bluuebunny/crossref_metadata_2025 huggingface dataset:
Constitutional Law and Islamic Hijabs in Kenyan Schools: The Supreme Court’s Specious Constraint in Methodist Church in Kenya
Authors: Sang YK Brian
Published: January 2021

This article analyses the content and implications of the Supreme Court of Kenya’s judgment in Methodist Church in Kenya v Mohamed Fugicha and 3 Others. There, by majority decision, the Supreme Court overturned the Court of Appeal’s ruling that reasonable accommodation be made for the wearing of Islamic hijabs by female Muslim students in Kenyan schools. While Methodist Church in Kenya was expected to clarify the scope of the right to manifest religious belief in Kenya, the Supreme Court used specious logic based on legalism to avoid that issue. This article shows how the majority decision contradicts principles of enforcement of constitutional rights by focusing unduly on procedural technicalities, avoiding the core issue of permissible restrictions on religious expression and leaving key legal questions unresolved. It also highlights the well-reasoned dissenting opinion that addressed the core issue and which has crucial import for future development of religious freedom jurisprudence in Kenya
Sexual Dimorphism in the Functional Development of the Cochlear Amplifier in Humans
Authors: Mishra Srikanta K. , Zambrano Samantha , Rodrigo Hansapani
Published: January 2021

Objectives:

Otoacoustic emissions, a byproduct of active cochlear mechanisms, exhibit a higher magnitude in females than in males. The relatively higher levels of androgen exposure in the male fetus are thought to cause this difference. Postnatally, the onset of puberty is also associated with the androgen surge in males. In this study, we investigated sexual dimorphism in age-related changes in stimulus-frequency otoacoustic emissions for children.

Design:

In a retrospective design, stimulus-frequency otoacoustic emissions were analyzed from a cross-sectional sample of 170 normal-hearing children (4 to 12 years) and 67 young adults. Wideband acoustic immittance and efferent inhibition measures were analyzed to determine the extent to which middle ear transmission and efferent inhibition can account for potential sex differences in stimulus-frequency otoacoustic emissions.

Results:

Male children showed a significant reduction in otoacoustic emission magnitudes with age, whereas female children did not show any such changes. Females showed higher stimulus-frequency otoacoustic emission magnitudes compared with males. However, the effect size of sex differences in young adults was larger compared with children. Unlike the otoacoustic emission magnitude, the noise floor did not show sexual dimorphism; however, it decreased with age. Neither the wideband absorbance nor efferent inhibition could account for the sex differences in stimulus-frequency otoacoustic emissions.

Conclusions:

The cochlear-amplifier function remains robust in female children but diminishes in male children between 4 and 12 years of age. We carefully eliminated lifestyle, middle ear, and efferent factors to conclude that the androgen surge associated with puberty likely caused the observed masculinization of stimulus-frequency otoacoustic emissions in male children. These findings have significant theoretical consequences. The cochlea is considered mature at birth; however, the present findings highlight that functional cochlear maturation, as revealed by otoacoustic emissions, can be postnatally influenced by endogenous hormonal factors, at least in male children. Overall, work reported here demonstrates sexual dimorphism in the functional cochlear maturational processes during childhood.
Factors Influencing Speech Perception in Adults With a Cochlear Implant
Authors: Heutink Floris , Verbist Berit M. , van der Woude Willem-Jan , Meulman Tamara J. , Briaire Jeroen J. , Frijns Johan H. M. , Vart Priya , Mylanus Emmanuel A. M. , Huinck Wendy J.
Published: January 2021

Objectives:

The primary objective of this study is to identify the biographic, audiologic, and electrode position factors that influence speech perception performance in adult cochlear implant (CI) recipients implanted with a device from a single manufacturer. The secondary objective is to investigate the independent association of the type of electrode (precurved or straight) with speech perception.

Design:

In a cross-sectional study design, speech perception measures and ultrahigh-resolution computed tomography scans were performed in 129 experienced CI recipients with a postlingual onset of hearing loss. Data were collected between December 2016 and January 2018 in the Radboud University Medical Center, Nijmegen, the Netherlands. The participants received either a precurved electrode (N = 85) or a straight electrode (N = 44), all from the same manufacturer. The biographic variables evaluated were age at implantation, level of education, and years of hearing loss. The audiometric factors explored were preoperative and postoperative pure-tone average residual hearing and preoperative speech perception score. The electrode position factors analyzed, as measured from images obtained with the ultrahigh-resolution computed tomography scan, were the scalar location, angular insertion depth of the basal and apical electrode contacts, and the wrapping factor (i.e., electrode-to-modiolus distance), as well as the type of electrode used. These 11 variables were tested for their effect on three speech perception outcomes: consonant–vowel–consonant words in quiet tests at 50 dB SPL (CVC50) and 65 dB SPL (CVC65), and the digits-in-noise test.

Results:

A lower age at implantation was correlated with a higher CVC50 phoneme score in the straight electrode group. Other biographic variables did not correlate with speech perception. Furthermore, participants implanted with a precurved electrode and who had poor preoperative hearing thresholds performed better in all speech perception outcomes than the participants implanted with a straight electrode and relatively better preoperative hearing thresholds. After correcting for biographic factors, audiometric variables, and scalar location, we showed that the precurved electrode led to an 11.8 percentage points (95% confidence interval: 1.4–20.4%; p = 0.03) higher perception score for the CVC50 phonemes compared with the straight electrode. Furthermore, contrary to our initial expectations, the preservation of residual hearing with the straight electrode was poor, as the median preoperative and the postoperative residual hearing thresholds for the straight electrode were 88 and 122 dB, respectively.

Conclusions:

Cochlear implantation with a precurved electrode results in a significantly higher speech perception outcome, independent of biographic factors, audiometric factors, and scalar location.
Relationships Between Daily Device Use and Early Communication Outcomes in Young Children With Cochlear Implants
Authors: Wiseman Kathryn B. , Warner-Czyz Andrea D. , Kwon Shari , Fiorentino Kim , Sweeney Melissa
Published: January 2021

Objectives:

Children with significant hearing loss can gain access to sound via a cochlear implant (CI), but they must wear the device to reap the communication benefits of the device. That is, poor daily device use may result in underdeveloped perceptual and language skills in children and adolescents using CIs. This retrospective study focuses on the relationship between daily CI use and communication performance (auditory skills, speech recognition, expressive and receptive language) in young children, with the hypothesis that greater daily device use coincides with better communication outcomes.

Design:

The authors conducted a clinical chart review of patients with CIs younger than 5 years old who used at least 1 CI speech processor with datalogging technology. Participants (n = 65) had a mean chronologic age of 3.5 years, mean implantation age of 1.9 years, and mean device experience of 1.6 years. Approximately one quarter of participants had additional disabilities. Daily device use (i.e., datalogging information), child characteristics (e.g., age at CI), and assessments of communication skills (i.e., parent questionnaires, speech recognition tests, standardized language assessments) were obtained from each child’s records. The investigators performed correlational analyses to examine relationships between communication outcomes and daily device use, and they employed group comparisons and correlations to identify child characteristics that were significantly associated with daily device use (p < 0.05, corrections for family-wise error).

Results:

Young children with CIs used their device, on average, 6.7 hr/d, with 63% below full-time use (<8 hr/d). Children without additional disabilities who wore their CI more hours per day had significantly better auditory, speech recognition, and language skills. A significant correlation also emerged between daily device use and early auditory skills in young CI users with additional disabilities, though relationships were more complicated for this subsample. Longer daily device use significantly correlated with younger age at CI and longer device experience. Differences in device use occurred in regards to absence versus presence of additional disabilities, bilateral versus unilateral device configuration, sign versus spoken language, and private versus government-assisted insurance.

Conclusions:

The strong relationship between daily device use and early communication suggests clinicians and parents should focus on increasing the number of hours per day young children wear their CIs to enhance auditory and language outcomes. However, intervention strategies must consider barriers to consistent device use and goals of the family to efficiently and effectively support families of young children with CIs who struggle with inconsistent device use.
Anxiety and Depressive Disorders in Children Born Preterm: A Meta-Analysis
Authors: Fitzallen Grace C. , Sagar Yashna K. , Taylor H. Gerry , Bora Samudragupta
Published: January 2021

Objective:

Preterm birth is associated with a high prevalence of psychiatric disorders including internalizing problems. However, there is a lack of consensus on the risk for depression and on specific diagnostic profiles. This meta-analysis investigates the independent pooled odds of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition anxiety and depressive disorders in children between 3 and 19 years of age born preterm compared with their term-born peers.

Method:

PubMed/MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature electronic databases were searched (last updated in September 2019) using population (“child”), exposure (“preterm birth”), and outcome (“anxiety”) terms for English peer-reviewed publications. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed with the risk of bias assessed using the Newcastle-Ottawa Quality Assessment Scale. Pooled odds ratio (OR) with 95% confidence intervals (CIs) was estimated using fixed-effects models.

Results:

Eleven independent studies met the inclusion criteria. The pooled sample comprised 1294 preterm and 1274 term-born children with anxiety outcomes and 777 preterm and 784 term-born children with depressive outcomes between 3 and 19 years of age. Children born preterm had significantly greater odds for anxiety (OR: 2.17; 95% CI, 1.43–3.29), generalized anxiety (OR: 2.20; 95% CI, 1.26–3.84), and specific phobia (OR: 1.93; 95% CI, 1.05–3.52) relative to their term-born peers. There were no significant between-group differences for reported depressive disorders.

Conclusion:

Preterm birth is associated with a higher prevalence of anxiety, but not depressive disorders, from 3 to 19 years of age, suggesting distinct etiological pathways in this high-risk population. The findings support variation in the rates of specific anxiety diagnoses, indicating the need to extend neurodevelopmental surveillance to encompass a holistic emotional screening approach.
Primary Resection and Immediate Autologous Reconstruction of Fronto-orbital Infantile Myofibromatoses
Authors: Lavie Jennifer L. , Rogers Camille L. , Stalder Mark W. , St. Hilaire Hugo
Published: January 2021

Infantile myofibromatosis is an unusual and rare lesion of the bone and soft tissue, which can be seen in the craniofacial skeleton. These complex tumors present a challenge to craniofacial surgeons regarding diagnosis, management, and safe and effective surgical treatment, frequently requiring complex reconstruction. We present the case of a 7-month-old girl with multicentric infantile myofibromatosis of the right parietal and fronto-orbital region, the associated clinical presentation, histopathologic findings, and surgical management, along with a review of the relevant literature.
Utility Outcome Measures for the Treatment of Ameloblastomas during Childhood
Authors: David Constanta , Efanov Johnny I. , Borsuk Daniel E.
Published: January 2021

Background:

Our objective was to determine the potential impact of the surgical treatment of ameloblastoma in children through validated health state utility outcome measures.

Methods:

A survey-based preference health utility assessment using the visual analog scale, time trade-off, and standard gamble methods was undertaken among a general population sample. Quality-adjusted life years were derived from these measures. A one-way ANOVA was used for statistical analysis, with a mean (P) value of 0.05 considered significant. Demographic parameters were individually assessed as possible predictors of each utility score.

Results:

In total, 86 participants took part in this study, with a mean age of 29.9 years. Greater utility scores were observed among participants reporting no religious beliefs (P = 0.025, t = 2.28). No other demographic parameters showed statistically significant prediction of utility score. From the mean utility scores (± SD) (visual analog scale = 0.60 ± 0.17; time trade-off = 0.65 ± 0.22; standard gamble = 0.64 ± 0.20), a gain of 30.0, 32.3, and 32.1 quality-adjusted life years may be derived, respectively. All utility outcome measures suggested that an ameloblastoma during childhood is perceived as more burdensome than several debilitating conditions, such as cleft lip and palate.

Conclusions:

To attain perfect health, participants would theoretically undergo surgical treatment of an ameloblastoma during childhood, with willingness to trade off 28.2 years of life and accepting a 35.7% risk of death. The objective assessment of the perceived burden of an ameloblastoma affliction during childhood may inspire cost-utility or cost-effectiveness analyses at broader societal levels.
Is the Use of Opioids Safe after Primary Cleft Palate Repair? A Systematic Review
Authors: Rossell-Perry Percy , Romero-Narvaez Carolina , Rojas-Sandoval Ruth , Gomez-Henao Paula , Delgado-Jimenez Maria Pia , Marca-Ticona Renato
Published: January 2021

Background:

Pharmacologic treatment of postoperative pain after cleft palate repair includes opioids and nonopioid analgesics, nerve blocks, and local anesthetic infiltration. Use of opioids in infants has concerns regarding sedation, risk of aspiration, respiratory depression, and respiratory distress. The main objective of this review was to analyze information available on the safety of the use of opioids during perioperative management of pain related to primary cleft palate repair in published studies.

Methods:

A systematic review of the literature for studies published until March 2020 was performed to evaluate the safety of opioid drugs during primary cleft palate repair pain management. The authors chose the following MesH terms for this systematic review: cleft lip and palate AND opioids AND pain management. The investigators performed a systematic literature search using the Pubmed/MEDLINE, Embase, Web of Science, and Cochrane Library databases.

Results:

After a literature search resulting in 70 identified studies, 9 were qualified for the final analysis, which included 772 patients. There was a high level of evidence in the selected studies according to the Oxford CEBM Level of Evidence classification and GRADE scale. The most common adverse event reported was postoperative nausea and vomiting (from 5% to 25%). Episodes of oxygen desaturation have been reported from 2.5% to 7.4% of the studied patients.

Conclusion

s: Definitive conclusions about the safety of opioid drugs during primary cleft palate repair pain management cannot be drawn. Vomiting and oxygen desaturation have been associated with the use of opioids in the studied population.
Systematic Review of Tissue Expansion: Utilization in Non-breast Applications
Authors: Langdell Hannah C. , Taskindoust Mahsa , Levites Heather A. , Mateas Catalin , Sergesketter Amanda R. , Kaplan Samantha J. , Marcus Jeffrey R. , Erdmann Detlev
Published: January 2021

Background:

Tissue expansion is a versatile reconstructive technique providing well-vascularized local tissue. The current literature focuses largely on tissue expansion for breast reconstruction and in the context of burn and pediatric skin/soft tissue replacement; however, less traditional applications are also prevalent. The aim of this study was to systematically review the utilization of tissue expansion in such less well-characterized circumstances.

Methods:

The authors conducted a systematic review of all publications describing non-breast applications of tissue expansion. Variables regarding expander specifications, expansion process, and complications were collected and further analyzed.

Results:

A total of 565 publications were identified. Of these, 166 publications described tissue expansion for “less traditional” indications, which fell into 5 categories: ear reconstruction, cranioplasty, abdominal wall reconstruction, orthopedic procedures, and genital (penile/scrotal and vaginal/vulva) reconstruction. While lower extremity expansion is known to have high complication rates, tissue expander failure, infection, and exposure rates were in fact highest for penile/scrotal (failure: 18.5%; infection: 15.5%; exposure: 12.5%) and vaginal/vulva (failure: 20.6%; infection: 10.3%; exposure: 6.9%) reconstruction.

Conclusions:

Tissue expansion enables index operations by providing additional skin before definitive reconstruction. Tissue expanders are a valuable option along the reconstructive ladder because they obviate the need for free tissue transfer. Although tissue expansion comes with inherent risk, aggregate outcome failures of the final reconstruction are similar to published rates of complications without pre-expansion. Thus, although tissue expansion requires a staged approach, it remains a valuable option in facilitating a variety of reconstructive procedures.
Quantification of tumor virulence based upon competition between dissimilar subcultured cancer cell lines
Authors: Weintraub Philip
Published: January 2021

Purpose:

A direct quantitative metric that represents the intrinsic virulent properties of a particular tumor is absent, and the development of such a numeric modifier would balance the disproportionate weight of qualitative elements that presently monopolize the nomenclature of cancer. To address this shortcoming, an in vitro model was developed to study the competitive nature of dissimilar cancer cell lines.

Methods:

A prospective series of surgically excised and pathologically confirmed malignant tumors were separated from their adherent state and subcultured according to international standards. After a total of 7 different tumor cell lines were established, each cell line was paired with a dissimilar cancer cell line, and by using all possible combinations, a total of 21 unique tumor pairs were assessed over 7 days after plating on diametrically opposed sections of gridded Petri dishes containing enriched growth medium. Each dish was then examined for changes in tumor cell position on the grid, and a scoring system was established that awarded points for aggressive behaviors.

Results:

Ovarian cancer, lymphoma, and lung cancers demonstrated overall dominance, with wins in at least 2/3 of their matches. Breast and kidney cancers were intermediate in performance, and gastric and colon cancers were subordinate in the majority of their matches.

Discussion:

This pilot experiment revealed that intercellular competition exists between previously untreated, subcultured, and dissimilar tumor cells in this in vitro assay. Moreover, such intercellular competition and the unilateral dominance of specific cancer tissue types have not been previously reported in the literature.
Surgical management of intertumor abscesses caused by fistulous communications with the intestine: rare complication in pediatric malignant tumor: 2 case reports
Authors: Kawakubo Naonori , Hishiki Tomoro , Shirakawa Nami , Arakawa Ayumu , Sugawara Shunsuke , Sone Miyuki , Arai Yasuaki , Ogawa Chitose , Shimada Kazuaki
Published: January 2021

Rationale:

Unresectable abdominal tumors cause various complications, and fistulizaton with intestine is a rare but serious complication. We report this condition in 2 cases.

Patient Concerns:

The first case was that of a 14-year-old male patient who had a desmoid tumor and the second case was that of a 17-year-old female patient with a recurrent malignant peripheral nerve sheath tumor. They were admitted with a giant chemo-resistant tumor that was gradually growing and causing abdominal pain.

Diagnoses:

They were diagnosed with intertumor abscesses caused by fistulous communications with the intestine.

Interventions:

Both the patients underwent percutaneous drainage, and after being stabilized, they underwent surgery.

Outcomes:

The patient with desmoid tumor was continuing his daily routine without any problem. The patient with malignant peripheral nerve sheath tumor was able to consume food orally and discharged after the surgery.

Lessons:

In the treatment of abdominal intratumor abscesses caused by fistulous communications with intestine, it is necessary to consider the optimal treatment strategies based on the tumor location and patient prognosis.
Intra-abdominal hypertension and abdominal compartment syndrome: a current review
Authors: Kimball Edward J.
Published: January 2021

Purpose of review

Intra-abdominal hypertension (IAH) and its deleterious effects are present in at least one-third of ICU patients. Increased recognition of IAH has led to significant reduction in the incidence of abdominal compartment syndrome (ACS). Many questions remain regarding what therapeutic interventions truly reduce morbidity and mortality associated with IAH/ACS. Recent research sheds new light on the effects of IAH in individual organ systems and unique disease states. This paper will review recent research in IAH/ACS recognition, treatment, and management.

Recent findings

Recent research on IAH/ACS includes an improved understanding of the prevalence of IAH/ACS and confirmation of its independent association with organ failure. Specifically, new research adds clarity to the effects of IAH/ACS on individual organ systems and specific disease states. These results combine to improve the clinical ability to diagnose, monitor, and treat IAH/ACS.

There is significant research on the broad impact of IAH/ACS in the ICU setting. Focus on IAH/ACS has gone beyond the purview of intensivists and surgeons to include outstanding work by specialists in multiple sub-specialties. These advances have generated improvements in current treatment algorithms. We review recent IAH/ACS literature and have categorized the most pertinent results into organ system-specific contributions.
Electroacupuncture in treatment of Parkinson disease
Authors: Gai Cong , Qiang Tianyao , Zhang Yuxin , Chai Yuan , Feng Wandi , Sun Hongmei
Published: January 2021

Background:

Parkinson disease (PD) is a worldwide spread neurodegenerative disorder. Dopamine replacement therapy is currently the mainstream treatment, which can alleviate the symptoms but induces motor complications. Electroacupuncture (EA) is beneficial for PD as an alternative medicine. However, few reliable clinical trials or objective systematic reviews are available to give a verdict on the effectiveness of EA in the treatment of PD. Thus, we evaluate the evidence for EA in PD patients by conducting this meta-analysis.

Methods:

PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Chinese Scientific and Technology Journal database, WanFang Digital Periodicals, and Chinese Biomedical Literature Database (SinoMed) will be systematically searched for evidence by 2 authors individually. The analysis will be conducted by RevMan 5.3 software according to Cochrane Handbook.

Results:

The efficacy and safety of EA for PD will be comprehensively assessed from the outcomes, including the effectiveness rate, scores of Unified Parkinson Disease Rating Scale, and Webster scale, superoxide dismutase, lipid peroxides, and dopamine content.

Conclusion:

This systematic review will provide evidence for whether EA can treatment PD.

Registration information:

PROSPERO CRD42019120956.
Evaluation of hydrogen peroxide-assisted endoscopic ultrasonography-guided necrosectomy in walled-off pancreatic necrosis
Authors: Günay Süleyman , Paköz Betül , Çekiç Cem , Çamyar Hakan , Alper Emrah , Yüksel Elif Saritaş , Topal Firdevs , Binicier Ömer Burcak
Published: January 2021

Hydrogen peroxide is a liquid that functions in mechanical removal of the necrotic tissue via the elimination of tissue debris.

In this study, we aimed to evaluate the effectiveness of the use of hydrogen peroxide in necrosectomy treatment of walled-off pancreatic necrosis.

Records of 24 patients who were diagnosed with pancreatic necrosis or walled-off pancreatic necrosis and underwent endoscopic necrosectomy (EN) were retrospectively assessed. Patients were divided into 2 groups; hydrogen peroxide used for treatment or not used, and these 2 groups were compared.

A total of 24 patients underwent endoscopic intervention for walled-off pancreatic necrosis. Procedural success was comparable between the 2 groups. During the post-procedural follow-up, the duration of the hospital stay, recurrence, and complication rates were found to be similar in both groups. The mean number of the endoscopic interventions was significantly lower in the hydrogen peroxide group (4.2 ± 1.4 vs 6.1 ± 4.2; P = .01).

The use of hydrogen peroxide for EN in walled-off pancreatic necrosis patients seems to have similar efficiency and safety. However, it can be said that the use of hydrogen peroxide could reduce the number of endoscopic procedures.
Low G0S2 gene expression levels in peripheral blood may be a genetic marker of acute myocardial infarction in patients with stable coronary atherosclerotic disease
Authors: Wang Xue , Meng Heyu , Ruan Jianjun , Chen Weiwei , Meng Fanbo
Published: January 2021

Background:

The G0/G1 switch 2 (G0S2) gene is closely related to lipolysis, cell proliferation, apoptosis, oxidative phosphorylation, and the development of a variety of tumors. The aim of the present study was to expand the sample size to confirm the relationship between the expression of the G0S2 gene in peripheral blood and acute myocardial infarction (AMI) based on previous gene chip results.

Methods:

Three hundred patients were initially selected, of which 133 were excluded in accordance with the exclusion criteria. Peripheral blood leukocytes were collected from 92 patients with AMI and 75 patients with stable coronary atherosclerotic disease (CAD). mRNA expression levels of G0S2 in peripheral blood leukocytes was measured by RT-PCR, and protein expression levels by Western blot analysis. The results of these assays in the 2 groups were compared.

Results:

mRNA expression levels of GOS2 in the peripheral blood leukocytes of patients with AMI were 0.41-fold lower than those of patients with stable CAD (P < .05), and GOS2 protein expression levels were 0.45-fold lower. Multivariate logistic regression analysis indicated that low expression levels of the G0S2 gene increased the risk of AMI by 2.08-fold in stable CAD patients.

Conclusions:

G0S2 gene expression in the peripheral blood leukocytes of AMI patients was lower than that of stable CAD patients. Low G0S2 gene expression in peripheral blood leukocytes is an independent risk factor for AMI in stable CAD patients.
Keratinized mucosa augmentation guided by double xenogeneic collagen matrix membranes around implants in the posterior mandible
Authors: Han Chunyu , Cai Qing , Li Baosheng , Li Yuyang , Liu Yanqun , Yu Haina , He Mengxiao , Meng Weiyan
Published: January 2021

Rationale:

Traditional free gingival graft (FGG) technique is usually used for patients with insufficient peri-implant keratinized mucosa. However, this technique often requires a second surgical area which increases the pain as well as the risk of infection in patients. Xenogeneic collagen matrix (XCM) membrane technique can obtain good results for keratinized mucosa increment.

Patient concerns:

The patient was a 66-year-old healthy female with loss of left mandibular first molar and second molar (FDI #36, #37) for 5 years. Two implants were placed submucosally for 3 months with no interference, while a stage II surgery was needed.

Diagnosis:

Probing depth measurements suggested that the mesial, medial, and distal widths of buccal keratinized mucosa within the edentulous area were 0.5, 0.5, and 1 mm, respectively, which were insufficient to maintain the health of peri-implant tissues.

Interventions:

Keratinized mucosa augmentation guided by XCM membranes was performed to increase the inadequate buccal keratinized mucosa.

Outcomes:

After 2 months of healing, the widths of mesial, medial, and distal buccal keratinized mucosa were 4, 3, and 3 mm, respectively, and the thickness of the augmented mucosa was 4 mm. Then a stage II surgery was followed. The patient was satisfied with the outcomes of keratinized mucosa augmentation.

Lessons:

Keratinized mucosa augmentation guided by double XCM membrane technique can be applied to cases with keratinized mucosa width within 2 mm around implants.
Comparative effectiveness of herb-partitioned moxibustion plus lifestyle modification treatment for patients with simple obesity
Authors: Wang Li-Hua , Lv Si-Ying , Liu Yi-Ran , Chen Xia , Wang Jia-Jie , Huang Wei , Zhou Zhong-Yu
Published: January 2021

Introduction:

Obesity is a global public health issue, which results in many health complications. Moxibustion may serve as an alternative management for simple obesity, where pharmacological therapy is always difficult to be accepted by the majority of obese patients based on its safety. However, the effects of herb-partitioned moxibustion as obesity intervention have not been confirmed. This study is designed as a single-blinded, 3-dummy randomized controlled trial to evaluate the efficacy and safety of herb-partitioned moxibustion plus lifestyle modification treatment in patients with simple obesity.

Methods and analysis:

This study will be a randomized, controlled trial conducted from April, 2019 to April, 2021 that includes 108 participants who have simple obesity and meet the eligibility criteria. The participants will be randomly divided into 3 treatment groups: heat application group, medicated plaster group, or herb-partitioned moxibustion group. Each treatment will last 4 weeks. The primary outcomes will be the clinical effectiveness. The secondary outcome measures include participants’ obesity-related indicators, the IWQOL-Lite scale, and the syndrome score of Traditional Chinese Medicine. Adverse events will be recorded during the intervention period.

Ethics and dissemination:

Ethical approval of this study was granted by the Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine on 15 November 2018 (Ethics Reference No: HBZY2018-C24-01). Written informed consents will be provided by all participants before they were enrolled in this study.

Trial registration number:

NCT04606680
Preventing nickel-titanium rotary instrument from breakage by continuous irrigation with different fluids during root canal preparation
Authors: Li Changjian , Liu Le , Li Yanfeng , Wang Xin , Liu Haiyun , Bao Jiaxin , Wang Jing , Fan Jiadong
Published: January 2021

To study the effect of continuous irrigation of rotating nickel-titanium instrument with several common clinical fluids on the diameter, breaking length and breaking position of nickel-titanium instrument, so as to provide some reference and theoretical basis for clinical operation and instrument improvement.

A standardized curved root canal model was established, and ProTaper Universal (PTU) F1 instrument was selected for root canal preparation. The nickel-titanium F1 instrument was flushed with distilled water, 0.9% NaCl, 0.2% chlorhexidine, 1% sodium hypochlorite and 5% sodium hypochlorite, and the diameter, length and position of the instrument before and after breakage were recorded.

Only 5% sodium hypochlorite influenced the diameter of 6 mm marker points under different irrigation conditions (P < .05). There was no statistical difference in the length of broken instruments among all the groups, and torsional deformation mainly occurred at the end of broken instruments. The broken positions of instruments in all the groups were located at the bending segment of the root canal. The breaking frequency of the 5% sodium hypochlorite group was the highest in the area 3–5.5 mm away from apical foramen, while the other 4 groups had the highest breaking frequency in the area 0 to 1.5 mm away from apical foramen.

External irrigation with different fluids did not influence the breaking length of instruments. The closer to the apical foramen was, the higher the breaking frequency of instruments was. However, only 5% sodium hypochlorite can affect the diameter of rotary nickel-titanium instruments, and may lead to early breakage of the instrument, indicating that the use of disinfectants, except 5% sodium hypochlorite, cannot reduce breakage resistance of nickel-titanium instrument compared with distilled water flushing. Furthermore, 5% hypochlorite could not be recommended for irrigation in clinical practice.
Effect of sigmoidectomy in treating sigmoid colon cancer
Authors: Hou Hua-ping , Gui Pu-guo
Published: January 2021

Background:

This study will assess the effect of sigmoidectomy in treating sigmoid colon cancer (SCC).

Methods:

This study will search the following databases from inception to the present: MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus, OpenGrey, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All electronic databases will be searched with no restrictions of language. Two researchers will independently handle all study selection, data extraction, and risk of bias, respectively. Any disparities between 2 researchers will be figured out by a third researcher through discussion. RevMan 5.3 software will be used for statistical analysis in this study.

Results:

This study will provide a high-quality synthesis of targeted outcomes to evaluate the efficacy and complications of sigmoidectomy in treating SCC.

Conclusion:

The results of this study will provide evidence to judge whether sigmoidectomy can benefit patients with SCC.

Study registration on OSF:

osf.io/dpxkg.
Evaluation on blood coagulation and C-reactive protein level among children with mycoplasma pneumoniae pneumonia by different chest imaging findings
Authors: Wang Juan , Mao Jianping , Chen Gang , Huang Yuanmei , Zhou Jinjin , Gao Changlong , Jin Danting , Zhang Chenying , Wen Juan , Sun Jun
Published: January 2021

Mycoplasma pneumoniae infection may induce a systemic hypercoagulable abnormality, like organ embolism and infarction. Indexes of blood coagulation and C-reactive protein (CRP) have been reported different between healthy people and mycoplasma pneumoniae pneumonia (MPP) patients, but this difference in MPP patients with different chest imaging findings has rarely been reported.

We performed a retrospective study of 101 children with MPP and 119 controls, combined with radiological examination and blood tests, to compare the blood coagulation and CRP level among MPP children with different chest imaging findings.

For the MPP children with different chest imaging findings, there were significant differences in CRP, fibrinogen (FIB) and D-dimer (D-D) levels among subgroups (P = .004, P = .008 and P < .001 respectively). The CRP level in group of interstitial pneumonia was significantly higher than that in groups of bronchopneumonia and hilar shadow thickening (P = .003 and P = .001 respectively). And the FIB and D-D values in group of lung consolidation were significantly higher than that in the other 3 groups (all P < .05). When compared with controls, the white blood cell, CRP, FIB, and D-D levels in MPP children were significantly higher, and the activated partial thromboplastin time and thrombin time levels were significantly lower (all P < .05).

Our results showed that CRP level changed most significantly in group of interstitial pneumonia, whereas FIB, D-D levels changed most significantly in the lung consolidation group.
Magnifying endoscopy in detecting early gastric cancer
Authors: Le Hao , Wang Lianjun , Zhang Lan , Chen Pengfei , Xu Bin , Peng Dengfa , Yang Ming , Tan Yong , Cai Changsong , Li Huqing , Zhao Qiu
Published: January 2021

Background:

Conventional white-light imaging endoscopy (C-WLI) had a significant number of misdiagnosis in early gastric cancer (EGC), and magnifying endoscopy (ME) combined with different optical imaging was more accurate in the diagnosis of EGC. This study aimed to evaluate the accuracy of ME and compare the accuracy of ME with different optical imaging in detecting EGC.

Methods:

A comprehensive literature search was conducted to identify all relevant studies. Pair-wise meta-analysis was conducted to evaluate the accuracy of ME, and Bayesian network meta-analysis was performed to combine direct and indirect evidence and estimate the relative effects.

Results:

Eight prospective studies were identified with a total of 5948 patients and 3 optical imaging in ME (ME with WLI (M-WLI), ME with narrow-band imaging (M-NBI), and ME with blue laser imaging (M-BLI)). Pair-wise meta-analysis showed a higher accuracy of ME than C-WLI (OR: 2.97, 95% CI: 1.68∼5.25). In network meta-analysis, both M-NBI and M-BLI were more accurate than M-WLI (OR: 2.56, 95% CI: 2.13∼3.13; OR: 3.13, 95% CI: 1.85∼5.71). There was no significant difference between M-NBI and M-BLI.

Conclusion:

ME was effective in improving the detecting rate of EGC, especially with NBI or BLI.
A randomized controlled trial protocol of the cardiovascular safety and efficacy of liraglutide in the treatment of type 2 diabetes
Authors: Liang Ying , Meng Hua , Li Ruiyu , Yang Jianbin , Jia Jingchao , Hou Yongli
Published: January 2021

Background:

Recently, many clinical experiments have evaluated the influences of liraglutide in the treatment of type 2 diabetes. However, the outcomes of these studies are inconsistent, and the number of high-quality prospective trials that conducted to assess the cardiovascular safety is limited. Hence, for this research, it was implemented for the assessment of the cardiovascular effectiveness and safety of liraglutide in type 2 diabetes patients.

Methods:

This research was a 26-week active controlled and randomized trial. Our research protocol follows the guidelines of Good Clinical Practice issued via the Helsinki Declaration and International Conference on Coordination. All the patients will receive the written informed consent in order to involve in our clinical experiment. The participants with type 2 diabetes aged from 18 years to 80 years, patients with 45.0 kg/m2 body-mass index or less, and with glycosylated hemoglobin of 7.5 to 10.0 percent, and received metformin (daily 1500 mg or more) for 3 months or longer were eligible. All the patients were randomized to 1 of 2 interventions (in the ratio of 1:1): liraglutide placebo once daily (blinded) and liraglutide once daily (blinded), respectively, both combined with the glimepiride and metformin (open-labeled). For the efficacy variable, the major endpoint was the baseline glycated hemoglobin change after treating for 26 weeks. The secondary end points involved: the percentage of participants who achieved the goals of postprandial blood glucose, fasting blood glucose, and glycosylated hemoglobin; the changes of mean postprandial blood glucose, fasting blood glucose, and the body weight, pancreatic B-cell function index, and changes in blood pressure and insulin resistance assessed by homeostasis model.

Conclusions:

For this research, the limitations involve the short trial period and the limitation of glimepiride in some countries, thus excluding the maximum doses of glimepiride.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6306).
Adjuvant targeted therapy combined with surgery for advanced and metastatic renal cell carcinoma
Authors: Jin Hongyu , Zhang Man , Jin Kun , Hu Chenggong
Published: January 2021

Background:

The aim of this systematic review and meta-analysis is to evaluate the efficacy and safety of adjuvant targeted therapy by sunitinib combined with surgery in the treatment of advanced or metastatic renal cell carcinoma.

Methods:

PubMed/Medline, Web of Science, Cochrane Library, ClinicalTrials.gov (http://www.ClinicalTrials.gov), China National Knowledge Infrastructure (CNKI) will be searched for clinical research articles related to the efficacy and safety of adjuvant therapy combined with surgery in the treatment of advanced and metastatic RCC. The identification, inclusion and exclusion flow charts will be conducted according to the PRISMA guidelines. The quality assessment will be done by Quadas-2 evaluation tool. Key parameters including OS in 10, 20, 30, and 40 months, PFS in 10, 20, and 30 months, objective response rate (ORR), stable disease (SD) rate, progressive disease (PD) rate, median OS and PFS, types of AEs and their occurrence rates, etc will be extracted. The evaluation of the efficacy and safety will be pooled by CMA.

Results:

This systematic review will provide evidence on the efficacy and safety of adjuvant therapy by sunitinib combined with surgery in treating advanced and metastatic RCC.

Conclusion:

The study aims to generalize data concerning the response rate, OS, PFS and rates of adverse effects of the perioperative use of sunitinib in advanced and metastatic RCC patients. The evidence provided by this systematic review and meta-analysis will help guide the clinical decision making and enlighten the future management of advanced or metastatic RCC.

Registration:

This protocol has been registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY registration number: INPLASY2020110093; INPLASY DOI number: 10.37766/inplasy2020.11.0093 Available at: https://inplasy.com).
The effects and acceptability of different exercise modes on glycemic control in type 2 diabetes mellitus
Authors: Shen Yuanlong , Yu Lina , Hua Zhen , Jia Ningxin , Zhou Yanan , Dong Xiaosheng , Ding Meng
Published: January 2021

Introduction:

Exercise has been believed to have positive effects on blood glucose control in patients with type 2 diabetes mellitus. However, few medical evidences have been found to ascertain which type of exercise has the best effect on blood glucose control in diabetes and which type of exercise is more acceptable. The purpose of this study is to compare the effects and acceptability of different exercise modes on glycemic control in type 2 diabetes patients by using systematic review and network meta-analysis.

Methods and analysis:

Relevant randomized controlled trial studies will be searched from PubMed, EMbase, CochraneCENTRAL, CNKI, VIP, and Chinese medical paper libraries. Primary outcome indicators: glycosylated hemoglobin and dropout rate of the research (number of dropouts/numbers of initially enrolled subjects). Secondary outcome measures: fasting blood glucose, body weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol, triglycerides (TG), diastolic pressure, systolic pressure (SBP). Two reviewers are arranged to screen Title, Abstract, and then review full text to further extract data. Standard meta-analysis and network meta-analysis of the data are performed afterward. Methodological quality assessment is planned to be conducted using Cochrane risk of bias tool. The outcome will be analyzed statistically according to Bayesian analysis methods. After that, subgroup analysis is conducted on the duration of intervention, whether there is supervision of intervention, frequency of intervention per week, age, gender, and medication use.

Trial registration number:

PROSPERO CRD42020175181

Discussion:

The systematic review and network meta-analysis include evidence of the impact of different exercise modes on blood glucose control in type 2 diabetes mellitus. There are 2 innovative points in this study. One is to conduct a classified study on exercise in as much detail as possible, and the other is to study the acceptability of different exercise modes. The network meta-analysis will reduce the uncertainty of intervention and enable clinicians, sports practitioners, and patients to choose more effective and suitable exercise methods.

Ethics and dissemination:

The findings of the study will be disseminated through publications in peer-reviewed journals and scientific conferences and symposia. Further, no ethical approval is required in this study.
The effectiveness of enteral nutrition for patients with primary liver cancer
Authors: Wang Li , Wang Xiaoyue , Wang Xuejun
Published: January 2021

Objective:

The objective of this study is to explore the influence of the enteral nutrition on primary liver cancer patients after receiving hepatectomy.

Method:

This is a prospective randomized controlled research, which will be conducted between April 2021 and April 2022. Approval is obtained from the Research Ethics Committee of Chun’ an County First People's Hospital (A20201108). Patients who meet the following conditions will be included in this experiment:

Patients with the following characteristics are excluded:

Our investigation includes sixty patients who meet our inclusion criteria. The primary endpoints are length of postoperative hospital stay and liver function index. The secondary results involve the first flatus time and the first defecation time.

Results:

Table 1 indicates the postoperative outcomes between treatment group and control group.

Conclusion:

Enteral nutrition can improve recovery in the primary liver cancer patients after receiving hepatectomy.

Trial registration:

The protocol has been registered in Research Registry (researchregistry6275)