bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting the Apgar score of offsprings born to mothers suffering from systemic lupus erythematosus
Authors: Shimada Hiromi , Kameda Tomohiro , Kanenishi Kenji , Miyatake Nobuyuki , Nakashima Shusaku , Wakiya Risa , Kato Mikiya , Miyagi Taichi , Mansour Mai Mahmoud Fahmry , Hata Toshiyuki , Kadowaki Norimitsu , Dobashi Hiroaki
Published: October 2020

To reveal which disease activity parameters affect low Apgar scores of newborns, which is considered as a predictive parameter for neurological development.

We examined retrospectively the data from 42 newborns who were delivered from systemic lupus erythematosus (SLE) mothers from 2006 to 2019. We evaluated whether the disease activity parameters, such as the achievement ratio of lupus low disease activity state (LLDAS), SLE disease activities index (SLEDAI), complement level, titer of anti-double stranded DNA (anti-dsDNA) antibody, therapeutic agents were related with low Apgar scores of newborns.

In 42 newborns, adverse pregnancy outcomes, especially preterm birth (16.7%), low birth weight (31.0%) light-for-date (11.9%) were associated with disease activity parameters or prednisolone dose. Apgar scores at 1 minute were related with unachieved LLDAS and the titer of anti-dsDNA antibody at first and third trimester, SLEDAI score and complement level at third trimester, mean prednisolone dose. Apgar scores at 5 minutes were also associated with the titer of anti-dsDNA antibodies at first and third trimester and mean prednisolone dose. Multivariate analysis showed only high titer of anti-dsDNA antibody was significantly associated with low Apgar score at both one minute and 5 minutes.

In our retrospective study, high titer of anti-dsDNA antibodies at first and third trimester was a risk factor for low Apgar scores of newborns born to SLE mothers. We considered that high titer of anti-dsDNA antibody influenced on childrens neurological development, therefore, there is a need for long-term follow-up study of SLE offsprings.
Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction
Authors: Chen Huang-Chung , Lee Wei-Chieh , Fang Hsiu-Yu , Fang Chih-Yuan , Chen Chien-Jen , Yang Cheng-Hsu , Wu Chiung-Jen
Published: October 2020

The ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) has been proposed as an easily obtainable atherogenic marker and high TG/HDL-C ratio is associated with insulin resistance. This study investigated the associated between a high TG/HDL-C ratio and cardiovascular mortality in patients with ST-segment elevation myocardial infarction (STEMI), with or without diabetes mellitus (DM).

Between January 2005 and December 2014, 1661 patients with STEMI underwent primary percutaneous coronary intervention in our hospital. Of these, 289 were classified into group 1 (with both DM and a high TG/HDL-C ratio), 295 into group 2 (with DM, but without a high TG/HDL-C ratio), 501 into group 3 (without DM, but a high TG/HDL-C ratio), and 576 into group 4 (without DM or a high TG/HDL-C ratio).

Older age, longer chest pain to reperfusion time, poor hemodynamic condition, and higher prevalence of multiple vessel coronary artery disease were noted in those with DM. Poor outcomes including higher 30-day and 1-year cardiovascular mortality and all-cause mortality rates were noted in those with DM but without a high TG/HDL-C ratio. Patients with DM but without a high TG/HDL-C ratio had a Hazard ratio of 3.637 for cardiovascular mortality relative to those without DM, but without a high TG/HDL-C ratio.

Even though a high TG/HDL-C ratio is associated with insulin resistance, patients with or without DM, but with a high TG/HDL-C ratio had better 30-day and 1-year outcomes.
The COVID-19 research landscape
Authors: Wang Junhui , Hong Na
Published: October 2020

Objectives:

The Coronavirus Disease 2019 (COVID-19) caused heavy burdens and brought tremendous challenges to global public health. This study aimed to investigate collaboration relationships, research topics, and research trends on COVID-19 using scientific literature.

Method:

COVID-19-related articles published from January 1 to July 1, 2020 were retrieved from PubMed database. A total of 27,370 articles were included. Excel 2010, Medical Text Indexer (MTI), VOSviewer, and D3.js were used to summarize bibliometric features.

Results:

The number of the COVID-19 research publications has been continuously increasing after its break. United States was the most productive and active country for COVID-19 research, with the largest number of publications and collaboration relationships. Huazhong University of Science and Technology from China was the most productive institute on the number of publications, and University of Toronto from Canada ranked as Top 1 institute for global research collaboration. Four key research topics were identified, of which the topic of epidemiology and public health interventions has gathered highest attentions. Topic of virus infection and immunity has been more focused during the early stage of COVID-19 outbreak compared with later stage. The topic popularity of clinical symptoms and diagnosis has been steady.

Conclusions:

Our topic analysis results revealed that the study of drug treatment was insufficient. To achieve critical breakthroughs of this research area, more interdisciplinary, multi-institutional, and global research collaborations are needed.
Comparative effectiveness of East Asian traditional medicine for treatment of idiopathic short stature in children
Authors: Lee Boram , Kwon Chan-Young , Jang Soobin
Published: October 2020

Background:

There are many East Asian traditional medicine (EATM) therapies that are widely used and effective for idiopathic short stature (ISS) in children. However, the comparative effectiveness of these therapies remains unclear. We describe the methods that will be used to comparatively evaluate the efficacy and safety of EATM therapies for the treatment of pediatric ISS.

Methods and analysis:

Fourteen electronic English, Korean, Chinese, and Japanese databases will be searched up to August 2020 for relevant randomized controlled trials of various EATMs for the treatment of pediatric ISS, without language or publication status restrictions. The primary outcome will be growth-related anthropometric indicators, and acceptability, measured through drop-outs that occur during treatment for any reason. We will conduct a pairwise meta-analysis for direct comparisons if multiple studies use the same types of intervention, comparison, and outcome measure. A frequentist network meta-analysis will be performed to summarize the available direct and indirect evidence regarding various EATM options for pediatric ISS. The risk of bias for the included studies will be evaluated using the Cochrane Collaboration's risk of bias tool.

Conclusions:

The findings of this review will provide evidence for the comparative effectiveness and ranks of current EATMs and help to inform clinical practitioners, patients, and policy makers in decision making.

Ethics and dissemination:

Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentations.

Protocol registration number:

OSF (URL: https://osf.io/s4vp7), PROSPERO CRD42020187160
Clinical features of capsule endoscopy in 825 children
Authors: Wu Jie , Huang Zhiheng , Wang Yuhuan , Tang Zifei , Lai Lingyu , Xue Aijuan , Huang Ying
Published: October 2020

Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel.

Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases.

In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed.

Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ± 3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis.

VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.
Implementation of a clinical nursing pathway for percutaneous coronary intervention
Authors: Zhang Zhimin , Bai Jincheng , Huang Yongmei , Wang Lingling
Published: October 2020

Background:

Acute myocardial infarction is a very common disease in the emergency room. Emergency percutaneous coronary intervention (PCI) is the first choice to open infarct-related artery in time to regain the active blood flow of myocardial tissue. Clinical nursing pathway (CNP), namely clinical project, is an original nursing mode with good quality, outstanding efficiency, and low treatment spending, so it has attracted more and more attention. However, few studies have reported the implementation of a CNP in PCIs. The purpose of the protocol is to assess the impact of CNP on the clinical efficacy of transradial emergency PCI.

Methods:

This is a randomized controlled, single center trial which will be implemented from January 2021 to June 2021. Hundred samples diagnosed with acute myocardial infarction will be included in this study. It was authorized via the Ethics Committee of Changshan County People's Hospital (CCPH002348). Patients are assigned to the following groups: control group, given normal routine care; CNP group, treated with CNP plan. The time from door to balloon, hospitalization expenses, length of stay, postoperative complications, patients’ satisfaction with treatment are compared and analyzed. All data are collected and analyzed by Social Sciences software version 21.0 (SPSS, Inc., Chicago, IL) program.

Results:

Differences of clinical outcomes between groups (Table 1).

Conclusion:

This original evidence-based nursing model can be used as the foundation for further research.

Trial registration number:

researchregistry6030
Effect of shenfu injection on microcirculation in shock patients
Authors: Zhang Xuemei , Guo Ting , Zhang Kaichen , Guo Wenhui , An Xing , Gao Peiyang
Published: October 2020

Background:

Shock is a major public health problem worldwide. At present, the morbidity and mortality of shock patients are relatively high. Vasomotor dysfunction is 1 of the key pathological aspects of shock. Shenfu injection has been widely used for the treatment of shock in China. Pharmacological studies have suggested that Shenfu injection can reduce peripheral circulation resistance and improve microcirculation. The purpose of this study is to evaluate the effect and safety of Shenfu injection on the microcirculation of patients with shock.

Methods:

This review summarizes and meta-analyzes randomized controlled trials of Shenfu injection for the treatment of shock.Searched the following electronic databases: PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data. The Cochrane risk assessment tool was used to evaluate the methodological quality of randomized controlled trials. All tests are analyzed according to the standards of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and Grading of Recommendations Assessment, Development, and Evaluation pro GDT web solution are used for data synthesis and analysis.

Results:

This review focuses on the effects of Shenfu injection on the microcirculation of shock patients (blood lactic acid level, arteriovenous oxygen saturation, arteriovenous carbon dioxide partial pressure difference, sublingual microcirculation), 28-day mortality, 28-day ICU hospitalization and adverse reaction rate.

Conclusion:

This review provides a clear basis for evaluating the impact of Shenfu injection on the microcirculation of shock patients, as well as the effectiveness and safety of the treatment.
Comparison of hemostatic agents in patients with spontaneous intracerebral hemorrhage
Authors: Li Yujian , Zheng Jun , Zhou Huiqing , Yang Xiang , Li Hao
Published: October 2020

Background:

Spontaneous intracerebral hemorrhage (sICH) is a serious stroke subtype. The effective therapies for patients with sICH are still unclear, and the role of hemostatic agents in sICH is still unclear. Although some studies have shown that hemostatic agents could benefit patients with sICH, different hemostatic drugs have different effects on patients with sICH, and which hemostatic drug has the best effect on the prevention of hematoma expansion and neurological deterioration in sICH patients remains unclear. To better understand the effects of hemostatic agents in patients with sICH, it is necessary to carry out a network meta-analysis to comprehensively compare the effects of different hemostatic agents.

Methods:

This protocol has been designed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. Related studies in the following databases will be searched until September 2020: PubMed, Embase, Scopus, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP and Wanfang. Randomized controlled trials and nonrandomized controlled studies comparing at least 2 different hemostatic agents in sICH patients will be included. A quality assessment will be conducted with the Cochrane Collaboration tool or the Newcastle-Ottawa Scale based on the study design. The primary outcome will be the incidence of hematoma expansion, and the secondary outcome will be the functional outcome. Pairwise and network meta-analyses will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate every agent. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.

Results:

According to disseminate through academic conferences, the results of this network meta-analysis are expected to publish in a peer-reviewed journal.

Conclusion:

This study will provide high quality evidence about effects of different hemostatic agents in patients with sICH.

Registration number:

CRD42020196039.
Association of inferior vena cava diameter ratio measured on computed tomography scans with the outcome of patients with septic shock
Authors: Kim Jee Hyeon , Kim Won Young , Oh Jaehoon , Kang Hyunggoo , Lim Tae Ho , Ko Byuk Sung
Published: October 2020

The collapsibility and diameter of the inferior vena cava (IVC) are known to predict the volume state in critically ill patients. However, no study has examined the prognostic value of the IVC diameter ratio measured on computed tomography (CT) in patients with septic shock. A retrospective observational study was conducted on adult septic shock patients visiting the emergency department at a university hospital in Korea. The IVC diameter ratio was calculated by dividing the maximal transverse and anteroposterior diameters. Multivariable logistic regression analysis was conducted to investigate whether the IVC diameter ratio predicted in-hospital mortality. The area under the curve (AUC) was calculated, and the sensitivity, specificity, positive predictive value, and negative predictive value with the cut-off values were computed. A total of 423 adult septic shock patients were included, and the in-hospital mortality rate was 17%. The median IVC diameter ratio in non-survivors was significantly greater than in survivors (1.56 cm vs 1.4 cm, P = .004). The IVC diameter ratio was found to be significantly associated with in-hospital mortality on multivariate logistic regression analysis after adjustment for confounding variables (odds ratio = 1.48, confidence interval: 1.097–1.998, P = 0.01). The AUC for IVC diameter ratio was 0.607. A cut-off IVC diameter ratio of ≥1.31 cm had 75% sensitivity and 42% specificity for predicting in-hospital mortality. The IVC diameter ratio measured on CT may to be helpful in predicting the prognosis of septic shock patients. However, due to its low diagnostic performance and sensitivity, further research is warranted.
Platelet-to-lymphocyte ratio as a predictive index for delirium in critically ill patients
Authors: Jiang Xuandong , Shen Yanfei , Fang Qiang , Zhang Weimin , Cheng Xuping
Published: October 2020

Delirium is a neuropsychiatric syndrome commonly encountered in critically ill patients, and systemic inflammation has been strongly implicated to underlie its pathophysiology. This study aimed to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR) for delirium in the intensive care unit (ICU).In this retrospective observational study, we analyzed the clinical and laboratory data of 319 ICU patients from October 2016 to December 2017. Using the Locally Weighted Scatterplot Smoothing technique, a PLR knot was detected at a value of approximately 100. Logistic regression was used to investigate the association between the PLR and delirium.Of the 319 patients included in this study, 29 (9.1%) were diagnosed with delirium. In the delirium group, the duration of mechanical ventilation was significantly longer than that in the no-delirium group (40.2 ± 65.5 vs. 19.9 ± 26.5 hours, respectively; P < .001). A multiple logistic regression analysis showed that PLR > 100 (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.001–1.005), age (OR: 2.76, 95% CI: 1.110–6.861), and the ratio of arterial oxygen partial pressure to the inspired oxygen fraction (OR: 0.996, 95% CI: 0.992–0.999) were independent predictors of delirium.In our study, a high PLR value on ICU admission was associated with a higher incidence of delirium. Owing to easy calculability, the PLR could be a useful delirium predictive index in ICUs, thereby enabling early interventions to be implemented.
Assessment of IGF-1 expression in the peripheral blood of women with recurrent breast cancer
Authors: Costa-Silva Danylo Rafhael , Barros-Oliveira Maria da Conceição , Alves-Ribeiro Francisco Adelton , Campos-Verdes Larysse Cardoso , Nery Junior Elmo de Jesus , Vieira-Valença Samara Fernanda , Vasconcelos-Valença Rodrigo Jose de , Soares Veronica Mendes , Pinho-Sobral André Luiz , Sousa Emerson Brandão , Lopes-Costa Pedro Vitor , dos Santos Alesse Ribeiro , Viana Jackeline Lopes , Cardoso Arquimedes Cavalcante , Luz-Borges Victoria Maria , Pereira Renato de Oliveira , Tavares Cleciton Braga , Silva Vladimir Costa , Rodrigues-Junior Dorival Mendes , Gebrim Luiz Henrique , da Silva Benedito Borges
Published: October 2020

Breast cancer is the most common malignancy affecting women worldwide. The insulin-like growth factor 1 (IGF-1) gene encodes a protein responsible for a wide variety of physiological processes, including differentiation and cell proliferation. Despite several studies on tumor tissues, no study has evaluated IGF-1 expression in the peripheral blood of women with recurrent breast cancer.

In this cross-sectional study, IGF-1 expression in the peripheral blood of 146 women with breast cancer treated approximately 5 years ago was quantified by quantitative reverse transcription polymerase chain. The women were divided into 2 groups: non-recurrence (n = 85) and recurrence (n = 61). Statistical analysis of the data was performed using ANOVA, Mann–Whitney, and Chi-squared tests (P < .05).

The results showed no significant difference in IGF-1 expression between the non-recurrence and recurrence groups (P = .988). In the subgroups of patients with lymph node involvement, no statistically significant difference was observed in IGF-1 expression between women with recurrence and those non-recurrence (P = .113). In patients without lymph node metastases, IGF-1 messenger ribonucleic acid (mRNA) expression levels were significantly higher in the non-recurrence group than in the recurrence group (P = .019). Furthermore, using the median IGF-1 mRNA expression as the cutoff point, it was obtained a statistically significant difference in tumor histological grade among women with recurrent breast cancer (P = .042).

These data showed significantly higher IGF-1 expression in women without lymph node metastases in the non-recurrence group compared with the recurrence group. In addition, a significant difference was observed in median IGF-1 mRNA expression in relation to tumor histological grade in women with recurrent breast cancer.
Risk factors and outcomes of myocardial injury after non-cardiac surgery in high-risk patients who underwent radical cystectomy
Authors: Yu Jihion , Lim Bumjin , Lee Yongsoo , Park Jun-Young , Hong Bumsik , Hwang Jai-Hyun , Kim Young-Kug
Published: October 2020

Radical cystectomy is considered the standard treatment for patients with muscle-invasive bladder tumors and has high postoperative complication rates among urological surgeries. High-risk patients, defined as those ≥45 years of age with history of coronary artery disease, stroke, or peripheral artery disease or those ≥65 years of age, can have a higher incidence of cardiac complications. Therefore, we evaluated the incidence, risk factors, and outcomes of myocardial injury after non-cardiac surgery (MINS) in high-risk patients who underwent radical cystectomy.

This retrospective observational study analyzed 248 high-risk patients who underwent radical cystectomy. MINS was defined as serum troponin I concentration ≥0.04 mg/L within postoperative 3 days. The risk factors for MINS were evaluated by multivariate logistic regression analysis. Postoperative outcomes were evaluated. The 1-year survival after radical cystectomy was also compared between patients who developed MINS (MINS group) and those who did not (non-MINS group) by Kaplan–Meier analysis.

MINS occurred in 35 patients (14.1%). Multivariate logistic regression analysis showed that early diastolic transmitral filling velocity (E)/early diastolic septal mitral annular velocity (E’) ratio (odds ratio = 1.102, 95% confidence interval [1.009–1.203], P = .031) and large volume blood transfusion (odds ratio = 2.745, 95% confidence interval [1.131–6.664], P = .026) were significantly associated with MINS in high-risk patients who underwent radical cystectomy. Major adverse cardiac events and 1-year mortality were significantly higher in the MINS group than in the non-MINS group (17.1% vs 6.1%, P = .035; 28.6% vs 12.7%, P = .021, respectively). Kaplan–Meier analysis showed significantly lower 1-year survival in the MINS group than in the non-MINS group (P = .010).

MINS occurred in 14.1% of patients. High E/E’ ratio and large volume blood transfusion were risk factors for MINS in high-risk patients who underwent radical cystectomy. Postoperative major adverse cardiac events and 1-year mortality were significantly higher in the MINS group than in the non-MINS group. Preoperative evaluation of risk factors for MINS may provide useful information to detect cardiovascular complications after radical cystectomy in high-risk patients.
Decitabine-induced kidney thrombotic microangiopathy with glomerular crescents formation and tubular necrosis
Authors: Qin Ai-bo , Tan Ying , Su Tao
Published: October 2020

Introduction:

Chemotherapeutic agents of direct cell damage play a role in initiating thrombotic microangiopathy (TMA), however still being underdiagnosed. Decitabine (DAC) is a pyrimidine analogue of the nucleoside cytidine, which can lead to injury to endothelium. Biopsy-proven DAC-induced kidney injury is rare.

Patient concerns:

A 47-year-old Chinese man with membranous nephropathy presented recurrent edema and acute kidney injury after a 3-day course of low dose DAC infusion because of cyclophosphamide-relating thrombocytopenia.

Diagnosis:

Laboratory data revealed nephrotic syndrome, hematuria, renal glycosuria and hypokalemia with hyperchloridemia. Renal pathological findings revealed TMA with secondary glomerular crescents formation (28%), partial foot process effacement and acute tubular necrosis. A diagnosis of DAC-induced renal TMA was considered.

Interventions:

As DAC had been timely discontinued before admission, the patient only received supportive treatment.

Outcomes:

The patient achieved rapid remission of acute kidney injury after DAC withdrawal, and his serum creatinine further decreased to normal level after 6 months.

Conclusion:

Careful monitoring of renal function especially serum creatinine should be emphasized during DAC treatment.
Endoscopic ultrasound-guided cholecystostomy for resection of gallbladder polyps with lumen-apposing metal stent
Authors: Shen Yonghua , Cao Jun , Zhou Xiaoliang , Zhang Song , Li Juan , Xu Guifang , Zou Xiaoping , Lu Ying , Yao Yuling , Wang Lei
Published: October 2020

Laparoscopic cholecystectomy is the routine method to treat gallbladder polyps. Nowadays, endoscopic ultrasound (EUS)-guided cholecystostomy as a bridge for per-oral transmural endoscopic resection of gallbladder polyps is introduced because preservation of gallbladder is increasingly getting attention. The aim of our study was to evaluate the approach in the treatment of patients with gallbladder polyps and symptomatic gallstones.

EUS-guided cholecystostomy with the placement of a lumen-apposing metal stent (LAMS) was performed for those patients with accompanying gallbladder polyps and symptomatic gallstones. Several days after the cholecystostomy with LAMS, a gastroscope was introduced into the gallbladder to remove gallbladder polyps.

All patients were successfully performed with the procedures of EUS-guided cholecystoduodenostomy (n = 3) or cholecystogastrostomy (n = 1) and endoscopic resection of gallbladder polyps. One patient experienced severe peritonitis. During the follow-up at 3 months, 1 patient was performed with laparoscopic cholecystectomy because ultrasonography examination showed the reappeared gallstones. No stone recurrence was found in other patients. During the follow-up of 3 to 15 months, no polyp recurrence was found in all the patients.

The approach is novel for performing EUS-guided gallbladder fistulization, which can subsequently allow procedures of per-oral transmural endoscopic resection of gallbladder polyps to avoid cholecystectomy in the patients with gallbladder polyps and gallstones. However, further studies are needed before clinical recommendation because of the complications and stone recurrence.
Does acute promyelocytic leukemia patient with the STAT5B/RARa fusion gene respond well to decitabine?
Authors: Wang Lei , Yan Xiaojing , He Juan
Published: October 2020

Rationale:

Most acute promyelocytic leukemia (APL) patients respond to all-trans-retinoic acid (ATRA)and have a good prognosis. However, variants APL who carry PLZF/RARа, STAT5B/RARа, and STAT3/RARа are insensitive to ATRA and have poor prognoses. The standard treatment for variants APL is still unclear due to the small sample size.

Patient concerns:

Here we reported a Chinese male who was admitted to our hospital with the complaint of rib pain, dyspnea, and fever (37.5°C). Blood tests showed leukopenia (1.83 × 109/L), anemia (hemoglobin 73 g/L), and thrombocytopenia (54 × 109/L). Prothrombin time and activated partial thromboplastin time were normal.

Diagnoses:

The patient was diagnosed as STAT5b-RARa-positive APL based on the clinical and laboratory findings.

Interventions:

ATRA was used immediately for induction treatment, then he was treated with ATRA + arsenic trioxide and got the severe cardiac insufficiency. Subsequently, consolidation chemotherapy was added with ATRA + Huangdai tablets + idarubicin and decitabine, cytarabine, aclamycin (DCAG).

Outcomes:

The patient relapsed soon after his first molecular complete remission (CRm), fortunately, he got a second CRm with DCAG. He has survived for more than 9 months and remains CRm, now he is looking for a suitable donor to prepare for hematopoietic stem cell transplantation (HSCT).

Lessons:

APL patients with STAT5B-RARa is not only resistant to ATRA, but also to conventional combination chemotherapy such as daunorubicin and cytarabine/idarubicin and cytarabine or other regimens. Relapse and extramedullary infiltration is common, HSCT is a effective treatment, and the best time for HSCT is after the first CR. It should be noted that this patient got CRm with DCAG after relapse, so the role of decitabine in APL with STAT5B-RARa needs to be considered.
Polymyxin B-induced rhabdomyolysis
Authors: Ni Ming , Meng Xiangdong , Wang Limin , Zhao Yanan , Yu Min , Shi Sheng
Published: October 2020

Rationale:

Polymyxin B has been used to treat extensively drug-resistant gram-negative bacteria and shown a better antibacterial effect in the clinic at present. Meanwhile, polymyxin B is associated with several adverse effects. However, there is a lack of awareness that polymyxin B can cause rhabdomyolysis. In this study, we firstly report a case of polymyxin B-induced rhabdomyolysis during antiinfection therapy.

Patient concerns:

A 70-year-old woman suffering from rheumatic heart disease underwent aortic and mitral valve replacement at our institute. Subsequently, she developed bacteremia and pneumonia caused by extensively drug resistance-acinetobacter baumannii. Polymyxin B was administered for 5 days. During treatment, the patient complained of muscle pain and limb weakness, and her serum creatine phosphokinase and myoglobin levels rose.

Diagnosis:

The clinical symptoms and laboratory examination confirmed rhabdomyolysis, and polymyxin B-induced rhabdomyolysis was considered.

Intervention:

We ceased polymyxin B treatment and monitored the patient daily.

Outcomes:

Serum creatine phosphokinase levels returned to normal, myoglobin levels decreased, and muscle pain was significantly alleviated after cessation of polymyxin B. We identified this as a case of polymyxin B-induced rhabdomyolysis.

Lessons:

Here, we report the first reported case of rhabdomyolysis induced by polymyxin B administration. The awareness of rare adverse reaction helps ensure the clinical safety of polymyxin B treatment.
Apatinib and fractionated stereotactic radiotherapy for the treatment of limited brain metastases from primary lung mucoepidermoid carcinoma
Authors: Yan Hongxia , Li Xiaolu , Peng Yi , Zhang Pingping , Zou Ning , Liu Xiyou
Published: October 2020

Rationale:

Apatinib is a novel anti-angiogenic agent that targets vascular endothelial growth factor receptor-2, thereby inhibiting tumor angiogenesis, and is effective in the treatment of brain metastases (BM) and peritumoral brain edema (PTBE). There are no previous reports of combination therapy with apatinib and fractionated stereotactic radiotherapy (FSRT) for BM from primary lung mucoepidermoid carcinoma (MEC).

Patient Concerns:

A 63-year-old man underwent left lower lobectomy and mediastinal lymph node dissection in April 2018.

Diagnoses:

Postoperative pathology demonstrated high-grade MEC. The patient developed 3 BM with PTBE 3 months after undergoing surgery.

Interventions:

The patient received a combination of FSRT and apatinib (250–500 mg/d) as maintenance therapy.

Outcomes:

The 3 BM showed nearly complete responses, and the PTBE areas shrank visibly. A new BM lesion occurred 7 months after the first FSRT and was treated with a second dose of FSRT. The patient developed extensive metastasis and atelectasis 9 months later. He died of pulmonary infection in December 2019. The overall survival time was 20 months.

Lessons:

Limited BM from primary lung MEC may be treated effectively with combination therapy with apatinib and FSRT when chemotherapy alone is not effective or tolerated. Further studies are needed to investigate the clinical outcomes and toxicities associated with the treatment.
Tracheobronchial amyloidosis in primary Sjögren syndrome
Authors: Luo Jiangyun , Ge Yongpeng
Published: October 2020

Rationale:

Tracheobronchial amyloidosis (TBA) associated with Sjögren syndrome is very rare. Here, we describe a case with this phenomenon, in order to better understand the condition.

Patient concerns:

A 52-year-old woman presented after 6 months of coughing, sputum, and dyspnea. Chest computed tomography revealed thickened bronchial walls, which were irregular on the left side the trachea. She had a history of dry eye and dry mouth of at least 3 years’ duration.

Diagnoses:

Sjögren syndrome was diagnosed based on her symptoms, ophthalmological and parotid examination, and immunological and autoantibody tests. The diagnosis of TBA was confirmed by Congo red staining of a tracheal biopsy.

Interventions:

The patient was given glucocorticoids without any other immunosuppressants.

Outcomes:

The symptoms improved after 6 months.

Lessons:

TBA associated with Sjögren syndrome is a rare condition. TBA is characterized by amyloid deposition to the trachea in the absence of systemic amyloidosis. Diagnosis requires tissue biopsy with demonstration of amyloid deposition.
Influence of parental education levels on eating habits of pupils in Nigerian primary schools
Authors: Umoke MaryJoy , Umoke Prince C. I. , Onyeke Nkechi G. , Victor-Aigbodion Vera , Eseadi Chiedu , Ebizie Elizabeth N. , Obiweluozo Patience Enuma , Uzodinma Uchenna Eugenia , Chukwuone Chiamaka Adaobi , Dimelu Ifeoma Ngozi , Uwakwe Rowland C. , Uba Mercy Benedette Ifeoma , Elom Chinyere Ori , Folorunsho Raphael Oluwasina Babalola
Published: October 2020

This study investigated the eating habits of pupils in Nigerian primary schools based on the respective education levels of their parents.

Data were obtained using the Child Eating Behavior Questionnaire (CEBQ). Participants included a total of 144 pupils who were purposively selected from 6 primary schools. Based on responses, a cross-sectional analytic study design was implemented to investigate how parental education levels (PELs) influenced the eating habits of their children. Data assessment was performed using a one-way between-group analysis of variance at the .05 probability level.

PELs significantly affected the eating habits of participants, respectively. Specifically, low PEL was associated with more satiety responsiveness to food (F [2, 141] = 14.251, P < .001), higher responsiveness to food (F [2, 141] = 36.943, P = <.001) greater food enjoyment (F [2, 141] = 93.322, P < .001), greater drinking desires (F [2, 141] = 23.677, P < .001), and the tendency for emotional over-eating (F [2, 141] = 13.428, P < .001), while high PEL was associated with slower eating (F [2, 141] = 11.665, P < .001), fussier responses to food (F [2, 141] = 14.865, P < .001), and a higher tendency for emotional under-eating (F [2, 141] = 5.137, P < .01).

This study examined PELs in relation to the respective eating habits of their children, who were attending Nigerian primary schools. Data showed that children with parents who had high, middle, and low education levels tended to exhibit progressively worse eating habits, in descending order.
Effects of Bushen Huoxue method for female with decreased ovarian reserve
Authors: Xie Zhuoting , Li Yin , Chen Zehua , Cao Qiuyu , Zhang Chunren , Fei Yang , Li Kunyin , Guan Yongge
Published: October 2020

Background:

Decreased ovarian reserve (DOR) is a common reproductive barrier in female. Bushen Huoxue (BSHX) method of TCM is widely applied to treat DOR clinically. The purpose of this study is to provide a systemic and comprehensive evaluation of BSHX in the treatment of DOR.

Methods:

We have registered this protocol with OSF registry and the DOI is 10.17605/OSF.IO/QNUE2. We will search 4 English databases (PubMed, EMBASE, MEDLINE, Cochrane Library) and four Chinese databases (China national knowledge infrastructure database, Wanfang database, VIP and Superstar database) from their inception to August 10, 2020. Two authors will search and extract independently all related studies. RevMan 5.3 software will be applied to synthesize data.

Results:

The results of this study will be published in a scientific journal after peer-review.

Conclusion:

This systematic review will provide reliable evidences for clinicians, and help them make decisions in DOR management.
Twitter Engagement of U.S. Psychiatry Residency Programs with Black Lives Matter and Coronavirus Disease 2019 (COVID-19)
Authors: El-Gabalawy Osama , Kim Candice J. , Chen Amanda V. , Kamal Shaan
Published: October 2020

Social media have become popular platforms to disseminate information, especially related to politicized topics such as BLM and COVID-19. To better understand how medical institutions have engaged with the social media discourse on BLM and COVID-19, we examined psychiatry residency programs’ tweets in response to George Floyd’s murder and during the first 6 months of the COVID-19 pandemic in the U.S. Only 14% of the 249 evaluated psychiatry residency programs had Twitter accounts (we included programs with their own account or their affiliated psychiatry department account) indicating a substantial absence on social media. Of those programs, 78% tweeted at least once about COVID-19 (1,153 tweets) and 56% tweeted at least once about the BLM movement (117 tweets). The top three purposes of tweets were sharing media, posting about an event, and sharing a resource.
Computerized physical exercise improves the functional architecture of the brain in patients with Parkinson’s Disease: a network science resting-state EEG study
Authors: Xefteris Vasileios Rafail , Styliadis Charis , Anagnostopoulou Alexandra , Kartsidis Panagiotis , Paraskevopoulos Evangelos , Klados Manousos , Zilidou Vasiliki , Karagianni Maria , Bamidis Panagiotis D.
Published: October 2020

Physical exercise is an effective non-pharmaceutical treatment for Parkinson’s disease (PD) symptoms, both motor and non-motor. Despite the numerous reports on the neuroplastic role of physical exercise in patients with PD (PwPD), its effects have not been thoroughly explored via brain network science, which can provide a coherent framework for understanding brain functioning. We used resting-state EEG data to investigate the functional connectivity changes of the brain’s intrinsic cortical networks due to physical exercise. The brain activity of 14 PwPD before and after a ten-week protocol of computerized physical training was statistically compared to quantify changes in directed functional connectivity in conjunction with psychometric and somatometric assessments. PwPD showed a significant reorganization of the post-training brain network along with increases in their physical capacity. Specifically, our results revealed significant adjustments in clustering, increased characteristic path length, and decreased global efficiency, in correlation to the improved physical capacity. Our results go beyond previous findings by indicating a transition to a reparative network architecture of enhanced connectivity. We present a meaningful relationship between network characteristics and motor execution capacity which support the use of motor treatment in tandem with medication. This trial is registered withClinicalTrials.govIdentifierNCT04426903.

Impact Statement

The effects of physical training (PT) on the neuroplasticity attributes of patients with Parkinson’s Disease (PwPD) have been well documented via neurophysiological evaluations. However, there is a knowledge gap on the role of training-induced neuroplasticity in whole-brain network organization. We investigated the PT effects on the brain network organization of 14 PwPD, using EEG and network indices coupled with psychosomatometric tests. We report evidence of reparative functional reorganization of the brain with more balanced integration and segregation abilities, in correlation to improved motor performance. The PD brain can repair and reestablish a better level of motor execution and control due to computer-empowered physical stimulation.
Pathogenic measles viruses cannot evolve to bypass vaccine-induced neutralizing antibodies
Authors: Muñoz-Alía Miguel Ángel , Nace Rebecca A. , Zhang Lianwen , Russell Stephen J.
Published: October 2020

After centuries of pestilence and decades of global vaccination, measles serotypes capable of evading vaccine-induced immunity have not emerged. Here, by systematically building mutations into the H-glycoprotein of an attenuated measles strain and assaying for serum neutralization, we show that virus evolution is severely constrained by the existence of numerous codominant H-glycoprotein antigenic sites, some critical for binding to pathogenicity receptors SLAMF1 and Nectin-4. We further demonstrate the existence in serum of protective neutralizing antibodies targeting codominant F-glycoprotein epitopes. Calculations suggest that evolution of pathogenic measles viruses capable of escaping serum neutralization in vaccinated individuals is a near-zero probability scenario.
echolocatoR: an automated end-to-end statistical and functional genomic fine-mapping pipeline
Authors: Schilder Brian M. , Humphrey Jack , Raj Towfique
Published: October 2020

echolocatoRintegrates a diverse suite of statistical and functional fine-mapping tools in order to identify, test enrichment in, and visualize high-confidence causal consensus variants in any phenotype. It requires minimal input from users (a summary statistics file), can be run in a single R function, and provides extensive access to relevant datasets (e.g. reference linkage disequilibrium (LD) panels, quantitative trait loci (QTL) datasets, genome-wide annotations, cell type-specific epigenomics, thereby enabling rapid, robust and scalable end-to-end fine-mapping investigations.

Availability and implementation

echolocatoRis an open-source R package available through GitHub under the MIT license:https://github.com/RajLabMSSM/echolocatoR
homologizer: Phylogenetic phasing of gene copies into polyploid subgenomes
Authors: Freyman William A. , Johnson Matthew G. , Rothfels Carl J.
Published: October 2020

Organisms such as allopolyploids and F1 hybrids contain multiple distinct subgenomes, each potentially with its own evolutionary history. These organisms present a challenge for multilocus phylogenetic inference and other analyses since it is not apparent which gene copies from different loci are from the same subgenome and thus share an evolutionary history.

Here we introducehomologizer, a flexible Bayesian approach that uses a phylogenetic framework to infer the phasing of gene copies across loci into their respective subgenomes.

Through the use of simulation tests we demonstrate thathomologizeris robust to a wide range of factors, such as incomplete lineage sorting and the phylogenetic informativeness of loci. Furthermore, we establish the utility ofhomologizeron real data, by analyzing a multilocus dataset consisting of nine diploids and 19 tetraploids from the fern family Cystopteridaceae.

Finally, we describe howhomologizermay potentially be used beyond its core phasing functionality to identify non-homologous sequences, such as hidden paralogs or contaminants.
The Biogeography of Fungal Communities Across Different Chinese Wine-producing Regions Associated with Environmental Factors and Spontaneous Fermentation Performance
Authors: Li Ruilong , Yang Siyu , Lin Mengyuan , Guo Sijiang , Han Xiaoyu , Ren Mengmeng , Du Le , Song Yinghui , You Yilin , Zhan Jicheng , Huang Weidong
Published: October 2020

Chinese Marselan grapes are believed to possess the potential to become a characteristic regional variety, whose quality is internationally recognized. The fermentation-related mycobiota from six climatically diverse Marselan-producing regions in China were analyzed via high-throughput sequencing (HTS), while the influence of environmental factors was evaluated as well. The results implied that the phyla Ascomycota and genusAureobasidiumdominated the fungal communities in 166 Marselan must and ferment samples. Significant differences were detected in the fungal microbiota from the regions, as well as the wineries, while these discrepancies decreased as the fermentation progressed. Moreover, the difference in fungal communities between the wineries exceeded the variation involving the regions, and higher diversity was identified in the types of species than in the compositions. Geoclimatic elements (Gc) and physicochemical indexes (Pi) exerted a significant effect on the fungal must consortium, explaining 58.17% of the taxonomic information. Therefore, a correlation was proposed between the spontaneous fermentation performance, as well as the polyphenol (PP) content, and their association with fungal taxonomic composition. In addition to enriching the knowledge regarding the wine microbiome and its influencing factors, this study may provide a new strategy for harnessing autochthonous “microbial terroir”.

Importance

Wine microbiome and their metabolism play a crucial role in wine quality. Chinese wine-producing regions are widely distributed with diverse geoclimatic conditions, this study reports a most comprehensive biogeography of fermentation-related fungal communities performed to date, taking the Chinese promising Marselan grape variety as the research object. It reveals significant differences in the fungal microbiota of Marselan must and ferment from different regions and wineries, and higher otherness between species type than that between species composition. The study also reports the main geoclimatic and physicochemical factors shaping fungal flora. Moreover, a correlation was proposed among the spontaneous fermentation performance with fungal taxonomic composition and polyphenol content. Taken together, the results shed light on the wine fungal communities and its influencing factors, which is crucial for vineyard and fermentation microorganism management, and may also provide a new strategy for harnessing autochthonous “microbial terroir” by utilizing spontaneous fermentation.