bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified multi-scale symbolic dynamic entropy and fuzzy broad learning-based fast fault diagnosis of railway point machines
Authors: Liu Junqi , Wen Tao , Xie Guo , Cao Yuan
Published: December 2022

Railway point machine (RPM) condition monitoring has attracted engineers’ attention for safe train operation and accident prevention. To realize the fast and accurate fault diagnosis of RPMs, this paper proposes a method based on entropy measurement and broad learning system (BLS). Firstly, the modified multi-scale symbolic dynamic entropy (MMSDE) module extracts dynamic characteristics from the collected acoustic signals as entropy features. Then, the fuzzy BLS takes the above entropy features as input to complete model training. Fuzzy BLS introduces the Takagi-Sugeno fuzzy system into BLS, which improves the model’s classification performance while considering computational speed. Experimental results indicate that the proposed method significantly reduces the running time while maintaining high accuracy.
Study on risk assessment and factors ranking of the LTE-M communication system
Authors: Wu Xiaochun , Gao Yu , Zheng Weichao
Published: December 2022

To assess the operational safety risk of long-term evolution for the metro (LTE-M) communication system more accurately, the guide maintenance strategy, the improved evidence theory and the multi-attribute ideal reality comparative analysis (MAIRCA) approaches are proposed. According to the features of LTE-M system, the risk evaluation system is established. The enhanced structural entropy weight method is used to obtain the weight. Furthermore, it is combined with nine-element fuzzy mathematics to transform the degree of membership, modifying the conflict and fusion rules to solve the confidence degree clashed problem of evidence theory. Then, the system risk grade assessment result is obtained. For the purpose of forming the ranking of indicator importance, the MAIRCA is introduced and the ranking is three-dimensional. The operational state of the metro line is used as the data source in various ways based on the test and calculation. The results show that the method is effective; compared with others, the confidence degree of the obtained risk grade increased by 7.12%. It is verified that MAIRCA can be applied to the field of urban rail transit because it has excellent stability and the ranking result of risk factors is reasonable. The influencing indicator with the highest importance is the ‘equipment failure rate’.
Research on anti-attack performance of a private cloud safety computer based on the Markov-Percopy dynamic heterogeneous redundancy structure
Authors: Wen Jiakun , Liu Zhen , Ding Huan
Published: December 2022

With the increasing computing demand of train operation control systems, the application of cloud computing technology on safety computer platforms of train control system has become a research hotspot in recent years. How to improve the safety and availability of private cloud safety computers is the key problem when applying cloud computing to train operation control systems. Because the cloud computing platform is in an open network environment, it can face many security loopholes and malicious network attacks. Therefore, it is necessary to change the existing safety computer platform structure to improve the attack resistance of the private cloud safety computer platform, thereby enhancing its safety and reliability. Firstly, a private cloud safety computer platform architecture based on dynamic heterogeneous redundant (DHR) structure is proposed, and a dynamic migration mechanism for heterogeneous executives is designed. Then, a generalized stochastic Petri net (GSPN) model of a private cloud safety computer platform based on DHR is established, and its steady-state probability is solved by using its isomorphism with the continuous-time Markov model (CTMC) to analyse the impact of different system structures and executive migration mechanisms on the system's anti-attack performance. Finally, through experimental verification, the system structure proposed in this paper can improve the anti-attack capability of the private cloud safety computer platform, thereby improving its safety and reliability.
Research on fault diagnosis of a railway point machine based on a multi-entropy feature extraction method and support vector machine
Authors: Zheng Yunting , Chen Shaohua , Tan Zhiyong , Sun Yongkui
Published: December 2022

A new fault diagnosis method is proposed to effectively extract the fault features of the sound signal of typical faults of ZDJ9 railway point machines. A multi-entropy feature extraction method is proposed by combing multi-scale permutation entropy and wavelet packet entropy. Firstly, empirical mode decomposition is performed on sound signals to obtain modal components with different time scales. Then, multi-scale permutation entropy is extracted from these components. Meanwhile, the wavelet packet entropy of the sound signals of these sensitive nodes is obtained by analysing the reconstructed signals of the last layer nodes. Since the multi-scale permutation entropy and the wavelet packet entropy can distinguish the subtle features of the signal, the subtle features of the original signal can be obtained as the feature vector of the ZDJ9 railway point machine in different states. To reduce the redundant information among the high-dimensional features, ReliefF is utilized. Finally, a support vector machine (SVM) is used to judge the fault type of a ZDJ9 railway point machine.
Drug Approved to Prevent Cisplatin-Associated Ototoxicity in Children
Authors: Aschenbrenner Diane S.
Published: December 2022

Sodium thiosulfate injection (Pedmark) has been approved to decrease the risk of ototoxicity associated with cisplatin use in children who are at least one month old and have localized nonmetastatic solid tumors.

Nurses should regularly weigh children taking this drug, as the dose is based on weight. Patients should be premedicated with antiemetics to prevent nausea and vomiting and monitored closely for evidence of electrolyte imbalances.
Multifaceted Intervention Reduces Newborn Falls in Mother–Baby Unit
Authors: Rosenberg Karen
Published: December 2022

According to this study:

A multifaceted intervention can reduce newborn falls and injuries in a clinical setting with high rates of prenatal opioid exposure and a strong culture of breastfeeding and rooming-in.
Laboratory test trends within 72 hours of hospital admission associated with death among COVID-19 patients
Authors: Zambrano Sarah , Davis Megan , Leeds David R. , Noronha Kelvin , McLaughlin Angela , Burns Rebecca H. , Mulvey Elizabeth , Linas Benjamin P. , Assoumou Sabrina A.
Published: December 2022

Early identification of patients at risk for severe coronavirus disease 2019 (COVID-19) is crucial for appropriate triage and determination of need for closer monitoring. Few studies have examined laboratory trends in COVID-19 infection and sought to quantify the degree to which laboratory values affect mortality. We conducted a retrospective cohort (n = 407) study of hospitalized patients with COVID-19 early in the course of the pandemic, from March 16th to April 8th, 2020 and compared baseline to repeat laboratory testing 72 hours into admission. The primary outcome was death. We found that rises of 25 mg/L C-reactive protein, 50 units/L lactate dehydrogenase, and 100 ng/mL ferritin were associated with 23%, 28%, and 1% increased odds of death, respectively. In contrast, changes in fibrinogen, D-dimer, white blood cell count, and creatinine in the first few days of hospital admission were not associated with mortality. These quantitative findings may assist clinicians in determining the risk of potential clinical decline in patients with COVID-19 and influence early management.
Effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer: A protocol for systematic review of clinical trials
Authors: Pires Luciana Bicalho Cevolani , Salaroli Luciane Bresciani , Lopes-Júnior Luís Carlos
Published: December 2022

Background:

Globally, pancreatic cancer is the seventh most common cause of cancer-related death in both sexes, accounting for 466,003 deaths and 495,773 new cases in 2020. The purpose of this study was to synthesize and evaluate evidence on the effects of omega-3 supplementation on the nutritional status of patients with pancreatic cancer.

Methods:

This systematic review protocol will be guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Five databases will be searched: MEDLINE/PubMed, CENTRAL Cochrane, EMBASE, Web of Science, and SCOPUS, with no restrictions on the publication date nor language. The internal validity and risk of bias of randomized controlled trials will be assessed using the revised Cochrane Risk-Of-Bias tool for randomized trials (RoB 2), whereas the risk of bias in non-randomized studies of interventions will be evaluated using the ROBINS-I. The heterogeneity among the studies will be assessed using the I
2 statistic. Based on the results of this test, we will verify whether the meta-analysis would be feasible. If feasibility would be confirmed, a random-effect model analysis will be performed. For data analysis, the calculation of the pooled effect estimates will have a 95% confidence interval, while the alpha will be set to 0.05 using the R statistical software version 4.0.4. All methodological steps of this review will be performed independently by two reviewers and will be conducted and managed in the EPPI-Reviewer Software™.

Results:

This review may be of particular interest to researchers and clinicians, given the low survival and overall burden of patients with pancreatic cancer. Furthermore, the results of this systematic review may contribute to the development of new nutritional interventions in these patients.

Conclusion:

To the best of our knowledge, this will be the first study to critically assess the scientific evidence and estimate the effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer. The review will perform a rigorous approach, adhering to the PRISMA Statement 2020 using a comprehensive and systematic search strategy in five databases and additional sources with no time period nor language restrictions.
Antimicrobial resistance in odontogenic infections: A protocol for systematic review
Authors: Cuevas-Gonzalez María Verónica , Mungarro-Cornejo Gabriela Anaid , Espinosa-Cristóbal León Francisco , Donohue-Cornejo Alejandro , Tovar Carrillo Karla Lizette , Saucedo Acuña Rosa Alicia , García Calderón Alma Graciela , Guzmán Gastelum Dalia Abril , Zambrano-Galván Graciela , Cuevas-Gonzalez Juan Carlos
Published: December 2022

Background:

It is estimated that up to 90% of head and neck infections have an odontogenic origin, which are considered among the most common in the oral cavity and maxillofacial region. Bacterial resistance has been 1 of the main problems related to the treatment of this type of infection in recent years. The frequency of this resistance is increasing, which is mainly due to patient self-medication and the mutations that bacteria present. Therefore, the objective of this study is to analyze the antimicrobial resistance of antibiotics commonly administered for the treatment of odontogenic infections.

Method:

To carry out the study, PubMed, ScienceDirect, and Scopus databases were reviewed using the keywords “odontogenic infection”, “pharmacological treatment”, and “microbial resistance. Studies whose main objective was the pharmacological treatment of odontogenic infections were selected. Exclusions were review-type studies, systematic reviews, or in vitro or animal model studies. For the analysis of risk of bias, the Checklist for Analytical Cross-Sectional Studies of the Joanna Briggs Institute was used. The search and analysis of the studies was carried out by 2 researchers independently.

Results:

A total of 13 studies were included in this review. The mean age was 39.6 years; the location of the infection in the study subjects was in the submandibular and vestibular spaces; there were periodontal, periapical, and dentoalveolar lesions; the main microorganisms identified were Streptococcus, Staphylococcus, Prevotella, Peptostreptococcus, Clostridium, and Klebsiella; and finally, the main microorganisms identified for bacterial resistance were penicillin, clindamycin and amoxicillin.

Conclusion:

The health professional is obliged to update their knowledge to avoid such antibiotic resistance and thus provide better patient care.
Orthopaedic surgeons can play important role in identifying victims of domestic violence in the emergency department – narrative review of Brazilian literature
Authors: Giordano Vincenzo , Giordano Carolina , Lopes Isadora Maria , Pires Robinson Esteves , Godoy-Santos Alexandre , Giannoudis Peter V.
Published: December 2022

Over the last year, with the social isolation imposed by the coronavirus disease pandemic, there has been a significant increase in complaints associated with physical violence against women. In the present study, an exploratory literature review was carried out on the role of the on-call orthopedic surgeon when faced with a suspicion of domestic violence, in accordance with Brazilian legislation. The main objective of the study was to show the role of this specialist in identifying victims of domestic violence by recognizing their profiles and associated risk factors. The secondary objectives were to demonstrate the most common skeletal and non-skeletal injuries in this type of violence and to present a quick and practical guide on how to identify, approach, and manage cases of domestic violence against women. The findings revealed that the main aggressors were close partners, such as spouses and ex-spouses. Young adult women, black or multiracial, and low socioeconomic status are major risk factors for intimate partner violence. Head and neck injuries are the most frequently observed lesions in this population, with more than one-third of victims reporting falls. Musculoskeletal injuries are present in up to 42% of victims of domestic violence, occurring predominantly in the upper limbs and chest, and are the leading cause of death in women aged 1 to 34 years. A practical guide for orthopedic surgeons who work in emergency departments is proposed, with basic information about their role and responsibility in identifying potential victims of intimate partner violence.
The efficacy and safety of traditional Chinese medicine physiotherapy combined with acupoint injection on diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis
Authors: Wang Lin , Guan Bugao , Li Guangrun , Feng Liquan , Sun Hui , Xu Jin
Published: December 2022

Background:

The efficacy and safety of traditional Chinese medicine physiotherapy combined with acupoint injection in treating diabetic peripheral neuropathy remains unknown. As a result, we will conduct a systematic review and meta-analysis to assess the evidence.

Methods:

We will look for pertinent randomized controlled trials in the following databases: China National Knowledge Infrastructure, WanFangData, Chinese biological medical database, Medline, Cochrane Library, PubMed, and Embase up to January 2022. Following the standards of Cochrane Review 6.2, 2 researchers independently evaluated the quality of the evidence in the relevant papers. Data analysis will be conducted by using Review Manager 5.4, including statistical analysis, subgroup analysis, making forest plot and funnel chart.

Results:

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

Conclusion:

The research will verify the safety and efficacy of traditional Chinese medicine physiotherapy in combination with acupoint injection for diabetic peripheral neuropathy.
Efficacy of electrical stimulation combined with ultrasound acupuncture therapy on treatment in patients with intrauterine adhesions: Study protocol for a placebo-controlled, single-blind, single-center, randomized trial
Authors: Xu Tao , Xie Li , Qin Xiaoling , Xie Xueting , Mo Sien , Jiang Qiu , Liang Feng , Zhu Xuehong , Li Bin , Lin Zhong
Published: December 2022

Background:

Recurrence of postoperative adhesions is one of the most important factors for poor reproductive outcomes after hysteroscopic surgery, particularly in cases diagnosed with severe intrauterine adhesions (IUAs), where the recurrence rate is significantly higher. This study aims to explore the effectiveness of the electrical muscle stimulation combined with ultrasound acupuncture therapy in preventing the recurrence of IUAs and improving reproductive outcomes after operative hysteroscopy.

Methods:

This study is a single-center, randomized controlled trial. A total of 210 patients with IUAs will be randomly assigned into 2 groups according to the ratio of 1:1, as the treatment group and the control group. Participants will receive the electrical muscle stimulation combined with ultrasound acupuncture therapy and oral hormone supplementation or receive oral hormone supplementation only. The primary outcome was the clinical response rate. There were 3 menstrual cycles of treatment and 3 menstrual cycles of follow-up in this study.

Ethics and Dissemination:

This study protocol was approved by the Ethics Committee of the Reproductive Hospital of Guangxi Zhuang Autonomous Region (approval number: KY-LL-2022-06). This trial will be conducted in accordance with the principles of the Declaration of Helsinki as well as Good Clinical Practice. Study results will be disseminated at academic presentations and publications in peer-reviewed journals.

Trial Registration:

Registry name: Clinical value of electroultrasonic instrument in the treatment of IUAs and changes of related protein expression; Registry number: ChiCTR2200058901; registration date: April 19th, 2022; http://www.chictr.org.cn/showproj.aspx?proj=166155.
Antioxidant effect of spirulina in chronic periodontitis
Authors: Kaipa Vinay Rama Krishna , Asif Shaik Mohammed , Assiri Khalil Ibrahim , Saquib Shahabe Abullais , Arem Saeed Abdullah , Sree Suma , Yassin Syed Mohammed , Ibrahim Mohammed , Shariff Mansoor , Shamsudeen Shaik Mohammed , Kaleem Sultan Mohammed , Ghaffar Khan Abdul Ahad
Published: December 2022

Background:

Production of reactive oxygen species (ROS) by polymorpho nuclear neutrophils occurs in chronic periodontitis. These ROS are mainly involved in bacterial destruction. However, extracellular release of same results in destruction of surrounding tissue. Spirulina, a potent antioxidant when administered sub gingivally in pockets can offer improved results in chronic periodontitis patients. This study was conducted to evaluate the effect of Spirulina when delivered sub gingivally in patients with chronic periodontitis.

Methods:

Sixty chronic periodontitis patients were divided into 2 groups. Group I (n = 30) were treated with Scaling and Root planning (SRP) followed by placement of placebo (SRP-P) and in Group II (n = 30) Spirulina microspheres were placed sub gingivally (SRP-S) following SRP. Clinical parameters like bleeding on probing (BOP), clinical attachment level (CAL), gingival index (GI) and probing pocket depth (PPD) were evaluated. Levels of salivary and serum Malondialdehyde (MDA) were estimated using ultra violet spectrophotometer.

Results:

At baseline, in both groups there was no statistically significant difference in clinical and biochemical parameters. Intra group comparisons of parameters from baseline to 90 days were statistically significant in both groups. After 90 days difference in clinical parameters and salivary MDA levels were statistically significant in SRP-S compared to SRP-P group. Though serum MDA levels were reduced in both groups, they were not significant statistically.

Conclusions:

Our study concluded that, local drug delivery of Spirulina adjunctive to SRP has potent antioxidant effect in treatment of chronic periodontitis.
QSOFA and SOFA scores are valuable tools for predicting postoperative sepsis resulting from ureteroscopic lithotripsy (URSL)
Authors: Laih Chun-Yo , Hsiao Po-Jen , Hsieh Po-Fan , Wang Yu-De , Lai Chun-Ming , Yang Chao-Tung , Lin Chu-Hsing , Huang Chi-Ping
Published: December 2022

The sequential organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA) scores are new tools which are used to assess sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock Task Force. This study aimed to evaluate the feasibility of using the SOFA and qSOFA to predict post-ureteroscopic lithotripsy (URSL) sepsis. Patients who underwent URSL due to ureteral stone obstruction were retrospectively reviewed using SOFA and qSOFA scores. Patient characteristics including age, gender, comorbidities, American Society of Anesthesiologists Classification, stone burden, stone location, hydronephrosis status, infectious status, preoperative SOFA and qSOFA score were collected. Preoperative factors were analyzed to determine if they were correlated with postoperative sepsis. A total of 830 patients were included in this study, of whom 32 (3.9%) had postoperative sepsis. Multivariate analysis revealed that older age, proximal ureteral stones, severe hydronephrosis, and high preoperative qSOFA or SOFA score were significantly associated with postoperative sepsis. The areas under the curves of a qSOFA score ≥ 1 and SOFA score ≥ 2 for predicting postoperative sepsis were 0.754 and 0.823, respectively. Preoperative qSOFA and SOFA scores are convenient and effective for predicting post-URSL sepsis. Further preventive strategies should be performed in these high-risk patients.
Groin surgical site infection incidence in vascular surgery with intradermal suture versus metallic stapling skin closure: A study protocol for a pragmatic open-label parallel-group randomized clinical trial (VASC-INF trial)
Authors: González-Sagredo Albert , Gil Miquel , D’Oria Mario , Spanos Konstantinos , Salinas Álvaro , Matus Selene , Carnaval Thiago , Llagostera Secundino , Lepidi Sandro , Giannoukas Athanasios , Bellmunt Sergi , García-Vidal Raul , Videla Sebastián , Vila Ramon , Iborra Elena
Published: December 2022

Background:

Surgical site infection is 1 of the most frightening complications in vascular surgery due to its high morbimortality. The use of intradermal sutures for skin closure might be associated with a reduction in infections incidence. However, the data available in the literature is scarce and primarily built on low-evidence studies. To our knowledge, no multicenter clinical trial has been published to assess if the intradermal suture is associated with a lower surgical site infection incidence than metallic staples in patients who will undergo revascularization surgery requiring a femoral approach.

Methods:

VASC-INF is a pragmatic, multicenter, multistate (Spain, Italy, and Greece), randomized, open-label, clinical trial assessing the surgical site infection incidence in patients undergoing revascularization surgery requiring a femoral approach. Patients will be randomized on a 1:1 ratio to intradermal suture closure (experimental group) or to metallic staples closure (control group).

The primary outcome is the number (percentage) of patients with surgical site infection (superficial and/or deep) associated with a femoral approach up to 28 (±2) days after surgery. Among the secondary outcomes are the number (percentage) of patients with other surgical wound complications; the number (percentage) of patients with surgical site infections who develop sepsis; type of antibiotic therapy used; type of microorganisms’ species isolated and to describe the surgical site infection risk factors.

Discussion:

Intradermal suture closure may be beneficial in patients undergoing revascularization surgery requiring a femoral approach. Our working hypothesis is that intradermal suture closure reduces the incidence of surgical site infection respect to metallic staples closure.
Examination of the microstructures of the lower cervical facet based on micro-computed tomography: A cadaver study
Authors: Li Kun , Ji Yucheng , Shi Jun , Zhang Shaojie , Song Haoyu , Wang Peng , Ma Chunying , Zhang Yansong , Dang Yexing , Ma Yuan , Wang Xing , Li Zhijun
Published: December 2022

The cervical facet has complicated 3D microstructures and inhomogeneities. The cervical facet joint, which also participates in the formation, plays a certain role in regulating and limiting the movement of the spine. Correct identification and evaluation of its microstructure can help in the diagnosis of orthopedic disease and predict early phases of fracture risk. To evaluate the safety of the cervical spine by measuring and analyzing the microstructures and morphometric parameters of bone trabeculae in the normal cervical facet with high-resolution 3D micro-computed tomography. Thirty-one sets of C3 to C7 lower cervical vertebrae (155 vertebrae) were scanned using micro-computed tomography. The morphological characteristics and direction of trabecular bone in the facet of the lower cervical vertebrae were observed by selecting and rebuilding the areas of interest, and the changes in the microstructure of the areas of interest were calculated to reveal the structural characteristics and weak areas. Images indicated an ossified center between the superior and inferior articular processes of the lower cervical spine. The cellular bone trabeculae of the articular process had complex reticular microstructures. The trabecular bone plate near the cortical bone was lamellar and relatively dense, and it extended around and transformed into a network structure, and then into the rod-shaped trabecular bone. The rod-shaped trabeculae converged with the plate-shaped trabeculae with only 1 to 2 layers surrounding the trabeculae cavity. Statistical results of the morphological parameters of the trabecular bone showed that trabecular bone volume fraction values were significantly higher for C7 than for C3 to C6 (P < .05). There were significant differences between C7 and C3 to C5 and between C6 and C4 in bone surface area/bone volume (P < .05). There was a significant difference between C7 and C3 to C6 in trabecular bone thickness values (P < .05). The degree of anisotropy value was significantly smaller for C3 than for C6 and C7 (P < .05). The changes in the C3 to C7 microstructure were summarized in this study. The loading capacity and stress of the C7 articular process tended to be limited, and the risk of injury tended to be higher for the C7 articular process.
Clinical characteristics and risk factors of 267 patients having severe fever with thrombocytopenia syndrome–new epidemiological characteristics of fever with thrombocytopenia syndrome: Epidemiological characteristics of SFTS
Authors: Dong Yu , Lin Shao-hua , Jiang Ling , Liu Hui
Published: December 2022

Objective:

To analyze the epidemiological distribution, clinical characteristics, and prognostic risk factors of patients having severe fever with thrombocytopenia syndrome (SFTS).

Methods:

We enrolled 790 patients with SFTS divided into the ordinary group and the severe group, analyzed the clinical characteristics, and screened the risk factors of severious patients by univariate logistic regression analysis.

Results:

Most of the 790 patients (SFTS) are farmers (84.56%). The proportion of patients with fieldwork history was 72.41%, of which 21.27% had a clear history of a tick bite and 98.61% were sporadic cases. The annual peak season is from April to November. 16.33% patients were not accompanied by fever. The incidence of severe thrombocytopenia was 47.59%. They were statistically significant between the 2 groups in indicators such as age, hypertension, coronary heart disease, diabetes mellitus, bunyavirus nucleic acid load and mean platelet count (P < .05). Multivariate non conditional Logistic regression analysis showed that the risk factors of the mild patients deteriorating severe disease were age (OR = 1.985, P 
≤ .003), diabetes mellitus (OR = 1.702, P 
≤ .001), coronary heart disease (OR = 1.381, P ≤ .003), platelet count (OR = 2.592, P 
≤ .001), viral nucleic acid loading (OR = 3.908, P 
≤ .001).

Conclusion:

The incidence population and seasonal distribution characteristics of patients with SFTS are obvious. The risk factors for poor prognosis of severe patients are old age, multiple basic medical histories, high viral load, a serious decrease of mean platelet count, and delay of treatment time.
Patient reported outcomes after navigated minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) using cortical bone trajectory screws
Authors: Sitoci-Ficici Kerim Hakan , Jiang Hongzen , Esmael Agrin , Ruess Daniel , Reinshagen Clemens , Brautferger Uta , Schackert Gabriele , Molcanyi Marek , Pinzer Thomas , Hudak Radovan , Zivcak Jozef , Rieger Bernhard
Published: December 2022

Prospective observational study. To evaluate patient-reported outcomes after navigation-guided minimally invasive hybrid lumbar interbody fusion (nMIS-HLIF) for decompression and fusion in degenerative spondylolisthesis (Meyerding grade I-II). Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) are well-known standard procedures for lumbar spinal fusion. nMIS-HLIF is a navigation-guided combined percutaneous and open procedure that combines the advantages of PLIF and TLIF procedures for the preparation of a single-port endoscopic approach. 33 patients underwent nMIS-HLIF. Core outcome measure index (COMI), oswestry disability index (ODI), numeric rating scale (NRS) back, NRS leg, and short form health-36 (SF-36) were collected preoperatively and at follow-up of 6 weeks, 3 months, 6 months, and 1 year. The impact of body mass index (BMI) was also analyzed. Computed tomography reconstruction was used to assess realignment and verify fused facet joints and vertebral bodies at the 1-year follow-up. 28 (85%) completed the 1-year follow-up. The median BMI was 27.6 kg/m2, age 69 yrs. The mean reduction in listhesis was 8.4% (P < .01). BMI was negatively correlated with listhesis reduction (P = .032). The improvements in the NRS back, NRS leg, ODI, and COMI scores were significant at all times (P < .001—P < .01). The SF-36 parameters of bodily pain, physical functioning, physical component summary, role functioning/physical functioning, and social functioning improved (P < .003). The complication rate was 15.2% (n = 5), with durotomy (n = 3) being the most frequent. To reduce the complication rate and allow transitioning to a fully endoscopic approach, expandable devices have been developed. The outcomes of nMIS-HLIF are comparable to the current standard open and minimally invasive techniques. A high BMI hinders this reduction. The nMIS-HLIF procedure is appropriate for learning minimally invasive dorsal lumbar stabilization. The presented modifications will enable single-port endoscopic lumbar stabilization in the future.
Effect of nucleos(t)ide analogues on blood lipid profiles in patients with chronic hepatitis B: A cross-sectional survey
Authors: Chen Jing Wen , Cao Xiong Yue , Qi Xun , Zhang Ji Ming
Published: December 2022

This study aimed to explore the effects of the 3 nucleos(t)ide analogues (NAs) on lipid levels. We retrospectively included patients treated with NAs at 2 centers and collected their clinical data at their visiting points. Differences in blood lipid levels were analyzed by statistical methods, and factors related to hyperlipidemia were discussed. In these 2 centers, the prevalence rates of hypercholesterolemia were 12/181 (6.6%) for tenofovir alafenamide fumarate (TAF)-, 0/158 (0%) for tenofovir disoproxil fumarate (TDF)-, and 13/182 (7.1%) for entecavir (ETV)-treated individuals (P = .003). The prevalence rates of hypertriglyceridemia were 30/181 (16.6%) for TAF-, 11/158 (7.0%) for TDF-, and 26/182 (14.3%) for ETV-treated individuals (P = .025). In TAF (n = 181, 10 [6, 15] months), TDF (n = 158, 18 [7.5, 45] months), and ETV (n = 182, 24 [10, 60] months) groups, total cholesterol (TC) levels were 4.63 ± 0.91 mmol/L, 3.86 ± 0.61 mmol/L, and 4.53 ± 0.87 mmol/L, respectively; triglyceride (TG) levels were 1.27 ± 0.76 mmol/L, 0.87 ± 0.51 mmol/L, and 1.14 ± 0.67 mmol/L, respectively (P < .001). In multivariate regression analysis, factors associated with hypercholesterolemia were age (adjusted hazard risk [HR] = 1.055 [1.018–1.094]; P = .003) and body mass index (BMI) (adjusted HR = 0.817 [0.669–0.998]; P = .048). Factors associated with hypertriglyceridemia were TAF group (vs. TDF group) (adjusted HR = 0.405 [0.167–0.980]; P = .045), age (adjusted HR = 1.028 [1.002–1.055]; P = .038), and sex (adjusted HR = 0.190 [0.079–0.456]; P < .001). Among the patients treated with TAF (10 [6, 15] months), TDF (18 [7.5, 45] months), and ETV (24 [10, 60] months), the blood lipid levels in the TDF group were lower than those in the TAF group and ETV group, and the occurrence of hyperlipidemia was associated with age, sex, BMI, and different treatment.
Clinicopathological characteristics and prognostic risk factors of cervical cancer patients aged ≤35 years old
Authors: He Juan , Zhuang Yali , Hu Chengyang
Published: December 2022

We aimed to explore the clinicopathological characteristics and prognostic risk factors of cervical cancer in patients aged ≤35 years. A total of 256 cervical cancer patients treated at Anhui Medical University Affiliated Maternity and Child Health Hospital and The First Affiliated Hospital of Anhui Medical University from January 2016 to October 2018 were divided into ≤35-year-old (n = 136) and >35-year-old (n = 120) groups. Their clinicopathological characteristics and 3-year cumulative disease-free survival (DFS) and overall survival (OS) rates were compared. The factors influencing the 3-year cumulative DFS rate of patients in the ≤35-year-old group were analyzed using univariate and multivariate Cox regression models. The human papillomavirus (HPV) infection rate, incidence rate of contact vaginal bleeding, depth of cervical interstitial infiltration, and incidence rates of parametrial metastasis and vascular infiltration were all significantly higher in the ≤35-year-old group than in the >35-year-old group. The 3-year cumulative DFS rates of all patients and those with HPV infection and contact vaginal bleeding were significantly lower in the ≤35-year-old group than in the >35-year-old group (69.12% vs. 77.50%, 68.29% vs. 80.85%, and 66.04% vs. 81.48%) (log-rank χ2 = 7.429, 4.339, and 4.276, P < .05). Depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration were independent risk factors for the prognosis of cervical cancer patients aged ≤35 years (P < .05). Cervical cancer aged ≤35 years have a worse postoperative prognosis than those aged >35 years, which is affected by the depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration. Therefore, it is necessary to identify more effective treatment methods for young patients with cervical cancer to improve the therapeutic effect and reduce the risk of recurrence and metastasis.
Clinical evaluations of pituitary apoplexy in incidental nonfunctional pituitary adenomas
Authors: Takeshita Kaori , Abe Ichiro , Kameda Wataru , Ishii Kota , Fujita Yuya , Nagata Mai , Ochi Kentaro , Senda Yuki , Koga Midori , Kudo Tadachika , Hada Yurika , Takase Kaoru , Morinaga Yusuke , Ito Miiko , Abe Makiko , Ishizawa Kenichi , Kobayashi Kunihisa
Published: December 2022

Pituitary apoplexy is an uncommon syndrome that often results in spontaneous hemorrhage or infarction of pituitary tumors or glands. We previously reported pituitary apoplexy occurred most frequently in nonfunctional pituitary adenomas among all types of pituitary incidentalomas. In the present study, we aimed to investigate the characteristics of pituitary apoplexy in patients with incidental nonfunctional pituitary adenomas. 65 patients with pituitary incidentaloma were enrolled. All patients underwent clinical/endocrinological/pathological investigations. As a result, 33 patients were diagnosed with nonfunctional pituitary adenomas. Of these, 12.1% of patients had pituitary apoplexy. There was no difference in tumor diameter, age, or sex between the apoplexy and the non-apoplexy groups. However, the liver enzymes aspartate transaminase and alanine aminotransferase were significantly higher, and plasma sodium and chloride levels were significantly lower in the apoplexy group than in the non-apoplexy group (each P < .05). In addition, low-density lipoprotein-cholesterol was significantly higher in the apoplexy group than in the non-apoplexy group (P < .05). Besides, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, and prolactin deficiencies were significantly more frequent in the apoplexy group than in the non-apoplexy group (each P < .05), and growth hormone and adrenocorticotropic hormone deficiencies were more frequent in the apoplexy group than in the non-apoplexy group (P = .09 and.08, respectively). Furthermore, tumor diameter was not associated with pituitary apoplexy, whereas thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone deficiencies were significantly associated with the apoplexy group (each P < .05). Hence, the present study indicated that pituitary apoplexy could not be related to tumor diameter. Moreover, hormonal deficiencies, hepatic dysfunction, hyponatremia or hypochloremia, and dyslipidemia might be indicators of pituitary apoplexy. There could be the possibility the treatment for dyslipidemia prevents pituitary apoplexy.
Prognostic value and immunological role of Kruppel-like transcription factor 9 gene in pan-carcinoma
Authors: Cai Weichao , Li Yecheng , Cao Weihong
Published: December 2022

Objective:

To investigate the correlation between the expression of Kruppel-like transcription factor 9 (KLF9) and the prognostic value of tumors as well as its relationship with tumor immune invasion.

Methods:

A series of bioinformatics methods were used to analyze the relationship between KLF9 and tumor prognosis, tumor mutation burden, microsatellite instability (MSI), and immune cell infiltration in multiple carcinomas.

Results:

In multiple tumor tissues, the expression of KLF9 was lower compared with paracancerous tissues. Therefore, KLF9 can serve as a protective factor to improve the prognosis of carcinoma patients with certain tumor types. KLF9 was closely related to the clinical staging of various carcinomas. The expression of KLF9 was not only associated with tumor mutation burden and MSI in some tumor types, but also positively correlated with immune and stromal cells in multiple tumors. Further studies have found that, the level of immune cell infiltration was significantly related to the expression of KLF9.

Conclusion:

KLF9 can affect the prognosis of pan-carcinoma, which is related to immune invasion. Therefore, KLF9 can be used as a potential biomarker for the prognosis of pan-carcinoma.
Clinical characteristics of 662 patients with pancreatic neuroendocrine tumors receiving antitumoral therapy
Authors: Loosen Sven H. , Kostev Karel , Eschrich Johannes , Krieg Sarah , Krieg Andreas , Luedde Tom , Jann Henning , Roderburg Christoph
Published: December 2022

Pancreatic neuroendocrine neoplasia constitute an important subentity of the gastroenteropancreatic neuroendocrine neoplasms accounting for up to 15% of all neuroendocrine neoplasm. Prognosis and oncological behavior of pancreatic neuroendocrine tumors (pNETs) is extremely heterogenous and dependent on the specific tumor stage and differentiation. However, systematic data on the specific epidemiology of pNET are scarce. We identified 662 patients with pNET within the Oncology Dynamics database (IQVIA). Patients were derived from 4 European countries (Germany, France, UK, Spain), 3 Asian countries (Japan, China, South Korea) and 2 South American countries (Mexico and Brazil) and with regard to major patient and tumor related characteristics including patients’ age, sex, tumor stage, tumor grading, and differentiation. The mean age of the study cohort was 62 years (SD 12 years) with 53.9.1% of all patients being male. The majority of patients had an Eastern co-operative of Oncology Group 1 performance status (63.3%). The most common Union international contre le cancer tumor stage was stage IV (85%) with liver metastases (89.0%) representing the most common site of extra-pancreatic tumor manifestation. The majority of all patients displayed well or moderate tumor differentiation (9.6% of patients had a Ki-67 expression below 2%. 67.6% of pNET patients had a Ki-67 expression between 2 and 20% and 22.8% of patients showed an expression above 20%). At time point of diagnoses, 93.1% of patients were classified as inoperable. Of note, 93.9 % of patients received systemic anti-tumoral therapy in palliative intention, while treatment was administered in 1.4 % of cases in neoadjuvant and in 4.7% of cases in in an adjuvant setting. Biological therapy was applied to 39.4% of patients, followed by targeted therapies (31.4%) and chemotherapy. Pancreatic neuroendocrine neoplasia are diagnosed in advanced tumor stages, globally. Systemic treatment was the most commonly used treatment modality. Such data may help to better understand the specific epidemiology of pNET worldwide.
Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report
Authors: Wu Liang , Liu Chao , Jiang Bing , He Lijiang
Published: December 2022

Rationale:

Osteochondral fracture (OCF) in weight-bearing area of lateral femoral condyle (LFC) is a rare combined injury caused by patellar dislocation.

Patient concerns:

A 15-year-old female student accidentally sprained her right knee while participating in sports activities. The patient felt pain in his right knee and limited movement. After hospitalization, the patients underwent computed tomography scan and magnetic resonance examination.

Diagnosis:

According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis.

Interventions:

Through the lateral parapatellar approach, we reduced the osteochondral mass and bundled it with absorbable sutures of anchors.

Outcomes:

The functional and radiographic outcome were satisfactory at 18 months after operation.

Lessons:

Anchor absorbable suture bridge fixation for this kind of OCF is not only effective, but also economical.
The emerging role of olanzapine in paediatric CINV control: A review
Authors: Barušić Anabella Karla
Published: December 2022

Chemotherapy-induced nausea and vomiting (CINV) is a serious side effect of chemotherapy that negatively impacts the quality of life of oncological patients and is associated with the emetogenic risk specific to administered chemotherapy. Current practice guidelines on the use of antiemetics in CINV include the option of adding olanzapine to antiemetic regimens in the management of adult CINV. The use of olanzapine in pediatric CINV has been restricted to children with poor CINV control. Research on the use of olanzapine in pediatric CINV has been limited. The aim of this review was to evaluate current evidence on the effective and safe antiemetic use of olanzapine in pediatric CINV of any type following chemotherapy of any emetogenicity. Ovid MEDLINE, Embase, CENTRAL databases were searched for any literature on the use of olanzapine in pediatric CINV published from 2015 to 2022. Studies that reported on the olanzapine-containing antiemetic regimen in peadiatric CINV control specifically were included. Search restrictions were placed on research published in English. The search generated 43 records that were assessed for eligibility. Out of 10 identified eligible studies a third were RCT. Findings of this review suggest that adding olanzapine to antiemetic regimen in pediatric CINV control is a worthwhile consideration. Further research is needed to establish the efficacy and safety of antiemetic olanzapine use in pediatric CINV.
Clinical and chest computed tomography features associated with severe Chlamydia psittaci pneumonia diagnosed by metagenomic next-generation sequencing: A multicenter, retrospective, observational study
Authors: Xu Limin , Zhao Ziwen , Mai Hui , Tan Xiaoying , Du Yubin , Fang Changquan
Published: December 2022

Chlamydia psittaci pneumonia is a rare disease with varying clinical presentations. Here, we aimed to investigate the clinical and chest computed tomography (CT) features of severe psittacosis pneumonia. Clinical data of 35 patients diagnosed with psittacosis pneumonia were retrospectively analyzed using metagenomic next-generation sequencing. The patients were classified into severe (n = 20) and non-severe (n = 15) groups. The median age of patients was 54 years, and 27 patients (77.1%) had a definite history of bird contact. Severe patients had more underlying comorbidities and were more prone to dyspnea and consciousness disorders than non-severe patients. The neutrophil count and D-dimer, lactate dehydrogenase, interleukin (IL)-2, IL-6, and IL-10 levels were higher, whereas the lymphocyte, CD3 + T cell, and CD4 + T cell counts, CD4+/CD8 + T cell ratio, and albumin level were substantially lower in severe patients than in non-severe patients. Chest CT findings of severe patients revealed large areas of pulmonary consolidation, and ground-glass opacities were observed in some patients, with a higher risk of involving multiple lobes of the lungs and pleural effusion. One patient died of multiple organ failure, whereas the condition of the other 34 patients improved, and they were discharged from the hospital. Patients with severe psittacosis pneumonia often have underlying comorbidities and are prone to developing dyspnea, consciousness disorder, and lesions in both lungs. Serum D-dimer, IL-2, IL-6, and IL-10 levels and lymphocyte, CD3 + T cell, and CD4 + T cell counts are associated with disease severity.
Clinical study of late-onset hemorrhagic cystitis after allo-HSCT without in vitro T-cell depletion
Authors: Yuan Hailong , Chen Gang , Qu Jianhua , Yang Ruixue , Muhashi Maria , Aizezi Gulibadanmu , Jiang Ming
Published: December 2022

This study is to investigate the hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) without in vitro T-cell depletion. Patients receiving allo-HSCT in 2019 were enrolled. The occurrence and clinical characteristics of HC after HLA-identical HSCT and haploidentical HSCT were retrospectively analyzed. BK, JC, cytomegalovirus, and other viruses were monitored when HC occurred. Conventional HC treatment was performed. Additionally, 5 cases of severe refractory HC were treated with adipose-derived mesenchymal stem cell (ADSC) besides conventional HC treatment. Totally, 54 patients with allo-HSCT were enrolled, including 12 cases with HLA-identical HSCT and 42 cases with haploidentical HSCT. Among them, 17 developed late-onset HC (LOHC). There was no early-onset HC. The median onset time was 33.5 (9–189) days, with a median duration of 19 (5–143) days. There were 8 cases of grade III HC and 2 cases of grade IV HC. The cumulative incidence of LOHC in 54 patients was 29.6%, and the cumulative incidence of LOHC in 42 patients with haploidentical HSCT was 40.5%. The 1-year expected progression-free survival (PFS) of 26 patients without HC was 86.6%, and the 1-year expected PFS of 16 HC patients was 74.5%. However, there was no statistically significant difference (P = .326). The urine BK virus of 14 patients was positive, with the lowest of 1.98 × 105 copies/mL, and the highest of 8.96 × 105 copies/mL. For the 5 patients with severe refractory HC, the lowest infusion dose of ADSC was 0.9 × 106/kg and the highest was 1.4 × 106/kg. All 5 patients were cured. The incidence of LOHC is higher after haploidentical HSCT. LOHC is positively correlated with urine BK virus. LOHC has no obvious effect on the overall PFS of patients. ADSC infusion has a good therapeutic effect on severe and prolonged LOHC.