimertinib and gefitinib
Authors: Bie Yanan , Wang Jin , Xiong Linmin , Wang Dong , Liao Jing , Zhang Yelin , Lin Hang
Published: March 2021

Introduction:

It has been well reported that non-small-cell lung cancer (NSCLC) patients with single epithelial growth factor receptor (EGFR) activating mutation have high objective response rate when treated with EGFR-TKIs. However, due to rarity of cases, the response of patients with EGFR double or multiple mutations is not yet well understood. Patient-derived organoid technology has become to a powerful tool in cancer personalized medicine.

Patient concerns:

A 60-year-old nonsmoking female was admitted to hospital for lung cancer after Chest CT.

Diagnoses:

The patient had no obvious clinical symptoms. Postoperative pathology confirmed a stage I of NSCLC. An EGFR double mutation 19Del/L643V was detected in the sequence of patient's cancer specimen.

Interventions:

The patient was in good condition after surgical resection, with no sign of lung cancer recurrence. The patient has not yet started on targeted medicine.

Outcomes:

A lung cancer organoid culture was established from the cancer tissue of the patient, which recapitulated the morphological and molecular characteristics of cancer tissue. The drug sensitivity test showed that the cancer organoids that retained original mutations were sensitive to anticancer agents osimertinib and gefitinib, while resistant to erlotinib and icotinib.

Conclusion:

The uncommon EGFR double mutation exhibits distinctive sensitivities towards different target drugs of EGFR-TKIs. Our findings provide a better understanding of EGFR-TKIs’ effects on patient-derived cancer organoids harboring uncommon EGFR double mutation(s).
Clinical features and viral RNA shedding of imported and local cases with COVID-19 in Wenzhou, China
Authors: He Guiqing , Wu Jing , Huang Jianping , Schieffelin John S. , Dai Jianyi , Gamber Michelle , Hu Xingzhong , Chen Quelu , Si Yang , Sun Wenjie , Cai Jing
Published: March 2021

Wenzhou had the highest number of confirmed novel coronavirus 2019 (COVID-19) cases outside the Hubei province. The aim of this study was to identify the difference in clinical features and viral RNA shedding between the imported and local COVID-19 cases in Wenzhou.

All patients with confirmed COVID-19 admitted to Wenzhou Sixth People's Hospital, Wenzhou Central Hospital Medical Group, from January 17 to February 11, 2020, were enrolled in this study. Data was analyzed and compared for the imported and local cases with regard to epidemiological, demographic, clinical, radiological features, and laboratory findings. Outcomes for the enrolled participants were followed up until May 7, 2020.

Of the 136 cases, 50 were imported from Wuhan. The median age was 45 years and 73 (53.7%) were men. The most common symptoms at onset were fever (104 [76.5%]) and cough (85[62.5%]). Pleural effusion was more common among imported cases compared to local cases. The white blood cell count, neutrophil count, lymphocyte count and platelet count of the imported cases were significantly lower than those of the local cases, while the prothrombin time was significantly longer than that of the local cases. Severe and critically ill patients accounted for 15.4% and 2.9%, respectively. The median duration of SARS-CoV-2 RNA shedding from symptom onset was 26 days (IQR 17–32.3 days) and there were no significant differences in duration of viral RNA shedding between the two groups.

The study findings suggest that imported cases from Wuhan were more likely to be severe compared to the local cases in Wenzhou. However, there was no difference between imported and local cases on the viral shedding among the COVID patients.
Study of item text in the Chinese Symptom Checklist-90
Authors: Zhou Jian , Yu Jian’er , Zhou Yuanyuan , Qiu Jianxia
Published: March 2021

Symptom Checklist-90 (SCL-90) is the popular and widely used instrument, whether in mental health screening, psychological consultation, or the diagnosis and estimate of mental illness. In 1984, it was translated from theEnglish version into Chinese and then SCL-90 has been widely used in China. It is a pity that the item text of Chinese version has not been revised since the birth of it until today. We analyzed the Chinese version of the 90-item text from 3 new perspectives: translation, semantic, and cross-cultural, and thought that 18 items should be revised. This study’ results have taken one step forward on the basis of previous studies, which will play an important role in improving the quality of Chinese version SCL-90 and improving the mental health level of Chinese people.
Comparison of efficacy and safety of traditional Chinese patent medicine in the treatment of vitiligo in children or adults
Authors: Yang Meng , Du Mengmeng , Tang Zhikun , Han Guanqing , Dong Wenyao , Chen Zhaoyu , Song Yeqiang
Published: March 2021

Background:

Vitiligo is a common depigmented skin disease in children or adults, which usually causes considerable psychological burden to life and work for the reason that it affects appearance. The conventional therapies, including external 308 nm excimer laser therapy along with oral administration of western medicine, are associated with distinct disadvantages. Notably, traditional Chinese patent medicine (TCPM) exerts a vital part in treating vitiligo. Currently, no existing research has examined the effectiveness and safety of different TCPMs in treating vitiligo among either child or adult patients. As a result, the present network meta-analysis was carried out for the systematic comparison of the effectiveness of different TCPMs in treating vitiligo.

Methods:

The electronic databases, like PubMed, Web of Science, EMBASE, The Cochrane Library, Chinese Scientific Journals Database, China National Knowledge Infrastructure, Wanfang database and China BioMedical Literature, were searched systemically by 2 reviewers independently from inception to August 2020 to identify relevant randomized controlled trial (RCTs) according to our study inclusion criteria. In data extraction, risk of bias among those enrolled articles was also detected. Besides, the Bayesian network meta-analysis method was utilized to evaluate the evidence and data collected. This adopted the STATA and Win BUGS software for analysis.

Results:

The present work assessed the safety and efficacy of different TCPMs in treating vitiligo among child or adult patients.

Conclusion:

Our findings can shed precious lights on applying TCPMs in clinic and help the clinicians to formulate the efficient diagnostic and therapeutic strategies.

Ethics and dissemination:

No ethical approval was needed in this study.

INPLASY registration number:

INPLASY2020120050.
The risk factors of children acquiring refractory mycoplasma pneumoniae pneumonia
Authors: Gong Hui , Sun Baijun , Chen Ye , Chen Huijie
Published: March 2021

Objectives:

Refractory mycoplasma pneumoniae pneumonia (RMPP) in children has been increasing worldwide. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of RMPP to provide suggestions on prevention and controlling for children.

Methods:

Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0.

Results:

We conducted a meta-analysis of 15 separate studies. Fever for more than 10 days (odds ratio [OR] 3.965, 95% confidence interval [CI] 2.109–7.456), pleural effusion (OR 6.922, 95% CI 2.058–23.282), extra-pulmonary complications (OR 17.762, 95% CI 11.146–28.305), pulmonary X-ray consolidation ≥2/3 (OR 8.245, 95% CI 1.990–34.153), CRP >40 mg/L (OR 4.975, 95% CI 2.116–11.697) were significantly related to the risk of RMPP. We did not find an association between male sex (OR 0.808, 95% CI 0.548–1.189), LDH >410IU/L (OR 1.033, 95% CI 0.979–1.091) and the risk of RMPP.

Conclusions:

Fever for more than 10 days, pleural effusion, extra-pulmonary complications, pulmonary X-ray consolidation≥ 2/3 and CRP >40 mg/L are risk factors for early evaluation of RMPP.
Breast tubular carcinoma at parasternal and retro-nipple area
Authors: Shi Junhua , Shi Junli , Yang Shengbo
Published: March 2021

Introduction:

Breast tubular carcinoma (TC) is a well-differentiated infiltrating ductal carcinoma, common in postmenopausal women.

Patient concerns:

Two patients concerned their abnormality of their breasts, one at deep parasternal higher chest wall in a 74-year-old female and the other behind the nipple in a 39- year-old female.

Diagnosis:

These masses were detected by mammography, ultrasound and magnetic resonance imaging (MRI) examinations. The parasternal mass identified by mammography showed long spicules along the edges of the mass. Ultrasound examination revealed that these masses had solid irregular hypoechoic nodules. The color Doppler ultrasound of the retro-nipple mass presented with increased blood flow resistance index. The dynamic contrast-enhanced MRI examination of the retro-nipple nodule demonstrated an intensely enhancing mass with a plateau-type time-signal intensity curve.

Interventions:

Two cases were surgically removed by local resection of foci under ultrasound guidance.

Outcomes:

These imaging examinations strongly suggest possible breast tubular carcinoma, which was confirmed by the pathological evaluation of frozen sections from surgically removed masses.

Conclusion:

Although uncommon, breast tubular carcinoma may be considered in the differential diagnosis of small solid masses with long spicules at parasternal breast or behind the nipples in adult women.
Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation
Authors: Jiang Changchun , Li Yuechun , Hao Fei , Yang Junfeng , Wang Baojun , Fan Yu
Published: March 2021

Rationale:

Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization.

Patient concerns:

A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission.

Diagnoses:

Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA.

Interventions:

Thrombectomy with 3 passes of the Solitaire FR device (Medtronic, Minneapolis, MN) was unsuccessful. Two stent retrievers were inserted in parallel by one microcatheter access point to each M2 branch, and then both stents were gradually retrieved out of the catheter while continuous suction was maintained.

Outcomes:

After thrombectomy, subsequent follow-up angiograms showed mTICI 3 reperfusion of MCA. The patient has mRS 2 at discharge and the 3-month mRS score after stroke is 1 score.

Lessons:

The presented Y-configuration double-stent-retriever thrombectomy technique constitutes a safe and effective rescue treatment method for refractory thrombus in MCA bifurcation.
Relationship between thrombomodulin gene polymorphism and susceptibility to venous thromboembolism
Authors: Wei Meihao , Xue Xiaohui , Pan Yipeng , Wu Yan
Published: March 2021

Background:

Previous studies displayed that thrombomodulin gene polymorphisms are closely associated with venous thromboembolism (VTE), while the results are inconsistent. Therefore, we conducted a meta-analysis to accurately determine the association between thrombomodulin gene polymorphism and the risk of VTE.

Methods:

Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, EmBase, and Web of Science databases were searched, and the time to build the database was set until January 2021. The association between thrombomodulin gene polymorphism and the risk of VTE was evaluated. Meta-analysis was performed with STATA 16.0 software, and the odds ratio and its 95% confidence interval were applied to estimate the relationship between thrombomodulin gene polym‘orphism and the risk of VTE.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This meta-analysis will summarize the relationship between thrombomodulin genepolymorphism and VTE risk.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:

DOI 10.17605/OSF.IO/UEHJP.
Verification and comparison of three prediction models of ischemic stroke in young adults based on the back propagation neural networks
Authors: Chen Yuyang , Mao Yingqi , Pan Xiaoyun , Jin Weifeng , Qiu Tao
Published: March 2021

This work aims to explore risk factors for ischemic stroke in young adults and analyze the Traditional Vascular Risk Factors Model based on age, hypertension, diabetes, smoking history, and drinking history. Further, the Lipid Metabolism Model was analyzed based on lipoprotein a [LP (a)], high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein AI (apo AI), apolipoprotein B (apo B), and the Early Renal Injury Model based on urinary microalbuminuria/creatinine ratio (UACR). Besides, we estimated glomerular filtration rate (eGFR), cystatin C (Cys-C), homocysteine (Hcy), β2 microglobulin (β2m), and validated their predictive efficacy and clinical value for the development of ischemic stroke in young adults.

We selected and retrospectively analyzed the clinical data of 565 young inpatients admitted to Zhejiang Provincial Hospital of Chinese Medicine between 2010 and 2020, 187 of whom were young stroke patients. A single-factor analysis was used to analyze the risk factors for stroke in young people and developed a traditional vascular risk factors model, a lipid metabolism model, and an early kidney injury model based on backpropagation (BP) neural networks technology to predict early stroke occurrence. Moreover, the prediction performance by the area under the receiver operating characteristics (ROC) curve (AUC) was assessed to further understand the risk factors for stroke in young people and apply their predictive role in the clinical setting.

Single-factor analysis showed that ischemic stroke in young adults was associated with hypertension, diabetes, smoking history, drinking history, LP(a), HDL, LDL, apo AI, apo B, eGFR, Cys-C, and β2m (P < .05). The BP neural networks technique was used to plot the ROC curves for the Traditional Vascular Risk Factors Model, the Lipid Metabolism Model, and the Early Kidney Injury Model in enrolled patients, and calculated AUC values of 0.7915, 0.8387, and 0.9803, respectively.

The early kidney injury model precisely predicted the risk of ischemic stroke in young adults and exhibited a certain clinical value as a reference for morbidity assessment. Whereas the prediction performance of the Traditional Vascular Risk Factors Model and the Lipid Metabolism Model were inferior to that of the early kidney injury model.
Effectiveness and safety of a newly designed partially covered tracheal metallic Y-shaped stent for the treatment of high cervical gastro-tracheal or tracheo-esophageal fistula
Authors: Jiao Dechao , Yao Yuan , Zhang Quanhui , Wang Ling , Ren Jianzhuang , Han Xinwei
Published: March 2021

The aim of this study was to evaluate the effectiveness and safety of a partially covered metallic tracheal Y-shaped stent for the treatment of high cervical gastro-tracheal fistula (GTF) and tracheo-esophageal fistula (TEF). From January 2017 to January 2019, 16 patients with high cervical GTF and TEF received partially covered metallic Y-shaped stent placement under fluoroscopic guidance. The technical and clinical success rates, incidence of major complications, and survival outcomes were analyzed. Eastern Cooperative Oncology Group (ECOG) score and quality of life (SF-36 questionnaire) were compared pre and post stent placement. Technical and clinical success rates were 100% and 81.3%, respectively. Major complications (severe tumor ingrowth, mucostasis, hyperplastic granulation tissue) occurred in 7/16 (43.8%) patients. ECOG score and 5 of the 8 domains of the SF-36 (physical function, role physical, general health, vitality, social function) were significantly improved at 1 month after treatment (P < .01). During the median follow-up period of 8.3 months, 9 patients were alive. Median overall survival was 10.3 months (95% CI, 8.0–12.6). The newly designed partially covered tracheal Y-shaped stent appears to be effective and safe for treatment of high cervical GTF and TEF.
IgG4-related pleural effusion with high adenosine deaminase levels
Authors: Shimoda Masafumi , Tanaka Yoshiaki , Morimoto Kozo , Okumura Masao , Shimoda Kiyomi , Takemura Tamiko , Oka Teruaki , Yoshiyama Takashi , Yoshimori Kozo , Ohta Ken
Published: March 2021

Rationale:

Levels of pleural fluid adenosine deaminase (ADA), a useful marker for the diagnosis of tuberculous pleurisy, are elevated in some reports of immunoglobulin G4 (IgG4)-related pleural effusion. We describe a patient with IgG4-related pleural effusion who exhibited a high concentration of ADA. Furthermore, we reviewed the literature to compare patients with IgG4-related pleural effusion and tuberculous pleurisy.

Patient concerns:

A 75-year-old male patient had dyspnea for 1 month with a left pleural effusion that was exudative, lymphocyte dominant. The pleural fluid test results revealed a total protein (TP) concentration of 6.60 g/dl, a lactate dehydrogenase (LDH) level of 383 IU/dl, and an ADA concentration of 54.5 U/L. An interferon gamma release assay showed a negative result.

Diagnoses:

Histological analysis of the thoracoscopic pleural biopsy revealed lymphoplasmacytic infiltration, with 80 IgG4-positive plasma cells/high-power field, and an IgG4/IgG ratio of approximately 40% to 50%. Other diseases were ruled out based on symptoms, negative autoimmune antigen results, and histopathologic findings. Thus, he was diagnosed with IgG4-related pleural effusion.

Interventions:

He received 15 mg of prednisolone as therapy.

Outcomes:

His pleural effusion and symptoms improved gradually within several months, and prednisolone was tapered to 6 mg daily.

Lessons:

It is important to distinguish between IgG4-related pleural effusion and tuberculous pleurisy. Therefore, we compared 22 patients with IgG4-related pleural effusion from PubMed and the Japan Medical Abstracts Society to 40 patients with tuberculous pleurisy at Fukujuji Hospital from January 2017 to May 2019. According to thoracentesis findings, 14 of 18 patients with IgG4-related pleural effusion had high ADA more than 40 U/L. The pleural effusion of patients with IgG4-related pleural effusion showed higher TP levels (P < .001) and lower LDH (P < .001) and ADA levels (P = .002) than those with tuberculous pleurisy. Moreover, the pleural fluid ADA/TP ratio was a good predictor for differentiating IgG4-related pleural effusion and tuberculous pleurisy (area under the receiver operating characteristic curve of 0.909; 95% confidence level: 0.824–0.994).
Analysis of the relationship between asthma and benign prostatic hyperplasia
Authors: Wee Jee Hye , Bang Woo Jin , Park Min Woo , Byun Soo-Hwan , Choi Hyo Geun
Published: March 2021

The purpose of this study was to evaluate the association between asthma and benign prostatic hyperplasia (BPH) in an adult Korean population and to evaluate this association based on the treatment status of asthmatics.

We utilized the Korean genome and epidemiology study health examinee 2004 to 2016 database. A total of 47,186 participants (825 asthmatics and 46,361 controls) were selected and their BPH histories were analyzed. We categorized the participants according to their asthma treatment status: “well controlled”; “being treated”; and “not being treated”. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for BPH were analyzed using multiple logistic regression. Subgroup analyses were performed according to age (60 years).

The results showed that the prevalence of BPH was higher among asthma patients (17.1%) than among controls (8.7%, P < .001). Asthma patients had a higher risk of having BPH (OR = 1.64, 95% CI = 1.37–2.01, P < .001) than controls, after adjustment for age, income, body mass index (BMI), smoking, alcohol consumption, frequency of physical activity, and the past medical diseases. The ORs for BPH were 1.35 (95% CI = 1.04–1.76) in those aged >60 years and 2.24 (95% CI = 1.70–2.96) in those aged ≤60 years. The ORs for BPH were 1.82 (95% CI = 1.16–2.87, P = .009) in the “well-controlled” group, 1.05 (95% CI = 0.74–1.49, P = .794) in the “being treated” group, and 2.24 (95% CI = 1.69–2.97, P < .001) in the “not being treated” group.

We found that there is a correlation between asthma and BPH in the adult Korean population. There is a stronger association between asthma and BPH in younger adults and in those who are not receiving treatment for asthma.
The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants
Authors: Oh Hyun Jin , Ryu Kum Hei , Park Bum Joon , Yoon Byung-Ho
Published: March 2021

Background:

Non-vitamin K antagonist oral anticoagulants (NOACs) have been widely used for stroke prevention in atrial fibrillation (AF) and the treatment and prevention of venous thromboembolism. There is an issue with safety, especially in clinically relevant bleeding. We performed a network meta-analysis to evaluate the risk of major gastrointestinal (GI) bleeding associated with NOACs.

Methods:

Interventions were warfarin, enoxaparin, apixaban, dabigatran, edoxaban, and rivaroxaban. The primary outcome was the incidence of major GI bleeding. A subgroup analysis was performed according to the following indications: AF, deep venous thrombosis/pulmonary embolism, and postsurgical prophylaxis.

Results:

A total of 29 randomized controlled trials (RCTs) and 4 large observation population studies were included. Compared with warfarin, apixaban showed a decreased the risk of major GI bleeding (relative risk [RR] 0.54, 95% confidence interval [CI] 0.25–0.76), and rivaroxaban tended to increase this risk (RR 1.40, 95% CI 1.06–1.85). Dabigatran (RR 1.25, 95% CI 0.98–1.60), edoxaban (RR 1.07, 95% CI 0.69–1.65), and enoxaparin (RR 1.24, 95% CI 0.63–2.43) did not significantly increase the risk of GI bleeding than did warfarin. In the subgroup analysis, according to indications, apixaban showed a decreased risk of major GI bleeding (RR 0.50, 95% CI 0.34–0.74) than did warfarin in AF studies. Dabigatran (RR 2.36, 95% CI 1.55–3.60, and rivaroxaban (RR 1.75, 95% CI 1.10–6.41) increased the risk of major GI bleeding than did apixaban. An analysis of studies on venous thromboembolism or pulmonary embolism showed that no individual NOAC or enoxaparin was associated with an increased risk of major GI bleeding compared to warfarin.

Conclusion:

Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.