bluuebunny/crossref_metadata_2025 huggingface dataset:
Global trajectories of liver cancer burden from 1990 to 2019 and projection to 2035
Authors: Yang Fan , Sun Dianqin , Xia Changfa , Li He , Cao Maomao , Yan Xinxin , He Siyi , Zhang Shaoli , Chen Wanqing
Published: April 2023

Background:

Large disparities exist in liver cancer burden trends across countries but are poorly understood. We aimed to investigate the global trajectories of liver cancer burden, explore the driving forces, and predict future trends.

Methods:

Data on the liver cancer burden in 204 countries and territories from 1990 to 2019 were extracted from the Global Burden of Disease Study. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) trajectories were defined using growth mixture models. Five major risk factors contributing to changes in the ASIR or ASMR and socioeconomic determinants were explored using the identified trajectories. A Bayesian age-period-cohort model was used to predict future trends through 2035.

Results:

Three trajectories of liver cancer burden were identified: increasing, stable, and decreasing groups. Almost half of the American countries were classified in the decreasing group (48.6% for ASIR and ASMR), and the increasing group was the most common in the European region (ASIR, 49.1%; ASMR, 37.7%). In the decreasing group, the decrease of liver cancer due to hepatitis B contributed 63.4% and 60.4% of the total decreases in ASIR and ASMR, respectively. The increase of liver cancer due to alcohol use, hepatitis C, and hepatitis B contributed the most to the increase in the increasing group (30.8%, 31.1%, and 24.2% for ASIR; 33.7%, 30.2%, and 22.2% for ASMR, respectively). The increasing group was associated with a higher sociodemographic index, gross domestic product per capita, health expenditure per capita, and universal health coverage (all P <0.05). Significant variations in disease burden are predicted to continue through 2035, with a disproportionate burden in the decreasing group.

Conclusion:

Global disparities were observed in liver cancer burden trajectories. Hepatitis B, alcohol use, and hepatitis C were identified as driving forces in different regions.
Surgical Core Excision With Tongue Flap Closure in Combination With Electron Beam Radiotherapy in the Treatment of Ear Keloids
Authors: Ahmednaji Nebil Mahamoud , Wu Xiao-yan , Wang Yi-xiao , Chen Xiao-dong
Published: April 2023

BACKGROUND

Ear keloids are disfiguring disorders resistant to various treatments.

OBJECTIVE

The authors aimed to assess the efficacy of surgical treatment of ear keloids in a Chinese population using a tongue flap with electron beam radiotherapy.

METHODS

The authors conducted a retrospective analysis of 41 patients treated at the Affiliated Hospital of Nantong University between January 2018 and May 2021. Core excision with a tongue flap was performed, followed by 3 days of electron beam radiotherapy and 3 to 6 months of pressure clip application. The Vancouver Scar Scale (VSS) and the Visual Analog Scale (VAS) were used to assess the results.

RESULTS

The mean age of the patients was 28.10 years (9–61 years). Postoperative follow-up ranged from 5 to 32 months (mean:12.07). The patients underwent 3 days of postoperative radiotherapy followed by pressure clips for 2 to 6 months. Thirty-seven patients had no recurrence, whereas 4 had a mild recurrence (<3 mm in height) with redness and itchiness. The VSS and VASscores significantly decreased. (p < .05)

CONCLUSION

Excision with a tongue flap and radiotherapy can be used as the primary treatment for ear keloids considering the good outcome and long-term management.
The Role of Extracellular Matrix in Wound Healing
Authors: Lin Pingping , Zhang Guohong , Li Hang
Published: April 2023

BACKGROUND

Extracellular matrix communicates with surrounding cells to maintain skin homeostasis and modulate multiple cellular processes including wound healing.

OBJECTIVE

To elucidate the dynamic composition and potential roles of extracellular matrix in normal skin, wound healing process, and abnormal skin scarring.

MATERIALS AND METHODS

Literature review was performed to identify relevant publications pertaining to the extracellular matrix deposition in normal skin and wound healing process, as well as in abnormal scars.

RESULTS

A summary of the matrix components in normal skin is presented. Their primary roles in hemostasis, inflammation, proliferation, and remodeling phases of wound healing are briefly discussed. Identification of novel extracellular matrix in keloids is also provided.

CONCLUSION

Abnormal scarring remains a challenging condition with unmet satisfactory treatments. Illumination of extracellular matrix composition and functions in wound healing process will allow for the development of targeted therapies in the future.
Artificial sweeteners and cardiovascular risk
Authors: Gomez-Delgado Francisco , Torres-Peña Jose David , Gutierrez-Lara Gema , Romero-Cabrera Juan Luis , Perez-Martinez Pablo
Published: April 2023

Purpose of review

Globalization and the increase in consumption of ultra-processed foods have led to a need for greater knowledge on the health impacts of certain nutrients such as artificial sweeteners. This review aims to analyse the role of artificial sweeteners (nutritive and nonnutritive) and their impact on cardiometabolic and cardiovascular disease (CVD) risk.

Recent findings

The detrimental effects of a high-calorie, high-sugar diet have been well established. In light of this, health authorities recommend limiting sugar consumption. This has led the food industry to develop different artificial sweeteners with specific properties, such as flavour and stability (nutritive artificial sweeteners: NAS), and others aimed at limiting sugar in the diet (nonnutritive artificial sweeteners: nNAS). Likewise, recent evidence explores the influence of artificial sweeteners (NAS and nNAS) on CVD risk through risk factors such as obesity and type 2 diabetes mellitus, among others.

This review aims to provide an updated overview of the impact of NAS and nNAS on cardiovascular health and provide recommendations regarding their consumption.
Management of acute pericarditis
Authors: Avula Sravani , Madsen Nicolas
Published: April 2023

Purpose of review

Provide an update on current management and most recent evidence in the treatment of pediatric pericarditis.

Recent findings

While treatment of acute pericarditis has not significantly changed over the last decade, management of recurrent acute pericarditis, with increased attention to autoinflammation as a causal mechanism, has evolved substantially. This includes clinical trial evidence that newer medications targeting interleukin-1 receptors are effective in recurrent forms of pericarditis. In addition, advanced imaging utilizing cardiac magnetic resonance has emerged as a particularly effective way to detect ongoing pericardial inflammation in support of more difficult-to-treat patients.

Recent advances in acute and recurrent pericarditis management have allowed for a more tailored approach to the individual patient. Yet, unresolved questions require further research.
Imaging of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy
Authors: Stewart Merrill , Elagizi Andrew , Gilliland Yvonne E.
Published: April 2023

Purpose of review

The current article reviews obstructive forms of hypertrophic cardiomyopathy and associated morphologic cardiac abnormalities. It focuses on echocardiographic imaging of the left ventricular (LV) outflow tract obstruction, its evaluation, prognostication, and differentiation from other conditions mimicking obstructive hypertrophic cardiomyopathy.

Recent findings

Symptomatic patients with LV outflow tract (LVOT) gradients at least 50 mmHg on maximally tolerated medical therapy are candidates for advanced therapies. Resting echocardiography may only identify 30% of patients with obstructive physiology. Provocative maneuvers are essential for symptomatic patients with hypertrophic cardiomyopathy (HCM). Exercise echocardiography is recommended if they fail to provoke a gradient. Although dynamic LV tract obstruction is seen with obstructive HCM, it is not specific to this condition and exists in other physiologic and pathophysiologic states. Careful clinical evaluation and imaging techniques aid in the differentiation of HCM from these conditions.

Imaging plays an integral role in the diagnosis, prognosis, and risk stratification of HCM patients. Newer imaging technologies, including 3D transthoracic echocardiography, 3D transesophageal, speckle-derived 2D strain, and cardiac MRI, allow for a better hemodynamic understanding of systolic anterior motion and LV tract obstruction. Evolving techniques, that is, artificial intelligence, will undoubtedly further increase diagnostic capabilities. Newer medical therapies are available with the hope that this will lead to better patient management.
Maternal Reasons for Early Termination of Exclusive Breastfeeding in Premature Infants
Authors: Skaaning Diana , Brødsgaard Anne , Kronborg Hanne , Kyhnæb Anne , Pryds Ole , Carlsen Emma
Published: April 2023

Purpose:

Maternal concerns for health and growth in prematurely born infants affect the breastfeeding duration.

Method:

This prospective observational study evaluated whether maternal concerns regarding insufficient milk supply were supported by inadequate nutrients in human milk or low infant growth. The study followed mothers of 211 premature born infants for 6 months after delivery.

Results:

Of the 211 infants, 156 were not exclusively breastfed for the recommended 6 months after delivery. For 79 of these 156 infants, termination was due to maternal concerns regarding insufficient milk supply. There was no difference in human milk nutrients or infant growth when comparing infants who were exclusively breastfed with those who were not.

Conclusion:

Maternal concern regarding insufficient milk supply was the primary explanation for termination of exclusive breastfeeding after premature delivery. Concerns regarding insufficient milk supply were not found associated with inadequate nutrients in the human milk, nor with low infant growth.

Implications:

Breastfeeding support should remain in focus in this population.
Analysis of heparin-induced thrombocytopenia diagnostic and management strategies in individuals with inconclusive antibody optical densities
Authors: Erich Bradley J. , Knutson Jace , Barnes Brian J.
Published: April 2023

Heparin-induced thrombocytopenia (HIT) is an uncommon but serious complication of exposure to heparin. Antibody optical densities (ODs) used to diagnose HIT exceeding 2 are highly suggestive of disease, whereas ODs less than 0.5 often ‘rule out’ HIT. Variation in the clinical care of patients with inconclusive ODs between 0.5 and 2 is likely. This single-centre, retrospective analysis evaluates the diagnosis, management and outcomes of those with antibody ODs between 0.5 and 2.

We queried our institution's Healthcare Enterprise Repository for Ontological Narration (HERON) database to identify individuals with antibody ODs between 0.5 and 2. Chart review was completed to calculate 4T scores, corroborate diagnosis codes with documented information in our electronic health record (EHR) and evaluate the diagnosis, management and outcomes of these individuals. These data were evaluated using descriptive and univariate statistics.

Among individuals evaluated for HIT between November 2007 and July 2020, we identified 302 individuals with ODs between 0.5 and 2. Serotonin release assays (SRAs) were assessed in 55% (165/302) and were positive in 12% (20/165). In those with available data, 96% with low 4T scores had negative SRAs and 4% had positive SRAs. As 4T scores and antibody ODs proportionally increased, SRA positivity also increased. Clinical management varied widely; however, 4T scoring remains a valuable assessment in this cohort.

In those with HIT antibody ODs between 0.5 and 2, true positives were uncommon, and their clinical management varied widely. Fortunately, 4T scoring is a useful prognostic tool that improves the diagnosis and management among those with inconclusive HIT.
The efficacy of glycerin suppositories for preterm infants: A meta-analysis of randomized controlled studies
Authors: Wen Lingling , Xu Liangyin
Published: April 2023

Background:

The effect of glycerin suppositories on full enteral feeds remained controversial in preterm infants, and thus we conducted this meta-analysis to identify the influence of glycerin suppositories on full enteral feeds in preterm infants.

Methods:

The protocol was registered in PROSPERO (CRD20214283090). We searched PubMed, EMbase, Web of science, EBSCO and Cochrane library databases through February 2020, and included randomized controlled trials assessing the effect of glycerin suppositories on full enteral feeds in preterm infants. This meta-analysis was performed using the random-effect model.

Results:

Six Randomized controlled trials were included in the meta-analysis. Overall, compared with control group in preterm infants, glycerin suppositories demonstrated no significant effect on days to full enteral feeds (mean difference = −0.26; 95% confidence interval [CI] = −1.16 to 0.65; P = .58), the incidence of necrotizing enterocolitis (odd ratio = 3.62; 95% CI = 0.56–23.32; P = .18) or death (odd ratio = 1.46; 95% CI = 0.40–5.40; P = .57), but may increase the days under phototherapy (mean difference = 0.50; 95% CI = 0.43–0.57; P < .00001). Only low heterogeneity was seen among all outcomes.

Conclusions:

Glycerin suppositories may provide no additional benefits to preterm infants.
COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study
Authors: Helou Mariana , Zoghbi Sanaa , El Osta Nour , Mina Jonathan , Mokhbat Jacques , Husni Rola
Published: April 2023

Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
A bibliometric analysis of obstructive sleep apnea and anesthesia
Authors: Öner Özlem , Ecevit Mustafa Cenk , Gökmen Ali Necati
Published: April 2023

To conduct a bibliographic analysis of obstructive sleep apnea (OSA) which has reached epidemic proportions and is a frequent, unknown, and important cause of perioperative morbidity and mortality, by examining the internationally most cited articles. For OSA, the most cited articles in the field of anesthesiology and reanimation, appropriate access terms were compiled and combined, and related publications were searched using the Thompson Reuters Web of Science Citation Indexing search engine. A total of 79 journal publications were found on OSA and anesthesia, with an average of 14.86 citations per article. The most cited publication was the “Society for Ambulatory Anesthesia Consensus Statement on Preoperative Selection of Adult Patients with Obstructive Sleep Apnea Scheduled for Ambulatory Surgery” published in the journal Anesthesia and Analgesia and was conducted by Joshi et al. It was found that 38 of the 79 studies reached as a result of the search were articles, and the average number of citations was 21.13. The Hirsch index of these articles, which were cited 803 times in total, was 15. A total of 31 articles (81.57%) were cited at least once, while the remaining 7 articles (18.43%) were not cited at all. The majority of the articles obtained are from the research fields of anesthesiology (n = 20; 52.63%), followed by otorhinolaryngology (n = 5; 13.15%), pediatrics (n = 5; 13.15%), respiratory system (n = 5; 13.15%), internal medicine (n = 4; 10.52%), and the rest were in various fields. Publications on “Obstructive Sleep Apnea” and “Anesthesia” have increased rapidly in the last decade. Anesthesia management and airway safety, patient management, including pain control in the postoperative period, and noninvasive mechanical ventilation treatment methods, such as continuous positive airway pressure, are hot topics.
Primary B-cell non-Hodgkin lymphoma of the parotid gland: An analysis based on the SEER database
Authors: Chen Xiang-Lei , Zhao Lu-Ming , Cai Yuan-Hua , Li Jing-Gang , Li Xin
Published: April 2023

Primary malignant lymphoma of the parotid gland is a rare entity. The disease is often misdiagnosed, and its survival factors remain unclear. This study included patients diagnosed with primary B-cell non-Hodgkin lymphoma of the parotid gland from 1987 to 2016 in the surveillance, epidemiology, and end results program. Univariate survival analysis was conducted using the Kaplan–Meier method, and multivariate analysis was performed using the Cox proportional hazards regression model. A competing risks regression model was applied to estimate the specific risks associated with parotid lymphoma mortality. A total of 1443 patients were identified. The overall survival of indolent primary B-cell lymphoma of the parotid gland was higher than that of aggressive lymphoma (hazard ratio 0.53, 95% confidence interval 0.44–0.64, P < .001), and older patients (≥70 years) exhibited inferior overall survival. Histological subtype and age are important prognostic factors in patients with primary B-cell non-Hodgkin lymphoma of the parotid gland.
The effect of a modified perioperative management model on the mental state, quality of life, and self-care ability score of patients after radical prostatectomy: A retrospective study
Authors: Zhang Miao , Hu Xianwen , Jia Jianxia , Wu Dequan
Published: April 2023

To explore the effects of an improved perioperative management model on the mental state, quality of life, and self-care ability scores of patients after radical prostatectomy. Overall, 96 postoperative prostate cancer patients admitted to our hospital between November 2019 and May 2021 were retrospectively analyzed and classified into an observation group and a control group with 48 patients each, according to the management model they received. The patients in the control group received routine care and were discharged. The observation group implemented an improved perioperative management model than the control group. Differences in mental state, quality of life, and self-care ability scores between the 2 groups were compared. After nursing, the self-rating anxiety scale and self-rating depression scale scores of the 2 groups were significantly lower than those before nursing, and the observation group’s self-rating anxiety scale and self-rating depression scale scores were significantly lower than those of the control group (P < .05). Regarding emotion, cognition, and society, the observation group’s quality of life scores was significantly higher than those of the control group. In contrast, overall health was significantly lower than that of the control group (P < .05). After nursing, the observation group’s self-care skills, self-responsibility, health knowledge, and self-concept scores were significantly better than those of the control group (P < .05). The improved prostate cancer perioperative management model helps improve patients’ unhealthy mental state, quality of life, self-care ability, and provides guidelines for the clinical care of patients after prostate cancer surgery.
Planning adaptive treatment by longitudinal response assessment implementing MR imaging, liquid biopsy and analysis of microenvironment during neoadjuvant treatment of rectal cancer (PRIMO)
Authors: Wurschi Georg W. , Güllmar Daniel , Gaßler Nikolaus , Clement Joachim , Kesselmeier Miriam , Müller-Wurschi Julia J. , Settmacher Utz , Mothes Henning , Helfritzsch Herry , Liebe Yves , Franiel Tobias , Mäurer Matthias A. , Ernst Thomas , Nicolay Nils H. , Wittig Andrea
Published: April 2023

Introduction:

Conducting neoadjuvant chemoradiotherapy (CRT) and additional preoperative consolidating chemotherapy (CTx), that is, total neoadjuvant therapy (TNT), improves local control and complete response (CR) rates in locally advanced rectal cancer (LARC), putting the focus on organ preservation concepts. Therefore, assessing response before surgery is crucial. Some LARC patients would either not benefit from intensification by TNT or may reach CR, making resection not mandatory. Treatment of LARC should therefore be based on patient individual risk and response to avoid overtreatment.

The “PRIMO” pilot study aims to determine early response assessment to form a basis for development and validation of a noninvasive response prediction model by a subsequent prospective multicenter trial, which is highly needed for individual, response-driven therapy adaptions.

Methods:

PRIMO is a prospective observational cohort study including adult patients with LARC receiving neoadjuvant CRT. At least 4 multiparametric magnetic resonance imaging (MRI) scans (diffusion-weighted imaging [DWI] and hypoxia-sensitive sequences) as well as repeated blood samples in order to analyze circulating tumor cells (CTC) and cell-free tumor DNA (ctDNA) are scheduled. Pelvic radiotherapy (RT, 50.4 Gy) will be performed in combination with a 5-fluorouracil/oxaliplatin regimen in all patients (planned: N = 50), succeeded by consolidation CTx (FOLFOX4) if feasible. Additional (immuno)histochemical markers, such as tumor-infiltrating lymphocytes (TIL) and programmed death ligand 1 (PD-L1) status will be analyzed before and after CRT. Routine resection is scheduled subsequently, nonoperative management is offered alternatively in case of clinical CR (cCR).The primary endpoint is pathological response; secondary endpoints comprise longitudinal changes in MRI as well as in CTCs and TIL. These are evaluated for early response prediction during neoadjuvant therapy, in order to develop a noninvasive response prediction model for subsequent analyses.

Discussion:

Early response assessment is the key in differentiating “good” and “bad” responders during neoadjuvant CRT, allowing adaption of subsequent therapies (additional consolidating CTx, organ preservation). This study will contribute in this regard, by advancing MR imaging and substantiating new surrogate markers. Adaptive treatment strategies might build on these results in further studies.
Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report
Authors: Zhou Binbin , Huang Junjie , Chen Xiaobin , Lin Chen , Xia Yin , Jiang Rong
Published: April 2023

Rationale:

Superior mesenteric artery (SMA) stenosis, as a common arterial disease, if coexists with other possible causes of abdominal pain, is complicated, which may require not only conservative treatment but also surgical intervention.

Patient concerns:

A 64-year-old male patient who was admitted to our hospital with pain located around the umbilicus and right lower quadrant for 12 hours.

Diagnosis:

SMA stenosis was initially diagnosed. After balloon dilatation of SMA and stent implantation, computed tomography angiography reexamination showed that the stent was migrated and the stenosis reoccurred. During the ileocecal resection and enterolysis, the necrotic bowel was found and cut open, and the intestinal fistula was found. Combined with his abdominal surgery history, the patient was diagnosed with complicated SMA stenosis with intestinal necrosis.

Interventions:

The balloon dilatation of SMA and stent implantation was performed. Because the stent was migrated and the stenosis reoccurred, so a balloon stent was implanted in the proximal stenosis of SMA again. The patient’s symptoms were relieved and reoccurred again. The ileocecal resection and enterolysis were performed.

Outcomes:

The computed tomography angiography showed that the stents were well deployed and unobstructed after 9 months follow-up.

Lessons:

When dealing with undetermined abdominal pain that especially has something to do with mesenteric artery ischemia, if there coexists with other possible causes of abdominal pain, we cannot only focus on vascular diseases. We should be vigilant, integrate multiple factors and their interactions to guarantee the accuracy and timeliness of diagnosis and therapy.
Association study of selenium-related gene polymorphisms with geriatric depression in China
Authors: Liu Yu , Wang Liqun , Wang Zhizhong , He Shulan
Published: April 2023

Depression is a common mental health problem in older adults, but its cause remains unclear. Selenium is an essential micronutrient and a powerful antioxidant in the brain and nervous system. Several recent studies have reported a relationship between selenium levels and depression. This study aimed to investigate the relationship between 4 genes co-associated with selenium and geriatric depression. 1486 participants were included in this study from 5 communities in Ningxia Hui Autonomous Region during 2013 to 2016 in a health examination program for urban and rural residents. Polymorphisms of 4 selenium-related genes were analyzed in 1266 healthy volunteers and 220 patients with depression. The genotyping of rs2830072, rs2030324, rs6265, rs11136000, rs7982, rs10510412, rs1801282, rs1151999, rs17793951, rs709149, rs709154, and rs4135263 were performed by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) technology. The analysis of selenium-related genes showed that there were significant differences between depression and controls for allele and genotype frequencies of peroxisome proliferator activated receptor gamma (PPARG) rs10510412, rs709149, and rs709154 (all P < .05). In this study, when adjusting for age, sex, marital status, education, and alcohol consumption, results showed that rs709149 and rs709154 were still significantly correlated with geriatric depression in the codominant, dominant, overdominant, and log-additive models. Logistic regression analysis showed that rs709149 AG or GG gene carriers were 1.630 and 1.746 times more susceptible to depression than AA gene carriers (95% CI = 1.042–2.549; 1.207–2.526). The results of this study suggest that the rs709149 polymorphism of the selenium-related gene PPARG is a genetic risk factor for depression in older adults.
Does one of the two most commonly used scoring systems have a decisive advantage over the other in diagnosing acute appendicitis in pregnant women?
Authors: Bardakçi Osman , Bahçecioğlu İbrahim Burak , Tatli Faik , Özgönül Abdullah , Güldür Muhammet Emin , Uzunköy Ali
Published: April 2023

This study aimed to compare the accuracy and reliability of Alvarado Score (AS) and Appendicitis Inflammatory Response Score (AIRS) in pregnant women undergoing surgery for acute appendicitis (AA). The files of 53 pregnant women with a diagnosis of AA who underwent surgery in our clinic between February 2014 and December 2018 were examined retrospectively. The patients were divided into 3 groups as follows: first trimester between 0 and 14 weeks, second trimester between 15 and 28 weeks, and third trimester between 29 and 42 weeks. The AS and AIRS values were calculated according to preoperative physical examination and laboratory results. The mean age of the patients was 28.58 (18–44) years. According to the pathology results, appendicitis was detected in 16 of 23 patients in the first trimester, in 22 of 25 patients in the second trimester, and in 2 of 5 patients in the third trimester. The AIRS was ≥ 9 in 9 patients and the AS was ≥ 7 in 19 of the 23 patients in the 1st trimester, while the AIRS was ≥ 9 in 11 patients and the AS was ≥ 7 in 19 of the 25 patients in the 2nd trimester. However, in the 3rd trimester, the AIRS was ≥ 9 in 2 patients and AS was ≥ 7 in 4 of the 5 patients. In conclusion, when the data obtained from the present study were evaluated, it was determined that both AS and AIRS are effective methods for diagnosing AA in pregnant women.
Dekyphosis operation combined with limited osteotomy to treat the symptomatic adult tethered cord syndrome with complicated malformations: A case report
Authors: Jiao Liang , Yang Xiao , Wang Shuang , Ma Jun-Xiong , Zheng Liang , Wang Hong , Yu Hai-Long , Chen Yu
Published: April 2023

Rationale:

Tethered cord syndrome (TCS) represents a spectrum of neurological symptoms that are caused by constant or intermittent axial traction of the terminal cone of the spinal cord due to abnormal positioning. It is uncommon for abnormal structures of TCS to be accompanied by split cord malformation, thoracic spinal stenosis, and other spinal cord diseases.

Patient concerns:

A 45-year-old male patient visited our hospital due to severe lower back pain, extensive left lower limb muscle weakness, and intermittent claudication.

Diagnoses:

TCS combined with stenosis of the thoracic canal, split cord malformation, and kyphosis deformity.

Interventions:

The patient underwent Dekyphosis operation combined with limited osteotomy symptoms.

Outcomes:

The patient felt the right lower limb improved after surgery. At 4-month follow-up, a radiological examination showed adequate decompression of the spinal cord and a good internal fixation position. Overall, the patient’s clinical symptoms significantly improved.

Conclusion:

This is a rare case of TCS combined with thoracic disc herniation and bony mediastinum. A more conservative invasive surgical approach was elected and markedly improved the patient’s symptoms. Additional clinical cases are needed to confirm the stability and feasibility of this surgical approach.
Deep muscle stimulator in the treatment of post-stroke spasticity: A protocol for systematic review and meta-analysis
Authors: Lei Junfang , Zhang Chengdong , Gai Jialin , Fan Xiaohua , Tang Jiqin
Published: April 2023

Background:

Spasticity is one of the most common complications and sequelae of stroke, with the main clinical manifestations being increased muscle tension, pain, stiffness, and other disorders. It not only increases the length of hospitalization and medical costs but also affects the quality of daily life and the stress of returning to society, increasing the burden on patients and their families. At present, 2 driver types of deep muscle stimulator (DMS) have been used in the clinical treatment of post-stroke spasticity (PSS) with good clinical results, but there is no evidence of clinical efficacy and safety. Therefore, this study aims to integrate direct and indirect comparative clinical evidence through a systematic review and network meta-analysis (NMA). According to the data, different driver types for DMS with the same body of evidence will be collected, analyzed, and sequenced in a quantitative and comprehensive manner and then screened for the optimal driver type of DMS device for PSS treatment. The study also aims to provide reference value and an evidence-based theoretical basis for the clinical optimization of DMS equipment selection.

Methods:

A comprehensive retrieval of China National Knowledge Infrastructure, Chinese scientific journal database, China biological feature database, Wanfang Chinese databases and the Cochrane Library, PubMed, Web of Science, and Embase foreign databases will be conducted. Randomized controlled trials of these 2 driver types of DMS devices combined with conventional rehabilitation training of PSS will be searched and published. The retrieval time is from the establishment of the database to December 20, 2022. The 2 first authors will screen references that meet the inclusion criteria, independently extract data according to predesigned rules, and assess the quality of the included studies and the risk of bias according to the Cochrane 5.1 Handbook criteria. R programming and Aggregate Data Drug Information System software will be used to perform a combined NMA of the data and to evaluate the probability of ranking for all interventions.

Results:

The NMA and probability ranking will determine the best driver type of DMS device for PSS.

Conclusion:

This study will offer a comprehensive evidence-based approach to DMS therapy and assist doctors, PSS patients, and decision-makers in selecting a more efficient, secure, and cost-effective treatment option.
Prognostic significance of JAM 3 in gastric cancer: An observational study from TCGA and GEO
Authors: Zhao Qinfu , Lian Jiayu , Pang Kai , Wang Ping , Ge Ruiyin , Chu Yanliu
Published: April 2023

Junctional adhesion molecule 3 (JAM3) can be used as a prognostic marker in multiple cancer types. However, the potential prognostic role of JAM3 in gastric cancer (GC) remains unclear. The purpose of this research was to gauge JAM3 expression and methylation as potential biomarkers for GC patient survival. Through bioinformatics research, we analyzed JAM3 expression, methylation, prognosis, and immune cell infiltrations. JAM3 methylation acts as a negative regulator of JAM3, leading to reduced expression of JAM3 in GC tissues relative to normal tissues. Patients with GC who expressed little JAM3 have a better chance of living a long time free of the disease, according to the Cancer Genome Atlas (TCGA) database. Through univariate and multivariate Cox regression analysis, inadequate JAM3 expression was labeled as an isolated indicator for overall survival (OS). The GSE84437 dataset was also used to confirm JAM3 prognostic role in GC, with consistent findings. A meta-analysis also found that low levels of JAM3 expression were significantly associated with longer OS. Finally, there was a strong correlation between JAM3 expression and a subset of immune cells. According to the TCGA database, low JAM3 expression could predict favorable OS and progression-free-survival (PFS) in GC patients (P < .05). The univariate and multivariate Cox regression demonstrated that low JAM3 expression was independent biomarker for OS (P < .05). Moreover, GSE84437 dataset was utilized to verify the prognostic role of JAM3 in GC, and the similar results were reached (P < .05). A meta-analysis revealed that low JAM3 expression was closely relevant to better OS. Finally, JAM3 expression exhibited a close correlation with some immune cells (P < .05). JAM3 might be a viable predictive biomarker and likely plays a crucial part in immune cell infiltration in individuals with GC.
Risk factors for postoperative complications in patients with Parkinson disease: A single center retrospective cohort study
Authors: Nakadate Yosuke , Nakashige Daiki , Omori Keiko , Matsukawa Takashi
Published: April 2023

Surgical treatment for patients with Parkinson disease (PD) under general anesthesia has become frequent. PD is a significant predictor of postoperative complications. However, the factors that predict complications in patients with PD remain unknown. We retrospectively recruited patients with PD who underwent surgery between April 2015 and March 2019. The prevalence of postoperative complications was analyzed. We compared the patient characteristics, medical data, and surgical data between patients with and without postoperative complications. We also estimated the odds ratios (OR) for postoperative complications in patients with PD who underwent surgery. Sixty-five patients were enrolled. Eighteen patients presented with 22 complications, including urinary tract infections (UTI) (n = 3; 5%), pneumonia (n = 1; 2%), surgical site infections (SSI) (n = 3; 5%), postoperative delirium (POD) (n = 7; 10%), and others (n = 8; 12%). Four patients presented with 2 complications each. The operation time, the red blood cell transfusion and the rate of rotigotine usage were higher in patients with complications than those without (314 ± 197 min vs 173 ± 145 min, P = .006; 0 [0–560] mL vs 0 [0–0] mL, P = .02; 39% vs 6%, P = .003, respectively) (mean ± standard deviation or median [interquartile range]). Preoperative rotigotine usage (OR: 9.33; 95% confidential interval [CI]: 2.07–42.07; P = .004) was an independent risk factors for postoperative complications. The findings indicate that clinicians should closely monitor postoperative complications when patients with PD who have received transdermal dopamine agonists undergone longer time surgery.
Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis
Authors: Hao Hong-Juan , Feng Li , Dong Li-Fei , Zhang Wei , Zhao Xiao-Li
Published: April 2023

Background:

Ectopic pregnancy (EP), one of the most common gynecological emergencies, is the major cause of maternal death in the first trimester and increases the incidence of infertility and repeat ectopic pregnancy (REP). The aim of this study was to compare the effects of different treatment methods for tubal EP on natural pregnancy outcomes.

Methods:

We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials for observational studies on EP (published until October 30,2022 in English) comparing methotrexate (MTX) versus surgery, MTX versus salpingostomy, MTX versus salpingectomy, salpingostomy versus salpingectomy, and MTX versus expectant treatment. Our main endpoints included subsequent natural intrauterine pregnancy (IUP) and REP. We assessed the pooled data using Review Manager software (version 5.3) with a random effects model.

Results:

Of 1274 identified articles, 20 were eligible and 3530 participants were included in our analysis. There was a significant difference in the odds of subsequent IUP in tubal EP patients who underwent MTX compared with those who were treated with surgery [odds ratios (OR) = 1.52, 95% confidence interval (CI):1.20–1.92]. No significant difference was found in the odds of REP between the 2 groups (OR = 1.12, 95% confidence interval [CI]: 0.84–1.51). There was no significant difference in the odds of subsequent IUP and REP in patients after MTX compared to those after salpingostomy (OR = 1.04,95% CI: 0.79–1.38; OR = 1.10, 95% CI: 0.64–1.90). There was a significant difference in the odds of subsequent IUP in patients after MTX compared with those after salpingectomy (OR = 2.11, 95% CI: 1.52–2.93). No significant difference was found in the odds of REP between the 2 groups (OR = 0.98, 95% CI: 0.57–1.71). There was a significant difference in the odds of subsequent IUP between patients who underwent salpingostomy and those who underwent salpingectomy (OR = 1.61, 95% CI: 1.29–2.01). No significant difference was found in the odds of REP between the 2 groups (OR = 1.21, 95% CI: 0.62–2.37). There was no significant difference in the odds of subsequent IUP and REP in patients after MTX compared with those after expectant treatment (OR = 1.25, 95% CI: 0.64–2.45; OR = 0.69, 95% CI: 0.09–5.55).

Conclusion:

For hemodynamically stable tubal EP patients, MTX has advantages over surgery, particularly salpingectomy, in improving natural pregnancy outcomes. However, MTX is not inferior to salpingostomy and expectant treatment.
The ascendancy of research in acronyms related to COVID-19 displayed on a growth-share matrix (GSM): Bibliometric analysis
Authors: Hou Cheng-Yu , Chien Tsair-Wei , Chow Julie Chi , Chou Willy
Published: April 2023

Background:

The acronym COVID, which stands for coronavirus disease, has become one of the most infamous acronyms in the world since 2020. An analysis of acronyms in health and medical journals has previously found that acronyms have become more common in titles and abstracts over time (e.g., DNA and human immunodeficiency virus are the most common acronyms). However, the trends in acronyms related to COVID remain unclear. It is necessary to verify whether the dramatic rise in COVID-related research can be observed by visualizations. The purpose of this study was to display the acronym trends in comparison through the use of temporal graphs and to verify that the COVID acronym has a significant edge over the other 2 in terms of research dominance.

Methods:

An analysis of the 30 most frequently used acronyms related to COVID in PubMed since 1950 was carried out using 4 graphs to conduct this bibliometric analysis, including line charts, temporal bar graphs (TBGs), temporal heatmaps (THM), and growth-share matrices (GSM). The absolute advantage coefficient (AAC) was used to measure the dominance strength for COVID acronym since 2020. COVID’s AAC trend was expected to decline over time.

Results:

This study found that COVID, DNA, and human immunodeficiency virus have been the most frequently observed research acronyms since 2020, followed by computed tomography and World Health Organization; although there is no ideal method for displaying acronym trends over time, researchers can utilize the GSM to complement traditional line charts, TBGs, and THMs, as shown in this study; and COVID has a significant edge over the other 2 in terms of research dominance by ACC (≥0.67), but COVID’s AAC trend has declined (e.g., AACs 0.83, 0.80, and 0.69) since 2020.

Conclusions:

It is recommended that the GSM complement traditional line charts, TBGs, and THMs in trend analysis, rather than being restricted to acronyms in future research. This research provides readers with the AAC to understand how research dominates its counterparts, which will be useful for future bibliometric analyses.
Clinical utility of single-shot echo-planar diffusion-weighted imaging using L1-regularized iterative sensitivity encoding in prostate MRI
Authors: Nishioka Noriko , Fujima Noriyuki , Tsuneta Satonori , Yoneyama Masami , Matsumoto Ryuji , Abe Takashige , Kimura Rina , Sakamoto Keita , Kato Fumi , Kudo Kohsuke
Published: April 2023

We investigated the ability of echo-planar imaging with L1-regularized iterative sensitivity encoding-based diffusion-weighted imaging (DWI) to improve the image quality and reduce the scanning time in prostate magnetic resonance imaging. We retrospectively analyzed 109 cases of prostate magnetic resonance imaging. We compared variables in the quantitative and qualitative assessments among 3 imaging groups: conventional parallel imaging-based DWI (PI-DWI) with an acquisition time of 3 minutes 15 seconds; echo-planar imaging with L1-regularized iterative sensitivity encoding-based DWI (L1-DWI) with a normal acquisition time (L1-DWINEX12) of 3 minutes 15 seconds; and L1-DWI with a half acquisition time (L1-DWINEX6) of 1 minute 45 seconds. As a quantitative assessment, the signal-to-noise ratio (SNR) of DWI (SNR-DWI), the contrast-to-noise ratio (CNR) of DWI (CNR-DWI), and the CNR of apparent diffusion coefficient were measured. As a qualitative assessment, the image quality and visual detectability of prostate carcinoma were evaluated. In the quantitative analysis, L1-DWINEX12 showed significantly higher SNR-DWI than PI-DWI (P = .0058) and L1-DWINEX6 (P < .0001). In the qualitative analysis, the image quality score for L1-DWINEX12 was significantly higher than those of PI-DWI and L1-DWINEX6. A non-inferiority assessment demonstrated that L1-DWINEX6 was non-inferior to PI-DWI in terms of both quantitative CNR-DWI and qualitative grading of image quality with a <20% inferior margin. L1-DWI successfully demonstrated a reduced scanning time while maintaining good image quality.
Clinical characteristics and influencing factors of infectious diarrhea in preschool children: An observational study
Authors: Chen Mu-Heng , Deng Su-Han , Wang Ming-Huan , Yan Xu-Ke
Published: April 2023

Infectious diarrhea is a common disease in preschool children, but the pathogenic species, origins, and influencing factors remain debatable. Therefore, more studies are required to solve these debatable topics. A number of 260 eligible preschool children diagnosed with infectious diarrhea in our hospital were enrolled in the infection group. Meanwhile, a number of 260 matched healthy children from the health center were enrolled in the control group. The pathogenic species and origins, the time of onset of infectious diarrhea in the infection group, demographic data, exposure history, hygiene habits, dietary habits, and other variables in both groups were initially collected from medical documents. In addition, a questionnaire was used to complete and confirm study variables through face-to-face or telephone interviews. Then, the univariate and multivariate regression analyses were used to screen the influencing factors of infectious diarrhea. Among 260 infected children, salmonella (15.77%), rotavirus (13.85%), shigella (11.54%), vibrio (10.38%), and norovirus (8.85%) were the top 5 common pathogens; January (13.85%), December (12.69%), August (12.31%), February (11.92%), and July (8.46%) were the top 5 frequent times of infectious diarrhea. The distribution of onset time for infectious diarrhea was commonly found in winter and summer, and the pathogens always originated from foods. The results of multivariate regression analysis showed that recent exposure to diarrhea, flies, and/or cockroaches indoors were the 2 risk factors for infectious diarrhea; Meanwhile, rotavirus vaccination, regular hand-washing, tableware disinfection, separate preparation of cooked and raw foods, and regular intake of lactobacillus products were the 5 protective factors for infectious diarrhea in preschool children. Infectious diarrhea has a diversity of pathogenic species, origins, and influencing factors in preschool children. Activities focusing on these influencing factors such as rotavirus vaccination, consumption of lactobacillus products, and other conventional factors would be beneficial to preschool children’s health.
Comprehensive analysis of immune implication and prognostic value of DHX33 in sarcoma
Authors: Zhang Xinan , Shao Yiming , Zhou Yaqi , Zhu Zhi , Wang Xiaohu
Published: April 2023

DEAH-box helicase 33 (DHX33) is an RNA helicase that has been identified to promote the progression of a variety of cancers. However, the relationship between DHX33 and sarcoma remains unknown. RNA expression data with clinical information for the sarcoma project was collected from TCGA database. The association between the differential expression of DHX33 and the prognosis for sarcoma was assessed using survival analysis. CIBERSORT was used to evaluate the immune cell infiltration in sarcoma sample tissues. We then further investigated the association between DHX33 and tumor-infiltrating immune cells in sarcoma using the TIMER database. Finally, the immune/cancer-related signaling pathways involved in DHX33 were analyzed using gene set enrichment analysis. High DHX33 expression was discovered to be a poor prognostic indicator in TCGA-SARC. Immune subpopulations in the TCGA-SARC microenvironment are dramatically altered compared to normal tissues. The tumor immune estimation resource analysis revealed a strong correlation between the expression of DHX33 and the abundance of CD8+ T cells and dendritic cells. Changes in copy number also affected neutrophils, macrophages, and CD4+ T cells. According to gene set enrichment analysis, DHX33 may be involved in a number of cancer- and immune-related pathways, such as the JAK/STAT signaling pathway, P53 signaling pathway, chemokine signaling pathway, T cell receptor signaling pathway, complement and coagulation cascades, and cytokine-cytokine receptor interaction. Our study emphasized that DHX33 may be involved in the immune microenvironment of sarcoma and play an important role. As a result, it is possible that DHX33 might serve as an immunotherapeutic target for sarcoma.