bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Hypercholesterolemia and Neck Pain in a Cross-Sectional Population-Based Study
Authors: Ahorukomeye Peter , Mahajan Arushi , Du Jerry , Yu Charles C. , Bhandutia Amit K. , Ahn Nicholas U.
Published: September 2022

Study Design.

Retrospective cross-sectional analysis.

Summary of Background Data.

Degenerative changes are a major contributor to chronic neck pain. According to the vascular hypothesis of disc disease, atherosclerosis of the segmental arteries contributes to ischemia of the lumbar discs and resulting degenerative changes. Prior studies have demonstrated an association between atherosclerotic risk factors and lumbar degenerative disease. Similarly, atherosclerosis may contribute to cervical disc degeneration. Cardiovascular disease is associated with the development of atherosclerosis, particularly in small vessels to the cervical spine. Hypercholesterolemia is a major contributor to the morbidity associated with cardiovascular disease. This study aims to examine the relationship between hypercholesterolemia and neck pain.

Methods.

Analysis was focused on the respondents to neck pain items of the standardized questionnaire. Odds ratios were calculated, and logistic regression analyses adjusted for demographic, education, and mental health conditions.

Results.

There were 30,461 participants in the 2018 MEPS survey. Of those, 1,049 (3.4%) subjects responded to presence of a diagnosis of cervical disorders with neck pain. Mean age of respondents was 62.6±16.1. Overall prevalence of neck pain was 21.1%. Prevalence of neck pain was similar by age, sex, education level and occupation (P>0.05 for each). Neck pain was more prevalent in white race and lower total family income (P<0.05). Current everyday smokers also had higher prevalence of neck pain (P<0.05). Logistic regression analysis revealed a higher prevalence of neck pain in those with hypercholesterolemia after controlling for relevant covariates (aOR=1.54 [95% CI 1.08–2.22], P=0.018).

Conclusions.

Subjects with hypercholesterolemia were 54% more likely to have neck pain after controlling for confounders. This suggests that hypercholesterolemia has a role to play in degeneration of the cervical spine. Therefore, prevention and proper management of high cholesterol may curtail the development and progression of degenerative cervical disc disease and thus, neck pain.
First-line Immune Checkpoint Inhibitor Versus Immune Checkpoint Inhibitor With Chemotherapy for Cisplatin-ineligible Metastatic Urothelial Carcinoma: Evidence From a Real-world, Multicenter Analysis
Authors: Lin Chang-Ting , Su Po-Jung , Huang Shih-Yu , Wu Chia-Che , Wang Hung-Jen , Cheng Yuan-Tso , Luo Hao-Lun , Chen Chien-Hsu , Liu Ting-Ting , Huang Chun-Chieh , Su Yu-Li
Published: September 2022

Immune checkpoint inhibitors (ICIs) are widely used for first-line cisplatin-ineligible patients with metastatic urothelial carcinoma (mUC). However, whether to use ICIs as monotherapy or in combination with chemotherapy is still uncertain. We retrospectively analyzed cisplatin-ineligible patients with mUC who underwent first-line ICI monotherapy or ICI plus chemotherapy at 2 medical centers in Taiwan from 2016 to 2021. We calculated the objective response rate, progression-free survival, and overall survival (OS) using the Kaplan-Meier method and Cox regression model for multivariable analysis. In total, 130 patients were enrolled and categorized into 2 groups: an ICI monotherapy group [immunotherapy (IO), n=101] and an ICI plus noncisplatin chemotherapy group [immunotherapy and chemotherapy (IC), n=29]. The median OS of patients in the IO and IC groups was 19.5 and 9.7 months (P=0.33). Among patients with high programmed cell death ligand-1–expressing tumors, the median OS was significantly prolonged in the IO group compared with the IC group (not reached vs. 6.3 mo, P=0.02). First-line ICI monotherapy demonstrated robust antitumor activity in cisplatin-ineligible patients with mUC. Combining noncisplatin chemotherapy with ICI did not improve clinical outcomes.
IRREVERSIBLE RETINAL PIGMENT EPITHELIUM TOXICITY ASSOCIATED WITH FIBROBLAST GROWTH FACTOR RECEPTOR INHIBITOR THERAPY
Authors: Houghton Odette M.
Published: September 2022

Purpose:

Erdafitinib is a fibroblast growth factor receptor inhibitor indicated for the treatment of cancer. A case of fibroblast growth factor receptor inhibitor–associated retinopathy that resulted in significant visual symptoms and chronic subretinal abnormalities is reported.

Methods:

A 73-year-old man with a history of relapsed multiple myeloma was treated with erdafitinib. Soon after his fourth treatment cycle, he developed blurred vision in both eyes. Therapy with erdafitinib was subsequently discontinued.

Results:

Funduscopic examination and optical coherence tomography of both eyes revealed multifocal subretinal fluid in the macula of both eyes. Eleven weeks after cessation of the erdafitinib, the visual acuity improved but the patient reported bilateral annular scotomas. Evaluation was notable for resolution of the subretinal fluid with the development irregular subfoveal thickening in both eyes. The patient's symptoms improved, but the subfoveal abnormalities were persistent at 14 months follow-up.

Conclusion:

Erdafitinib may be associated with permanent retinal pigment epithelium toxicity.
Leaky Gut and Dermatological Conditions
Authors: Nickles Melissa A. , Velez Kathie , Maloh Jessica , Shakhbazova Anastasia , Singh Marvin , Sivamani Raja K.
Published: September 2022

BACKGROUND

Increased intestinal permeability, known as leaky gut syndrome, occurs when the intestinal lining of the gastrointestinal tract has been damaged. The influx of unwanted material in the bloodstream can induce an immune response releasing proinflammatory cytokines that have been thought to be correlated with dermatologic conditions.

OBJECTIVE

We aimed to evaluate the role of leaky gut in dermatological conditions.

Methods

PubMed and Embase were systematically searched through September 2020 for clinical studies that measured intestinal permeability in participants with a dermatological condition.

RESULTS

We identified 20 studies including participants with dermatitis herpetiformis, atopic dermatitis/eczema, systemic sclerosis, psoriasis, bullous pemphigoid, and pemphigus vulgaris/foliaceus. Atopic dermatitis was the most well studied. Studies utilized a range of measures of intestinal permeability, including sugar excretion tests and serum markers. For all disorders reviewed, except bullous pemphigoid and pemphigus vulgaris/foliaceus, there was evidence of increased intestinal permeability in the disease state compared with controls.

LIMITATIONS

The range of methodology across clinical studies makes it difficult to draw conclusions across results. In addition, studies tended to be small, and only one study included an intervention to target leaky gut syndrome.

CONCLUSIONS

We have found preliminary evidence of a relationship between leaky gut and certain dermatological conditions.
Allergic Contact Dermatitis After Prior Burn Injury
Authors: Holmes Maggie , Tabba Daim , Mockbee Chelsea S. , Brodell Robert T. , Nahar Vinayak K.
Published: September 2022

Localized pruritus and blistering is commonly caused by an allergic contact dermatitis. A patient with a thermal burn is presented who applied triple antibiotic cream leading to the development of this iatrogenic condition.
Alopecia Areata
Authors: Caro Sarah R.
Published: September 2022

OBJECTIVE

The purpose of this search was to review the literature on the subject of alopecia areata.

METHODS

This literary review utilized the library databases of Cumulative Index of Nursing and Allied Health Literature and PubMed as well as the medical research platform Ovid, exploring topics associated with the subject matter of alopecia areata examining issues associated with the autoimmune disorder including diagnosis, treatment, and the patient experience. This investigation examines the diagnosis and progression of the autoimmune disease including relevant and recent literature reflecting research outcomes from the specialties of dermatology, psychology, genetics, and nursing.

RESULTS

In summary, the outcome of the literature exploration reflects research from the specialties of dermatology, psychology, and medicine, revealing numerous difficulties patients diagnosed with alopecia areata experience.

CONCLUSION

The nursing profession pursues research to promote best practice and improve patient outcomes; however, nursing research falls short on the topic of alopecia areata. This autoimmune disorder causes a significant psychological impact on people living with the disease; therefore, individuals diagnosed with the condition experience the unique phenomenon of living without hair. The literature review indicates the need for further investigation of the essence of living with the daily reality of cyclic patterns of hair loss and the resulting health-illness transition from one stable state of health to another state of health.
Design of a Nursing Intervention Program to Prevent Adolescents' Perioperative Anxiety
Authors: Pestana-Santos Marcia , Pestana-Santos Adriana , Martins Inês Esteves , Santos Margarida Reis , Lomba Lurdes
Published: September 2022

Introduction

Adolescents undergoing surgery have expressed a willingness to obtain information about their surgery and to be involved in the decisions about their health care process. Around 80% of adolescents experience anxiety before undergoing surgery. On the basis of the adolescents' shared experiences, areas of possible nursing intervention have been identified to prevent anxiety and the multitude of adverse effects associated with it. The purpose of this study is to present a nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) designed based on the first phase of the complex intervention's framework.

Methods

The design of this program followed the updated guidance for developing complex interventions issued by the Medical Research Council and the National Institute for Health Research. Five Portuguese nurses, experts in perioperative nursing, and pediatric specialists evaluated and validated the final version of this program.

Results

The nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) consists of three phases that correspond to the preoperative, intraoperative, and postoperative periods. The first phase includes conducting a preoperative nursing consultation to identify stressors, providing written and verbal information about the surgery, and applying nonpharmacological interventions to reduce anxiety. In the intraoperative period, nonpharmacological interventions are implemented in the anesthetic induction room immediately before the adolescent falls asleep. Finally, the postoperative period comprises a nursing visit to identify postoperative complications and promote the adolescents' well-being.

Discussion

The program is structured with specific interventions to be implemented in each of the perioperative periods. Because of its flexibility, it may be fully or partially implemented considering the identified needs, priorities, and resources when caring for an adolescent with anxiety during the perioperative period.
A phase II, multicenter, open-label trial to evaluate the safety and efficacy of ISU303 (Agalsidase beta) in patients with Fabry disease
Authors: Hwang Soojin , Lee Beom Hee , Kim Woo-Shik , Kim Dae-Seong , Cheon Chong Kun , Lee Chang Hwa , Choi Yunha , Choi Jin-Ho , Kim Ja Hye , Yoo Han-Wook
Published: September 2022

Background:

Fabry disease (FD) is caused by a deficiency in the activity of the lysosomal enzyme, α-galactosidase A (α-Gal A), which leads to globotriaosylceramide (Gb3) deposition in multiple tissues. The current management of FD is enzyme replacement therapy (ERT). We report on the efficacy and safety of a new agalsidase beta, ISU303, in FD.

Methods:

Ten patients (7 males, 3 females) were enrolled and administered a 1 mg/kg dose of ISU303, every other week for 6 months. The primary endpoint was the normalization of plasma Gb3 level. The secondary endpoints were the changes from baseline in urine Gb3 and the plasma and urine lyso-globotriaosylsphingosine (lyso-Gb3) level. Echocardiography, renal function test, and pain-related quality of life were also assessed before and after administration. Safety evaluation was performed including vital signs, laboratory tests, electrocardiograms, antibody screening tests, and adverse events at each visit.

Results:

At 22 weeks of treatment, plasma and urine Gb3 level decreased by a mean of 4.01 ± 1.29 μg/mL (range 2.50–5.70) (P = .005) and 1.12 ± 1.98 μg/mg Cr. (range 0.04–5.65) (P = .017), respectively. However, no significant difference was observed in plasma and urine lyso-Gb3 levels. Echocardiography also was not changed. Renal function and pain-related quality of life showed improvements, but there was no clinical significance. No severe adverse events were observed. Only 1 patient developed an anti-drug antibody without neutralizing activity during the trial.

Conclusion:

This study showed the efficacy and safety of ISU303. Treatment with ISU303 significantly resulted in plasma and urine Gb3 decrease in patients with FD. These results suggest that ISU303 is safe and effective and can alternative ERT for FD.
Association between the LINC00673 rs11655237 C> T polymorphisms with cancer risk in the Chinese population: A meta-analysis
Authors: Zhang Hongyu , Wu Baixiu , Liang Ka , Ke Liuhua , Ma Xingxuan , Luo Changliu , He You
Published: September 2022

Objectives:

The present study aimed to conduct a meta-analysis of previously published studies in order to clarify the association of long noncoding RNA (lncRNAs) LINC00673 rs11655237 C> T polymorphism with cancer risk.

Design:

Systematic review and meta-analysis.

Setting:

Electronic databases of PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, and Wanfang Database were used to search relevant studies. Studies published up to October 20, 2019 were included. The included studies were assessed in the following genetic model: allelic model, homozygote model, Heterozygote model, dominant model, recessive model. Data syntheses were conducted using STATA 12.0.

Participants:

Participants with various types cancers were included.

Primary and secondary outcome measures:

Odds ratio (ORs) and 95% confidence interval (CIs) were calculated to assess the risk of tumor.

Results:

Seven articles including 7 case-control studies, 7423 cases and 11,049 controls were adopted for meta-analysis. Our result demonstrated that LINC00673 rs11655237 C> T was related to the cancer among all model including allelic model (T vs C: pooled OR = 1.24, 95% CI = 1.16–1.41, P < .001), homozygous model (TT vs CC: pooled OR=1.54, 95% CI = 1.36–1.76, P < .001), heterozygous model (CT vs CC: pooled OR=1.24, 95% CI = 1.16–1.32, P < .001), dominant model (CT + TT vs CC: pooled OR=1.28, 95% CI = 1.20–1.36, P < .001) and recessive model (TT vs CT+ CC: pooled OR=1.42, 95% CI = 1.25–1.61, P < .001). Subgroup analysis also demonstrated that polymorphisms at this site also increased the risk of neuroblastoma.

Conclusions:

Our results find that rs11655237 contributed to occurrence of cancer in all models in Chinese population.
Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis
Authors: Yang Shaohua , Hu Sheng , Gu Xiaohui , Zhang Xiaowen
Published: September 2022

Background:

To explore the risk factors of bile duct injury in laparoscopic cholecystectomy (LC) in China through meta-analysis.

Methods:

The study commenced with a search and selection of case–control studies on the risk factors for bile duct injury in LC in China using the following databases: PubMed, EMBASE, ScienceNet.cn, CNKI, Wanfang Data, and VIP. Data were extracted from the collected documents independently by 2 researchers, following which a meta-analysis of these data was performed using Revman 5.3.

Results:

The compilation of all data from a total of 19 case–control studies revealed that among 41,044 patients, 458 patients experienced bile duct injury in LC, accounting for the incidence rate of 1.12% for bile duct injury. The revealed risk factors for bile duct injury were age (≥40 years) (odds ratio [OR] = 6.23, 95% CI [95% confidence interval]: 3.42–11.33, P < .001), abnormal preoperative liver function (OR = 2.01, 95% CI: 1.50–2.70, P < .001), acute and subacute inflammation of gallbladder (OR = 8.35, 95% CI: 5.32–13.10, P < .001; OR = 4.26, 95% CI: 2.73–6.65, P < .001), thickening of gallbladder wall (≥4 mm) (OR = 3.18, 95% CI: 2.34–4.34, P < .001), cholecystolithiasis complicated with effusion (OR = 3.05, 95% CI: 1.39–6.71, P = .006), and the anatomic variations of the gallbladder triangle (OR = 11.82, 95% CI: 6.32–22.09, P < .001). However, the factors of gender and overweight (body mass index ≥ 25 kg/m2) were not significantly correlated with bile duct injury in LC.

Conclusions:

In the present study, age (≥40 years), abnormal preoperative liver function, gallbladder wall thickening, acute and subacute inflammation of the gallbladder, cholecystolithiasis complicated with effusion, and anatomic variations of the gallbladder triangle were found to be closely associated with bile duct injury in LC.
Association between proteinuria and the development of malignant middle cerebral artery infarction: A retrospective cohort study
Authors: Wu Meng-Ni , Fang Pen-Tzu , Yang I-Hsiao , Hsu Chung-Yao , Lai Chiou-Lian , Liou Li-Min
Published: September 2022

A disrupted blood-brain barrier (BBB) with extravasation of macromolecules plays a critical role in the development of malignant middle cerebral artery infarction (MMI). Proteinuria is considered a marker of generalized endothelial dysfunction, including BBB disruption. This study aimed to clarify whether proteinuria identified in the acute stage of stroke is associated with MMI development. Patients with infarctions involving the middle cerebral artery territory were reviewed. Urine samples collected within 8 hours after stroke were analyzed using urine dipsticks. Patients were divided into proteinuria (urine dipstick reading of 1 + to 4+) and nonproteinuria groups. MMI was present if either signs of uncal herniation or a progressive conscious disturbance were recorded along with a midline shift > 5 mm identified on follow-up computed tomography (CT). Among the 1261 patients identified between January 2010 and June 2019, 138 were eligible for final analyses. Patients in the MMI group had lower Alberta Stroke Program Early CT Scores (ASPECTS), higher National Institutes of Health Stroke Scale scores, and a greater proportion of proteinuria than those in the non-MMI group. Four multivariate logistic regression models were used to clarify the role of proteinuria in MMI development. In model 1, proteinuria was significantly associated with MMI after adjusting for age, sex, dyslipidemia and ASPECTS (OR = 2.987, 95% CI = 1.329–6.716, P = .0081). The risk of developing MMI in patients with proteinuria remained significant in model 2 (OR = 3.066, 95% CI = 1.349–6.968, P = .0075) after adjusting for estimated glomerular filtrate rate (eGFR) < 60ml/min/1.73 m2 in addition to variables in model 1. In model 3, proteinuria was still significantly associated with MMI after adjusting for age, sex, dyslipidemia, ASPECTS, hypertension, diabetes, and atrial fibrillation (OR = 2.521, 95% CI = 1.075–5.912, P = .0335). In model 4, the risk of developing MMI in patients with proteinuria remained significant (OR = 2.579, 95% CI = 1.094–6.079, P = .0304) after adjusting for eGFR < 60ml/min/1.73 m2 in addition to variables in model 3. Proteinuria is independently associated with MMI development. Proteinuria may be a clinically accessible predictor of MMI development.
Clinical outcomes of gastroduodenal neuroendocrine tumors according to their WHO grade: A single-institutional retrospective analysis
Authors: Ryu Dae Gon , Kim Su Jin , Choi Cheol Woong , Kang Dae Hwan , Kim Hyung Wook , Park Su Bum , Nam Hyeong Seok , Lee Si Hak , Hwang Sun Hwi
Published: September 2022

The management of gastroduodenal neuroendocrine tumor (NET) has been controversial between radical surgical resection and local excision including endoscopic resection. A gastroduodenal NET grade (G), measured by their mitotic rate and Ki67 proliferation index, is important to predict prognosis. In this study, we aimed to compare the clinical outcomes of gastroduodenal NET according to grades in order to identify poor prognostic factors of gastroduodenal NETs. Fifty-four gastroduodenal NETs diagnosed between December 2008 and December 2020 in a tertiary referral hospital were retrospectively reviewed. The clinical outcomes of gastroduodenal NETs, according to tumor grades and factors associated with NET G2-3, were analyzed. A total of 52 gastroduodenal NET patients was enrolled. The mean follow-up period was 56.2 ± 40.1 months. The mean size of gastric and duodenal NET was 7.9 ± 11.0 mm and 9.8 ± 7.6 mm, respectively. During the study period, 72.7% (16/22) of gastric NETs and 83.3% (25/30) of duodenal NETS were G1. All G1 gastroduodenal NETs showed no lymph node or distant metastasis during the study periods. All G3 gastroduodenal NETs showed metastasis (one lymph node metastasis and 3 hepatic metastases). Among metastatic NETs, the smallest tumor size was a 13 mm gastric G3 NET. Factors associated with G2-3 NETs were larger tumor size, mucosal ulceration, proper muscle or deeper invasion, and lymphovascular invasion. A small-sized gastroduodenal NET confined to submucosa without surface ulceration may be suitable for endoscopic resection. After local resection of a gastroduodenal NET (G1) without lymphovascular and muscle proper invasion, follow-up examination without radical surgical resection can be recommended. G3 NETs may be treated by radical surgical resection, regardless of tumor size.
Effect of real-time feedback on patient’s outcomes and survival after cardiac arrest: A systematic review and meta-analysis
Authors: Lv Guang Wei , Hu Qing Chang , Zhang Meng , Feng Shun Yi , Li Yong , Zhang Yi , Zhang Yuan Yuan , Wang Wen Jie
Published: September 2022

Purpose:

This study investigated the effect of real-time feedback on the restoration of spontaneous circulation, survival to hospital discharge, and favorable functional outcomes after hospital discharge.

Methods:

PubMed, ScienceDirect, and China National Knowledge Infrastructure databases were searched to screen the relevant studies up to June 2020. Fixed-effects or random-effects model were used to calculate the pooled estimates of relative ratios (RRs) with 95% confidence intervals (CIs).

Results:

Ten relevant articles on 4281 cardiac arrest cases were identified. The pooled analyses indicated that real-time feedback did not improve restoration of spontaneous circulation (RR: 1.13, 95% CI: 0.92–1.37, and P = .24; I
2 = 81%; P < .001), survival to hospital discharge (RR: 1.27, 95% CI: 0.90–1.79, and P = .18; I
2 = 74%; P < .001), and favorable neurological outcomes after hospital discharge (RR: 1.09, 95% CI: 0.87–1.38; P = .45; I
2 = 16%; P = .31). The predefined subgroup analysis showed that the sample size and arrest location may be the origin of heterogeneity. Begg’s and Egger’s tests showed no publication bias, and sensitivity analysis indicated that the results were stable.

Conclusion:

The meta-analysis had shown that the implementation of real-time audiovisual feedback was not associated with improved restoration of spontaneous circulation, increased survival, and favorable functional outcomes after hospital discharge.
The efficiency and safety of immune checkpoint inhibitors for advanced biliary tract cancers based on gene profiles: A retrospectively controlled study
Authors: Yao G.L. , Fan Y.G.
Published: September 2022

Immune checkpoint inhibitors are potential agents to improve the survival of advanced biliary tract cancers (ABTCs). The current results are controversial because the predictors are imprecise. We present our primary experience with ABTCs based on gene landscape with exciting outcomes. ABTCs who were admitted to The First Affiliated Hospital of Henan University of Science and Technology from October 2019 to March 2021 were enrolled. They were divided into chemotherapy group or immunotherapy group according to the treatment. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoints were response and toxicities. SSPS 16.0 was used for statistical analysis. A total of 33 patients were enrolled, including 25 in the chemotherapy group and 8 in the immunotherapy group. The median OS and PFS of the chemotherapy group were 2 and 4 months, respectively. The estimated median OS and PFS of immunotherapy were 10 + and 10 + months, respectively. The differences of OS and PFS between the 2 groups were significant (P = .000; P = .003). Stratified analysis showed that these differences were mainly from those patients with high expression of PD-L1 > 10%. The difference in the overall response was significant between 2 groups (χ2 = 9.275; P = .026). The difference in adverse events between the 2 groups was not significant. Immune checkpoint inhibitors were effective and safe for ABTCs with high expression of PD-L1. The threshold should be precise.
The quality of telepsychiatry in terms of accessibility, appropriateness, effectiveness, and safety among psychiatric patients in King Abdulaziz Medical City: An observational cross-sectional analytical study
Authors: Wafia Gada , Bahadur Ola , Thabet Salman , Alsalem Moayyad , Khan Muhammad Anwar , Alharbi Majed A. , Alsaleh Ahmad
Published: September 2022

There has been an increasing demand for psychiatric care in recent decades, and “telepsychiatry” was developed to meet these demands. It is a type of telemedicine in which they provide many medical services virtually, such as therapy, counseling, and medication management. Telepsychiatry has numerous advantages, including lower costs, reduced stigma, and improved continuity of care. To the best of our knowledge, no previous studies in the western region of Saudi Arabia addressed patients satisfaction with telepsychiatry. This cross-sectional study aims to assess patient satisfaction in telepsychiatry in terms of accessibility and timeliness, appropriateness, effectiveness, and safety, and to see whether patient satisfaction affects their decision to use the service again in the future. A cross-sectional study was conducted using a prestructured survey on the basis of the Client Satisfaction Questionnaire-18, which is a validated questionnaire used to assess patients’ satisfaction with the services provided to them. From January 2021 to July 2021, all male and female psychiatric patients over the age of 18 years who had psychiatric virtual appointments were included in this study. This study included 182 patients, of whom 106 were female. Patients were generally satisfied with the telepsychiatry services; 56.6%, 81.9%, 86.8%, and 91.2% of the participants were satisfied with the access and timeliness, appropriateness, effectiveness, and safety, respectively, and a total of 58.3% either strongly agree or agree of the overall satisfaction level. Depression and anxiety disorders were the most common psychiatric diseases. The statistical analysis revealed no significant relationships between patients’ satisfaction and demographic characteristics. Telepsychiatry has been evaluated to meet the growing demand for psychiatric care; it also has significant advantages. Patients had an overall positive satisfaction level toward telepsychiatry service, and so the results of this study support the continuity of using telepsychiatry in the future. Further research area could include a comparison between patients’ and providers’ satisfaction levels with telepsychiatry.
The utility of a genetic progression risk test for Barrett esophagus
Authors: Gong Dennis , Lunz Daniel , Stover James S. , Meltzer Stephen J.
Published: September 2022

This study sought to characterize the utility of a gene methylation-based biomarker test that has been validated to predict progression towards esophageal adenocarcinoma. Barrett esophagus (BE) is a precursor condition for esophageal adenocarcinoma (EAC) with somewhat variable approaches among gastroenterologists toward managing neoplastic progression risk. Capsulomics has developed a validated multigene DNA methylation-based biomarker assay performed on BE biopsies designed to address this variability by classifying BE patients into progression risk groups. In the current study, a survey was administered to practicing gastroenterologists in order to assess the potential impact of this assay on clinical practice. In this context, 89% (95% Cl: 85.4–92.6%) of surveyed physicians felt strongly that the multigene Barrett Esophagus test helped resolve uncertainties and optimize care of patients with BE by impacting their decisions on surveillance intervals and use of active treatments, such as ablation. The assay significantly impacted surveillance intervals for both high-risk (22.0 no assay vs 12.3 months with assay; P = 1.7E-8) and low-risk (7.9 no assay vs 11.4 months with assay, P = 8.8E-4) stratified case results. Finally, the assay also significantly impacted decisions to pursue active ablation treatments in both high-risk (5% recommending ablation without assay vs 42% with assay; P = 3.7E-11) and low-risk (42% recommending ablation without assay vs 29% with assay; P = .049) stratified case results. Results demonstrated a strong effect of the assay on clinical decision making, even in conjunction with established clinical guidelines.
Association between small dense LDL levels and hepatic fibrosis in patients with nonalcoholic fatty liver disease
Authors: Young Kim Sun , Mun Subin , Yu Jung Hwan , Jin Young-Joo , Ju Suh Young , Cho Sang-Heon , Lee Jin-Woo
Published: September 2022

While patients with nonalcoholic fatty liver disease (NAFLD) continue to increase worldwide, few hematological biomarkers are helpful. This study examined the potential of small dense low density lipoprotein (sdLDL) as a noninvasive biomarker for NAFLD and investigated the relevance of liver fibrosis. One hundred seventy two patients were enrolled: 121 NAFLD patients and 51 healthy controls. The lipoprotein profiles of NAFLD patients and controls were analyzed, and transient elastography (Fibroscan®) was performed to evaluate the degree of NAFLD. The liver biopsy results in some NAFLD patients were also analyzed. Age-gender matching was performed among the 172 patients, and a comparison with 46 NAFLD patients with the control group confirmed that the sdLDL (P < .001) is significantly higher in the NAFLD group. A liver fibrosis test performed on 121 NAFLD patients confirmed a positive correlation between the degree of hepatic fibrosis and the sdLDL/LDL ratio (R = 0.215, P = .017). The area under the curve of the sdLDL for the diagnosis of NAFLD was 0.734 (95% CI, 0.631–0.838), and the area under the curve of the sdLDL/LDL ratio was 0.730 (95% CI, 0.621–0.829). The sdLDL and NAFLD activity scores of the 11 NAFLD patients who underwent liver biopsy showed a positive correlation, but it was not statistically significant. The sdLDL was higher in NAFLD patients than in controls and showed a tendency to increase gradually with increasing degree of hepatic steatosis and fibrosis. In particular, the sdLDL/LDL ratio showed a significant correlation with the degree of hepatic fibrosis, and the sdLDL measurement could be useful in NAFLD patients.
Clinicopathological and prognostic significance of SOX9 expression in gastric cancer patients: A meta-analysis
Authors: Wang Qian , Chen Hao , Yang Congying , Liu Yi , Li Feng , Zhang Chunfang
Published: September 2022

Background:

SOX9 is a potential prognostic marker in gastric cancer (GC) patients. This meta-analysis aimed to highlight the clinicopathological and prognostic implications of SOX9 expression in GC patients.

Methods:

A systematic literature search was conducted to identify relevant studies by the electronic literature databases (PubMed, Web of Science, EMBASE and Chinese databases). Review Manager version 5.4 was employed to evaluate the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CIs).

Results:

Seventeen studies with a total of 2893 GC patients were enrolled in this meta-analysis. The analysis with ten articles clarified that higher expression of SOX9 was observed in GC cancers than that of normal gastric samples (OR = 16.26; 95% CI: 8.16 to 32.42; P < .00001). Consequently, the results also showed that SOX9 expression was closely associated with age (OR = 1.34; 95% CI: 1.04–1.72; P = .03), tumor size (OR = 0.67; 95% CI: 0.49–0.91; P = .01), histological differentiation (OR = 0.62; 95% CI: 0.36–1.06; P = .002), tumor stage (OR = 0.48; 95% CI: 0.20–1.12; P = .04), lymph node metastasis (OR = 0.36; 95% CI: 0.19–0.67; P = .0010) and advanced TNM stage (OR = 0.46; 95% CI: 0.30–0.70; P = .0003), but not significantly related to gender, distant metastasis and vascular invasion. Furthermore, high SOX9 expression could significantly indicate poorer overall survival (OS) (HR = 1.40; 95% CI: 1.14–1.72; P = .001).

Conclusion:

SOX9 overexpression might be related to poor prognosis and could serve as a potential predictive marker of poor clinicopathological prognosis factor in GC patients.
Using the alluvial plot to visualize the network characteristics of 100 top-cited articles on attention-deficit/hyperactivity disorder (ADHD) since 2011: Bibliometric analysis
Authors: Tsai Ya-Ching , Chien Tsair-Wei , Wu Jian-Wei , Lin Chien-Ho
Published: September 2022

Background:

Attention-deficit/hyperactivity disorder (ADHD) is a common neuro developmental disorder that affects children and adolescents. It is estimated that the prevalence of ADHD is 7.2% throughout the world. There have been a number of articles published in the literature related to ADHD. However, it remains unclear which countries, journals, subject categories, and articles have the greatest influence. The purpose of this study was to display influential entities in 100 top-cited ADHD-related articles (T100ADHD) on an alluvial plot and apply alluvial to better understand the network characteristics of T100ADHD across entities.

Methods:

Using the PubMed and Web of Science (WoS) databases, T100ADHD data since 2011 were downloaded. The dominant entities were compared using alluvial plots based on citation analysis. Based on medical subject headings (MeSH terms) and research areas extracted from PubMed and WoS, social network analysis (SNA) was performed to classify subject categories. To examine the difference in article citations among subject categories and the predictive power of MeSH terms on article citations in T100ADHD, one-way analysis of variance and regression analysis were used.

Results:

The top 3 countries (the United States, the United Kingdom, and the Netherlands) accounted for 75% of T100ADHD. The most citations per article were earned by Brazil (=415.33). The overall impact factor (IF = citations per 100) of the T100ADHD series is 188.24. The most cited article was written by Polanczyk et al from Brazil, with 772 citations since 2014. The majority of the articles were published and cited in Biol Psychiatry (13%; IF = 174.15). The SNA was used to categorize 6 subject areas. On the alluvial plots, T100ADHD’s network characteristics were successfully displayed. There was no difference in article citations among subject categories (F = 1.19, P = .320). The most frequently occurring MeSH terms were physiopathology, diagnosis, and epidemiology. A significant correlation was observed between MeSH terms and the number of article citations (F = 25.36; P < .001).

Conclusion:

Drawing the alluvial plot to display network characteristics in T100ADHD was a breakthrough. Article subject categories can be classified using MeSH terms to predict T100ADHD citations. Bibliometric analyses of 100 top-cited articles can be conducted in the future.
Satisfactory outcome with activated clotting time <160 seconds in extracorporeal cardiopulmonary resuscitation
Authors: Kim Beong Ki , Hong Jeong In , Hwang Jinwook , Shin Hong Ju
Published: September 2022

Patients undergoing cardiopulmonary resuscitation (CPR) prior to extracorporeal membrane oxygenation (ECMO) can have severely altered physiology, including that of the coagulation pathway. This could complicate the extracorporeal cardiopulmonary resuscitation (ECPR) management. We aimed to show that targeting an activated clotting time (ACT) < 160 seconds does not affect the complication rates in these patients. In this single-centered retrospective study, the medical records of 81 adult patients who were on ECMO support from March 2017 to March 2020 were reviewed. We compared the low ACT and conventional ACT groups, which were defined on the basis of the median of the ACT values of the included patients (160 seconds). The primary outcomes included bleeding or thromboembolic events. This study included 32 patients, who were divided into the low (n = 14) and conventional (n = 18) ACT groups. There were 2 cases of gastrointestinal bleeding (P = .183), one of intracranial hemorrhage (P = .437), and one of peripheral skin color change (P = .437) in the low ACT group. There was one case of prolonged bleeding at the cannulation site (P = 1.000) reported in the conventional ACT group. The successful weaning rate differed significantly between the low and conventional ACT groups (92.9% vs 50.0%; P = .019). Maintaining the ACT lower than the conventional ACT in patients requiring ECPR did not show a significant increase in the thromboembolic risk. Therefore, targeting a low ACT should be considered for this particular group of patients.
Relationship between hyperhidrosis and hypothalamic injury in patients with mild traumatic brain injury
Authors: Jang Sung Ho , Kwon Hyeok Gyu
Published: September 2022

Hyperhidrosis is clinical symptom of various diseases and is an important clinical feature of paroxysmal sympathetic hyperactivity (PSH). Traumatic brain injury (TBI) is known to be most common condition associated with PSH, and PSH has been mainly reported in moderate and severe TBI. However, very little has been reported on PSH or hyperhidrosis in mild TBI patients. In this study, we used diffusion tensor imaging (DTI) to investigate the relationship between hyperhidrosis and hypothalamic injury in patients with mild TBI. Seven patients with hyperhidrosis after mild TBI and 21 healthy control subjects were recruited for this study. The Hyperhidrosis Disease Severity Scale was used for evaluation of sweating at the time of DTI scanning. The fractional anisotropy and apparent diffusion coefficient DTI parameters were measured in the hypothalamus. In the patient group, the fractional anisotropy values for both sides of the hypothalamus were significantly lower than those of the control group (P < .05). By contrast, the apparent diffusion coefficient values for both sides of the hypothalamus were significantly higher in the patient group than in the control group (P < .05). In conclusion, we detected hypothalamic injuries in patients who showed hyperhidrosis after mild TBI. Based on the results, it appears that hyperhidrosis in patients with mild TBI is related to hypothalamic injury.
Effect of postmastectomy radiotherapy on pT1-2N1 breast cancer patients with different molecular subtypes: A real-world study based on the inverse probability of treatment weighting method
Authors: Ye Shangyue , Hu Weixian
Published: September 2022

To investigate the significance of postmastectomy radiotherapy (PMRT) for different molecular subtypes of female breast cancer T1-2N1M0 based on inverse probability of treatment weighting (IPTW). The data of breast cancer patients diagnosed between 2010 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database were extracted. According to the status of hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2), the patients were classified into luminal-A (HR+/HER2-), luminal-B (HR+/HER2+), HER2-enriched (HR-/HER2+), and TNBC (HR-/HER2-) subtypes. The association between radiation therapy and breast cancer-specific survival (BCSS) and Overall survival (OS) was retrospectively analyzed. Inverse probability of treatment weighting (IPTW) was applied to balance measurable confounders. Among the 16 894 patients, 6 055 (35.8%) were in the PMRT group and 10 839 (64.2%) were in the nonPMRT group, with a median follow-up of 48 months. There were 1003 deaths from breast cancer and 754 deaths from other causes. After IPTW, the covariates between groups reached complete equilibrium, the multifactorial Cox regression analysis showed that PMRT significantly prolonged OS and BCSS in Luminal-A and TNBC subtype breast cancer patients, yet it brought little significant survival advantage in Luminal-B and HER2-enriched subtype patients. Our study demonstrates a beneficial impact for PMRT on OS and BCSS among Luminal-A and TNBC subtype breast cancer patients with T1-2N1 disease.
Transcriptomic analysis reveals genetic factors regulating early steroid-induced osteonecrosis of the femoral head
Authors: Tian Cong , Shao Wenhui , Zhou Honghai
Published: September 2022

The present study aimed to explore the signaling pathways involved in development of early steroid-induced osteonecrosis of the femoral head (SONFH) and identify diagnostic biomarkers regulating peripheral blood in SONFH patients. We downloaded transcriptome data and identified differentially expressed genes (DEGs) using the R software. We used ClusterProfiler to perform enrichment analysis of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes, and analyzed protein–protein interactions using the STRING database. Network X was used to visualize the networks in Python. A total of 584 DEGs were identified, of which 294 and 290 were upregulated and downregulated, respectively. Enrichment analysis showed that the DEGs were mainly involved in red blood cell differentiation, cell protein catabolism, gas transportation, activation of myeloid leukocytes, phagocytosis, and inflammatory response. Pathway analysis revealed that these DEGs were involved in regulation of mitophagy-animal, human T-cell leukemia virus-1 infection, Forkhead box O, phagocytosis, osteoclast differentiation, and cytokine–cytokine receptor interaction. Quantitative real-time polymerase chain reaction results were consistent with findings from protein–protein interaction network analysis. Several genes, including peroxiredoxin 2, haptoglobin, matrix metallopeptidase 8, formyl peptide receptor 2, and integrin subunit alpha X, promote SONFH occurrence by regulating the redox, inflammatory response, and osteoblast and osteoclast structure and function pathways. They may be important targets for designing approaches for early diagnosis and treatment of SONFH.
Nodular fasciitis arising from the buccal region after segmentectomy with rapid growth mimicking postirradiation myxofibrosarcoma: A case report
Authors: Yoshizawa Kunio , Ishii Hiroki , Sakurai Daiju , Inoue Tomohiro , Ueki Koichiro
Published: September 2022

Rationale:

Nodular fasciitis (NF) can be misdiagnosed as a sarcoma because of its rapid growth and pathological features, such as nuclear atypia and mitoses.

Patient concerns:

We present a rare case of a 72-year-old Japanese man who developed NF with suspected postirradiation myxofibrosarcoma (MFS) after segmentectomy for left-sided osteoradionecrosis (ORN) of the mandible.

Diagnosis:

A mass appeared in the intraoral postoperative wound 1 year after left-sided mandibular segmentectomy and showed rapid growth, reaching a size of 50 mm within 2 months. Incisional biopsy revealed strongly Ki-67-positive spindle-shaped cells with large irregular nuclei and a diagnosis of postirradiation MFS.

Interventions:

The patient was diagnosed with oropharyngeal cancer (T4aN2bM0) and underwent surgical resection of primary oropharyngeal squamous cell carcinoma with selective neck dissection and reconstruction with a rectus abdominis musculocutaneous flap at the age of 57 years, followed by postoperative 66 Gy of radiotherapy combined with cisplatin administration. No recurrent or metastatic lesions of oropharyngeal squamous cell carcinoma have been detected for > 10 years. However, the ORN of the jaw worsened, and the patient underwent sequestrectomy 3 times on the right side of the mandible, followed by a left-sided segmentectomy at the age of 72 years. One year after segmentectomy, a 10-mm mass with soft-to-firm consistency appeared in the buccal mucosa of the wound and grew rapidly. An incisional biopsy revealed MFS. Complete resection under general anesthesia was immediately performed.

Outcomes:

The histopathological diagnosis of the excised specimen was NF without any malignant findings. Two years after surgery, there was no evidence of recurrence or metastasis.

Lessons:

NF grows rapidly and has pathological features similar to sarcoma, making differential diagnosis difficult at the time of incisional biopsy. Further studies should be conducted to determine the clinical and pathological features of this tumor.
Efficacy of decitabine combined with allogeneic hematopoietic stem cell transplantation in the treatment of recurrent and refractory acute myeloid leukemia (AML): A systematic review and meta-analysis
Authors: Zhang Donghui , Chen Jiahui
Published: September 2022

Background:

This analysis aimed to assess the effect of decitabine combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in treating recurrent and refractory acute myeloid leukemia.

Method:

The present analysis was carried out according to the principles of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline statement. Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang Data databases were searched for trials published from their corresponding inception to September 13, 2021. Retrospective research or published randomized controlled trials in Chinese or English were ruled out. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Mean differences with 95% confidence intervals were used to analyze continuous data. The I
2 test was used to determine heterogeneity, and the meta-analysis was conducted using Revman 5.4.

Results:

Eight studies including 795 participants in total were identified. Decitabine and allo-HSCT showed significant reductions in recurrence after transplantation (odds ratio [OR] = 0.29, 95% confidence interval [CI] (0.17, 0.50), P < .00001), leukemia-free survival (OR = 2.17, 95% CI (1.47, 3.21), P < .0001), graft related death (OR = 0.50, 95% CI (0.25, 0.98), P = .04), and significant improvements in complete remission (OR = 0.39, 95% CI = 0.23–0.68, P = .0007) and partial remission (OR = 0.46, 95%CI = 0.27–0.78, P = .004). The median follow-up time, acute graft-versus-host disease, and no remission had no significant difference between treatment and control groups (the median follow-up time: OR = −1.76, 95% CI (−6.28, 2.76), P = .45; acute graft-versus-host disease: OR = 0.72, 95% CI (0.50, 1.03), P = .08; no remission: OR = 3.19, 95%CI = 2.06–4.94, P = .05). Overall, the magnitude of the effect was found to be in the small to moderate range.

Conclusion:

Decitabine combined with allo-HSCT can obtain lower recurrence risk and longer disease-free survival time, and improve the prognosis of patients. The safety is relatively stable. Due to the varying quality level of the included studies, the validation of multiple high-quality studies still needs improvement.