bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey
Authors: Li Lin , Borland Ron , Cummings K Michael , Gravely Shannon , Quah Anne C K , Fong Geoffrey T , Miller Connor R , Goniewicz Maciej L , Le Grande Michael , McNeill Ann
Published: March 2021

Introduction

This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender, and age.

Methods

Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February–June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the United States. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); noncombustible tobacco (smokeless tobacco, and heated tobacco products [HTPs]); and non-tobacco nicotine products (nicotine vaping products [NVPs], nicotine replacement therapy [NRT], and nicotine pouches).

Results

Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and noncombustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco.

Conclusion

Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation.

Implications

The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and noncombustible nicotine-containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.
Efficacy and Tolerability of Calcitonin Gene–Related Peptide–Targeted Monoclonal Antibody Medications as Add-on Therapy to OnabotulinumtoxinA in Patients with Chronic Migraine
Authors: Cohen Fred , Armand Cynthia , Lipton Richard B , Vollbracht Sarah
Published: March 2021

Background

We examined the efficacy and tolerability of calcitonin gene–related peptide–targeted monoclonal antibodies (CGRP-targeted mAbs) as add-on therapy for patients with chronic migraine (CM) undergoing treatment with onabotulinumtoxinA (onabot) who require additional preventive therapy.

Methods

We reviewed medical records of patients with CM receiving treatment with onabot who were subsequently prescribed a CGRP-targeted mAb medication. The primary outcome was the change in number of monthly headache days (MHDs) reported. Secondary outcomes were change in headache pain severity, discontinuation due to lack of tolerability, and severe adverse events.

Results

Of 153 patients, 111 (72.5%) reported a decrease in either MHDs or headache pain severity, with documentation of MHDs in 66 patients. Among these 66 patients, the average number of MHDs before initiation of onabot treatment was 25.7. After onabot treatment, an average decrease of 10.9 MHDs was reported (P < 0.001). After the addition of a CGRP-targeted mAb medication, patients experienced a further decrease of 5.7 MHDs (P < 0.001). With combined therapy, patients reported a total decrease of 16.6 MHDs (P < 0.001). Adverse effects occurred in 13 patients (8.5%) after addition of the CGRP-targeted mAb and included constipation, injection site reaction, and fatigue. No serious adverse events were reported.

Conclusion

Adding a CGRP-targeted mAb to onabot in patients with CM was associated with further reductions in MHDs without major tolerability issues across a range of mAbs. This retrospective review supports the conduct of a well-designed double-blind study adding a CGRP-targeted mAb or placebo to onabot.
Real-life analysis of the causes of death in patients consecutively followed for giant cell arteritis in a French centre of expertise
Authors: Antonini Luca , Dumont Anael , Lavergne Amandine , Castan Paul , Barakat Clivia , Gallou Sophie , Sultan Audrey , Deshayes Samuel , Aouba Achille , de Boysson Hubert
Published: March 2021

Objectives

To describe, in a real-life setting, the direct causes of death in a cohort of consecutive patients with GCA.

Methods

We retrospectively analysed the deaths that occurred in a cohort of 470 consecutive GCA patients from a centre of expertise between January 2000 and December 2019. Among the 120 patients who died, we retrieved data from the medical files of 101 patients.

Results

Cardiovascular events were the dominant cause of death (n = 41, 41%) followed by infections (n = 22, 22%), geriatric situations (i.e. falls or senile deterioration; n = 17, 17%) and cancers (n = 15, 15%). Patients in each of these four groups were compared with the other deceased patients pooled together. Patients who died from cardiovascular events were more frequently male (46 vs 27%; P = 0.04) with a past history of coronary artery disease (29 vs 8%; P = 0.006). Patients who died from infections mostly had ongoing glucocorticoid treatment (82 vs 53%; P = 0.02) with higher cumulative doses (13 994 vs 9150 mg; P = 0.03). Patients who died from geriatric causes more frequently had osteoporosis (56 vs 17%; P = 0.0009) and had mostly discontinued glucocorticoid treatment (76 vs 33%; P = 0.001). The predictive factors of death in multivariate analysis were a history of coronary disease [hazard ratio (HR) 2.39; 95% CI 1.27, 4.21; P = 0.008], strokes at GCA diagnosis (HR 2.54; 95% CI 1.05, 5.24; P = 0.04), any infection during follow-up (HR 1.93; 95% CI 1.24, 2.98; P = 0.004) and fever at GCA diagnosis (HR 1.99; 95% CI 1.16, 3.28; P = 0.01).

Conclusion

Our study provides real-life insight on the cause-specific mortality in GCA patients.
Differences in intestinal microbiota profiling after upper and lower gastrointestinal surgery
Authors: Lin Xi-Hsuan , Yang Ueng-Cheng , Luo Jiing-Chyuan , Chang Tien-En , Lin Hung-Hsin , Huang Chi-Wei , Chiou Jen-Jie , Fang Wen-Liang , Huang Kuo-Hung , Huang Yi-Hsiang , Hou Ming-Chih , Lee Fa-Yauh
Published: March 2021

Background:

We aimed to investigate the long-term effects of metabolic profiles and microbiota status in patients after upper gastrointestinal (GI) surgery and lower GI surgery and compared them with a control group.

Methods:

In this cross-sectional study, we analyzed the occurrence of metabolic syndrome (MS) in 10 patients who underwent curative total gastrectomy with Roux-en-Y esophagojejunostomy (RYEJ) anastomosis, 11 patients who underwent curative partial colectomy with right hemicolectomy (RH), and 33 age- and sex-matched controls. Fecal samples were also analyzed by a next-generation sequencing method.

Results:

Compared with the control group, the occurrence of MS was significantly lower among patients who underwent total gastrectomy with RYEJ than the controls over the long-term follow-up (>8 years; p < 0.05). Patients who received RH only had a trend of higher serum fasting glucose (p = 0.10). The diversity of the gut microbiota significantly decreased after RH in comparison with the control group and RYEJ group, respectively (p < 0.05). Principal component analysis revealed significant differences between the control, RYEJ, and RH groups (p < 0.001). At the genus level, the ratio of Prevotella to Bacteroides (P/B) was significantly higher in the RYEJ group than in the control group, whereas the P/B ratio was significantly lower in the RH group than in the control group (p < 0.05).

Conclusion:

Early gastric cancer patients who received total gastrectomy with RYEJ had a lower occurrence of MS than the controls, while early colorectal cancer patients who received RH were associated with a higher serum fasting glucose than the controls during long-term follow-up. In parallel with the metabolic differences, the P/B ratio was also significantly altered in patients after upper and lower GI surgery.
Predicting Schwannoma Growth in a Tumor Model Using Targeted Imaging
Authors: Morrison Daniel R. , Sorace Anna G. , Hamilton Ellis , Moore Lindsay S. , Houson Hailey A. , Udayakumar Neha , Ovaitt Alyssa , Warram Jason M. , Walsh Erika M.
Published: March 2021

Introduction:

Vestibular schwannoma (VS) is a common pathology encountered in neurotology clinics. Many patients are observed with a “wait and scan” approach. Previous efforts to determine radiographic indicators of future growth have been unsuccessful. Using a mouse subcutaneous tumor model, we seek to determine if fluorescent imaging with directed immunotargets could be used to predict schwannoma growth rate.

Methods:

Anti-VEGFR2 and anti-Her2/Neu monoclonal antibodies were covalently linked to a near-infrared probe (IRDye800). Immunodeficient mice underwent subcutaneous injections with a rat-derived schwann (R3) cell line. When tumor growth was evident, either Anti-VEGFR2-IRDye800, anti-Her2/Neu-IRDye800, or Immunoglobulin G (IgG) Isotype-IRDye800 (control) were injected via tail vein. The mice were serially imaged in a closed field near-IR device. Fluorescent data were analyzed for tumor signal and correlated with tumor sie and growth rate. Heterogeneity of fluorescent tumor signal was also assessed.

Results:

In both anti-VEGFR2 and anti-Her2/Neu groups, there were strong correlations between day 1 mean tumor fluorescence and eventual maximum tumor volume (p = 0.002, 0.001; r
2 = 0.92, 0.86). There was also strong correlation with maximum tumor signal on day 1 and maximum tumor volume (p = 0.003, 0.008; r
2 = 0.90, 0.91). There was no such correlation in the control group (p = 0.99, 0.75; r
2 = 0.0002, 0.028).

Conclusion:

Given the potential morbidity in VS intervention, observation is an appropriate approach for patients with slow-growing or stagnant tumors. We seek to identify immunotargets in a murine model that show promise in predicting schwannoma growth with advanced imaging techniques. Both Her2/Neu and VEGFR2 correlated strongly wth tumor size and growth rates and are promising targets that merit further investigation.
Delirium caused by topical administration of cyclopentolate for cataract surgery in mild cognitive impairment due to Alzheimer's disease
Authors: Shin Yu Yong , Lee Jin San , Park Key-Chung , Rhee Hak Young
Published: March 2021

Rationales:

Cholinergic modification by anticholinergic medication can produce adverse effects in central nervous system (CNS) and cyclopentolate is an antimuscarinic agent widely used for ophthalmologic management. We demonstrate a rare case of hyperactive delirium caused by topical administration of cyclopentolate in a patient with amnestic mild cognitive impairment (MCI) due to Alzheimer's disease (AD).

Patient concerns:

A 74-year-old man showed acute confusion after preparation for cataract operation in day surgery clinic. The patient became confused and agitated after instillation of topical cyclopentolate drop into the eye and the symptoms persisted over several hours.

Diagnosis:

Previously the patient had been diagnosed with amnestic MCI with the finding of bilateral medial temporal atrophy on brain magnetic resonance imaging. 18F-flutemetamol positron emission tomography scan demonstrated multifocal amyloid deposition in the brain.

Interventions:

The patient was closely observed with the supportive management.

Outcomes:

The patient began to recover 5 h after the onset of symptoms and the cognitive function was reverted to previous state within 24 h.

Lessons:

It is well known that several drugs with anticholinergic effects used in perioperative periods make the patients susceptible to delirium, but even the topical administration of cyclopentolate for cataract surgery also produce adverse CNS effects in a vulnerable patient who is diagnosed with MCI due to AD in this case.
The impact of COVID-19 on sexual behaviors of young women and men
Authors: Zhang Qi , Lu Hua , Li Fangyuan , Li Xinyun , Wang Tong , Yang Qian , Mi Ling
Published: March 2021

Background:

The worldwide impact of COVID-19 has reached all spheres of human health. Individuals may also experience unique changes in their sexual behaviors during the COVID-19 self-isolation/social distancing period. Studies in many countries have assess the effects of the pandemic on sexual behavior, or quality of sexual life. However, no systematic review has comprehensively explored the association between COVID-19 and the sexual behaviors of young women and men to date. This systematic review and meta-analysis protocol aims to ascertain the association between COVID-19 and sexual behaviors of young women and men that may get targeted interventions to improve health and well-being of young people's sexual health.

Methods:

This systematic review and meta-analysis will be reported following the PRISMA guidelines. Observational designs (including cross-sectional, case-control, and cohort) will be eligible. Studies eligible for inclusion must contain participants aged 15 to 45 in any country affected by the pandemic of COVID-19. The search will be conducted in the following databases, including PubMed, Cochrane Library, EMBASE, EBSCO, Ovid, WHO COVID-19 database, China National Knowledge Internet (CNKI), WanFang Data, Chinese Scientific and Technological Journal Database (VIP), and Chinese Biomedical Databases (CBM). A pre-designed search strategy of medical subject heading (MeSH) terms and free words for the concepts “COVID-19” and “sexual behaviors” will be used. Two authors will independently complete literature screening, data extraction, and risk of bias assessment. Disagreements will be resolved by consensus with a third reviewer. The reviewer will follow the PECOS steps (population, exposure, comparator, outcomes, and study design) to obtain eligible extraction items. The risk of bias and quality of included studies will be assessed using RevMan 5.3. We will assess heterogeneity according to the I
2 statistics. If there is substantial heterogeneity in the included trials, subgroup analysis will be carried out to seek the potential causes.

Ethics and dissemination:

It is not necessary to obtain ethical approval as we will use data from published articles. The findings of this systematic review will be published in a peer- reviewed journal.

PROSPERO registration number:

PROSPERO 2020: CRD42020190867.
Self-perception of theoretical knowledges and practical skills by primary health care physicians in life-threatening emergencies according to their gender
Authors: Cernuda Martínez José Antonio , Castro Delgado Rafael , Arcos González Pedro
Published: March 2021

To assess the training received in Emergency Medicine (EM) by the Primary Health Care physicians of Asturias, as well as their perception of their own theoretical knowledge and practical skills in a series of procedures employed in life-threatening emergencies, and also to analyze the differences according to gender. The degree of preparation of Primary Health Care physicians for handling emergencies, according to the gender of the professionals, has never been studied before.

Cross-sectional study of a sample of 213 Primary Health Care physicians from the Primary Health Care Service of Asturias, Spain, from among the total of 851 physicians on the staff of the Primary Health Care Service of Asturias. The survey was design ad hoc using the Body of Doctrine of Emergency Medicine proposed by the Spanish Society of Emergency Medicine, which indicates the theoretical and practical procedures that must be mastered by the Primary Health Care physicians.

There are nonsignificant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied depending on the gender.

Female and male Asturian Primary Health Care physicians are generally well prepared to handle life-threatening emergencies. The degree of self-perception and acquisition of general theoretical knowledge and general practical skills for handling life-threatening emergencies is heterogeneous, and differences according to gender are not statistically significant.
A comparison of the effects of Chinese non-pharmaceutical therapies for pain control in knee osteoarthritis
Authors: Shi Xiaowei , Yu Wenjing , Wang Dongfeng , Zhao Ying , Deng Xiaofeng , Chen Chen , Shi Shufeng
Published: March 2021

Background:

Knee osteoarthritis (KOA) is a chronic degenerative joint disease, leading to pain and functional limitation in the elderly. The non-pharmaceutical therapy is recommended firstly by different guidelines for KOA management strategies. In China, there are various forms of non-pharmaceutical treatments for KOA, which are considered beneficial in relieving KOA pain. However, there is no consensus on which is the optimal non-pharmaceutical regimens. Thus, present network meta-analysis aims to assess the comparative efficacy of available Chinese non-pharmaceutical therapies, especially in pain management.

Methods:

PubMed, EMBASE, Cochrane library, Web of Science, China national knowledge infrastructure, VIP, Wan Fang will be systematically searched their inception to April 2020. Randomized controlled trials that compared the effect of non-pharmaceutical therapies on pain control in KOA will be included, including traditional acupuncture, electroacupuncture, warming needle, fired needle, acupuncture followed by moxibustion, moxibustion and massage. The primary outcome was the knee pain levels, and secondary outcome was the comprehensive indicators. Risk of bias assessment of the included studies will be performed according to the Cochrane risk of bias tool. The pairwise and network meta-analysis will be performed by STATA 14.0 and GeMTC softwares.

Results:

This study is ongoing and will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study will provide a comprehensive evidence on the effects of Chinese non-pharmaceutical therapies for pain control in KOA.

PROSPERO registration number:

CRD42018106575
Herbal medicine for behavioral and psychological symptoms of dementia
Authors: Kwon Chan-Young , Lee Boram , Ha Da-Jung
Published: March 2021

Background:

Dementia is becoming a major public health problem worldwide with the aging of the world's population. Behavioral and psychological symptoms of dementia (BPSD), associated symptoms of dementia, not only predicts the poor prognosis of patients with dementia, but is also a major factor causing the care burden on caregivers, especially informal caregivers. For BPSD management, an alternative to existing psychotropic drugs is needed, given the benefit-harm ratio. Therefore, in this systematic review, we will evaluate the effectiveness and safety of herbal medicine for BPSD.

Methods and analysis:

Thirteen electronic databases will be comprehensively searched. Clinical studies reporting the efficacy (or effectiveness) and safety of herbal medicines in BSPD management published from their inception to December 2020 will be included. The primary outcome will be BPSD symptoms assessed by the validated tool. Moreover, total effective rate, daily living activities and quality of life of patients, burden and quality of life of caregiver, placement in a long-term care facility from home, and safety data will be regarded as the secondary outcome. Two independent researchers will perform the study selection, data extraction, and quality assessment process. To assess the methodological quality of the included studies, validated tools according to its design, such as the Cochrane Collaboration's risk of bias tool will be used. To perform meta-analysis, RevMan version 5.3 will be used, with mean differences for continuous outcomes and risk ratio for binary outcomes, and 95% confidence intervals. According to the heterogeneity and number of included studies, a fixed- or random-effects model will be used,

Registration number:

OSF (URL: https://osf.io/3u8ch), PROSPERO (CRD42020211000) (URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020211000).
Postpartum ovarian vein thrombophlebitis presenting as vaginal bleeding
Authors: Chiang Tsai-Lien , Chang Chuan-Yaw , Ong Jiann Ruey
Published: March 2021

Rationale:

Postpartum ovarian vein thrombophlebitis (POVT) is a rare condition, and it can lead to severe complications and mortality. Here we report a patient who presented with vaginal bleeding and the diagnosis of POVT was confirmed by imaging.

Patient concerns:

A 38-year-old postpartum woman without remarkable medical history presented with vaginal bleeding and lower abdominal pain.

Diagnoses:

The diagnosis was confirmed by computed tomography scan marked by a thrombus mass involving the right ovarian vein and inferior vena cava.

Interventions:

The patient was treated with intravenous antibiotics and low-molecular-weight heparin.

Outcomes:

The patient recovered smoothly without complications.

Lessons:

We should pay high attention to the recognition and management of POVT to prevent morbidity and mortality.
Effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on renal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease
Authors: Yu Baisong , Dong ChunXia , Hu ZhiJuan , Liu Bing
Published: March 2021

Background:

Many studies have shown the effects of SGLT2 inhibitors on type 2 diabetes, but the effects in patients with type 2 diabetes with chronic kidney disease remains unclear. This study aims to evaluate the effects of SGLT2 inhibitors on renal outcomes in patients with type 2 diabetes mellitus with chronic kidney disease.

Methods:

We conducted systematic searches of PubMed, Embase, and Cochrane Central Register of Controlled Trials up to April 30, 2020 and included randomized controlled trials of SGLT2 inhibitors in adult type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) reporting estimated glomerular filtration rate (eGFR) and/or urine albumin/creatinine ratio (UACR) changes and/or acute kidney injury or failure (AKI). Random effects models were adopted to measure the pooled outcomes.

Results:

Nine studies with 8826 participants were included. SGLT2 inhibitors were not associated with a significant change in eGFR (mean difference (MD), −0.75 ml/minutes per 1.73 m2, 95% CI −1.61 to 0.10, P = .09) in type 2 diabetic patients with CKD. UACR reduction after SGLT2 inhibitors was significant in type 2 diabetic patients with CKD (MD −24.27 mg/g, 95% CI −44.46 to −4.09, P = .02). SGLT2 inhibitors associated with AKI in the patients were significant (OR 0.80, 95% CI [0.66 to 0.98], P = .03).

Conclusion:

SGLT2 inhibitors had no significant effect on kidney function (eGFR measured) in the pooled analysis. And SGLT2 inhibitors effectively reduced UACR in T2DM with CKD. Besides, SGLT2 inhibitors could reduce the incidence of AKI.
What are the mechanisms of action of anti-inflammatory agents in adipose tissue?
Authors: Nascimento Sara Sayonara da Cruz , de Queiroz Jaluza Luana Carvalho , de Medeiros Amanda Fernandes , de França Nunes Ana Clara , Piuvezam Grasiela , Maciel Bruna Leal Lima , Passos Thaís Souza , de Araújo Morais Ana Heloneida
Published: March 2021

Background:

Obesity is a disease characterized by the abnormal accumulation of adipose tissue in the body, triggering a chronic subclinical state of inflammation. Bioactive compounds, given their anti-inflammatory properties, are a safe and promising alternative in controlling the inflammatory condition of obesity. This study describes a systematic review protocol aiming to analyze the anti-inflammatory molecules mechanisms and compounds action on adipocytes.

Methods:

Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) will outline the protocol and PRISMA to the systematic review. The databases used for research will be PubMed, Science Direct, Scopus, Web of Science, BVS, and EMBASE. Experimental studies performed on rats and mice with a control group that describes treatment with anti-inflammatory agents (drugs, nutraceuticals, bio active compounds, among others) at any frequency, time, and dose will be included. Three independent reviewers will select studies and extract data. The evaluation of the methodological quality of each research will be performed using the SYRCLE tool. If at least 2 studies show clinical and/or methodological and/or statistical homogeneity, a meta-analysis will be performed, using the RevMan Analyzes statistical package in Review Manager v.5.3.

Results:

In this study, we hope to find a considerable number of articles presenting mechanisms involved in the action of anti-inflammatory molecules and compounds on adipocytes.

Conclusion:

The systematic review produced from this protocol will present evidence on the mechanisms involved in the action of anti-inflammatory molecules and compounds in adipocytes. It will also contribute to developing new research and new insights about anti-inflammatory therapies with a future application view.

Record of systematic review:

This review was registered with the International Register of Prospective Systematic Reviews on May 18, 2020 (registration: CRD42020182897). Available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182897.
Immediate effect of non-invasive auricular acupoint stimulation on the performance and meridian activities of archery athletes
Authors: Tsai Yi-Hsun , Wu Szu-Ying , Hu Wen-Long , Lai Yun-Ru , Tsao Yu , Yen Ke-Tien , Lin Cheng-Hsien , Kuo Chun-En Aurea
Published: March 2021

Background:

Archery has existed in human history for millenniums. Being a unique exercise and precision sport, the keys to performance are emotional control, attention, and concentration rather than explosive force, muscle power, and endurance. During the execution of archery, attention is the key to performance in elite players, especially in the initial period while drawing the bow. Auricular acupoint stimulation is one of the therapeutic methods of traditional Chinese medicine and has been reported for its use in amplifying the anesthesia effect, weight reduction, cessation of substance abuse, and autonomic nervous modulation.

Methods:

The study will recruit archery players in school teams among junior and senior high schools and colleges. The subjects will be randomly assigned to the ear and sham acupressure groups. This is a randomized controlled trial with crossover design. The outcome measures will be obtained, including the meridian activities and balance index with Ryodoraku device, the movement stability with WIMU tracking system, the continuous heart rate record, and the scores of the 2 sections as the performance. The subjects will rate their attention and fatigue levels through self-reported questionnaires.

Objectives:

This study aims to investigate the immediate effect of non-invasive auricular acupoint stimulation on the performance and meridian activities of archery athletes.

Trial registration:

ClinicalTrials.gov Identifier: NCT04637607.
Sclerosing encapsulating peritonitis presenting with paroxysmal abdominal pain and strangulated mechanical bowel obstruction
Authors: Tang Hua , Xia Rong , Xu Shuyu , Tao Chenzhe , Wang Chao
Published: March 2021

Rationale:

Sclerosing encapsulated peritonitis (SEP) is a rare chronic peritoneal inflammation with unknown etiology, and is also known as abdominal cocoon. This occurs when the intestinal annulus is enveloped in the peritoneal cavity, resulting in intestinal obstruction. Its preoperative diagnosis and treatment strategy remains a challenge.

Patient concerns:

The study reports a 53-year-old male, who presented with a 4-day history of paroxysmal abdominal pain, without the adverse reaction of nausea, vomiting, or diarrhea.

Diagnosis:

The accurate diagnosis of SEP was made after the emergency diagnostic laparoscopy.

Interventions:

The laparoscopic exploration revealed that the small intestine was wrapped by a layer of peritoneum. Then, the abdominal fibrous membrane was removed surgically, and adhesiolysis were performed. The patient recovered well, and gradually recovered by the 10th post-operative day.

Outcomes:

The patient was discharged uneventfully after 10 days, and the patient recovered well. After the 12-month follow-up, no symptoms of recurrence or complications were observed.

Lessons:

The preoperative diagnosis of SEP remains difficult, and the onset of SEP has exhibited a younger trend. The diagnosis of SEP should remain on the list of differential diagnosis for paroxysmal abdominal pain. single-photon emission computed tomography/computed tomography and laparoscopic exploration have been proven to be helpful for establishing the diagnosis. In the early stage of intestinal obstruction caused by SEP, surgical intervention was immediately carried out in emergency department, and the patient recovered well after the operation. The present study also presents a review of the literature for other cases of SEP. The external evidence was helpful in making clinical decisions for patient care.
Predictors of severe sepsis-related in-hospital mortality based on a multicenter cohort study
Authors: Hagiwara Akiyoshi , Tanaka Noriko , Inaba Yosuke , Gando Satoshi , Shiraishi Atsushi , Saitoh Daizoh , Otomo Yasuhiro , Ikeda Hiroto , Ogura Hiroshi , Kushimoto Shigeki , Kotani Joji , Sakamoto Yuichiro , Shiino Yasukazu , Shiraishi Shin-ichiro , Takuma Kiyotsugu , Tarui Takehiko , Tsuruta Ryosuke , Nakada Taka-aki , Hifumi Toru , Yamakawa Kazuma , Takeyama Naoshi , Yamashita Norio , Abe Toshikazu , Ueyama Masashi , Okamoto Kohji , Sasaki Junichi , Masuno Tomohiko , Mayumi Toshihiko , Fujishima Seitaro , Umemura Yutaka , Fujimi Satoshi
Published: March 2021

This study aimed to identify prognostic factors for severe sepsis-related in-hospital mortality using the structural equation model (SEM) analysis with statistical causality. Sepsis data from the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma study (FORECAST), a multicenter cohort study, was used. Forty seven observed variables from the database were used to construct 4 latent variables. SEM analysis was performed on these latent variables to analyze the statistical causality among these data. This study evaluated whether the variables had an effect on in-hospital mortality. Overall, 1148 patients were enrolled. The SEM analysis showed that the 72-hour physical condition was the strongest latent variable affecting mortality, followed by physical condition before treatment. Furthermore, the 72-hour physical condition and the physical condition before treatment strongly influenced the Sequential Organ Failure Assessment (SOFA) score with path coefficients of 0.954 and 0.845, respectively. The SOFA score was the strongest variable that affected mortality after the onset of severe sepsis. The score remains the most robust prognostic factor and can facilitate appropriate policy development on care.
Smell disorders in COVID-19 patients: role of olfactory training
Authors: Zhang Yu , Mei Tao , Chen Ying , Wang Lina , Jiang Lulian , Liu Ke , Zhao Liping , Luo Ziyu , Chi Wenxin , Zhu Xiangyu
Published: March 2021

Background:

As the coronavirus disease 2019 (COVID-19) spread around the world, a surge of evidence suggests that smell disorders are common symptoms in COVID-19 infection. This dysfunction may cause loss of appetite, malnutrition, poisoning, and depression. Obviously, the impairment has a strong impact on the quality of life. Therefore, there is an urgent need to identify effective treatments. Various therapies have been studied to treat smell disorders after infection, and olfactory training (OT) is considered a promising treatment option. Assessing the effectiveness and safety of olfactory training for COVID-19 patients with smell disorders is the main purpose of this systematic review protocol.

Methods:

PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, ClinicalTrials.gov trials registry, and Chinese Clinical Trial Registry will be searched from January 2019 to January 2021. A combination of subject words and free text words will be applied in the searches. The language is limited to Chinese and English. The complete process will include study selection, data extraction, risk of bias assessment, and meta-analyses. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by Review Manager V.5.3 (Cochrane Collaboration) or Stata V.16.0 software.

Results:

This proposed study will assess the effectiveness and safety of OT for COVID-19 patients with smell disorders.

Conclusion:

The conclusion of this study will provide evidence to prove the effectiveness and safety of olfactory training for COVID-19 patients with smell disorders.

Ethics and dissemination:

This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval.

Registration:

PEROSPERO CRD42020218009.
Group-based constraint-induced movement therapy in the rehabilitation of chronic poststroke patients
Authors: Galvão Fábio R.O. , Silvestre Maria C.A. , Gomes Camila L.A. , Pereira Nayara K.F. , Nóbrega Viviane T.B. , Lima Wellington S. , Gondim Afonson L.M. , Cacho Enio W.A. , Cacho Roberta O.
Published: March 2021

Background:

This study aimed to describe the effects of a 90-minute group-based constraint-induced movement therapy protocol (CIMT) on upper extremity (UE) rehabilitation in poststroke patients.

Method:

The study was a case series clinical study with 6 patients with chronic stroke admitted to the institutional integrated clinic. Ten 90-minute CIMT sessions were administered, based on the principles of the original therapy. On completion of the protocol, participants underwent group care once a week, for 1 hour a day. For comparison purposes, the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Canadian Occupational Performance Measure (COPM) were applied on admission, shortly after completing the protocol, and 3 months after completion. In addition, the MAL and shaping tasks were applied daily.

Results:

There was a statistically significant difference only in the MAL Amount of Use Scale applied daily between the 2nd (3.56) and 9th (3.31) and 2nd and 10th days (4.49) (P = .004), with a moderate effect size (d’ = 0.46), and in the average value of shaping repetitions between the 1st (16.10) and 2nd (6.00) and 1st and 10th tasks (7.00) (P = .014), with a moderate effect size (d’ = 0.35).

Conclusion:

The 90-minute CIMT protocol resulted in significant improvements in use of the more affected arm in activities of daily living during the 2-week protocol. Additional research with a larger sample and a control group is needed to confirm its effectiveness.
Music intervention on physiological and psychological responses of patients with cancer
Authors: Li Nan , Liu Dan , Zhang Lei , Zhao Linshan , Guo Fan , Zang Aimin
Published: March 2021

Background:

Cancer is a life-threatening condition and also one of the biggest challenges facing human health and the medical community. This meta-analysis was to investigate the effects of music intervention on physiological and psychological responses of patients with cancer.

Methods and analysis:

The following electronic databases will be searched from inception to December 2020: PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, Chinese Science and the Wanfang Database. We only included music intervention vs placebo in cancer patients and pooled results were summarized by STATA 12.0 software. Two investigators independently selected the studies according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of the selected studies. The existence of statistical heterogeneity would be evaluated by Chi2 test and its extension by the I
2 test (I
2 > 50% indicates high heterogeneity among studies). Publication bias was ruled out by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias).

Results:

The study results will be published in relevant peer-reviewed journals and key findings will be presented at international scientific meetings.

Conclusion:

Our study aims to systematically assess the effects of music intervention in cancer patients, which will be provide clinical guidance for cancer patients.
Early prediction model for progression and prognosis of severe patients with coronavirus disease 2019
Authors: Liu Li , Dong Lei , Zhang Benping , Chen Xi , Song Xiaoqing , Li Shengzhong , Wei Wang
Published: March 2021

Coronavirus disease 2019 (COVID-19) has been a rampant worldwide health threat and we aimed to develop a model for early prediction of disease progression.

This retrospective study included 124 adult inpatients with COVID-19 who presented with severe illness at admission and had a definite outcome (recovered or progressed to critical illness) during February 2020. Eighty-four patients were used as training cohort and 40 patients as validation cohort. Logistic regression analysis and receiver operating characteristic curve (ROC) analysis were used to develop and evaluate the prognostic prediction model.

In the training cohort, the mean age was 63.4 ± 1.5 years, and male patients (48, 57%) were predominant. Forty-three (52%) recovered, and 41 (49%) progressed to critical. Decreased lymphocyte count (LC, odds ratio [OR] = 4.40, P = .026), elevated lactate dehydrogenase levels (LDH, OR = 4.24, P = .030), and high-sensitivity C-reactive protein (hsCRP, OR = 1.01, P = .025) at admission were independently associated with higher odds of deteriorated outcome. Accordingly, we developed a predictive model for disease progression based on the levels of the 3 risk factors (LC, LDH, and hsCRP) with a satisfactory performance in ROC analysis (area under the ROC curve [AUC] = 0.88, P < .001) and the best cut-off value was 0.526 with the sensitivity and specificity of 75.0% and 90.7%, respectively. Then, the model was internally validated by leave-one-out cross-validation with value of AUC 0.85 (P < .001) and externally validated in another validation cohort (26 recovered patients and 14 progressed patients) with AUC 0.84 (P < .001).

We identified 3 clinical indicators of risk of progression and developed a severe COVID-19 prognostic prediction model, allowing early identification and intervention of high-risk patients being critically illness.
Right atrial isomerism diagnosed by STIC-HD live flow and autopsy
Authors: Yang Linhua , Zhou Liuying , Chen Lin
Published: March 2021

Rationale:

Right atrial isomerism (RAI) is one of the most severe forms of congenital heart disease. This case of RAI was so complex that it incorporated 7 heart defects. It can be challenging to display the spatial relationship between different anatomical structures using conventional two-dimensional and color ultrasound (2D-Doppler imaging); therefore, we used spatio-temporal image correlation (STIC) and high definition live flow imaging technology to vividly display this case of RAI in a stereoscopic mode.

Patient concerns:

A 24-year-old woman was referred to our tertiary center at 24 weeks of gestation. The woman had difficult conceiving. Once pregnant, she was opposed to abortion, even if there was a possibility of deformity.

Diagnosis:

The fetus presented with an atrioventricular septal defect, persistent left superior vena cava, supra-cardiac total anomalous pulmonary venous connection (TAPVC), double outlet right ventricle, right ductus arteriosus, right aortic arch (RAA) with mirror image branching, and aortic arch dysplasia.

Interventions:

After consulting a pediatric cardiologist, the woman requested an abortion and consented to an autopsy.

Outcomes:

Autopsy supported the echocardiographic findings.

Lessons:

Accurate diagnosis of RAI is essential for clinical and parent decision making. 2D-Doppler imaging combined with STIC-HD live flow can be used to visualize the spatial morphology of blood vessels, including the cardiac chambers and great vessels of the fetal heart, and smaller peripheral vessels.
Albuminuria, proteinuria, and dipsticks: novel relationships and utility in risk prediction
Authors: Harrison Tyrone G. , Elliott Meghan J. , Ronksley Paul E.
Published: March 2021

Purpose of review

Albuminuria is associated with progression of kidney disease and is the accepted gold standard for screening, staging, and prognostication of chronic kidney disease. This review focuses on current literature that has explored applications of albuminuria as a surrogate outcome, variable used in kidney failure risk prediction for novel populations, and variable that may be predicted by other proteinuria measures.

Recent findings

Change in albuminuria shows promise as a surrogate outcome for kidney failure, which may have major implications for trial design and conduct. The kidney failure risk equation (KFRE) has been validated extensively to date and has now been applied to pediatric patients with kidney disease, advanced age, different causes of kidney disease, various countries, and those with prior kidney transplants. As albumin-to-creatinine ratios (ACRs) are not always available to clinicians and researchers, two recent studies have independently developed equations to estimate ACR from other proteinuria measures.

The utility of albuminuria and the KFRE continues to grow in novel populations. With the ability to convert more widely available (and inexpensive) proteinuria measures to ACR estimates, the prospect of incorporating kidney failure risk prediction into routine care within economically challenged healthcare jurisdictions may finally be realized.
Is Busulfan Clearance Different in Patients With Sickle Cell Disease? Let’s Clear Up That Case With Some Controls
Authors: Remy Amandine , Théorêt Yves , Ansari Marc , Bittencourt Henrique , Ducruet Thierry , Nava Tiago , Pastore Yves , Rezgui Mohamed A. , Krajinovic Maja , Kleiber Niina
Published: March 2021

In busulfan-based conditioning regimen for hematopoietic stem cell transplantation in children, accurate a priori determination of the first dose is important because of its narrow therapeutic window. Sickle cell disease (SCD) influences pharmacokinetics of the commonly used drugs by affecting organs responsible for drug metabolism and elimination. This pharmacokinetics study assesses the influence of SCD on the metabolic pathway of busulfan that is mainly metabolized in the liver. In this retrospective cross-sectional case-control study, 16 patients with SCD were matched to 50 patients without SCD on known busulfan clearance’s covariates (glutathione-S-transferase alpha1 polymorphisms, age, weight). Clearance of the first dose of busulfan was not significantly different independently of genetic or anthropometric factors in patients with or without SCD.
Hemostatic Management in an Infant With Neuroblastoma and Severe Hemophilia B With Extended Half-life Recombinant Factor IX Fusion Protein
Authors: Cuntz Franziska , Deubzer Hedwig E. , Schulte Johannes H. , Nimtz-Talaska Antje , Eggert Angelika , Holzhauer Susanne
Published: March 2021

In the rare co-occurrence of childhood cancer and severe hemophilia, hemostatic management is of paramount therapeutic importance. We present the case of an 11-month-old boy with severe congenital hemophilia B, who was diagnosed with metastatic high-risk neuroblastoma. He consequently developed paraneoplastic coagulopathy with life-threatening tumor hemorrhage and intracranial hemorrhage, showing central nervous system relapse. Management consisted of factor IX replacement with extended half-life factor IX fusion protein, adjusted to bleeding risk. Additional interventions included factor XIII, fibrinogen, fresh frozen plasma, tranexamic acid, and platelet transfusions. The half-life of factor IX products was markedly reduced requiring close factor IX monitoring and adequate replacement. This intensified treatment allowed chemotherapy, autologous stem cell transplantation, and GD2 antibody immune therapy without bleeding or thrombosis.
Hypoglycemia Due to Acquired Carnitine Deficiency in a Pediatric Patient Receiving Chemotherapy
Authors: Vasta Lauren M. , Reynolds Sarah M. , Sami Seppideh , Schacht John P. , Emerick Jill E. , Parekh Dina S. , Vogt Karen S.
Published: March 2021

We describe a 21-month-old male with relapsed clear cell sarcoma of the kidney receiving enteral nutrition who experienced recurrent, ketotic hypoglycemia. During relapse therapy, he had recurrent hypoglycemia episodes, in the setting of hematochezia and diarrhea. Evaluation revealed low carnitine levels. He received supplementation with oral levocarnitine throughout the remainder of treatment, resulting in normalization of serum carnitine levels and no further hypoglycemia. We believe adverse effects of the chemotherapy on his single kidney and gastrointestinal insult resulted in hypoglycemia and carnitine deficiency. Our case highlights that carnitine deficiency should be considered when acute onset hypoglycemia without obvious cause occurs.
Secondary Leukemia in a Patient With EBV-HLH Carrying Heterozygous STXBP2 Variant
Authors: Liao Meiling , Yu Jie
Published: March 2021

Hemophagocytic lymphohistiocytosis (HLH) is a symptom with severe systemic hyperinflammation. A 26-month-old male presented with Epstein-Barr virus associated HLH with a heterozygous variant of syntaxin-binding protein-2 (STXBP2). Complete remission was achieved with the HLH-2004 protocol, but the disease soon relapsed. Four weeks after re-installing HLH-2004 protocol, HLH was resolved. The cumulative dosage of etoposide was 2100 mg/m2. He developed acute promyelocytic leukemia 17 months later. The patient underwent standard chemotherapy and since remained in complete remission. In conclusion, a regular screening of malignance might be in necessity for the patients harboring gene variants associated with familial HLH.