bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined abnormalities of femoral version and acetabular version and McKibbin Index in FAI patients evaluated for hip preservation surgery
Authors: Lerch Till D , Antioco Tiziano , Meier Malin K , Boschung Adam , Hanke Markus S , Tannast Moritz , Siebenrock Klaus A , Schmaranzer Florian , Steppacher Simon D
Published: April 2022

Frequencies of combined abnormalities of femoral version (FV) and acetabular version (AV) and of abnormalities of the McKibbin index are unknown. To investigate the prevalence of combined abnormalities of FV and AV and of abnormalities of the McKibbin index in symptomatic patients with femoroacetabular impingement (FAI), a retrospective, Institutional Review Board (IRB)-approved study of 333 symptomatic patients (384 hips) that were presented with hip pain and FAI was performed. The computed tomography/magnetic resonance imaging based measurement of central AV, cranial AV and FV was compared among five subgroups with distinguished FAI subgroups and patients that underwent a hip preservation surgery. The allocation to each subgroup was based on AP radiographs. Normal AV and FV were 10–25°. The McKibbin index is the sum of central AV and FV. Of patients that underwent a hip preservation surgery, 73% had a normal McKibbin index (20–50°) but 27% had an abnormal McKibbin index. Of all patients, 72% had a normal McKibbin index, but 28% had abnormal McKibbin index. The prevalence of combined abnormalities of FV and AV varied among subgroups: a higher prevalence of decreased central AV combined with decreased FV of patients with acetabular-retroversion group (12%) and overcoverage (11%) was found compared with mixed-type FAI (5%). Normal AV combined with normal FV was present in 41% of patients with cam-type FAI and in 34% of patients with overcoverage. Patients that underwent a hip preservation surgery had normal mean FV (17 ± 11°), central AV (19 ± 7°), cranial AV (16 ± 10°) and McKibbin index (36 ± 14°). Frequency of combined abnormalities of AV and FV differs between subgroups of FAI patients. Aggravated and compensated McKibbin index was prevalent in FAI patients. This has implications for open hip preservation surgery (surgical hip dislocation or femoral derotation osteotomy) or hip arthroscopy or non-operative treatment.
Atypical presentation of an obstructed obturator hernia in a 99-year-old female: a case report
Authors: Anyaugo Ngozi , Nwogwugwu Obisike , Rossi Chiara , Toney Zara
Published: April 2022

An obturator hernia is the protrusion of an organ/tissue through the obturator canal. Fondly called ‘little old lady’s hernia’, as they typically affect elderly thin female patients [7]. They are rare and difficult to clinically diagnose [2]. Diagnosis is often delayed and presentation could vary from symptoms of bowel obstruction, and pain in the groin or medial thigh [6] to atypical presentations like in our case. We report a case of a 99-year-old female with a 3-day history of low back pain, nausea and constipation. Computerized tomography scan revealed small bowel obstruction with transition point in left obturator hernia. The obstruction was successfully relieved via surgery without the need for bowel resection. This case highlights the importance of a high index of suspicion when faced with vague symptoms. Obturator hernias carry a reasonable degree of morbidity and mortality without intervention but have good outcomes if promptly managed.
The [O III]λ5007 equivalent width distribution at z ∼ 2: the redshift evolution of the extreme emission line galaxies
Authors: Boyett Kristan N K , Stark Daniel P , Bunker Andrew J , Tang Mengtao , Maseda Michael V
Published: April 2022

We determine the [O III]λ5007 equivalent width (EW) distribution of $1.700\lt \rm {z}\lt 2.274$ rest-frame ultraviolet (UV)-selected (MUV < −19) star-forming galaxies in the GOODS North and South fields. We make use of deep HDUV broad-band photometry catalogues for selection and 3D-HST WFC3/IR grism spectra for measurement of line properties. The [O III]λ5007 EW distribution allows us to measure the abundance of extreme emission line galaxies (EELGs) within this population. We model a lognormal distribution to the [O III]λ5007 rest-frame EWs of galaxies in our sample, with location parameter μ = 4.24 ± 0.07 and variance parameter σ = 1.33 ± 0.06. This EW distribution has a mean [O III]λ5007 EW of 168 ± 1 Å. The fractions of $\rm {z}\sim 2$ rest-UV-selected galaxies with [O III]λ5007 EWs greater than 500, 750, and 1000 Å are measured to be $6.8^{+1.0}_{-0.9}{{\ \rm per\ cent}}$, $3.6^{+0.7}_{-0.6}{{\ \rm per\ cent}}$, and $2.2^{+0.5}_{-0.4}{{\ \rm per\ cent}}$, respectively. The EELG fractions do not vary strongly with UV luminosity in the range (−21.6 < MUV < −19.0) considered in this paper, consistent with findings at higher redshifts. We compare our results to $\rm {z}\sim 5$ and $\rm {z}\sim 7$ studies, where candidate EELGs have been discovered through Spitzer/IRAC colours, and we identify rapid evolution with redshift in the fraction of star-forming galaxies observed in an extreme emission line phase (a rise by a factor ∼10 between $\rm {z}\sim 2$ and $\rm {z}\sim 7$). This evolution is consistent with an increased incidence of strong bursts in the galaxy population of the reionization era. While this population makes a sub-dominant contribution of the ionizing emissivity at $\rm {z}\simeq 2$, EELGs are likely to dominate the ionizing output in the reionization era.
A rare case of COVID-19 pneumonia with severe hyperlipoproteinemia
Authors: Shimoda Masafumi , Tanaka Yoshiaki , Morimoto Kozo , Kokutou Hiroyuki , Abe Taro , Suga Miyuri , Yoshiyama Takashi , Yoshimori Kozo , Ohta Ken
Published: April 2022

A 55-year-old woman was admitted to our hospital for coronavirus disease 2019 (COVID-19) pneumonia. Her symptoms improved upon treatment with steroids, remdesivir and heparin. After discharge, she consumed excessive alcohol because of taste disorder due to COVID-19; she also had chylomicronemia with a triglyceride (TG) level of 8750 mg/dl. Chylomicrons and very-low-density lipoprotein were detected by electrophoresis, and she was diagnosed with severe hyperlipoproteinemia, suspected to be Type V hyperlipoproteinemia. She did not have any symptoms of pancreatitis, and her TG levels decreased with fat intake restriction and sobriety. This is a rare case of COVID-19 with hyperlipoproteinemia, and the causes of hyperlipoproteinemia might be associated with COVID-19 complications, steroids and/or lifestyle changes during the pandemic; therefore, changes in TGs should be observed carefully after the resolution of COVID-19.
Longitudinal Changes in Skeletal Muscle Metabolism, Oxygen Uptake, and Myosteatosis During Cardiotoxic Treatment for Early-Stage Breast Cancer
Authors: Kirkham Amy A , Pituskin Edith , Mackey John R , Grenier Justin G , Ian Paterson D , Haykowsky Mark J , Thompson Richard B
Published: April 2022

Background

While cardiotoxic chemotherapy is known to negatively impact cardiac function and hemoglobin levels, the impact on skeletal muscle has been understudied among patients. The purpose was to longitudinally characterize myosteatosis (muscle fat), skeletal muscle metabolism, and oxygen (O2) consumption during cardiotoxic chemotherapy for breast cancer.

Patients and Methods

Thirty-four patients with stage I-III breast cancer were enrolled before trastuzumab-containing and/or anthracycline-containing chemotherapy. We used magnetic resonance imaging to non-invasively quantify thigh myosteatosis (fat-water imaging), and lower leg metabolism (31P spectroscopy), O2 consumption (custom techniques), and peak power output during single-leg plantarflexion exercise at pre-, mid-, end-chemotherapy, and 1-year. We also measured pulmonary VO2peak and maximal leg press strength.

Results

During chemotherapy, VO2peak and leg press strength decreased while peak plantarflexion power output was maintained. At mid-chemotherapy, hemoglobin decreased (16%) and lower leg blood flow increased (37%) to maintain lower leg O2 delivery; exercise Pi:PCr and myosteatosis increased. Between mid- and end-chemotherapy, lower leg O2 extraction (28%) and O2 consumption (21%) increased, while plantarflexion exercise efficiency (watts/O2 consumed) decreased. At one year, VO2peak and leg press strength returned to pre-chemotherapy levels, but lower leg exercise O2 extraction, consumption and Pi:PCr, and myosteatosis remained elevated.

Conclusion

Lower leg skeletal muscle blood flow and O2 extraction adapt to compensate for chemotherapy-related hemoglobin reduction for small muscle mass exercise but are insufficient to maintain large muscle mass exercise (pulmonary VO2peak, leg press strength). The excess O2 required to perform work, increased Pi:PCr ratio and myosteatosis together suggest suppressed fat oxidation during chemotherapy.
Clinicopathologic and Genomic Landscape of Non-Small Cell Lung Cancer Brain Metastases
Authors: Huang Richard S P , Harries Lukas , Decker Brennan , Hiemenz Matthew C , Murugesan Karthikeyan , Creeden James , Tolba Khaled , Stabile Laura P , Ramkissoon Shakti H , Burns Timothy F , Ross Jeffrey S
Published: April 2022

Background

In patients with non-small cell lung cancer (NSCLC), 10%-40% will eventually develop brain metastases. We present the clinicopathologic, genomic, and biomarker landscape of a large cohort of NSCLC brain metastases (NSCLC-BM) samples.

Materials and Methods

We retrospectively analyzed 3035 NSCLC-BM tested with comprehensive genomic profiling (CGP) during routine clinical care. In addition, we compared the NSCLC-BM to a separate cohort of 7277 primary NSCLC (pNSCLC) specimens. Finally, we present data on 67 paired patients with NSCLC-BM and pNSCLC.

Results

Comprehensive genomic profiling analysis of the 3035 NSCLC-BMs found that the most frequent genomic alterations (GAs) were in the TP53, KRAS, CDKN2A, STK11, CDKN2B, EGFR, NKX2-1, RB1, MYC, and KEAP1 genes. In the NSCLC-BM cohort, there were significantly higher rates of several targetable GAs compared with pNSCLC, including ALK fusions, KRAS G12C mutations, and MET amplifications; and decreased frequency of MET exon14 skipping mutations (all P < .05). In the subset of NSCLC-BM (n = 1063) where concurrent PD-L1 immunohistochemistry (IHC) was performed, 54.7% of the patients with NSCLC-BM were eligible for pembrolizumab based on PD-L1 IHC (TPS ≥ 1), and 56.9% were eligible for pembrolizumab based on TMB-High status. In addition, in a series 67 paired pNSCLC and NSCLC-BM samples, 85.1% (57/67) had at least one additional GA discovered in the NSCLC-BM sample when compared with the pNSCLC sample.

Conclusions

Herein, we defined the clinicopathologic, genomic, and biomarker landscape of a large cohort of patients with NSCLC-BM which can help inform study design of future clinical studies for patients with NSCLC with BM. In certain clinical situations, metastatic NSCLC brain tissue or cerebral spinal fluid specimens may be needed to fully optimize personalized treatment.
A brief history of English bird names and the American Ornithologists’ Union (now American Ornithological Society)
Authors: Winker Kevin
Published: April 2022

English bird names exist to increase the effectiveness of communication and to make ornithology more accessible to English speakers and readers. This purpose was recognized from the first edition of the Check-list, when it was considered important to include both a vernacular and technical name for each taxon. Every edition of the Check-list and its Supplements have thus included English names. Improving communication is an important job, and to be most effective a single name usually has to be chosen, especially among birds with widespread distributions and many vernacular names. The Check-list has been the standard for North America for over a century, and it provides the formal scientific basis for avian diversity and its management and conservation across most of the continent. Choices for the English names given in the Check-list have been made under clear criteria and guidelines that are responsive both to increased scientific knowledge and implicitly to changing societal mores. For more than a century, and for many different reasons, many people have been unhappy with choices made about English bird names and about the underlying processes. From the published history alone, it is clear that no process will achieve global consensus, yet there remain many merits to a standardized and widely adopted approach to English bird names. Consideration of these issues in a broader context of linguistics, culture, and history is also warranted.
Generation of Human Nociceptor-Enriched Sensory Neurons for the Study of Pain-Related Dysfunctions
Authors: Holzer Anna-Katharina , Karreman Christiaan , Suciu Ilinca , Furmanowsky Lara-Seline , Wohlfarth Harald , Loser Dominik , Dirks Wilhelm G , Pardo González Emilio , Leist Marcel
Published: April 2022

In vitro models of the peripheral nervous system would benefit from further refinements to better support studies on neuropathies. In particular, the assessment of pain-related signals is still difficult in human cell cultures. Here, we harnessed induced pluripotent stem cells (iPSCs) to generate peripheral sensory neurons enriched in nociceptors. The objective was to generate a culture system with signaling endpoints suitable for pharmacological and toxicological studies. Neurons generated by conventional differentiation protocols expressed moderate levels of P2X3 purinergic receptors and only low levels of TRPV1 capsaicin receptors, when maturation time was kept to the upper practically useful limit of 6 weeks. As alternative approach, we generated cells with an inducible NGN1 transgene. Ectopic expression of this transcription factor during a defined time window of differentiation resulted in highly enriched nociceptor cultures, as determined by functional (P2X3 and TRPV1 receptors) and immunocytochemical phenotyping, complemented by extensive transcriptome profiling. Single cell recordings of Ca2+-indicator fluorescence from >9000 cells were used to establish the “fraction of reactive cells” in a stimulated population as experimental endpoint, that appeared robust, transparent and quantifiable. To provide an example of application to biomedical studies, functional consequences of prolonged exposure to the chemotherapeutic drug oxaliplatin were examined at non-cytotoxic concentrations. We found (i) neuronal (allodynia-like) hypersensitivity to otherwise non-activating mechanical stimulation that could be blocked by modulators of voltage-gated sodium channels; (ii) hyper-responsiveness to TRPV1 receptor stimulation. These findings and several other measured functional alterations indicate that the model is suitable for pharmacological and toxicological studies related to peripheral neuropathies.
Psychometric Evaluation of Age Discrimination Measures Using Classic Test and Item Response Theories
Authors: Peng Yisheng , Min Hanyi , Rosenblatt Alexa , Zhang Wenqin
Published: April 2022

Although workplace age discrimination research has been recognized as increasingly important, much less agreement has been reached regarding the operationalization and measurement of age discrimination. There are multiple age discrimination scales, yet no systematic investigation of potential convergence across those scales exists. We conducted two investigations of age discrimination scales that differ in multiple measurement characteristics (e.g., content domain). Findings of confirmatory factor analyses from Study 1 (N = 248) indicated that although different age discrimination scales were related to the same higher-order construct, they were not interchangeable as they each accounted for idiosyncratic measurement variance. The usage of different scales resulted in different magnitudes of the relationships between age discrimination and its correlates. In addition to the replication of these results in Study 2 (N = 939), an item response theory approach was applied to demonstrate that different age discrimination scales possess different levels of test information at different places of the latent trait continuum. Taken together, our findings provide implications for researchers to thoughtfully choose their operationalization of age discrimination.
Elevated Sound Levels in the Neonatal Intensive Care Unit
Authors: Mayhew Kelli J. , Lawrence Sarah L. , Squires Janet E. , Harrison Denise
Published: April 2022

Background:

Premature and sick neonates may require weeks of hospitalization in a noisy neonatal intensive care unit (NICU) environment with sound levels that may reach 120 decibels. The American Academy of Pediatrics recommends a maximum sound level of 45 decibels.

Purpose:

To measure sound levels in a level III NICU and to describe contributing environmental factors.

Methods:

Descriptive quantitative study. Sound levels were measured using a portable sound meter in an open-bay level III NICU. Contributing environmental factors were recorded and analyzed.

Results:

Mean sound levels for day, evening, and night shifts were 83.5, 83, and 80.9 decibels, respectively. Each period of time exceeded the recommended guidelines 90% of the time and was almost double the American Academy of Pediatrics' recommendation. Multiple linear regression findings demonstrated significant factors associated with elevated sound levels including number of neonates, number of people, number of alarms, acuity level, and shift type. Observational data explain 14.5% of elevated sound levels.

Implications for Practice:

An understanding of baseline sound levels and contributing environmental factors is the first step in developing strategies to mitigate excessive noise in the NICU.

Implications for Research:

Research should focus on effective and sustainable ways to reduce sound levels in the NICU, including inside the isolette, in order to provide an environment that is conducive to optimal growth and neurodevelopment for preterm and sick infants.
Prospective Study of PET/MRI Tumor Response During Chemoradiotherapy for Patients With Low-risk and Intermediate-risk p16-positive Oropharynx Cancer
Authors: Witek Matthew E. , Kimple Randall J. , Avey Gregory D. , Burr Adam R. , Chandereng Thevaa , Yu Menggang , Hu Rong , Wieland Aaron M. , Labby Zacariah E. , Bruce Justine Y. , Brower Jeffrey V. , Hartig Gregory K. , Harari Paul M.
Published: April 2022

Objective:

The objective of this study was to examine tumor response with positron emission tomography (PET)/magnetic resonance imaging (MRI) during chemoradiotherapy as a predictor of outcome in patients with p16-positive oropharynx cancer.

Materials and Methods:

Patients with p16-positive oropharynx cancer were treated with chemoradiotherapy. Low-risk (LR) disease was defined as T1-T3 and N0-2b and ≤10 pack-years and intermediate-risk (IR) disease as T4 or N2c-3 or >10 pack-years. Patients underwent a PET/MRI scan pretreatment and at fraction 10. Change in value of imaging means were analyzed by analysis of variance. K-means clustering with Euclidean distance functions were used for patient clustering. Silhouette width was used to determine the optimal number of clusters. Linear regression was performed on all radiographic metrics using patient and disease characteristics.

Results:

Twenty-four patients were enrolled with 7 LR and 11 IR patients available for analysis. Pretreatment imaging characteristics between LR and IR patients were similar. Patients with LR disease exhibited a larger reduction in maximum standardized uptake value (SUV) compared with IR patients (P<0.05). Cluster analysis defined 2 cohorts that exhibited a similar intratreatment response. Cluster 1 contained 7 of 7 LR patients and 8 of 11 IR patients. Cluster 2 contained 3 of 11 IR patients. Cluster 2 exhibited significant differences compared with cluster 1 in the change in primary tumor peak SUV and largest lymph node median SUV.

Conclusions:

We identified that IR p16-positive oropharynx cancers exhibit heterogeneity in their PET/MRI response to chemoradiotherapy. These data support further study of intratreatment imaging response as a potential mechanism to identify patients with IR oropharynx cancer suitable for treatment deintensification.
Comprehensive Understanding and Evolutional Therapeutic Schemes for Pseudomyxoma Peritonei
Authors: Ye Suiting , Zheng Song
Published: April 2022

Pseudomyxoma peritonei is an infrequent solid tumor in clinical practice. The low morbidity and deficient understanding of this mucus-secreting malignant disease increase the risks of delayed identification or uncontrollable deterioration. In quite a lot cases, patients go through complete cytoreduction surgery and hyperthermic intraperitoneal chemotherapy could receive a long time survival over 5 years. But the recurrence rate is also hard to overlook. Unlike other types of cancer, the standard treatment for this considerable groups has not been confirmed yet. With the advanced medical progression, studies have been carrying out based on pathogenesis, biological characters, and mutated gene location. All but a few get statistical survival benefits, let alone the breaking progress on research or therapeutic practice in the field. We try to give a comprehensive exposition of pseudomyxoma peritonei around the epidemiology, radiologic features, clinical manifestation, present treatment and promising schemes, hoping to arise much attention and reflection on the feasible solutions, especially for the recrudescent part.
The Impact of Complementary and Integrative Medicine Following Traumatic Brain Injury: A Scoping Review
Authors: Kim Sonya , Mortera Marianne H. , Wen Pey-Shan , Thompson Karla L. , Lundgren Kristine , Reed William R. , Sasson Nicole , Towner Wright Sarah , Vora Ariana , Krishnan Shilpa , Joseph Justin , Heyn Patricia , Chin Bridget S.
Published: April 2022

Objective:

To examine the evidence levels, study characteristics, and outcomes of nonpharmacologic complementary and integrative medicine (CIM) interventions in rehabilitation for individuals with traumatic brain injury (TBI).

Data Sources:

MEDLINE (OvidSP), PubMed (NLM), EMBASE (Embase.com), CINAHL (EBSCO), PsycINFO (OvidSP), Cochrane Library (Wiley), and National Guidelines Clearinghouse databases were evaluated using PRISMA guidelines. The protocol was registered in INPLASY (protocol registration: INPLASY202160071).

Data Extraction:

Quantitative studies published between 1992 and 2020 investigating the efficacy of CIM for individuals with TBI of any severity, age, and outcome were included. Special diets, herbal and dietary supplements, and counseling/psychological interventions were excluded, as were studies with mixed samples if TBI data could not be extracted. A 2-level review comprised title/abstract screening, followed by full-text assessment by 2 independent reviewers.

Data Synthesis:

In total, 90 studies were included, with 57 001 patients in total. This total includes 2 retrospective studies with 17 475 and 37 045 patients. Of the 90 studies, 18 (20%) were randomized controlled trials (RCTs). The remainder included 20 quasi-experimental studies (2-group or 1-group pre/posttreatment comparison), 9 retrospective studies, 1 single-subject study design, 2 mixed-methods designs, and 40 case study/case reports. Guided by the American Academy of Neurology evidence levels, class II criteria were met by 61% of the RCTs. Included studies examined biofeedback/neurofeedback (40%), acupuncture (22%), yoga/tai chi (11%), meditation/mindfulness/relaxation (11%), and chiropractic/osteopathic manipulation (11%). The clinical outcomes evaluated across studies included physical impairments (62%), mental health (49%), cognitive impairments (39%), pain (31%), and activities of daily living/quality of life (28%). Additional descriptive statistics were summarized using narrative synthesis. Of the studies included for analyses, 97% reported overall positive benefits of CIM.

Conclusion:

Rigorous and well experimentally designed studies (including RCTs) are needed to confirm the initial evidence supporting the use of CIM found in the existing literature.
Late-onset Group B Streptococcus Bacteremia Evaluated in the Pediatric Emergency Department and Risk Factors for Severe Infection
Authors: Ecclesia Francesco Giuseppe , Alonso Cadenas José Antonio , Gómez Borja , Gangoiti Iker , Hernández-Bou Susanna , de la Torre Espí Mercedes ,   on behalf of the Bacteremia Study Working Group from the Infectious Diseases Working Group, Spanish Society of Pediatric Emergencies
Published: April 2022

Background:

To describe the infants presenting to pediatric emergency departments (PEDs) and diagnosed with group B Streptococcus (GBS) late-onset disease (LOD) bacteremia and identify risk factors for severe infection and pediatric intensive care unit (PICU) admission.

Methods:

Observational study and subanalysis of a multicenter prospective registry. Setting: pediatric emergency department. Inclusion criteria: infants between 7 and 89 days of age with positive blood culture for GBS seen between 2011 and 2016 at any of 22 Spanish PEDs. Main outcome: risk factors (clinical and laboratory variables) for severe infection (sepsis/septic shock or meningitis) and PICU admission. Second, the prevalence of poor outcomes (acute complications, sequelae or death).

Results:

Among 118 patients with LOD, 74 (62.7%) presented a severe infection: 66 sepsis/septic shock (11 with associated meningitis) and 8 meningitis. Thirty-five patients (29.7%) were admitted to a PICU. An altered Pediatric Assessment Triangle (PAT) upon arrival and leukopenia were the only independent risk factors for severe infection [odds ratio (OR): 43.6; 95% confidence interval (CI): 8.1–235.7, P < 0.01] and PICU admission (OR: 11.6; 95% CI: 1.5–91.4; P < 0.019), respectively. Six patients (5.1%) developed a poor outcome, including 2 deaths (1.7%); all had an altered PAT, elevated procalcitonin (range 4.7–100 ng/ml), and were diagnosed with sepsis/septic shock and admitted to a PICU. Four developed leukopenia.

Conclusions:

Infants with GBS LOD frequently develop sepsis/septic shock and bacterial meningitis, associated with non-negligible morbidity and mortality. Clinical appearance was the only risk factor for severe infection, whereas leukopenia was related to PICU admission.
Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist Hospital, Bekwai Municipality, Ghana
Authors: Acheanpong Kwabena , Pan Xiongfeng , Kaminga Atipasa Chiwanda , Liu Aizhong
Published: April 2022

Depression, arising in the perinatal period are a major health issue in low- and middle-income countries. However, little attention has been paid in the research of depression symptoms. This study aimed to estimate the prevalence and risk factors of depression during pregnancy.

A cross-sectional study was conducted in pregnant women attending antenatal clinic at Adventist Hospital in the Bekwai Municipality, Ghana, between February and May 2020. Information on sociodemographic, medical, and obstetric factors were collected from the antenatal booklet and prenatal depression symptoms was defined as a patient health questionnaire scores ≥10. Descriptive statistics, Chi-Squared test, and Fisher exact test were used to analyze dichotomous variables. Multivariate logistic regression model was applied to estimate the adjusted odds ratios (AOR) and 95% confidence interval (95% confidence interval [CI]) for risk factors associated with prenatal depression. All statistical analyses were performed using SPSS version 20.0.

The prevalence of prenatal depression in this study was 26.9% (95% CI; 24.6%–29.2%). Advance maternal age ≥35years (AOR = 1.49, 95% CI 1.05–2.11, P < .026) and low educational attainment (AOR 2.15, 95% CI 1.23–2.34, P < .007) were significantly higher among women with parental depression compared with maternal age <35years and higher educational attainment respectively. Similarly, nulliparous women (AOR = 4.93, 95% CI 1.60–15.16, P < .005), primiparous women (AOR = 5.42, 95% CI 1.76–16.71, P < .003) and multiparous women (AOR = 4.79, 95% CI 1.61–14.22, P < .005) were significantly higher among women with parental depression compared with grand multiparous woman (≥7 deliveries). Finally, prenatal depression was found to be significantly associated with hypertension in pregnancy (AOR = 1.71, 95% CI: 1.12–2.60, P < .013).

Depression during pregnancy is high in the study area and is significantly associated with advance maternal age, low educational attainment, parity less than 7 deliveries, and hypertension during pregnancy.
Efficacy and safety of Mudan granules for painful diabetic peripheral neuropathy
Authors: Zhang Aixia , Wang Qian , Liu Min , Tan Mengxia , Zhang Xiaodan , Wu Raoping
Published: April 2022

Background:

As one of the most challenging complications in the management of diabetes mellitus, painful diabetic peripheral neuropathy (PDPN) is accompanied by various clinical manifestations, including numbness, burning, coldness, and other sensory abnormalities in the extremities. Meanwhile, PDPN seriously affects the life quality of patients and causes great pain. Western medicine mostly provides symptomatic treatments, such as antioxidants, aldose reductase inhibitors, nerve nutrition, microcirculation improvement, and analgesic drugs on the basis of blood sugar control. Although certain efficacy has been achieved, the problem has not been solved at root. Mudan granules have some advantages in the treatment of PDPN, but there is insufficient high-quality clinical studies to verify this. Therefore, the purpose of this study was to evaluate the efficacy and safety of Mudan granules in treating PDPN.

Methods:

A randomized, double-blind, placebo, and parallel-controlled trial design was used to study the efficacy and safety of Mudan granules in the treatment of PDPN. In this study, 93 patients with painful diabetic neuropathy were recruited and randomly divided into a treatment group and a placebo group based on 1:1. The treatment group was given Mudan granules and the control group accepted placebo treatment, and the basic treatment was performed according to the recommended guidelines. During the treatment period, the patients’ visual analog scores, clinical efficacy, Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores, nerve conduction velocity, and drug-induced adverse reactions were observed at baseline after 8 and 10 weeks.

Discussion:

This study will evaluate the efficacy and safety of Mudan granules in treating PDPN. The experimental results will provide evidence support to treat PDPN with Mudan granules.

Trial registration:

DOI 10.17605/OSF.IO/5CE32.
A comparison of high-flow nasal cannula and standard facemask as pre-oxygenation technique for general anesthesia
Authors: Kuo Hsien-Cheng , Liu Wan-Chi , Li Chun-Cheng , Cherng Yih-Giun , Chen Jui-Tai , Wu Hsiang-Ling , Tai Ying-Hsuan
Published: April 2022

Background:

Current practice guidelines recommend the use of nasal cannula as an alternative pre-oxygenation method for tracheal intubation. However, the efficacy of high-flow nasal oxygenation versus standard facemask oxygenation has not been fully evaluated.

Methods:

We searched PubMed, Cochrane Library, and ClinicalTrials.gov for English-language studies published from January 1, 2000 to November 30, 2021. We included randomized controlled trials which compared high-flow nasal oxygenation and facemask oxygenation as the pre-oxygenation maneuver. Primary outcome was arterial partial pressure of oxygen (PaO2) after pre-oxygenation. Secondary outcomes were safe apnea time, arterial desaturation during intubation, lowest peripheral capillary oxygen saturation during intubation, and patient comfort score. Random-effects models and Mantel–Haenszel method were used for data synthesis.

Results:

A total of 16 randomized controlled trials and 1148 patients were included. High-flow nasal oxygenation achieved a higher PaO2 compared with facemask, mean difference: 64.86 mm Hg (95% confidence interval [CI]: 32.33–97.40, P < .0001). Safe apnea time was longer in high-flow nasal oxygenation, mean difference: 131.03 seconds (95% CI: 59.39–202.66, P < .0001). There was no difference in the risk of peri-intubation desaturation or lowest peripheral capillary oxygen saturation between groups. Patient comfort score was higher in high-flow nasal oxygenation, mean difference: 1.00 (95% CI: 0.46–1.54, P = .0003).

Conclusion:

High-flow nasal oxygenation better enhanced PaO2 and extended safe apnea time and is not inferior to facemask oxygenation in preventing desaturation during tracheal intubation. High-flow nasal oxygenation may be considered as an alternative method, especially for patients with a potential difficult airway.
Analysis of cognitive dysfunction and its risk factors in patients with hypertension
Authors: Zhuo Xiuping , Huang Meinv , Wu Meifang
Published: April 2022

To observe whether obstructive sleep apnea syndrome (OSAS) can aggravate the cognitive dysfunction of patients with hypertension (HTN), and to explore other risk factors.

One hundred one hypertensive patients were selected for information collection. After the polysomnography test, they were divided into HTN-obstructive sleep apnea (OSA) and HTN groups. The Montreal cognitive assessment and the mini-mental state examination scales were used to appraise the patients’ cognitive function. Logistic regressive analysis was used to determine the risk factors of cognitive dysfunction in patients with HTN.

Compared with the HTN patients, HTN-OSA patients performed worse in mini-mental state examination (25.5 ± 2.9 vs 23.5 ± 3.2; P = .01) and Montreal cognitive assessment (28 ± 1.58 vs 21.2 ± 3.96; P = .003), and patients in the HTN-OSA group seemed more likely to suffer from dementia (31% vs 66%; P < .01). The apnea-hypopnea index (AHI) in the HTN group was lower than HTN-OSA group. Through multivariate logistic regression analysis, we can found that alcohol drinking, body mass index, long-term medication, diabetes, hypercholesterolemia, coronary heart disease, and OSAS were the independent risk factors of cognitive dysfunction in patients with HTN.

OSAS can aggravate the cognitive dysfunction of hypertensive patients, besides, drinking, high-body mass index, long-term medication, diabetes, hypercholesterolemia, and coronary heart disease were also the risk factors of cognitive dysfunction in patients with hypertension. The cognitive dysfunction of patients with HTN can benefit from sleep apnea treatment.
Effectiveness of intervention for aromatase inhibitor-associated musculoskeletal symptoms
Authors: Meng Hui , Chen Yuhan , Yu Mingwei , Wang Xiaomin
Published: April 2022

Background:

Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are among the most common prominent side effects in patients using aromatase inhibitors (AIs) for breast cancer. Muscle and joint pain, morning stiffness, arthritis, and bone loss are common clinical symptoms in individuals. Traditional Chinese medicine (TCM) has been demonstrated to be useful in the treatment of AIMSS in previous investigations, although the sample sizes were limited, and systematic reviews were inadequate. The effectiveness and safety of TCM in the treatment of AIMSS will be investigated in this study.

Methods:

Randomized controlled trials from January 2010 to October 2021 were limited to English or Chinese. We searched PubMed, EMBASE, Cochrane Library, Web of Science, Medline, China Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database, and the VIP database. Two researchers reviewed the literature and retrieved the data independently. Review Manager V5.3.was used to conduct the statistical analysis.

Results:

This systematic review and meta-analysis presents the most recent data on the use of TCM to treat AIMSS and offers a scientifically sound foundation for therapeutic practice. Upon completion, the findings will be submitted to a peer-reviewed journal.

Ethics and dissemination:

As the systematic review protocol did not involve human subjects, ethical approval was not required.

PROSPERO registration number:

CRD42020192553.
McLeod syndrome with a novel XK frameshift mutation
Authors: Xia Shilin , Yu Xinrui , Song Fan , Sun Bo , Wang Ying
Published: April 2022

Rationale:

McLeod syndrome (MLS) is a rare X-linked neurohematologic disorder caused by loss-of-function mutations in the XK gene. However, variations in the XK gene remain to be elucidated. Here, we report the clinical phenotype and genetic features of a patient with MLS caused by a novel frameshift mutation in the XK gene.

Patient concerns:

A 44-year-old man presented with chorea, cognitive impairment, mental disorders, and seizures accompanied by peripheral neuropathy, hyperCKemia, and acanthocytosis. The proband's mother had a mild chorea. One older brother who died 10 years ago without a confirmed diagnosis showed symptoms of both chorea and mental disorders, while the other brother also developed mild chorea.

Diagnosis:

The patient was diagnosed with MLS based on the family history, clinical manifestations, and accessory examinations. Whole-exome sequencing studies revealed a novel frameshift mutation resulting from a nucleotide variation in exon 2 (452delA) that leads to an amino acid residue conversion from Gln to Arg and early termination of the XK protein (Gln151ArgfsTer2). The patient and one of his older brothers were hemizygotes, and his mother was heterozygous.

Interventions:

The patient was treated with haloperidol to control chorea and levetiracetam to control seizures.

Outcomes:

Six months after treatment, the proband was seizure-free, but showed little improvement in chorea and cognitive dysfunction.

Lesson:

We describe a family with MLS caused by a novel frameshift mutation in the XK gene. The causes of the mild clinical presentation in the proband's mother require further investigation.
Single-stage intraoperative ERCP combined with laparoscopic cholecystectomy versus preoperative ERCP Followed by laparoscopic cholecystectomy in the management of cholecystocholedocholithiasis
Authors: Liao Yang , Cai Qichen , Zhang Xiaozhou , Li Fugui
Published: April 2022

Objectives

The optimal treatment strategy for cholecystocholedocholithiasis is still controversial. We conducted an up-to-date meta-analysis to compare the efficacy and safety of the intra- endoscopic retrograde cholangiopancreatography (ERCP) + LC procedure with the traditional pre-ERCP +  laparoscopic cholecystectomy (LC) procedure in the management of cholecystocholedocholithiasis.

Methods

We searched the PubMed, Embase, Cochrane Library, and Web of Science databases up to September 2020. Published randomized controlled trials comparing intra-ERCP + LC and pre-ERCP + LC were considered. This meta-analysis was performed by Review Manager Version 5.3, and outcomes were documented by pooled risk ratio (RR) and mean difference (MD) with 95% confidence intervals.

Results

Eight studies with a total of 977 patients were included in this meta-analysis. There was no significant difference between the two groups regarding CBD stone clearance (RR = 1.03, P = .27), postoperative papilla bleeding (RR = 0.41, P = .13), postoperative cholangitis (RR = 0.87, P = .79), and operation conversion rate (RR = 0.71, P = .26). The length of hospital stay was shorter in the intra-ERCP + LC group (MD = −2.75, P < .05), and intra-ERCP + LC was associated with lower overall morbidity (RR = 0.54, P < .05), postoperative pancreatitis (RR = 0.29, P < .05) and cannulation failure rate (RR = 0.22, P < .05).

Conclusions

Intra-ERCP + LC was a safer approach for patients with cholecystocholedocholithiasis. It could facilitate intubation, shorten hospital stay, and lower postoperative complications, especially postoperative pancreatitis, and reduce stone residue and reduce the possibility of reoperation for stone removal.
Unilateral branch retinal artery occlusion in a patient with systemic lupus erythematosus
Authors: Zhang Linglin , Guan Chaoqiang , Ye Zuke , Lu Yan
Published: April 2022

Rationale:

Ocular involvements in systemic lupus erythematosus (SLE) are not rare but extremely varied. Here we present a very meaningful case with unilateral branch retinal artery occlusion (BRAO) secondary to undetected SLE, for which immunotherapy showed significant effect, which led to complete resolution of macular edema.

Patient concerns:

A 31-year-old female patient, so far without any previous illnesses, presented with a sudden onset of painless diminution of vision in left eye for 5 days. Diagnosis: Signs of branch retinal artery occlusion and macular ischemic edema were observed on the left fundus, which was further confirmed by Fundus fluorescein angiography and OCT. BRAO was initially proposed. However, after ophthalmological treatment for BRAO, visual acuity and macular edema improvement was limited. Physical examination revealed erythema on the hands and feet, together with her experience of hair loss and joint pain. The patient was diagnosed with SLE.

Interventions and outcomes:

The patient received systemic immunotherapy, which resulted in visual improvement to 20/20.

Lessons:

This is a rare monocular vaso-occlusive retinopathy in SLE with mainly diffuse nonperfusion and small arterial and arteriolar occlusion in the retina, as distinct from more common vasculitis. Even without intravitreal injection of anti-VEGF, systemic immunotherapy can be effective for the treatment of macular edema.
The telemedicine experience: using principles of clinical excellence to identify disparities and optimize care
Authors: Khan Sheena , Llinas Edward J. , Danoff Sonye K. , Llinas Rafael H. , Marsh Elisabeth B.
Published: April 2022

The use of telemedicine has increased significantly during the Corona virus disease 2019 pandemic. This manuscript serves to identify the underlying principles of clinical excellence in telemedicine and to determine whether effective care practices can be generalized as a one-size-fits-all model or must instead be tailored to individual patient populations.

A survey assessing care quality and patient satisfaction for patients using telemedicine was created and administered via email to 2 urban cohorts of varying demographics and socioeconomic backgrounds: a population of patients with prior stroke and cerebrovascular disease, and a cohort of patients followed for interstitial lung disease. Results were compared across groups to determine the generalizability of effective practices across populations.

Individuals taking part in telemedicine were more likely to be White, more affluent, and woman, regardless of clinical diagnosis compared with a similar cohort of patients seen in-person the year prior. A lower-than-expected number of patients who were Black and of lower socioeconomic status followed up virtually, indicating potential barriers to access. Overall, patients who participated in televisits were satisfied with the experience and felt that the care met their medical needs; however, those who were older were more likely to experience technical difficulties and prefer in-person visits, while those with less education were less likely to feel that their questions were addressed in an understandable way.

When thoughtfully designed, telemedicine practices can be an effective model for patient care, though implementation must consider population characteristics including age, education, and socioeconomic status, and strategies such as ease of access versus optimization of communication strategies should be tailored to meet individual patient needs.
Income and social support related with mental health during COVID-19 outbreak in China
Authors: Huang Chenwei , Feng Qiyun , Zhang Borui , Ren Huiguang , Liu Zihao , Kang Yuwei , Zhang Fan
Published: April 2022

To investigate psychological response of Chinese public during the regular prevention and control of Corona Virus Disease 2019 (COVID-19), and explore the relationship among income loss, social support and mental health.

Five hundred twenty-six participants were randomly selected by snowball sampling method. Chinese version of Perceived Psychological Stress Scale, Perceived Social Support Scale, self-rating anxiety scale, and the PTSD Checklist for DSM-5 were used to measure the levels of psychological stress, social support, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Demographic variables, income loss and income satisfaction during the outbreak period were also collected.

The prevalence rate of anxiety, PTSD symptoms and stress problems were 19.8%, 23.8%, and 24.7% respectively. Multiple Regression Analysis illustrated that social support associated with stress, anxiety and PTSD after controlling demographic variables; for non-student samples, stress, anxiety, and PTSD were corelated with change in income and social support.

During the regular prevention and control of COVID-19, social support might help reducing stress, anxiety, and PTSD symptoms. In addition to social support, change of income level was also an important factor for mental health. This study suggested the importance of maintaining a steady income after acute outbreak of COVID-19.
Long-term efficacy and safety of levonorgestrel-releasing intrauterine system as a maintenance treatment for endometriosis
Authors: Kim Hye Yun , Song Soo Youn , Jung Soo Hwa , Song Hyun Jeong , Lee Mina , Lee Ki Hwan , Jung Ye Won , Yoo Heon Jong
Published: April 2022

This study evaluated the efficacy and feasibility of long-term use of levonorgestrel releasing intrauterine system (LNG-IUS) in endometriosis patients after using LNG-IUS for >5 years as their postoperative maintenance therapy.

Data were obtained retrospectively from patients who maintained medical therapy for >5 years after surgical treatment of endometriosis from January 2008 to April 2015. Patients were divided into study group and control group according to the type of medication; the study group consisted of patients who received LNG-IUS as maintenance therapy, and patients in the control group received combined oral contraceptives (ethinyl estradiol 20 μg and drospirenone 3 mg) or dienogest 2 mg.

A total of 263 patients (94 patients in the study group, 169 in the control group) were included in the study. 91.5% (86/94) of the patients in the study group maintained the treatment for >5 years, whereas only 21.9% (37/169) of patients in the control group maintained the treatment for >5 years.

LNG-IUS significantly decreased the pain score for non-cyclic pelvic/back pain (from 4.0 ± 1.6 to 0.6 ± 1.3, P < .001), dysmenorrhea (from 6.5 ± 1.7 to 6.5 ± 1.7, P < .001), and dyspareunia/dyschezia (from 6.5 ± 1.7 to 1.3 ± 1.4, P = .006) after 1 year, and the effect was persistent for 10 years (P < .01). When compared with control group, the effect on pain reduction was comparable to the oral contraceptives or dienogest, with less systemic side effects such as mood change or nausea.

LNG-IUS for >5 years as a postoperative maintenance therapy for endometriosis patients is an effective and feasible treatment that shows significant effect on pain reduction with less systemic side effect compared with other types of treatment. Therefore, LNG-IUS can be recommended as a long-term postoperative therapy for endometriosis patients who do not plan to become pregnant for several years.