bluuebunny/crossref_metadata_2025 huggingface dataset:
Histories of Rights in Nature
Authors: Cederlöf Gunnel
Published: December 2019

This is a study of the formation of legal rights in nature during British colonial rule in South India. Though focusing on a limited geographical area, it has relevance for land law within the colonies of the British Empire. It targets specifically rights of access and ownership of land in territories dominated by indigenous communities, whom the British administration defined as ‘tribal’. Chapter one introduces the larger theme and contextualises the Nilgiri Hills as the location of a close empirical study of land conflicts during its most intense period until the first more encompassing code of rights in nature in the Nilgiris in 1843. The chapter further juxtaposes contemporary debates on how the past and history have been a battleground for codifying such rights. Here, the chapter contrasts the production of history with memory wherein the critique of Eurocentrism has challenged long-term legacies of historismus. Oral history and memory that have been argued to be the privileged arena of subaltern and colonised populations are considered in view of written history being originally oral testimony. Other debates, foundational for the formation of legal codes, have targeted the impact of evolutionary science on history and the role of the resulting discipline as both an imperial and a modern project.
Libraries in Ancient Egypt, c.2600–1600 BCE
Authors: Parkinson R. B.
Published: December 2019

This chapter surveys the textual and archaeological evidence for libraries in ancient Egypt c.2600–1600 BCE, discussing surviving administrative ‘archives’ as models for how literary texts could have been circulated and stored. The implications of the material form of surviving manuscripts for issues of manufacture and storage are discussed. Possible evidence for extensively centralized systems of circulation and storage is reviewed, together with specific case studies of private archives form the town of el-Lahun and examples of Middle Kingdom tomb-libraries—collections of manuscripts deposited in private individual’s burial chambers as displays of culture and prestige.
Archives and Libraries in the Old Babylonian Period, c.1900–1600 BCE
Authors: Delnero Paul
Published: December 2019

In this chapter two substantial textual assemblages of Sumerian literary compositions from Ur and Nippur (two major urban centres in southern Mesopotamia in the late third and early second millennium) are described and compared to address the question of the extent to which assemblages such as these can be considered textual archives or libraries. Particular emphasis is given to the types of compositions that are found in the two assemblages, as well as to how the archaeological contexts in which the assemblages were discovered and the material aspects of the texts themselves (the format and layout of the clay tablets on which the compositions were copied) might shed light on how and why the texts in these assemblages were copied (and possibly archived) as a group.
Assurbanipal’s Library
Authors: Finkel Irving
Published: December 2019

This illustrated chapter is intended to convey something of the wonder of the great royal library of cuneiform tablets assembled at Nineveh by King Assurbanipal (668–c.627 BC), the last great king of Assyria, of which some 20,000 items are now in the British Museum, London. The king’s intention was to bring together under his control the whole of inherited lore and knowledge recorded in cuneiform documents, for editing and recopying by his chancery calligraphers, to constitute a unique resource both for the running of the state and his own edification. The result exceeded all expectations, in that the modern recovery and decipherment of its contents has conferred immortality on the great scholar king and endowed the Humanities with one of its greatest treasures.
Genomic Regions Associated with Virulence in Pyrenophora teres f. teres Identified by Genome-Wide Association Analysis and Biparental Mapping
Authors: Martin Anke , Moolhuijzen Paula , Tao Yongfu , McIlroy Judy , Ellwood Simon R. , Fowler Ryan A. , Platz Greg J. , Kilian Andrzej , Snyman Lisle
Published: December 2019

Net form net blotch (NFNB), caused by the fungal pathogen Pyrenophora teres f. teres, is an important foliar disease present in all barley-producing regions of the world. This fungus is a hemibiotrophic and heterothallic ascomycete, where sexual recombination can lead to changes in disease expression in the host. Knowledge of the genetic architecture and genes involved in virulence is vital to increase the durability of NFNB resistance in barley cultivars. We used a genome-wide association mapping approach to characterize P. teres f. teres genomic regions associated with virulence in Australian barley cultivars. One hundred eighty-eight P. teres f. teres isolates collected across five Australian states were genotyped using Diversity Arrays Technology sequence markers and phenotyped across 20 different barley genotypes. Association mapping identified 14 different genomic regions associated with virulence, with the majority located on P. teres f. teres chromosomes 3 and 5 and one each present on chromosomes 1, 6, and 9. Four of the regions identified were confirmed by quantitative trait loci (QTL) mapping. The QTL regions are discussed in the context of their genomic architecture together with examination of their gene contents, which identified 20 predicted effectors. The number of QTL shown in this study at the population level clearly illustrates a complex genetic basis of P. teres f. teres virulence compared with pure necrotrophs, such as the wheat pathogens Parastagonospora nodorum and Parastagonospora tritici-repentis.
Common and Challenging Behaviors Among Individuals on Long-term Opioid Therapy
Authors: Young Sarah R. , Azari Soraya , Becker William C. , Edelman E. Jennifer , Liebschutz Jane M. , Roy Payel , Starrels Joanna L. , Merlin Jessica S.
Published: December 2019

Objective:

Long-term opioid therapy (LTOT) is commonly prescribed for chronic pain, despite risks such as opioid use disorder (OUD) and overdose. Caring for patients on LTOT can be difficult, given lack of evidence about assessment of challenging behaviors among patients on LTOT. To develop this evidence, a critical first step is to systematically identify the common and challenging behaviors that primary care providers encounter among patients on LTOT, and also to highlight to diverse range of behaviors encountered.

Method:

We conducted a Delphi study in 42 chronic pain experts to determine consensus on how to address the top common and challenging behaviors. This paper reports on the first round of the study, which elicited a range of behaviors. We conducted thematic analysis of the behaviors and also used the Diagnostic and Statistical Manual (DSM)-5 criteria for OUD as a priori codes.

Results:

In all, 124 unique behaviors were identified by participants and coded into 4 thematic categories: concerning behaviors that map onto DSM-5 criteria for OUD, and those that do not which were: behaviors that suggest deception, signs of diversion, and nonadherence to treatment plan. Those behaviors that fell outside of OUD criteria we identified as “gray zone” behaviors.

Conclusions:

While some of these challenging behaviors fall under the criteria for an OUD, many fall outside of this framework, making diagnosis and treatment difficult, and consensus on how to deal with these “gray zone” behaviors is vital. Future research should explore how these “gray zone” behaviors can best be assessed and managed in a primary care setting.
Prevalence of ulnar nerve palsy with flexion-type supracondylar fractures of the humerus
Authors: Kim Kelvin Y. , Conaway William , Schell Ryan , Hennrikus William L.
Published: December 2019

The aim of this study is to report the rate and type of neurologic injury associated with flexion supracondylar fractures at a tertiary, university institution treated over a 10-year period. All supracondylar humerus fracture cases treated at our institution between January 2004 and January 2014 were retrospectively reviewed. Twenty-three flexion-type fractures were identified. Patient demographics as well as fracture classification, treatment modalities, and pre-and post-treatment neurologic status were analyzed. Twenty-three flexion-type supracondylar humerus fractures were identified and reviewed out of a total of 1000 supracondylar humerus fractures (2.3%). Details of the patients’ neurologic status upon presentation demonstrated that 17 (74%) patients were intact and six (26%) patients presented with an ulnar neuropraxia. Zero type I fractures, one type II fractures (14.3%), and five type III fractures (33.3%) demonstrated an ulnar nerve palsy. Of these, all six nerve deficits resolved following treatment. One additional patient was identified with median nerve neuropraxia following treatment with closed reduction casting, which resolved following observation. A total of 4 (17.4%) patients were treated with closed reduction casting, 15 (65.2%) with closed reduction percutaneous pinning, and four (17.4%) with open reduction internal fixation. Flexion-type supracondylar fractures of the humerus are rare yet significant injuries. The 26% of patients who developed an ulnar neuropraxia following a displaced flexion supracondylar fracture were higher than previous studies reported in the literature. This increased prevalence may be due to the high rates of type III fractures reported in the current study. Level of evidence: III, Retrospective comparative cohort analysis.
Immunotherapy for the rheumatoid arthritis-associated coronary artery disease: promise and future
Authors: Wang Lun , Zhang Yang , Zhang Shu-Yang
Published: December 2019

Objective:

To review the latest progress on the pathogenic mechanism and management of rheumatoid arthritis (RA)-associated coronary artery disease (CAD), and propose advice on future management optimization as well as prospects for research and development of new therapeutic regimen.

Data sources:

This study was based on data obtained from PubMed up to May 2019 using various search terms and their combinations, including coronary artery disease, myocardial ischemia, cardiovascular diseases, RA, rheumatic diseases, treatment, therapy, strategies, immunotherapy, inflammation, and anti-inflammation.

Study selection:

All retrieved literature was scrutinized, most relevant articles about the pathogenic mechanism and clinical management, especially anti-inflammatory therapy of RA-associated CAD were reviewed.

Results:

RA is an immune-mediated chronic inflammatory disease which has a great social disease burden. In addition to typical arthritic manifestations, RA also affects extra-articular tissues and organs, within which the involvement of the cardiovascular system, especially incorporating CAD, is the leading cause of death for patients with RA. Recently, numerous basic and clinical studies have been carried out on the mechanism of CAD development and progression under the inflammatory cascade of RA. The effect of traditional RA drugs on CAD risk management has been gradually clarified, and more emerging biologic agents are being explored and studied, which have also achieved satisfactory outcomes. Furthermore, with the success of the CANTOS clinical trial, novel anti-inflammatory therapy for the prevention of cardiovascular disease is believed to have a broad prospect.

Conclusions:

RA is an independent risk factor for CAD, which mainly results from the underlying inflammatory cascade; therefore, anti-inflammatory therapy, especially the emerging novel biologic drugs, is important for CAD management in patients with RA and may also be a promising approach among the general population.
Nonhomologous end-joining repair is likely involved in the repair of double-stranded DNA breaks induced by riluzole in melanoma cells
Authors: Cerchio Robert , Marinaro Christina , Foo Tzeh Keong , Xia Bing , Chen Suzie
Published: December 2019

Our group described the oncogenic potential of a normal neuronal receptor, metabotropic glutamate receptor 1 (GRM1/mGluR1, gene/protein), when aberrantly expressed in melanocytes led to cell transformation in vitro and spontaneous metastatic tumors in vivo. Earlier, we demonstrated the accumulation of phosphorylated histone H2AX (γH2AX), a marker for DNA damage when mGluR1-expressing melanoma cells were treated with a functional inhibitor, riluzole. The precise mechanisms on how riluzole induces DNA damage in these cells are unknown. In an attempt to begin to identify possible DNA repair pathways that may be involved in riluzole-induced DNA damage, we took advantage of specific inhibitors to two well-known DNA repair pathways, homologous recombination and nonhomologous end joining (NHEJ) repair pathways. Using flow cytometry and a fluorescent antibody to γH2AX, our results demonstrate that NHEJ is likely to be the preferred DNA repair pathway to restore DNA double-stranded breaks induced by riluzole in mGluR1-expressing melanoma cells.
Transitioning from clinician to nurse practitioner clinical faculty: A systematic review
Authors: McQuilkin Mary Allison , Gatewood Elizabeth , Gramkowski Bridget , Hunter Jay Michael , Kuster Andrea , Melino Katerina , Mihaly Lisa Klee
Published: December 2019

Background:

Schools of nursing are challenged with recruiting and retaining nurse practitioner (NP) clinical faculty in a job market where the few qualified candidates have competing professional opportunities. The role transition from clinician to clinical faculty is stressful, and many faculty have unmet needs for support.

Objectives:

This article will identify strategies universities can implement to increase retention in the faculty role by facilitating the transition from clinician to NP clinical faculty.

Data sources:

Articles were identified from the following databases: PubMed, Embase, PsychInfo, CINAHL Plus, Web of Science, Google Scholar, and Cochrane Library.

Conclusions:

The transition from clinician to the NP role can be very difficult. New faculty experience culture shock and concerns about maintenance of clinical practice. Orientation, peer support, and mentoring can mitigate the challenges and support the transition.

Implications for practice:

Schools of nursing can facilitate the transition from clinician to NP clinical faculty by developing an onboarding program that integrates mentoring, orientation, and ongoing support.
Emerging incidence trends and application of curative treatments of pancreatic cancer in the USA
Authors: Pei Xiaxia , Song Feixue , Wang Zhiping
Published: December 2019

Annual pancreatic tumor incidence rates have been increasing. We explored pancreatic tumor incidence trends by treatment and clinicopathologic features.

Data from the Surveillance, Epidemiology and End Results (SEER) was retrieved to evaluate temporal trends and pancreatic cancer rates from 2000 to 2015. Joinpoint regression analyses were carried out to examine trend differences.

Overall, the incidence of pancreatic cancer was on the increase. The initial APC increased at a rate of 2.22% from 2000 to 2012, and increased from 2012 to 2015 at a rate of 9.05%. Joinpoint analyses revealed that trends within different demographics of pancreatic cancer showed different characteristics. The rate of pancreatic cancer also varied with histologic types. In addition, the trends by cancer stage showed significant increase incidences of stage I and II pancreatic cancer from 2000 to 2013 (stage I: APC: 2.71%; stage II: APC: 4.87%). Incidences of patients receiving surgery increased from 2000 to 2008 (APC: 7.55%), 2008 to 2011 (APC: 2.17%) and then there was a significant acceleration from 2011 to 2015 (APC: 10.51%). The incidence of cases in stage II receiving surgery increased significantly from 2004 to 2009 (APC: 9.28%) and 2009 to 2013 (APC: 2.57%). However, for cases in stage I, the incidence of cases with surgery decreased significantly since 2009 (APC: −4.14%). Patients undergoing surgical treatment without chemotherapy and radiotherapy had the higher rates compared with those who received other combined treatments.

Pancreatic cancer has been increasing overall, but patterns differ by demographics and clinicopathologic features. Efforts to identify and treat more eligible candidates for curative therapy could be beneficial.
CUL4A expression is associated with tumor stage and prognosis in nasopharyngeal carcinoma
Authors: Jin Xin , Ma Yong-Chi , Zhu Wen-Yan , Fan Lun
Published: December 2019

Cullin 4A (CUL4A) is a protein of E3 ubiquitin ligase with many cellular processes. CUL4A could regulate cell cycle, development, apoptosis, and genome instability. This study aimed to analyze the expression of CUL4A in nasopharyngeal carcinoma (NPC) tissues and the associations of CUL4A expression with prognostic significance. A total of 115 NPC patients were collected to assess the protein expression of CUL4A by immunohistochemistry, so as to analyze the relationships between CUL4A expression and clinicopathological and prognostic parameters. All patients were followed-up until death or 5 years. The results showed that high expression of CUL4A was significantly associated with larger primary tumor size (P = .026), higher nodal status (P = .013), more distant metastasis (P = .020), and higher TNM stage (P = .005). Kaplan–Meier curves showed that patients with higher CUL4A expression had significantly shorter overall survival (OS) and progression-free survival (PFS) (both P < .001). In multivariate Cox analysis, CUL4A is an independent prognostic factor for OS (P = .016; hazard ratio [HR] = 2.770, 95% CI: 1.208–6.351) and PFS (P = .022; HR = 2.311, 95% CI: 1.126–4.743). In conclusion, high expression of CUL4A was associated with advanced disease status of NPC, and might serve as an independent prognostic factor.
Acute diffuse edematous-hemorrhagic Epstein–Barr virus meningoencephalitis
Authors: Han Jingzhe , Kang Zhilei , Xie Yanan , Li Hui , Yan Haiyan , Song Xueqin
Published: December 2019

Introduction:

In this study, we presented a rare case of Epstein–Barr virus (EBV) meningoencephalitis presented with meningoencephalitis-like symptoms and diffuse edematous hemorrhage.

Patient concerns:

A 77-year-old male patient was admitted to our hospital with fever, headache, confusion, and unconsciousness for 7 days. Physical examination revealed unconsciousness and stiffness of the neck.

Diagnosis:

The final diagnosis was EBV meningoencephalitis.

Interventions:

Ganciclovir (two times 350 mg/day, 21 days), methylprednisolone sodium succinate (120 mg, 5 days), and IV immunoglobulins (IV Ig) (0.4 g/kg, 5 days) were given to this patient.

Outcomes:

But the patient's clinical symptoms did not improve, and he was still in a coma. His family refused to be further diagnosed and discharged. After discharge for 2 months, the patient was in a coma. Four months later, the patient died of complications of pulmonary infection.

Conclusion:

The patient is an adult, and imaging was dominated by intracranial diffuse microhemorrhage and edema, which was different from the typical imaging characteristics of EBV encephalitis as previously reported. This specific imaging change may provide new clinical value for the diagnosis of EBV encephalitis.
Ocular findings and strabismus surgery outcomes in Chinese children with Angelman syndrome
Authors: Ye Haiyun , Lan Xiaoping , Liu Qingyu , Zhang Yidan , Wang Siying , Zheng Ce , Di Yue , Qiao Tong
Published: December 2019

Rationale:

Angelman syndrome (AS) is an uncommon genetic disease characterized as serious retarded mental development and ocular abnormality.

Patient concerns:

This report aims to present the ophthalmological features, and identify the diagnosis and outcomes of strabismus surgery in AS patients.

Diagnosis:

Three children with exotropia were diagnosed with AS based on their typical clinical features.

Interventions:

All patients underwent multiplex ligation-dependent probe amplification (MLPA) analysis and accepted lateral rectus recession surgery with the assistance of intravenous combined inhalation anesthesia.

Outcomes:

The maternal heritage deletion of chromosome 15q11.2-q13 was verified in all patients by MLPA. All patients with strabismus could not cooperate during the vision test, and had astigmatism. The strabismus type of AS patients was horizontal exotropia, and no vertical strabismus was found. One of these patients was combined with high myopia. The hypopigmentation on the hair and iris was ubiquitous. However, retina pigmentation was normal. After different degrees of lateral rectus recession, the exotropia was significantly relieved, and the surgical effects were stable postoperatively.

Lessons:

Horizontal exotropia is the major strabismus type. Severe intellectual disability, hyperactivity, and speech impairment are the common characteristics of AS children. Its examination and operation design remains challenging. Thus, repeated examinations and intelligence rehabilitation are essential.
Efficacy and safety of cisplatin for the management of adult patients with oral cancer
Authors: Feng Yao , Yang Dian-song , Tang Hai-bo , Ding Yuan-sheng , Li Xiao-guang
Published: December 2019

Background:

Cisplatin is often used for the treatment of oral cancer (OC). However, there are inconsistent results. Thus, this study plans to systematically assess the clinical efficacy and safety of cisplatin for adult patients with OC.

Methods:

We will search for PUBMED, EMBASE, Cochrane Library, AMED, Cumulative Index to Nursing and Allied Health Literature, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All of them will be searched from the construction of each database up to the present with no restrictions of language and publication status. The data analysis will be conducted using RevMan 5.3 software to assess the efficacy and safety of cisplatin for adult patients with OC.

Results:

This study will summarize the most recent high-quality evidence and will provide helpful information about the efficacy and safety of cisplatin for adult patients with OC.

Conclusion:

The findings of this study will provide convinced evidence of cisplatin for adult patients with OC, and provide recommendations for clinical practice.

Systematic review registration:

PROSPERO CRD42019156558.
Lethal infective endocarditis due to Streptococcus agalactiae in a man with a history of alcohol abuse
Authors: D’Angelo Myriam , Boretti Ilaria , Quattrocchi Salvina , Alongi Giovanni , Rifici Carmela , Corallo Francesco , Magazù Angela , Milardi Demetrio , Cannavà Gaetano , Bramanti Placido , Duca Antonio
Published: December 2019

Rational:

Infective endocarditis (IE) is defined as an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium.

Patient concerns:

A 53-years-old man with a history of alcohol abuse was admitted in hospital for fever, paroxysmal atrial fibrillation cardioverted by Amiodarone and pulmonary infection.

Diagnosis:

A case of recurrent severe endocarditis, with neurological complications both ischemic and hemorrhagic and heart failure caused by Streptococcus agalactiae in healthy man we reported.

Interventions:

Surgery was performed 2 weeks after admission.

Outcomes:

The onset of intracranial hemorrhage delayed second cardiac surgery and the patient died because of end-stage heart failure.

Conclusions:

Infective endocarditis caused by S. agalactiae is very rare, particularly in patients without underlying structural heart disease. This study showed that IE due to S. Agalactiae is a disease with high mortality when associated with neurological complication, heart failure but especially when it is recurrent and hits valve prosthesis.
Airway management using laryngeal mask airway (LMA) in a patient in a lateral decubitus position
Authors: Lim Jung A , Jeong Min Yeong , Kim Jong Hae
Published: December 2019

Rationale:

Airway management of patients in a lateral decubitus position (LDP), who cannot lie supine is challenging for anesthesiologists. In a previous study, laryngeal mask airway (LMA) was found to be superior to conventional endotracheal intubation in LDP.

Patient Concerns:

A 38-year-old man diagnosed with type I neurofibromatosis presented with pain caused by a large hematoma (28 × 8 cm) located in the left upper back. On arrival at the operating theater, he was in a right LDP because of the aggravation of pain in the supine position.

Diagnoses:

Laryngoscopy-guided endotracheal intubation was expected to be difficult in LDP.

Interventions:

After the induction of anesthesia, a non-inflatable LMA was introduced into the laryngopharynx with the patient in LDP. He was then maneuvered into a supine position and removal of the LMA was followed by endotracheal intubation.

Outcomes:

The surgery for the removal of the hematoma was performed in a prone position. The airway intubated with an endotracheal tube was well maintained during the entire surgery.

Lessons:

LMA is a useful device for airway management in patients in LDP who cannot lie supine.
A randomized double-blind study comparing prophylactic norepinephrine and ephedrine infusion for preventing maternal spinal hypotension during elective cesarean section under spinal anesthesia
Authors: Xu Shiqin , Mao Mao , Zhang Susu , Qian Ruifeng , Shen Xiaofeng , Shen Jinchun , Wang Xian
Published: December 2019

Background:

Studies have shown the efficacy of norepinephrine in the treatment of maternal hypotension during cesarean section by comparing it to treatment with phenylephrine. However, few studies have compared the efficacy of norepinephrine to ephedrine.

Methods:

Ninety-seven women undergoing elective cesarean section were administered norepinephrine at 4 μg/minute (group N; n = 48) or ephedrine at 4 mg/minute (group E; n = 49) immediately postspinal anesthesia, with an on-off titration to maintain systolic blood pressure (SBP) at 80% to 120% of baseline. A rescue bolus of 8 μg norepinephrine was given whenever SBP reached the predefined lower limit. Our primary outcome was the incidence of tachycardia. Secondary outcomes included the incidence of bradycardia, hypertension, hypotension, severe hypotension, hypotensive episodes, number of rescue top-ups, hemodynamic performance error including median performance error (MDPE), and median absolute performance error (MDAPE). Neonatal Apgar scores and umbilical arterial (UA) blood gas data were also collected.

Results:

Women in group N experienced fewer cases of tachycardia (4.2% vs 30.6%, P = .002, odds ratio: 0.11 [95% confidence interval, CI: 0.02–0.47]), a lower standardized heart rate (HR) (70.3 ± 11 vs 75 ± 11, P = .04, difference: 4.7 ± 2.2 [95% CI: 0.24–9.1]), and a lower MDPE for HR (1.3 ± 9.6 vs 8.4 ± 13.5 bpm, P = .003, difference: 3.1 ± 1.8 [95% CI: −0.6–6.7]). In addition, the lowest or the highest HR was lower in group N compared to group E (both P < .05). Meanwhile, the standardized SBP in group N was lower than that in group E (P = .04). For neonates, the UA blood gas showed a higher base excess (BE) and a lower lactate level in group N compared to E (both P < .001). Other hemodynamic variables, maternal, and neonatal outcomes were similar.

Conclusion:

Infusion of 4 μg/minute norepinephrine presented fewer cases of tachycardia, less fluctuation and a lower HR compared to baseline values, as well as a less stressed fetal status compared to ephedrine infusion at 4 mg/minute. In addition, norepinephrine infusion presented a lower standardized SBP compared to ephedrine.
Acupuncture therapy for patients with hemifacial spasm
Authors: Yang Han , Zhou Jun , Zhong Dongling , Yin Zihan , Xu Guixing , Chen Jiao , Li Juan , Liang Fanrong
Published: December 2019

Background:

Hemifacial spasm (HFS) brings a lot of trouble to patients’ daily life, having a severe influence on the psychological and physical wellbeing of patients. Relevant researches suggested that acupuncture therapy has potential benefits for HFS. However, there is no consistent conclusion. The purpose of our study is to assess whether acupuncture therapy is effective and safe for HFS.

Methods:

To collect relevant randomized controlled trials (RCTs), the following electronic databases will be searched: Web of Science, the Cochrane Library, EMBASE, MEDLINE, ISI Web of Knowledge, PsycINFO, Allied and Alternative Medieine, Chinese National Knowledge Infrastructure, Wanfang data, and Chinese Scientific Journals Database. We will take the cure rate and the total effective rate as the primary outcomes, and change in intensity after treatment, change in frequency after treatment, the recurrence rate, and adverse events as secondary outcomes. Endnote software 9.1 will be used for study selection, Review Manager software 5.3, and STATA 13.0 software will be used for analysis and synthesis.

Results:

Current relevant studies will be synthesized to assess whether acupuncture therapy is effective and safe for HFS.

Conclusion:

Our research will provide evidence of acupuncture therapy for HFS.

Registration:

International Prospective Register of Systematic Reviews (PROSPERO) CRD42019142473.
Atypical musculoskeletal manifestations on flexor hallucis longus tendon of gout causing tarsal tunnel syndrome in diabetic patients
Authors: Kim Yoon Seok , Lee Min Ki , Yi Young
Published: December 2019

Rationale:

Deposition of tophus is a common feature in chronic gout; however, signs and symptoms are not always well-pronounced in cases of uncommon sites. We report a rare case with a tophaceous tendonitis on the flexor hallucis longus (FHL) tendon with tarsal tunnel syndrome (TTS). This is the first surgical case of TTS by gouty tophi in FHL.

Patient Concerns:

A 55-year-old woman presented with a 6-month history of mild discomfort at the right foot, which gradually worsened in the past 3 weeks. The patient visited our outpatient clinic due to persistent and aggravating foot pain and swelling around the tarsal tunnel.

Diagnosis:

The patient was diagnosed with hyperuricemia and diabetes mellitus with chronic kidney disease, and did not receive regular antigout treatments. Paresthesia was found along the distribution of medial and plantar nerve and tinel test was positive on tarsal tunnel. Biochemical examination showed she had raised serum uric acid (10.6 mg/dL) and decreased estimated glomerular filtration rate (69 mL/min/1.73 m2). Conventional radiography examination showed negative pathology except soft tissue swelling. Magnetic resonance imaging revealed a fusiform mass within the FHL tendon and fluid collection around tarsal tunnel.

Interventions:

Surgical exploration was performed to remove the mass. Inflammation fluid exploded out from FHL tendon sheath, which was later proven to have infiltration of monosodium urate crystal. Superficial dissection revealed a white chalky mass and posterior tibial nerve was significantly compressed by the tophus mass.

Outcomes:

The mass was removed and the symptoms were relieved at immediate postoperative period.

Lessons:

A tophaceous tendonitis on FHL tendon can cause TTS and surgical decompression of the gout lesion can reduce the symptoms.
A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris
Authors: Chen Mingtai , Men Ling , Wu Haibin , Zhong Guofu , Ou Lijun , Li Tao , Guo Yingyi , Lin Haidan , Zhang Jian , Wang Dongcai , Zhang Zhong
Published: December 2019

Background:

A growing number of studies suggest that Gualou Xiebai Banxia (GLXBBX) decoction, a well-known Chinese herbal formula, has beneficial effects on eliminating angina pectoris symptoms and improving condition of stable angina pectoris (SAP) patients. However, whether this treatment is effective and safe for SAP or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies. This study aimed to evaluate the effectiveness and safety of GLXBBX in treating SAP.

Methods:

The major databases (MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Database) were searched from inception to March 2019. Randomized controlled trials (RCTs) of GLXBBX alone or combined with conventional drugs against conventional drugs for SAP were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers.

Result:

Totally 17 clinical RCTs were included in this study, involving 1676 patients. Due to the high probability of bias of the included studies, it was inappropriate to undertake a meta-analysis. Thus, we only conducted a systematic review and mainly discussed the methodology and limitation of the included studies.

Conclusion:

Although the current evidence prompted that GLXBBX might benefit SAP patients in improvement of angina pectoris, ECG, and blood lipid on a certain extent, this systematic review revealed no definite conclusion about the application of GLXBBX for SAP due to the poor methodological quality, high risk of bias, and inadequate reporting on clinical data. More rigorous, multicenter, sufficient-sample, and double-blind randomized clinical trials are warranted.
The efficacy and safety of omadacycline in treatment of acute bacterial infection
Authors: Lan Shao-Huan , Chang Shen-Peng , Lai Chih-Cheng , Lu Li-Chin , Chao Chien-Ming
Published: December 2019

Background:

This study aims to assess the clinical efficacy and safety of omadacycline for the treatment of acute bacterial infections in adult patients through meta-analysis.

Methods:

PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched up to May 2019. Only randomized controlled trials (RCTs) that evaluated omadacycline and other comparators for treating acute bacterial infections in adult patients were included. The primary outcome was the clinical response rate at the posttreatment evaluation, whereas the secondary outcomes were risk of an adverse event (AE) and mortality.

Results:

Four RCTs were included. Overall, omadacycline had a clinical response rate noninferior to comparators in the treatment of acute bacterial infection in the modified intent-to-treat population (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.04–1.65; I
2 = 0%) and in the clinically evaluable population (OR, 1.53; 95% CI, 1.11–2.11; I
2 = 0%). Furthermore, no significant differences were found between omadacycline and comparators for the risk of treatment-emergent AEs (OR, 1.13; 95% CI, 0.60–2.14; I
2 = 93%), treatment-related AEs (OR, 0.70; 95% CI, 0.46–1.04; I
2 = 56%), serious AEs (OR, 1.01; 95% CI, 0.64–1.58; I
2 = 0%), and discontinuation of study drug due to an AE (OR, 0.78; 95% CI, 0.47–1.29; I
2 = 0%). However, in the clinical trial, NCT02877927, in which omadacycline was used in only oral form, the reported incidence of nausea and vomiting were 30.2% (111/368) and 16.9% (62/368), respectively. Finally, the mortality rate was similar between omadacycline and comparator in the treatment of acute bacterial infection (OR, 1.32; 95% CI, 0.47–3.67; I
2 = 0%).

Conclusion:

The clinical efficacy of omadacycline is not inferior to that of comparators in the treatment of acute bacterial infections in adult patients, and this antibiotic is also well tolerated.
Relationship between urate within tophus and bone erosion according to the anatomic location of urate deposition in gout
Authors: Shi Dan , Chen Jie-Yu , Wu Hua-Xiang , Zhou Qi-Jing , Chen Hai-Yan , Lu Yuan-Fei , Yu Ri-Sheng
Published: December 2019

The aim of this study was to measure the urate volume within tophus and bone erosion volume using dual-energy computed tomography in patients with tophaceous gout. Furthermore, our study aims to quantitatively analyze the relationship between monosodium urate (MSU) crystal deposition and bone erosion according to the anatomic location of urate deposition.

Seventy-seven subjects with chronic gout were positively identified for the presence of urate deposition. Only 27 subjects identified for the presence of urate in contact with bone erosion were included in this study. The urate volumes and associated erosion volumes were measured. The relationships between urate within tophus and bone erosion were separately analyzed according to the anatomic location of urate deposition.

Twenty-seven subjects were all male (100%) with a median (interquartile range, IQR) age of 52 (45–61) years. From all the subjects, 103 tophi depositions were identified in contact with bone erosion, including 58/103 tophi that contained an intraosseous component and 45/103 nonintraosseous tophi. Tophi containing intraosseous components were larger than nonintraosseous tophi (urate volume: median [IQR] 45.64 [4.79–250.89] mm3 vs 19.32 [6.97–46.71] mm3, P = .035) and caused greater bone erosion (erosion volume: 249.03 [147.08–845.33] mm3 vs 69.07 [32.88–111.24] mm3, P < .001). Almost all erosion volumes were larger than urate volumes in nonperiarticular tophi, in contrast to most erosion volumes, which were less than urate volumes in the tophi that contained a periarticular component (odds ratio, 95% confidence interval: 74.00, 14.70–372.60; P < .001). Urate volume and erosion volume demonstrated positive correlations in intraosseous tophi, intraosseous-intra-articular-periarticular tophi, and intraosseous-intra-articular tophi (rs = 0.761, rs = 0.695, rs = 0.629, respectively, P < .05).

MSU crystal deposition shows a promoting effect on the development of bone erosions in varying degrees, associated with the location of MSU crystals deposited in the joints. The intraosseous tophi contribute the most to bone erosions, followed by intra-articular tophi, and periarticular tophi.
The management of Salter-Harris type II fracture with associated posterior sternoclavicular joint displacement using a locking compression plate
Authors: Vitali Matteo , Drossinos Andreas , Pironti Pierluigi , Pesce Elisa , Salini Vincenzo
Published: December 2019

Rationale:

Posterior sternoclavicular joint dislocations (PSCJDs) are particularly rare injuries, accounting for 3% to 5% of sternoclavicular joint dislocations. With very few cases reported in the literature, these injuries are often misdiagnosed and imaging is not always clear, thus making physicians often unaware of them. The present case report aims to investigate a rare case involving a clavicular Salter-Harris II fracture with associated posterior displacement of the diaphysis, a term coined a “pseudodislocation.”

Patient concerns:

We present a case of a 14-year-old adolescent who sustained a traumatic injury to the shoulder while falling during a soccer match. His main concern was about recovery time and the return to daily life activities.

Diagnoses:

Multiple imaging studies imaging (X-rays, computed tomography, magnetic resonance imaging) revealed a Salter-Harris II fracture of the right clavicle with posterior displacement of the diaphysis.

Interventions:

The patient underwent primary surgery to reduce the fracture, using an articular locking compression plate, and secondary surgery to remove the hardware.

Outcomes:

Following the removal of the hardware at 60 days after the initial surgery and a number of cycles of physiotherapy the patient reported a pain-free range of motion with slight limitation at extremes. Full return to recreational and everyday life activities were achieved at 3 months from the initial surgery.

Lessons:

The PSCJDs are challenging injuries, as they are surrounded by delicate structures inside the mediastinum. Attention must be taken while diagnosing and treating these injuries as the risk of complications and iatrogenic injuries is high. To the author's knowledge, this case is one of the first of its kind described in the literature where we have a Salter-Harrys type II fracture associated with a posterior pseudodislocation of the lateral clavicle. Given the positive results of the case, we recommend the above-mentioned treatment protocol in PSCJD with associated Salter-Harris II fractures in adolescent patients.
Reactivation of latent tuberculosis infection induced by cabazitaxel in a patient with prostate cancer
Authors: Hashimoto Mamoru , Minami Takafumi , Hamaguchi Mamoru , Fujimoto Saizo , Takahashi Tomoki , Kikuchi Takashi , Adomi Shogo , Banno Eri , Ohzeki Takayuki , Shimizu Nobutaka , Mori Yasunori , Nozawa Masahiro , Nose Kazuhiro , Yoshimura Kazuhiro , Uemura Hirotsugu
Published: December 2019

Rationale:

Latent tuberculosis infection (LTBI) describes the dormant state of tuberculosis (TB), in which persistent immune-related interaction between TB and T-cells maintain its state. Cabazitaxel (CBZ) is reported to improve overall survival in patients with castration-resistant prostate cancer (CRPC) after progression observed in regimens including docetaxel. CBZ is known for severe myelosuppression; however there is no recommendation for the treatment of LTBI before CBZ treatment. To the authors’ knowledge, this is the first report to describe reactivation of LTBI induced by CBZ.

Patient concerns:

A 75-year-old Japanese male with a medical history of TB since 16 years of age had been treated for prostate cancer (PC) (initial prostate-specific antigen 532 ng/ml; cT4N1M1b; Gleason score4+4) with androgen deprivation therapy, abiraterone, and docetaxel. Calcified nodules and radiological findings of LTBI were present in the upper right lobe since the diagnosis of PC. After progression was observed during these treatments, CBZ was administered combined with pegfilgrastim, long-acting granulocyte colony-stimulating factor (G-CSF). Seven days after the third course of CBZ, he was admitted to the authors’ hospital to treat febrile neutropenia (FN). High fever persisted even after myelosuppression had recovered. Computed tomography (CT) revealed distribution of small nodules in the bilateral lungs, for which miliary TB was included in the differential diagnosis. T-Spot, interferon-gamma-release assay, and bronchoscopy yielded no significant findings; however, sputum and urine culture confirmed the diagnosis of TB.

Diagnosis:

CT, sputum and urine culture confirmed the diagnosis of miliary TB.

Interventions:

The patient was treated with anti-bacterial therapy (cefepime) on hospital admission, which was not effective. After the diagnosis of miliary TB was confirmed, anti-TB drugs, including isoniazid, rifampicin, pyrazinamide and ethambutol, were administered.

Outcomes:

Despite anti-TB therapy, high fever persisted and radiological findings worsened. Fifty days after the third course of CBZ, the patient died of respiratory dysfunction caused by progression of miliary TB.

Lessons:

Management of LTBI is needed in cases of radiographic findings of LTBI and medical history of TB before CBZ treatment, despite the rarity of LTBI reactivation in patients with PC.
A nomogram for prediction of posthepatectomy liver failure in patients with hepatocellular carcinoma
Authors: Shen Yi-Nan , Tang Tian-Yu , Yao Wei-Yun , Guo Cheng-Xiang , Yi-Zong  , Song Wei , Liang Ting-Bo , Bai Xue-Li
Published: December 2019

To generate a nomogram to predict posthepatectomy liver failure (PHLF), we attempted to elucidate salient risk factors in patients with hepatocellular carcinoma (HCC).

We performed a retrospective review of 665 patients with HCC who received hepatectomy in 2 academic institutions in China. Independent risk factors for PHLF were identified from putative demographic, intrinsic, biochemical, surgery-related, and volumetric data. A predictive nomogram was formulated based on relevant risk factors, and we compared this with existing models.

We identified clinical signs of portal hypertension (P = .023), serum total bilirubin (P = .001), serum creatinine (P = .039), and intraoperative hemorrhage (P = .015) as being important risk factors in predicting PHLF. The nomogram had a C-index of 0.906 for the externally validated data. The nomogram displayed better predictive value than 2 of the other most cited models (C-indices of 0.641 and 0.616, respectively) in the current cohort. Additionally, we were able to patients into low- (<10%), intermediate- (10–30%), and high-risk (≥30%) groups based on the nomogram. This allows us to facilitate person-specific management.

Here, we constructed a simple nomogram for prediction of PHLF in patients with HCC weighted by independent risk factors. Further prospective studies are required to confirm the predictive ability of our nomogram.
The low-density lipoprotein cholesterol lowering is an ineffective surrogate marker of statin responsiveness to predict cardiovascular outcomes
Authors: Hyun Myung Han , Jang Jae Won , Choi Byoung Geol , Na Jin Oh , Choi Cheol Ung , Kim Jin Won , Kim Eung Ju , Rha Seung-Woon , Park Chang Gyu , Lee Eunmi , Seo Hong Seog
Published: December 2019

Statins therapy decrease both low-density lipoprotein cholesterol (LDL-C) levels and the risk of atherosclerotic cardiovascular disease (ASCVD) with considerable individual variability. Whether the amount of LDL-C lowering is a surrogate maker of statin responsiveness to ASCVD prevention has not been fully investigated. Among 2352 eligible patients with statin prescriptions in a cardiovascular center between January 2005 and February 2014, one-third of patients (33%) on statin therapy failed to achieve effective reductions in LDL-C (LDL-C level reduction of less than 15%). By using, propensity-score matched population (480 pairs, n = 960), the 5-year cumulative incidences of total major adverse cardiac events (MACE) were evaluated. The 5-year total MACE did not differ between normal cholesterol responders and non-responders (15.4% vs 16.1%, respectively; P = .860). In the subgroup analysis, male sex, older age, percutaneous coronary intervention, and heart failure were positive predictors, and dyslipidemia at the beginning of statin therapy was the only negative predictor of MACE in the 5-year follow-up (all P value < .05). However, cholesterol responsiveness after statin therapy did not influence the incidence of MACE (P = .860). The amount of LDL-C lowering did not predict beneficial effect on clinical outcomes of ASCVD after statin therapy. This result supports that given statin therapy, total ASCVD risk reduction should be tailored, which may not dependent to adherence to degree of LDL-C lowering or LDL-C goal based treatment.