bluuebunny/crossref_metadata_2025 huggingface dataset:
What Is the Return on Investment of Spine Society Research Grants?
Authors: Merchan Nelson , Bernstein David N. , Maqsoodi Noorullah , Ikpeze Tochukwu , Mesfin Addisu
Published: June 2021

Study Design.

Retrospective, observational -study.

Objective.

The objective of this study is to evaluate the return on investment (ROI) of the Cervical Spine Research Society (CSRS), Scoliosis Research Society (SRS), and North America Spine Society (NASS) grants as quantified by the number of publications generated and federal grants obtained (National Institute of Health [NIH], Department of Defense [DOD]).

Summary of Background Data.

The CSR, SRS, and NASS, have awarded numerous research grants over the past three decades.

Methods.

Through publicly available data we identified grants awarded by the Spine Societies. We collected the type of grant awarded, the Principal Investigator information, dollar amount of the grant, number of publications in PubMed from each grant, number of citations, and the publication journal. The NIH and DOD website were queried to determine which grantees subsequently received either NIH or DoD funding.

Results.

From 1989 to 2016: 81 (CSRS), 126 (SRS), and 93 (NASS) grants were awarded. From these grants 206 publications acknowledged receiving financial support from the spine societies. The SRS funded 100 papers, NASS 62 papers, and CSRS 44 papers. A total of 32 NIH grants and four DOD grants were subsequently awarded. The conversion rate to NIH grants was 15% (n = 12 CSRS), 7.9% (n = 10 SRS), and 11% (n = 10 NASS). The conversion rate to DOD grants was 3.7% (n = 3 CSRS), 0.8% (n = 1 SRS), and 0% (n = 0 NASS). ROI of spine society grant dollars per future NIH and DoD grants were the lowest for CSRS (Dollars Per NIH Grant: $207,434; Dollars Per DoD Grant: $829,734). Male investigators received 85% of CSRS grants, 75% of SRS grants, and 83% of NASS grants.

Conclusion.

CSRS grants appear to have the highest ROI of all spine society grants when evaluating subsequent NIH and DOD funding. However, the overall conversion rate to NIH and DOD grants remains low.

Level of Evidence: 3
Influence of an Acute Exacerbation During Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease Awaiting Lung Transplantation
Authors: Gloeckl Rainer , Jarosch Inga , Leitl Daniela , Schneeberger Tessa , Nell Christoph , Langer Daniel , Koczulla Andreas R. , Kenn Klaus
Published: June 2021

Purpose:

Pulmonary rehabilitation (PR) has been shown to be an effective intervention in patients with very severe chronic obstructive pulmonary disease (COPD) awaiting lung transplantation (LTx). The objective of this study was to characterize the prevalence of acute exacerbations (AEs) during PR and their impact on the outcomes of pre-LTx PR.

Methods:

In this retrospective analysis, 559 patients with COPD awaiting LTx who were referred to a 4-wk inpatient PR program were evaluated. A total of 114 patients (20%) acquired an AE during PR and continued in an adapted fashion. Pulmonary function testing, 6-min walk test (6MWT), and a health-related quality-of-life questionnaire (SF-36) were administered on admission and on discharge of PR.

Results:

Following PR, both groups, patients with and without AE, increased their 6MWT significantly (P < .001) to a clinically relevant amount (58 ± 72 and 52 ± 64 m, respectively). The sum scores of the SF-36 also improved significantly without any between-group differences. No observed changes were different between the two groups. No relevant predictors for PR outcomes could be detected by logistic regression.

Conclusions:

Our data show that patients with end-stage COPD listed for LTx can achieve clinically relevant improvements in functional exercise capacity and quality of life even if they develop an AE during PR.
Rituximab Maintenance Versus Observation After Immunochemotherapy (R-CHOP, R-MCP, and R-FCM) in Untreated Follicular Lymphoma Patients: A Randomized Trial of the Ostdeutsche Studiengruppe Hämatologie und Onkologie and the German Low-Grade Lymphoma Study Group
Authors: Hirt Carsten , Hoster Eva , Unterhalt Michael , Hänel Mathias , Prange-Krex Gabriele , Forstpointner Roswitha , Florschütz Axel , Graeven Ullrich , Frickhofen Norbert , Wulf Gerald , Lengfelder Eva , Lerchenmüller Christian , Schlag Rudolf , Dierlamm Judith , Fischer von Weikersthal Ludwig , Ahmed Asima , Harich Hanns-Detlev , Rosenwald Andreas , Klapper Wolfram , Dreyling Martin , Hiddemann Wolfgang , Herold Michael
Published: June 2021

The German study groups, the German Low-Grade Lymphoma Study Group (GLSG) and Ostdeutsche Studiengruppe Hämatologie und Onkologie (OSHO), initiated in 2007 a double randomized trial to investigate efficacy and safety of rituximab maintenance versus observation in remission after randomly assigned induction treatment in the first-line follicular lymphoma. Previously untreated patients with stage II–IV follicular lymphoma in need of therapy were randomized to receive 6 cycles of R-CHOP, R-MCP, or R-FCM. Responding patients were subsequently randomized to 2 years rituximab maintenance or observation, stratified by type of immunochemotherapy, quality of remission, and Follicular Lymphoma International Prognostic Index (FLIPI). Recruitment was stopped in 2011 after the PRIMA results had been published. Median age of the 206 recruited patients was 66 years (range, 24–86), and (FLIPI) was low in 13%, intermediate in 28%, and high in 60%. High and comparable overall response rates were observed after R-CHOP (88%), R-MCP (89%), and R-FCM (91%). Rituximab maintenance substantially prolonged progression-free survival (PFS) in comparison to observation in remission (hazard ratio 0.39, P = 0.0064). In the rituximab maintenance group, the 3-year PFS was 89% compared with 69% in the observation group. No differences in overall survival were observed for maintenance vs. observation (hazard ratio 1.04, 95% confidence interval 0.32–3.43, P = 0.95). In this randomized trial, 2 years of rituximab maintenance was associated with significantly prolonged PFS in comparison to observation after response to first-line immunochemotherapy in follicular lymphoma. Our data represent an independent confirmation of the PRIMA trial results.

(Clinical Trial EudraCT Number: 2005-005473-29, 2006-09-26)
The impact of rotavirus vaccination in the prevalence of gastroenteritis and comorbidities among children after suboptimal rotavirus vaccines implementation in Taiwan
Authors: Lu Meng-Che , Shia Ben-Chang , Kao Yi-Wei , Lin Sheng-Chieh , Wang Chuan-Yu , Lin Wen-Chuan , Chen Shih-Yen
Published: June 2021

In Taiwan, rotavirus vaccination was implemented in 2006 in the private sector. The population-based impact of rotavirus vaccination on gastroenteritis and comorbidities of children remains under-investigated.

We analyzed the annual prevalence of rotavirus-related disease, including gastroenteritis, convulsions, epilepsy, type I diabetes mellitus, intussusception, and biliary atresia among children under 5 years of age. Data were collected from Taiwan's National Health Insurance Research Database, a nationwide population-based database. A 16-year retrospective cohort study was conducted between 2000 and 2015.

Among children <5 years of age, the prevalence of gastroenteritis decreased after 2012 (44,259.69 per 100 thousands) and remained lower through 2015 (39,931.11per 100 thousands, P < .001). The prevalence of convulsions rose steadily and significantly from 2007 (775.90 per 100 thousands) to 2015 (962.17 per 100 thousands, P < .001). The prevalence of epilepsy decreased significantly until reaching a nadir in 2013 (from 501.56 to 293.53 per 100 thousands, P < .001). The prevalence of biliary atresia tended upward, and surged suddenly in 2007 with a peak in 2013 (18.74 per 100 thousands). Among infants (<1 year of age) from 2000 to 2015, the prevalence of gastroenteritis declined steadily, and more rapidly after 2007 (22,513 to 17,285 per 100 thousands).

In Taiwan, after introducing rotavirus vaccination, gastroenteritis in young children decreased, especially in infancy. However, gastroenteritis is still common in children, given other emerging pathogens. Our results highlight the impact of rotavirus vaccines on children's health in Taiwan and provide indications for future preventive medicine and healthcare strategies in children.
Peripheral blood CD45RO+T cells is a predictor of the effectiveness of neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Authors: Zhai Zhiwei , Wang Zhenjun , Jin Mulan , Zhang Kunning
Published: June 2021

To investigate the relationship between the changes in circulating CD45RO+T lymphocyte subsets following neoadjuvant therapy for rectal cancer in patients with locally advanced rectal cancer.

The clinicopathological data of 185 patients with rectal cancer who received neoadjuvant therapy in the General Surgery Department of Beijing Chaoyang Hospital affiliated to Capital Medical University from June 2015 to June 2017 were analyzed. Venous blood samples were collected 1 week before neoadjuvant therapy and 1 week before surgery, and the expression of CD45RO+T was detected by flow cytometry. The receiver operating characteristic curve analysis was used to determine the optimal cut-off point of CD45RO+ratio. Log-rank test and multivariate Cox regression were used to analyze the overall survival rate (OS) and disease-free survival rate (DFS) associated with CD45RO+ratio.

Circulating CD45RO+ratio of 1.07 was determined as the optimal cut-off point and CD45RO+ratio-high was associated with lower tumor regression grade grading (P = .031), T stage (P = .001), and tumor node metastasis (TNM) stage (P = .012). The 3-year DFS and OS rate in the CD45RO+ratio-high group was significantly higher than that in the CD45RO+ratio-low group (89.2% vs 60.1%, P<.001; 94.4% vs 73.2%, P<.001). The multivariate Cox analysis revealed that elevated CD45RO+ratio was an independent factor for better DFS (OR, 0.339; 95% CI, 0.153–0.752; P = .008) and OS (OR, 0.244; 95% CI,0.082–0.726; P = .011).

Circulating CD45RO+ratio could predict the tumor regression grade of neoadjuvant therapy for rectal cancer, as well as long-term prognosis. These findings could be used to stratify patients and develop alternative strategies for adjuvant therapy.
Jejunal Dieulafoy lesion with intraintestinal calcification on computerized tomography
Authors: Wang Mudan , Cao Haijun , Dai Jinfeng , Chen Shanshan , Xu Li , Li Shangao
Published: June 2021

Rationale:

A Dieulafoy lesion is a rare cause of gastrointestinal (GI) bleeding, especially in the jejunum, and the presence of calcifications on CT might be suspicious of the diagnosis.

Patient concerns:

We describe a 72-year-old woman with anemia and melena. Hemoglobin was 6.0 g/dL, and the stools were positive for occult blood (4+). Blood pressure was 116/54 mm Hg. Physical examination showed pale face and pitting edema in both lower limbs. Abdominal computerized tomography showed calcification in the small intestine of the left lower abdomen. Capsule endoscopy showed a blood clot.

Diagnoses:

Dieulafoy lesion.

Interventions:

Single balloon endoscopy was performed via the oral approach and showed a blood clot on the suspected submucosal tumor of jejunum. A hemostatic clip was placed at the base of the lesion to allow the surgeon to locate it during the operation. Laparoscopy was performed, and the lesion was resected.

Outcomes:

The postoperative pathology showed a Dieulafoy lesion. The lower extremity edema subsided. GI bleeding did not recur over 1 year of follow-up, and hemoglobin was 12.2 g/dL. A Dieulafoy lesion is a rare cause of GI bleeding, and it is even rarer in the jejunum.

Lessons:

A Dieulafoy lesion does not have special imaging features, but the presence of calcifications in the small intestine on computerized tomography might be suspicious of the diagnosis. When endoscopic treatment is difficult, surgical treatment could be considered.
Effects of patient characteristics on the efficacy of complete revascularization for treatment of ST-segment elevation myocardial infarction with multivessel disease
Authors: Li Lu-Feng , Qiu Mei , Liu Shu-Yan , Zhou Hai-Rong
Published: June 2021

Background:

Several randomized controlled trials (RCTs) have evaluated the efficacy of complete vs culprit-only revascularization for treatment of ST-segment elevation myocardial infarction (STEMI) with multivessel disease. However, the efficacy of complete revascularization vs culprit-only revascularization in some STEMI patient subgroups remains unclear.

Methods:

We searched PubMed and Embase for related RCTs from the start date of databases to January 3, 2020. The endpoint assessed in this meta-analysis was major adverse cardiac events (MACE). Random-effects meta-analysis was conducted stratified by each of the 5 factors of interest (i.e., sex, age, history of diabetes, ECG infarct location, and the number of arteries with stenosis) to estimate pooled hazard ratio and 95% confidence interval. Random-effects meta-regression was conducted to assess subgroup differences. We examined publication bias by drawing funnel plots and performing Egger test. This meta-analysis is reported according to the PRISMA statement.

Results:

Six RCTs were included for pooled analysis. Compared with culprit-only revascularization, complete revascularization significantly reduced the risk of MACE (hazard ratio 0.48, 95% confidence interval 0.42–0.55; I
2 = 0%; P for relative effect < .001). This significant reduction in the risk of MACE exhibited by complete revascularization was observed in most of the subgroups of interest. All of the subgroup effects based on the 5 factors of interest were not statistically significant (P
subgroup ranged from 0.198 to 0.556). Publication bias was not suggested by funnel plots and Egger test.

Conclusions:

Compared with culprit-only revascularization, complete revascularization significantly reduces the MACE risk in patients with STEMI and multivessel disease, which is independent of sex, age, history of diabetes, ECG infarct location, and the number of arteries with stenosis.
Diagnostic accuracy of ultrasound shear wave elastography combined with superb microvascular imaging for breast tumors
Authors: Bian Jinyi , Zhang Jili , Hou Xiukun
Published: June 2021

Background:

Shear wave elastography (SWE) is a new ultrasonic elastography technique for evaluating the hardness of living tissue by measuring the propagation velocity of shear wave in tissue, which is characterized by real-time, non-invasive and quantitative. The SWE technique can be used to diagnose the lesions of different tissues and organs, and the quantitative measurement of SWE is considered as more objective information about breast masses. Superb microvascular imaging (SMI) is a new noninvasive Doppler ultrasound imaging method, which can display blood flow information with high spatial resolution and high frame rate, while keeping the minimum low-speed blood flow components. Therefore, SMI can diagnose diseases closely related to angiogenesis at a relatively early stage. However, the results of these studies have been contradictory. The present meta-analysis aimed at determining the accuracy of SWE combined with SMI in the differential diagnosis between benign and malignant breast lesions.

Methods:

We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the April 18, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14. 0 software will be used for data analysis.

Results:

This systematic review will determine the accuracy of shear wave elastography combined with superb microvascular imaging in the differential diagnosis between benign and malignant breast tumors.

Conclusion:

Its findings will provide helpful evidence for the accuracy of shear wave elastography combined with superb microvascular imaging in the differential diagnosis between benign and malignant breast tumors.

Systematic review registration:

INPLASY202150075
Bismuth breast-shield use in chest computed tomography for efficient dose reduction and sufficient image quality
Authors: Ko Chih-Hsiang , Lee Shiou-Ping , Hsieh Yi-Chien , Lee Yuan-Hao , Yao Melissa Min-Szu , Chan Wing P.
Published: June 2021

Background:

Radiosensitivity in the breasts increases the risk of carcinogenesis from exposure to the ionizing radiation of computed tomography (CT) administered in the course of medical attention. Bismuth shielding techniques have been used to reduce radiation, but image noise increased, degrading image quality.

Purpose:

The aim of this study was to investigate how the use of iterative reconstruction (IR) combined with bismuth shielding influences image quality.

Materials and Methods:

Women aged at least 20 years with body mass indexes <28 were recruited and randomly assigned to 1 of 3 CT scanning protocols without shielding, with a bismuth breast shield before the scout view, or with a bismuth breast shield after the scout view. All obtained images were reconstructed using an IR algorithm. To evaluate radiation dose, 2 Gafchromic films were placed over the clothes, 1 near each nipple.

Results:

Average dose reduction was significant (27.99%,
P
 < .05) when bismuth shielding was applied after the scout view. Using the contrast-to-noise ratio, the image quality was found to be superior when the IR algorithm was applied. Using quantitative evaluations by 2 radiologists applying a 4-point Likert scale, significant differences in image quality were not found among the 3 protocols.

Conclusion:

Bismuth breast shields, particularly when used after acquiring scout images, are effective at reducing radiation dose without undermining the diagnostic value of the images when the IR technique is applied.
Operative treatments for osteochondral lesions of the talus in adults
Authors: Tan Hongbo , Li Anxu , Qiu Xiong , Cui Yi , Tang Wenbao , Wang Gang , Ding Wei , Xu Yongqing
Published: June 2021

Purpose:

This systematic review aimed to identify the available evidence regarding the comparative effectiveness and safety of various operative treatments in adult patients with osteochondral lesions of the talus (OLT).

Materials and methods:

The PubMed, Embase, ISI Web of Knowledge, and the Cochrane Controlled Trial Register of Controlled Trials were searched from their inception date to September 2019. Two reviewers selected the randomized controlled trials (RCTs) and non-RCTs assessing the comparative effectiveness and safety of various operative treatments for OLT. The meta-analysis was performed using Revman 5.3.

Results:

Eight studies (1 RCT and 7 non-RCTs) with 375 patients were included in this review. The difference in the American Orthopaedic Foot and Ankle Society (AOFAS) score between the cartilage repair and replacement was not significant. The cartilage regeneration with or without cartilage repair had significant superiority in improving the AOFAS score compared with the cartilage repair. The difference in the magnetic resonance observation of cartilage repair tissue score between the cartilage repair and replacement and between cartilage repair and cartilage repair plus regeneration was significant.

Conclusions:

Cartilage regeneration and cartilage repair plus regeneration had significant superiority in improving the ankle function and radiological evaluation of OLT, although the trials included did not have high-level evidence. Moreover, which treatment between the 2 was safer could not be addressed in this review as most of the trials did not report the safety outcome. Further studies are needed to define the best surgical option for treating OLT.
Donafenib treatment for hepatocellular carcinoma
Authors: Li Qiaoqi , Zhu Hong
Published: June 2021

Rationale:

Hepatocellular carcinoma (HCC) is the most common liver cancer. The efficacy of the present treatment is disappointing, and the prognosis is poor. Donafenib, a novel multikinase inhibitor, is a new deuterated derivative of sorafenib. It can improve overall survival in patients with advanced HCC, with a favorable safety and tolerability profile over sorafenib.

Patient concerns:

Here, we report the case of a 51-year-old male patient who presented with experienced epigastric discomfort for the prior several days. He had a history of untreated chronic hepatitis B virus infection for >29 years and no other underlying diseases. Based on further investigations, he was diagnosed with advanced HCC and refused surgery.

Diagnosis:

Based on the patient's performance status, tumor status assessed by computed tomography, liver function, and percutaneous liver biopsy, he was diagnosed with advanced HCC Barcelona Clinic Liver Cancer Stage C.

Interventions:

The patient was administered a 200-mg oral dose of donafenib twice-daily.

Outcomes:

The patient was followed-up from the time of diagnosis. He received donafenib for 31 months, and the progression-free survival time was 31 months (from May 2017 to December 2019); the overall survival time was not reached. The patient reported little abdominal distension with no other obvious discomfort while taking the medication.

Lesson:

Donafenib showed good efficacy for the treatment of advanced HCC, with mild side effects. Deuterium-containing drugs seem to be a promising avenue for medical innovation.
Next-generation sequencing diagnostics of bacteremia in pediatric sepsis
Authors: Schmoch Thomas , Westhoff Jens H. , Decker Sebastian O. , Skarabis Annabell , Hoffmann Georg F. , Dohna-Schwake Christian , Felderhoff-Müser Ursula , Skolik Caroline , Feisst Manuel , Klose Christina , Bruckner Thomas , Luntz Steffen , Weigand Markus A. , Sohn Kai , Brenner Thorsten
Published: June 2021

Introduction:

Sepsis and septic shock are the most severe forms of infection affecting predominantly elderly people, preterm and term neonates, and young infants. Even in high-income countries sepsis causes about 8% of admissions to pediatric intensive care units (PICUs). Early diagnosis, rapid anti-infective treatment, and prompt hemodynamic stabilization are crucial for patient survival. In this context, it is essential to identify the causative pathogen as soon as possible to optimize antimicrobial treatment. To date, culture-based diagnostic procedures (e.g., blood cultures) represent the standard of care. However, they have 2 major problems: on the one hand, in the case of very small sample volumes (and thus usually in children), they are not sufficiently sensitive. On the other hand, with a time-to-result of 2 to 5 days, blood cultures need a relatively long time for the anti-infective therapy to be calculated. To overcome these problems, culture-independent molecular diagnostic procedures such as unbiased sequence analysis of circulating cell-free DNA (cfDNA) from plasma samples of septic patients by next-generation sequencing (NGS) have been tested successfully in adult septic patients. However, these results still need to be transferred to the pediatric setting.

Methods:

The Next GeneSiPS-Trial is a prospective, observational, non-interventional, multicenter study used to assess the diagnostic performance of an NGS-based approach for the identification of causative pathogens in (preterm and term) neonates (d1–d28, n = 50), infants (d29 to <1 yr, n = 50), and toddlers (1 yr to <5 yr, n = 50) with suspected or proven severe sepsis or septic shock (according to the pediatric sepsis definition) by the use of the quantitative sepsis indicating quantifier (SIQ) score in comparison to standard of care (culture-based) microbiological diagnostics. Potential changes in anti-infective treatment regimens based on these NGS results will be estimated retrospectively by a panel of 3 independent clinical specialists.

Discussion:

Neonates, infants, and young children are significantly affected by sepsis. Fast and more sensitive diagnostic approaches are urgently needed. This prospective, observational, non-interventional, multicenter study seeks to evaluate an NGS-based approach in critically ill children suffering from sepsis.

Trial registration:

DRKS-ID: DRKS00015705 (registered October 24, 2018). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015705
Acupuncture combined with western medicine for the treatment of hypertension
Authors: Wang Si-Han , Xu Jia-Tuo , Hu Xiao-Juan , Cui Ji
Published: June 2021

Background:

Hypertension is a kind of cardiovascular syndrome with the main clinical manifestation of continuous increase of systemic arterial blood pressure. Hypertension coexists with other cardiovascular risk factors and is an important risk factor for cardiovascular and cerebrovascular diseases. Acupuncture is an important part of Traditional Chinese Medicine intervention. The antihypertensive effect of acupuncture on hypertension is based on the neuroendocrine system, characterized by multichannel and multitarget. This study aims to provide latest and updated proof of systematic review to assess the effectiveness and safety of acupuncture for hypertension.

Methods:

We will systematically search 9 databases from their inceptions to February 2021. Only randomized controlled trials of acupuncture combined with western medicine in the treatment of hypertension will meet the inclusion criteria. The main outcome measures we focus on include clinical efficacy, syndrome efficacy, Traditional Chinese Medicine syndrome score, diastolic and systolic blood pressure changes, blood pressure variability, heart rate variability, pulse rate variability, and adverse reactions. The research screening, data extraction, and risk of bias assessment will be employed by 2 reviewers independently, and disagreement will be decided by a third senior reviewer. The Revman 5.3 software will be used for meta-analysis. The confidence of proof will be rated adopting grading of recommendations assessment, development and evaluation tool and methodological quality of this research will be assessed using assessment of multiple systematic reviews-2 and risk of bias in systematic reviews. The publication quality will be evaluated by preferred reporting items for systematic reviews and meta-analyses (PRISMA).

Results:

This systematic review (SR) will provide evidence-based medical evidence for hypertension therapy by acupuncture combined with western medicine and we will submit the findings of this SR for peer-review publication.

Conclusions:

This SR will provide latest and updated summary proof for assessing the effectiveness and safety of acupuncture for hypertension.

Registration number:

INPLASY 202150047
Acupuncture for patients recovering from lacunar infarction
Authors: Wang Haoran , Fu Xiaoyan , Ju Jing , Meng Dan , Sun Shengming , Guo Chenchen , Jia Hongling , Sun Qiangsan
Published: June 2021

Background:

Lacunar infarction (LI) is the mild type in the classification of ischemic stroke, mostly occurs in the middle-aged and elderly, with mild hemiplegia and partial sensory disorder as the main manifestations. In the treatment of LI, acupuncture is often regarded as dominant therapy in the convalescence period. However, acupuncture for treatment of LI in the recovery period lacks high-quality reports and evidence-based medical evidence. Thus, we aim to evaluate the curative effect and safety of acupuncture for LI objectively.

Methods:

Pubmed, Cochrane Library, Web of Science, EBSCO, Springer, China National Knowledge Infrastructure, Chinese Scientific and Technical Journals Database (VIP), Wan-fang Database, Chinese Biomedical Literature Database, Chinese Science Citation Database, and other electronic databases will be retrieved from the inception to May, 2021. Randomized controlled trials related to this subject will be searched. The inclusion criteria are established and a detailed literature search strategy is designed through discussion. Article retrieval, screening, excluding repetitive studies, assessment of quality, and data processing will be conducted by 2 reviewers independently using EndNote (X9) and Review Manager (5.3.5). The outcome measures include primary outcome measures (total effective rate, National Institute of Health Stroke Scale score, and Fugl-Meyer Assessment score), secondary outcome measures (blood pressure, plasma glucose, and blood lipid), and safety outcome measures. We will perform a meta-analysis, descriptive analysis, and subgroup analysis based on data conditions.

Results:

The study of total effective rate, National Institute of Health Stroke Scale score, Fugl-Meyer Assessment score, blood pressure, plasma glucose, blood lipid, and adverse effects will provide evidenced outcome for high-quality synthesis and descriptive analysis.

Conclusion:

This systematic review will kindly provide evidence of whether acupuncture is an effective and safe intervention for LI in the recovery period.

INPLASY registration number:

INPLASY202150060 (DOI:10.37766/inplasy2021.5.0060).
Clinical, randomized, double blind clinical trial to study the effect of parenteral supplementation with fish oil emulsion in the nutritional support in esophagectomized patients
Authors: Suárez-Lledó Ana , Leiva-Badosa Elisabet , Llop-Talaveron Josep M. , Fernández-Alvarez Mónica , Farran-Teixidor Leandre , Miró-Martín Mónica , Virgili-Casas Nuria , Creus-Costas Glòria , Bas-Minguet Jordi , Poyatos-Canton Elisabet , Navarro-Velazquez Sergio , Badia-Tahull María B.
Published: June 2021

Introduction:

Esophagectomy is a major surgery with a high degree of catabolic and post-surgical inflammatory response accompanied by high morbidity and significant mortality. Post-surgical nutritional support via enteral administration of ω-3 fatty acids has been seen to be effective although its bad tolerance. There are few clinical trials with parenteral ω-3 fatty acids in these patients. We propose to investigate the effect of combining a parenteral fish oil lipid emulsion with the standard enteral nutrition (EN) support.

Materials and methods:

Prospective, single-center, randomized, double-blind study in esophagectomized patients, and treated after surgery with parenteral lipid emulsions of ω-3 fatty acids or a mixture of ω-6 long-chain triglycerides/short-chain triglycerides 50%. These emulsions will be added to the standard nutritional support in continuous infusion until 5 days of treatment have been completed. Patients will be randomized 1:1:1 in Group A receiving 0.4 g/kg/d of fish-oil lipid emulsion and 0.4 g/kg/d of a lipid emulsion mixture of ω-6 long-chain fatty acids (LCT) plus medium-chain fatty acids (MCT) (total dose of 0.8 g/kg/d of lipid emulsion); Group B receiving 0.8 g/kg/d of fish oil lipid emulsion and Group C receiving 0.8 g/kg/d of LCT/MCT emulsion.

The main objective is to determine whether 5 days administration of intravenous ω-3 fatty acid lipid emulsion is effective in normalizing interleukin-6 levels compared with LCT/MCT emulsions, and whether a 0.8 g/kg/d dose is more effective than 0.4 g/kg/d. Secondary outcomes include other inflammatory markers such as C-reactive protein, tumor necrosis factor alpha and interleukin-10, and parameters of morbidity, safety, nutrition and mortality.

Samples will be collected at the time when surgery is indicated and on days 0, 1, 3, 5 and 21 to determine inflammatory, nutritional, hepatic and safety parameters. In addition, clinical follow-up will be continued throughout the hospital admision and up to 1 year after surgery.

Discussion:

Studies of ω-3 fatty acids administered parenterally in esophagectomized patients are scarce. This study proposes to investigate the effect of combining fish-oil lipid emulsions administered parenterally with EN support. Potential benefits include fast incorporation of lipids to the cellular membranes and to the inflammatory cascade, and the use of only 1 pharmaconutrient.

Trial Registration:

FAR-NP-2017-01 EudraCT number: 2016-004978-17.

https://reec.aemps.es/reec/public/detail.html searching the EudraCT number.

Version Identifier:

Version 2, 08/06/2017.
Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren
Authors: García Pérez Alvaro , González-Aragón Pineda Alvaro Edgar , Rosales Ibáñez Raúl , Rodríguez Chávez Jaqueline Adelina , Cuevas-González Juan Carlos , Pérez Pérez Nora Guillermina , Villanueva Gutiérrez Teresa
Published: June 2021

The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren.

This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories---a high, middle, or low-income level---of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions.

The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4–6) than schoolchildren with high-income level (56.3% vs 15.8%, P = .009). The multinomial logistic regression models showed that mother's level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4–6), [odds ratio = 1.79 (1.17 – 2.75); P = .007], [OR = 2.21 (1.23 – 3.97); P = .008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1–3).

An association was found between the presence of cavitated caries lesions and the subject's mother's level of education and a low-income level. Socioeconomic factors were found to be associated with inequalities in caries distribution in the age group studied.
Successful use of trametinib and dasatinib combined with chemotherapy in the treatment of Ph-positive B-cell acute lymphoblastic leukemia
Authors: Wang Jing , Shen Shu-Hong , Hu Bin-Fei , Wang Guan-Ling
Published: June 2021

Rationale:

Relapsed or refractory acute lymphoblastic leukemia poses a significant clinical challenge due to its poor prognosis, showing survival rates of less than a year even with the use of novel therapies. In this report, we describe the safe and effective use of trametinib combined with dasatinib in a patient with acute lymphoblastic leukemia (ALL). To the best of our knowledge, this is the first report on the successful use of 2 targeted drugs such as trametinib and dasatinib in a pediatric patient with Ph+ ALL and recurrent pancreatitis.

Patient concerns:

A 6-year-old boy with ALL and Philadelphia chromosome (Ph+) who had recurrent asparaginase-associated pancreatitis.

Diagnosis:

The patient was diagnosed with ALL, based on clinical features, laboratory analyses, bone marrow aspiration evaluation in morphology, immunology, cytogenetics, and molecular.

Interventions:

The patient was treated with dasatinib combined with an intermediate risk-oriented chemotherapy. However, owing to recurrent asparaginase-associated pancreatitis, the patient has to abandon asparaginase in consolidation. Considering the high risk of relapse, we used trametinib and dasatinib combined with chemotherapy as maintenance chemotherapy.

Outcomes:

After 6 months, there were no obvious side effects or residual disease.

Lessons:

We suggest that the combination of trametinib and dasatinib may represent a viable option to treat patients with potential relapsed/refractory Ph+ ALL.
The effect of mind-body exercise on blood pressure in middle-aged and elderly patients with hypertension
Authors: Ge Beihai , Chen Hao , Liao Xianhui
Published: June 2021

Background:

Depending on the person, cervical spondylosis may have no clinical symptoms, but cervical spondylosis will definitely cause changes in people's blood pressure, which will further affect physical and mental health.

Objectives:

This study aims to explore the effect and safety of mind-body exercise intervention on the blood pressure in middle-aged and elderly patients with hypertension through meta-analysis.

Methods:

This meta-analysis searched studies from 4 research databases: the China National Knowledge Infrastructure (from 1979), Web of Science (from 1950), PubMed (from 1965), and Cochrane (from 1991), Date of retrieval: January 22, 2021, Two authors will independently search literature records, scan titles, abstracts, and full texts, collect data, and assess materials for risk of bias. The data will be analyzed by Stata 14.0 software.

Results:

The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed.

Discussion:

This meta-analysis may provide clinical practice with more reliable evidence-based medical evidence that mind-body exercise can benefit the blood pressure of middle-aged and elderly hypertensive patients.

INPLASY Registration Number:

INPLASY202130072.
Serum NSE and S100B protein levels for evaluating the impaired consciousness in patients with acute carbon monoxide poisoning
Authors: Zhang Litao , Zhao Jing , Hao Qingqing , Xu Xin , Han Hu , Li Jianguo
Published: June 2021

The aim of this study was to investigate the associations between the levels of neuron-specific enolase (NSE) and S100B protein and coma duration, and evaluate the optimal cut-off values for prediction coma duration ≥ 72 hours in patients with acute carbon monoxide poisoning (ACOP).

A total of 60 patients with ACOP were divided into 3 following groups according to their status of consciousness and coma duration at admission: Awake group [Glasgow Coma Scale score (GCS score) ≥ 13 points], Coma < 72 hours group (GCS score < 13 points and coma duration < 72 h), and Coma ≥ 72 hours group (GCS score < 13 points and coma duration ≥ 72 h). The levels of serum NSE and S100B protein were measured after admission.

There were significant differences in GCS score, carbon monoxide (CO) exposure time, NSE, and S100B levels between the Coma ≥ 72 h group and the Awake group, and between the Coma < 72 h group and the Awake group. Significant differences in GCS score, NSE, and S100B levels were also found between Coma ≥ 72 h group and Coma < 72 h group. Correlation analysis showed that NSE and S100B were positively correlated (r
s = 0.590, P < .01); NSE and S100B were negatively correlated with GCS score (r
s = -0.583, r
s = -0.590, respectively, both P < .01). The areas under the curve (AUCs) of NSE, S100B, and GCS score to predict the coma duration ≥ 72 hours were 0.754, 0.791, and 0.785, respectively. Pairwise comparisons did not show differences among the 3 groups (all P > .05). The sensitivity and specificity of NSE prediction with a cut-off value of 13 μg/L were 80% and 64%, respectively, and those of S100B prediction with a cut-off value of 0.43 μg/L were 70% and 88%, respectively.

The NSE and S100B protein levels were significantly correlated with the degree of impaired consciousness and had the same clinical value in predicting coma duration of ≥ 72 hours in patients with ACOP.
A simple noninvasive model to predict significant fibrosis in children with chronic hepatitis B
Authors: Zhang Kang-Ling , Chen Xiu-Qi , Lv Zi-Li , Tang Qing , Shan Qing-Wen
Published: June 2021

To develop a noninvasive model to predict significant fibrosis in children with chronic hepatitis B (CHB).

A total of 116 CHB pediatric patients who underwent liver biopsy were included in the study. Liver histology, which is the gold standard for assessing fibrosis, was performed. Blood routine examination, coagulation function, liver biochemistry, viral serology, and viral load were analyzed. Receiver operating characteristic curve analysis was used to analyze the sensitivity and specificity of all possible cut-off values.

Based on the correlation and difference analyses, 7 available clinical parameters (total bile acid, gamma-glutamyl transpeptidase [GGT], aspartate transaminase, direct bilirubin to total bilirubin ratio, alanine aminotransferase, prealbumin [PA], and cholinesterase) were included in the modeling analysis. A model to predict significant liver fibrosis was derived using the 2 best parameters (PA and GGT). The original model was

. After the mathematical calculation, the G index=600 × GGT/PA2 predicted significant fibrosis, with an area under the receiving operating characteristics (AUROC) curve of 0.733, 95% confidence interval (0.643–0.811). The AUROC of the G index (0.733) was higher than that of aminotransferase to platelet ratio index (APRI) (0.680) and Fibrosis index based on 4 factors (FIB-4) (0.601) in predicting significant fibrosis in children with CHB. If the values of the G index were outside the range of 0.28 to 1.16, 52% of children with CHB could avoid liver biopsy, with an overall accuracy of 75%.

The G index can predict and exclude significant fibrosis in children with CHB, and it may reduce the need for liver biopsy in children with CHB.
Stroop interference in children with developmental dyslexia
Authors: Shen Chengwei , Jiang Qi , Luo Yan , Long Ji , Tai Xiujuan , Liu Shuqing
Published: June 2021

Previous studies have identified inhibitory deficits in dyslexic children, but we have little understanding of their neural mechanisms, especially for Chinese children with developmental dyslexia.

We used a double-blind controlled trial to study the electroencephalogram responses of dyslexic and non-dyslexic children when performing the Stroop color-word test.

Behavioral data showed differences in response time and accuracy between the 2 groups. In the event-related potentials (ERP) results, dyslexic children displayed larger P2 and P3b on congruent trials, while non-dyslexic children displayed larger P2 and P3b on incongruent trials, the 2 groups showed opposite brain activation patterns on the Stroop test.

Dyslexic children have poor inhibitory function, and this poor inhibition may be related to their abnormal brain activation patterns.
Immunohistochemistry in postmortem diagnosis of acute cerebral hypoxia and ischemia
Authors: Barranco Rosario , Bonsignore Alessandro , Ventura Francesco
Published: June 2021

Background

: Discovery of evidence of acute brain ischemia or hypoxia and its differentiation from agonal hypoxia represents a task of interest but extremely difficult in forensic neuropathology. Generally, more than 50% of forensic autopsies indicate evidence of brain induced functional arrest of the organ system, which can be the result of a hypoxic/ischemic brain event. Even if the brain is the target organ of hypoxic/ischemic damage, at present, there are no specific neuropathological (macroscopic and histological) findings of hypoxic damage (such as in drowning, hanging, intoxication with carbon monoxide) or acute ischemia. In fact, the first histological signs appear after at least 4 to 6 hours. Numerous authors have pointed out how an immunohistochemical analysis could help diagnose acute cerebral hypoxia/ischemia.

Data sources: This review was based on articles published in PubMed and Scopus databases in the past 25 years, with the following keywords “immunohistochemical markers,” “acute cerebral ischemia,” “ischemic or hypoxic brain damage,” and “acute cerebral hypoxia”.

Objectives

: Original articles and reviews on this topic were selected. The purpose of this review is to analyze and summarize the markers studied so far and to consider the limits of immunohistochemistry that exist to date in this specific field of forensic pathology.

Results

: We identified 13 markers that had been examined (in previous studies) for this purpose. In our opinion, it is difficult to identify reliable and confirmed biomarkers from multiple studies in order to support a postmortem diagnosis of acute cerebral hypoxia/ischemia. Microtubule-associated protein 2 (MAP2) is the most researched marker in the literature and the results obtained have proven to be quite useful.

Conclusion:

Immunohistochemistry has provided interesting and promising results, but further studies are needed in order to confirm and apply them in standard forensic practice.
Identification of hub genes, pathways, and related transcription factors in systemic lupus erythematosus
Authors: Wang Yanfeng , Ma Qian , Huo Zhenghao
Published: June 2021

Background:

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ damage and the production of a variety of autoantibodies. The pathogenesis of SLE has not been fully defined, and it is difficult to treat. Our study aimed to identify candidate genes that may be used as biomarkers for the screening, diagnosis, and treatment of SLE.

Methods:

We used the GEO2R tool to identify the differentially expressed genes (DEGs) in SLE-related datasets retrieved from the Gene Expression Omnibus (GEO). In addition, we also identified the biological functions of the DEGs by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. Additionally, we constructed protein–protein interaction (PPI) networks to identify hub genes, as well as the regulatory network of transcription factors related to DEGs.

Results:

Two datasets were identified for use from the GEO (GSE50772, GSE4588), and 34 up-regulated genes and 4 down-regulated genes were identified by GEO2R. Pathway analysis of the DEGs revealed enrichment of the interferon alpha/beta signaling pathway; GO analysis was mainly enriched in response to interferon alpha, regulation of ribonuclease activity. PPIs were constructed through the STRING database and 14 hub genes were selected and 1 significant module (score = 12.923) was obtained from the PPI network. Additionally, 11 key transcription factors that interacted closely with the 14 hub DEGs were identified from the gene transcription factor network.

Conclusions:

Bioinformatic analysis is an effective tool for screening the original genomic data in the GEO database, and a large number of SLE-related DEGs were identified. The identified hub DEGs may be potential biomarkers of SLE.
Classification of circadian pain rhythms and pain characteristics in chronic pain patients
Authors: Tanaka Yoichi , Shigetoh Hayato , Sato Gosuke , Fujii Ren , Imai Ryota , Osumi Michihiro , Morioka Shu
Published: June 2021

This study aimed to perform cluster analysis in patients with chronic pain to extract groups with similar circadian rhythms and compare neuropathic pain and psychological factors among these groups to identify differences in pain-related outcomes. A total of 63 community-dwellers with pain lasting at least 3 months and Numerical Rating Scale scores of ≥2 were recruited from 3 medical institutions. Their pain circadian rhythms were evaluated over 7 days by measuring pain intensity at 6-time points per day using a 10-cm visual analog scale. Cluster analysis was performed using 6 variables with standardized visual analog scale values at 6-time points for individual participants to extract groups with similar pain circadian rhythms. The results of the Neuropathic Pain Symptom Inventory and psychological evaluations in each group were compared using the Kruskal–Wallis test. The results revealed 3 clusters with different circadian rhythms of pain. The total and evoked pain subscale Neuropathic Pain Symptom Inventory scores differed among the 3 clusters. The results suggest that a thorough understanding of circadian pain rhythms in chronic pain patients may facilitate the performance of activities of daily living and physical exercise from the perspective of pain management.