bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperbole in Early Modern Missionary Travel Accounts of China
Authors: Teo Emily
Published: October 2022

For much of the early modern period, Europeans identified China as a land of opulence and abundance. This image was later dismissed as an unfaithful representation, wilfully created by missionaries who overstated the positive qualities of China, and understated its negative attributes. This chapter explores the beginnings of overstatement and exaggeration in the earliest Iberian missionary accounts of China. As travel publications flooded the sixteenth-century print market, new literary conventions emerged, privileging eyewitness observations over hearsay. Negotiating the porous categories of fact and fiction, missionaries sought to convince audiences of their reliability while creating impressive accounts. This chapter demonstrates that hyperbole, more than mere exaggeration, was creatively and strategically used by the missionaries not to deceive, but to highlight to their audiences the promise and potential of China. By insisting that the reality of China exceeded the limits of the textual medium, the missionaries liberally created an image of an abundant land. As their texts gained popularity and underwent translations, redactions and reprints, the reception and repetitions of these hyperboles could not always be shaped and controlled as the missionaries had intended. The missionaries’ hyperbolic China was further amplified and veered precariously between the boundaries of information and disinformation.
Deep Learning for Multi-Tissue Segmentation and Fully Automatic Personalized Biomechanical Models from BACPAC Clinical Lumbar Spine MRI
Authors: Hess Madeline , Allaire Brett , Gao Kenneth T , Tibrewala Radhika , Inamdar Gaurav , Bharadwaj Upasana , Chin Cynthia , Pedoia Valentina , Bouxsein Mary , Anderson Dennis , Majumdar Sharmila
Published: October 2022

Study Design

In vivo retrospective study of fully automatic quantitative imaging feature extraction from clinically acquired lumbar spine magnetic resonance imaging (MRI).

Objective

To demonstrate the feasibility of substituting automatic for human-demarcated segmentation of major anatomic structures in clinical lumbar spine MRI to generate quantitative image-based features and biomechanical models.

Setting

Previous studies have demonstrated the viability of automatic segmentation applied to medical images; however, the feasibility of these networks to segment clinically acquired images has not yet been demonstrated, as they largely rely on specialized sequences or strict quality of imaging data to achieve good performance.

Methods

Convolutional neural networks were trained to demarcate vertebral bodies, intervertebral disc, and paraspinous muscles from sagittal and axial T1-weighted MRIs. Intervertebral disc height, muscle cross-sectional area, and subject-specific musculoskeletal models of tissue loading in the lumbar spine were then computed from these segmentations and compared against those computed from human-demarcated masks.

Results

Segmentation masks, as well as the morphological metrics and biomechanical models computed from those masks, were highly similar between human- and computer-generated methods. Segmentations were similar, with Dice similarity coefficients of 0.77 or greater across networks, and morphological metrics and biomechanical models were similar, with Pearson R correlation coefficients of 0.69 or greater when significant.

Conclusions

This study demonstrates the feasibility of substituting computer-generated for human-generated segmentations of major anatomic structures in lumbar spine MRI to compute quantitative image-based morphological metrics and subject-specific musculoskeletal models of tissue loading quickly, efficiently, and at scale without interrupting routine clinical care.
IQ, Expectations, and Choice
Authors: D’Acunto Francesco , Hoang Daniel , Paloviita Maritta , Weber Michael
Published: October 2022

We use administrative and survey-based micro data to study the relationship between cognitive abilities (IQ), the formation of inflation expectations, and the consumption plans of a representative male population. High-IQ men display 50 $\%$ lower forecast errors for inflation than other men. High-IQ men, but not others, have consistent inflation expectations and perceptions over time. In terms of choice, only high-IQ men increase their consumption propensity when expecting higher inflation as the consumer Euler equation prescribes. Education levels, income, other expectations, and socio-economic status, although important, do not explain the variation in expectations and choice by IQ. Recent modelling attempts to incorporate boundedly rational agents into macro models do not fully capture all the facts we document. We discuss which dimensions of expectations formation and choice are important for heterogeneous-agents models of household consumption and for the transmission of fiscal and monetary policy.
Diagnosing and treating ANCA-associated vasculitis: an updated review for clinical practice
Authors: Chevet Baptiste , Cornec Divi , Casal Moura Marta , Cornec-Le Gall Emilie , Fervenza Fernando C , Warrington Kenneth J , Specks Ulrich , Berti Alvise
Published: October 2022

ANCA-associated vasculitides (AAV) are a group of rare, primary, systemic necrotizing small-vessel vasculitides. Granulomatosis with polyangiitis and microscopic polyangiitis account for ∼80–90% of all AAV. Exposure to silica dust, farming and chronic nasal Staphylococcus aureus carriage are associated with increased risk of developing AAV. When a diagnosis of AAV is suspected, as in patients with multisystem organ dysfunction or those with features such as chronic recurrent rhinosinusitis, cavitated lung nodules, palpable purpura or acute kidney injury, then appropriate further investigations are needed, including ANCA testing. In this scenario, a structured clinical assessment should be conducted, evaluating all the organs possibly involved, and tissue biopsy may be necessary for confirmation of the diagnosis. Therapeutic algorithms vary based on the severity of AAV, the clinical diagnosis/ANCA specificity, and the patient’s age, weight, comorbidities and prognosis. Recent data favour rituximab as a preferable option for both induction and maintenance of remission. In addition, regimens with less glucocorticoids are equally effective and safer in inducing remission compared with conventional regimens, and avacopan is an effective glucocorticoid-sparing option. In contrast, there is not compelling evidence to support the routine use of plasma exchange in addition to standard remission-induction therapy in AAV. ANCA and other biomarkers can be helpful in association with clinical assessment to guide diagnosis and treatment decisions. Patients should be frequently evaluated during follow-up for possible disease relapses or treatment-related morbidity, and for monitoring damage accrual, especially metabolic and cardiovascular damage.
A legitimacy approach to social innovation initiatives at universities
Authors: Donati Letizia , Wigren-Kristoferson Caroline
Published: October 2022

A striving for research excellence and the implementation of third mission activities in the form of technology transfer have become standard practices at modern higher education institutions. The recent call for universities to include social innovation in their third mission and the apparent lack of involvement of universities in this area indicate that social innovation is not yet perceived as a legitimate activity by the academic community. We examine why this is the case and disentangle the legitimation journey of social innovation in research-intensive environments.
Descriptions of Hearing Loss Severity Differentially Influence Parental Concern about the Impact of Childhood Hearing Loss
Authors: Sapp Caitlin , McCreery Ryan , Holte Lenore , Oleson Jacob , Walker Elizabeth
Published: October 2022

Purpose:

The purpose of this study was to measure how parent concern about childhood hearing loss varies under different description conditions: classification-based, audibility-based, and simulation-based descriptions.

Method:

We randomly allocated study participants (n = 143) to complete an online survey about expected child difficulties with listening situations with hearing loss. Our participants were parents of children with typical hearing in the 0- to 12-month age range. Participants were exposed to one type of description (classification-based, audibility-based, or simulation-based) and one level of hearing loss (slight, mild, and moderate or their audibility and simulation equivalents), producing nine total groups. Participants rated the level of expected difficulty their child would experience performing age-appropriate listening tasks with the given hearing loss. They also selected what they perceived as the most appropriate intervention from a list of increasingly intense options.

Results:

Our findings revealed that audibility-based descriptions elicited significantly higher levels of parent concerns about hearing loss than classification-based strategies, but that simulation-based descriptions elicited the highest levels of concern. Those assigned to simulation-based and audibility-based groups also judged relatively more intense intervention options as appropriate compared to those assigned to classification-based groups.

Conclusions:

This study expands our knowledge base about descriptive factors that impact levels of parent concern about hearing loss after diagnosis. This has potentially cascading effects on later intervention actions such as fitting hearing technology. It also provides a foundation for developing and testing clinical applications of audibility-based counseling strategies.
Accuracy of intraocular lens calculations in eyes with keratoconus
Authors: Vandevenne Magali M.S. , Webers Valentijn S.C. , Segers Maartje H.M. , Berendschot Tos T.J.M. , Zadok David , Dickman Mor M. , Nuijts Rudy M.M.A. , Abulafia Adi
Published: October 2022

Purpose:

To compare the prediction accuracy of the Barrett True-K for keratoconus with standard formulas (SRK/T, Barrett Universal II, and Kane) and the Kane keratoconus formula.

Setting:

Shaare Zedek Medical Center, Jerusalem, Israel, and University Eye Clinic, Maastricht, the Netherlands.

Design:

Multicenter retrospective case series.

Methods:

Eyes with stable keratoconus undergoing cataract surgery were included. The predicted refractions were calculated for SRK/T, Barrett Universal II, Barrett True-K for keratoconus (predicted and measured), Kane, and Kane adjusted for keratoconus formulas. Primary outcomes were prediction error (PE), absolute error (AE), and percentage of eyes with PE ±0.25 diopters (D), ±0.50 D, and ±1.00 D. Subgroup analyses were performed based on the severity of the keratoconus.

Results:

57 eyes were included in the study. The PE was not significantly different from zero for SRK/T, Barrett True-K (predicted and measured), and Kane keratoconus formulas (range 0.09 to 0.22 D, P > .05). The AE of Barrett True-K predicted (median 0.14 D) and Barrett True-K measured (median 0.10 D) were significantly lower from Barrett Universal II (median 0.47 D) and Kane (median 0.50 D), P < .001.

Conclusions:

The Barrett True-K formulas for keratoconus had higher prediction accuracy as compared with new generation formulas and a similar prediction accuracy as compared with the Kane keratoconus formula.
Meta-analytical evidence of functional and structural abnormalities associated with pain processing in migraine patients: An activation likelihood estimation
Authors: Al Qawasmeh Majdi , Ahmed Yaman B. , Al-Bzour Ayah N. , Al-Majali Ghayda’a N. , Alzghoul Saja M. , Al-Khalili Anas A. , Ibrahim Ruaa B. , Hamza Ammar I. , Al-Mannai Ramaz S. , Refaie Haneen , Alhayek Kefah , Kofahi Raed , Leffler Alexandra , El Salem Khalid
Published: October 2022

Background:

Migraine is a primary headache disorder that causes debilitating throbbing pain. Several functional MRI (fMRI) and voxel-based morphometry (VBM) studies have been used to investigate the structural and functional alteration in migraine. Here, we aim to study the converged brain regions of functional and structural abnormalities in gray matter volume (GMV) associated with pain processing and management in migraineurs and healthy controls (HC).

Methods:

A systematic search through PubMed and Sleuth was carried out for peer-reviewed functional and structural neuroimaging studies on migraine patients and HC yielded a total of 1136 studies. We performed an activation likelihood estimation (ALE) meta-analysis on VBM and pain stimulation task-based fMRI studies to investigate the converged areas of GMV and functional abnormalities between migraineurs and HC. We performed two subgroup analyses between migraine with aura (MwA) and migraine without aura (MwoA) relative to HC, and between chronic migraine (CM) and episodic migraine (EM) compared to HC.

Results:

The total sample included 16 fMRI and 22 VBM studies, consisting of 1295 migraine patients, compared to 995 HC. In fMRI analysis, ALE maps for pain stimulation tasks revealed hyperactivation in migraineurs in the substantia nigra compared to HC, whereas hypoactivation was seen in the cerebellum. For the VBM analysis, ALE clusters of increased GMV in migraineurs were observed in the parahippocampus and putamen nucleus. Whereas clusters of reduced GMV in migraineurs were seen in the frontal gyri. Compared to HC, MwoA patients showed a GMV reduction in the insula, and anterior cingulate, whereas MwA patients showed GMV reduction in the cerebellum, cingulate gyrus, and insula. CM patients showed decreased GMV in the precentral gyrus, whereas EM patients showed decreased GMV in the parahippocampus, and inferior frontal gyrus when compared to HC.

Conclusions:

Our findings represent a potential biomarker for the diagnosis and management of migraine, by showing clustered brain regions of abnormal patterns of activation and GMV changes between migraineurs and HC which might be associated with hyposensitivity to pain in migraineurs. Further studies are required to determine disease progression or therapeutic interventions’ effect on migraine.
Occurrence of patient safety incidents during cancer screening: A cross-sectional investigation of the general public
Authors: Mahmudah Noor Afif , Im Dasom , Pyo Jeehee , Ock Minsu
Published: October 2022

This study aimed to explore the various types and frequency of patient safety incidents (PSIs) during a cancer screening health examination for the general public of Ulsan Metropolitan City, South Korea. Furthermore, the associated elements and responses to PSIs during a cancer screening were examined. The survey, conducted in the five districts of Ulsan, was completed by residents aged 19 years and older who agreed to participate. Descriptive analysis, Chi-square or Fisher exact test, and multivariable logistic regression were performed to analyze the data. A total of 620 participants completed the survey, with 11 (1.8%) individuals who experienced PSIs themselves and 11 (1.8%) by their family members. The highest type of PSIs was those related to procedures. The multivariable logistic regression analysis showed no significant variables associated with experiencing PSIs during cancer screening. However, there was a significant association between the judgment of medical error occurrence and level of patient harm both in experience by family members and total experience of PSIs (P < .05). There was also a significant difference between with and without an experience of PSIs disclosure (P < .001). This study comprehensively analyzed the types and extent of PSIs experienced by Korean individuals and their family members in Ulsan. These findings suggest that patient safety issues during cancer screening should not be overlooked. Furthermore, an investigation system to regularly monitor PSIs in cancer screening should be developed and established.
Ultrasound-guided percutaneous nephrolithotomy without indwelling ureteral catheter in older adults with upper urinary calculi: A retrospective study
Authors: Zhang Xicai , Zhu Zhiguo , Shen Daqing , Cao Xianxiang , Cao Xiande
Published: October 2022

Retention of ureteral catheter to establish artificial hydronephrosis is a routine step of percutaneous nephrolithotomy procedure, which can improve the success rate of puncture, but it can prolong the procedure time and increase the risk of postoperative infection, especially for immunocompromised elderly patients. Therefore, this study aims to investigate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy without indwelling ureteral catheter for older patients with upper urinary calculi. The clinical data of 119 older patients admitted to the Affiliated Hospital of Jining Medical University for percutaneous nephrolithotomy from January 2019 to December 2021 were retrospectively analyzed. The patients were divided into study and control groups according to whether the physician decided to use ureteral catheter during the procedure, and the differences in the success rate of one-time puncture, operative time, single-stage stone removal rate, postoperative hospital stay, and complication rate were compared between the 2 groups. There were no significant differences in the success rate of one-time puncture and single-stage stone removal rate between the 2 groups (P > .05). The operation time were significantly shorter in the study group [(30.0–61.0) minute vs (54.8–106.8) minute, P = .00], and the intraoperative bleeding was less in the study group [(5–20) mL vs (10–30) mL, P = .03]. The postoperative hospital stay was shorter in the study group [(2.5–4.0) days vs (3.0–5.0) days, P = .00], and the medical expenses were lower in the study group [(17,309.5–22,652.7) yuan vs (19,148.0–24,407.6) yuan, P = .02]. The incidence of systemic inflammatory response syndrome was lower in the study group (3.5% vs 19.4%, P = .007). There were no statistically significant differences in complications such as postoperative fever, renal artery embolism and blood transfusion between the two groups (P > .05). Ultrasound-guided percutaneous nephrolithotomy without indwelling ureteral catheter for elderly patients with upper urinary stones is safe and feasible.
Correlation between the 72-hour fatality ratios and out-of-hospital cardiac arrest ratios in patients with extremely high outlier values of 57 laboratory test items: A single-center retrospective inception cohort study
Authors: Watanabe Tamami , Sugawara Hitoshi , Fukuchi Takahiko , Omoto Kiyoka
Published: October 2022

The association between extremely high outlier values (EHOV) of laboratory test items (LTIs) and short-term prognosis or out-of-hospital cardiac arrest (OHCA) remains unclear. This retrospective study investigated the correlation between 72-hour fatality ratios and OHCA ratios in patients with the top 100 EHOV of 57 LTIs without focusing on the disease group and which test items were predictors of 72-hour fatality. This single-center retrospective inception cohort study enrolled patients aged ≥ 18 years who underwent any combination of laboratory tests at the Saitama Medical Center, Japan between January 1, 2008, and December 31, 2013. The primary outcome was the correlation between the 72-hour fatality ratios and OHCA ratios in patients with the top 100 EHOV for 57 LTIs without focusing on the disease group. The LTIs included hematology, blood chemistry, erythrocyte sedimentation, blood coagulation, and arterial blood gas test results. The secondary outcome was which of the 57 LTIs with the top 100 EHOV were more likely to associate with the 72-hour fatality. We evaluated the correlation between the 72-hour fatality ratios and the OHCA ratios for each laboratory test item using the Passing–Bablok regression method. The 72-hour fatality ratios for the top 100 EHOV of 57 LTIs were significantly positively correlated with the OHCA ratios. The regression coefficient of the regression line was 0.394, and the correlation coefficient (95% confidence interval) was 0.644 (0.458–0.775, P < .001). These 72-hour fatality ratios tended to be lower than the OHCA ratios. The top 100 EHOV of 13 LTIs including total bilirubin, direct bilirubin, C-reactive protein, base excess, bicarbonate ion, creatine kinase, uric acid, partial pressure of oxygen, sodium, chloride, blood urea nitrogen, aspartate aminotransferase, and lactate dehydrogenase had 72-hour fatality ratios that were above the upper limit of the linear confidence region of the regression line, with higher 72-hour fatality ratios than the OHCA ratios. The 72-hour fatality ratios for the top 100 EHOV of 57 LTIs tended to be lower than the OHCA ratios. The top 100 EHOV of these 13 LTIs were found to be more likely to associate with 72-hour fatality than OHCA.
Decision curve analysis to identify optimal candidates of liver resection for intermediate-stage hepatocellular carcinoma with hepatitis B cirrhosis: A cohort study
Authors: Li He , Chen Siyu , Lu Linbin , Hu Xinyu , Lin Shan , Zhu Lijun
Published: October 2022

The selection criterion for liver resection (LR) in intermediate-stage (IM) hepatocellular carcinoma (HCC) is still controversial. This study aims to compare LR and transarterial chemoembolization (TACE) in the range of predicted death risk The multivariable Cox regression model (MVR) was estimated to predict mortality at 5 year. The cutoff values were determined by a 2-piece-wise linear regression model, decision curve analysis with MVR model, and hazard ratio curve for treatment plotted against the predicted mortality. 825 IM-hepatocellular carcinoma (IM-HCC) with hepatitis B cirrhosis were included for analysis (TACE, n = 622; LR, n = 203). The 5-year overall survival (OS) rate of LR patients was higher than the TACE group (52.8% vs 20.8%; P < .0001). The line of LR and TACE were crossing with predicted death risk at 100% (P for interaction = .008). The benefit of LR versus TACE decreased progressively as predicted death risk > 0.55 (95%CI: 0.45, 0.62). When predicted death risk over 0.7, decision curve analysis suggested that LR and TACE did not increase net benefit. Patients were then divided into 4 subgroups by the cutoff values (<0.45, 0.45≥/<0.62, 0.62≥/<0.7, ≥0.7). The stratified analysis of treatment in different subgroups, hazard ratios were 0.39 (95%CI: 0.27, 0.56), 0.36 (95%CI: 0.23, 0.56), 0.51 (95%CI: 0.27, 0.98), and 0.46 (95%CI: 0.27, 0.80), respectively. LR reached the maximal relative utility in the interval of 0.45 to 0.62, and both LR and TACE did not increase net benefit at the 5-year death risk over 0.7.
Clinical characteristics of rheumatic disease-associated hypophysitis: A case series and review of literature
Authors: Yan Rui , Jin Yue-Bo , Li Xue-Rong , Luo Liang , Liu Xiao-Min , He Jing
Published: October 2022

Rheumatic diseases have been reported to sometimes involve the pituitary gland. This study aims to characterize the clinical features and outcomes of patients with rheumatic disease-associated hypophysitis. We used the electronic medical record system in our hospital to identify nine patients with pituitary involvement in rheumatoid disease. We summarized the clinical characteristics, radiographic findings, treatments, and clinical outcomes of the 9 patients. We also performed a systematic literature review of systemic lupus erythematosus (SLE) cases with pituitary involvement published in PubMed and Wanfang databases from 1995 to 2021, and eight patients with complete information were selected. In the nine-patient cohort, the median age was 54 years, and the spectrum of rheumatic diseases included immunoglobulin G4-related disease (IgG4RD) (4/9), SLE (2/9), vasculitis (2/9), and Sjögren syndrome (SS) (1/9). All patients had pituitary abnormalities on radiological assessment, 6 developed diabetes insipidus (DI), and 8 presented with anterior pituitary hormone deficiencies in the disease duration. All the patients had multisystem involvement. As compared to hypophysitis with IgG4RD (IgG4-H), the age at onset of hypophysitis with SLE (SLE-H) patients was younger [(30.4 ± 16.4) years vs. (56.0 ± 0.8) years] and the disease duration was shorter [(14.0 ± 17.5) months vs. (71.0 ± 60.9) months] (P < .05). All patients were managed with glucocorticoids (GC) in combination with another immunosuppressant, and the majority of patients improved within 4 months. Six patients achieved disease remission while four required at least one hormone replacement therapy. Hypophysitis is a rare complication secondary to a variety of various rheumatic diseases that can occur at any stage. GC combined with additional immunosuppressants could improve patients’ symptoms; however some patients also required long-term hormone replacement therapy in pituitary disorders.
A prospective analysis of concentration of 25-OHD between northern and southern district in Japan in year-round study
Authors: Horikawa Akira , Kasukawa Yuji , Hongo Michio , Kodama Hiroyuki , Sano Akihisa , Miyakoshi Naohisa
Published: October 2022

Although osteoporotic patients have already been recognized as having a low-volume vitamin D status, the concentration of active vitamin D precursor has not been studied in detail. This trial aimed to clarify the concentration of 25-hydroxyvitamin D (25-OHD), which is a natural type of vitamin D and compare between 2 separate areas in Japan. To compare and clarify the concentration of 25-OHD between 2 separate areas, Japanese patients who were diagnosed as having osteoporosis based on bone mineral density were studied. We analyzed 2 different hospitals’ patients whose residence is separated into a northern district (Akita city: north latitude 39” 43’) and a southern district (Shizuoka city: north latitude 34” 58’). Both of them have completely different daylight hours. Three-hundred sixty eight patients (174 in Akita, 194 in Shizuoka) were enrolled in this trial to compare the differences of concentration of 25-OHD by Welch’s t t-test. There were significant differences in the concentration of 25-OHD and age between them. Akita patients were significantly higher than that of Shizuoka patients despite Shizuoka having much daylight hours of Akita. In conclusion, there might be no relationship between the concentration of 25 OHD and exposure to sunlight.
Treatment of scarring central airway stenosis with pirfenidone: Case report
Authors: Li Xiao , Pan Jinbing , Qian Haoyu , Ma Yun , Gao Bulang
Published: October 2022

Introduction:

Benign scarring central airway stenosis can be managed by high-pressure balloon dilatation, laser, surgery and stent implantation. The stenosis may have a high recurrence rate that necessitates repeated treatment. Pirfenidone (PFD) has anti-fibrosis effects and has been used in a variety of fibrosis diseases. Animal experiments suggested that PFD can prevent tracheal stenosis.

Patient concerns:

Patients with scarring central airway stenosis usually have chest tightness, cough and dyspnea.

Diagnosis:

Computed tomography scanning showed stenosis of the trachea and/or bronchus. Bronchoscopy revealed occlusion or stenosis of the trachea or bronchus.

Interventions:

The use of PFD in combination with other interventional management was reported to treat 2 cases of tracheobronchial stenosis after injury in this study. In the combined use of PFD and interventional management, PFD could help to alleviate tracheobronchial stenosis, prolong the time interval of bronchoscopic interventional treatment, and reduce medical costs.

Outcomes:

The stenosis in the trachea and/or bronchus is relieved and the patients do not have any relevant symptoms.
Global research trends on precision oncology: A systematic review, bibliometrics, and visualized study
Authors: Zhang Baoyue , Ao Bo , Lu Xinyue , Yang Shuang , Bao Pengfei , Wang Hongyun , Li Ruifeng , Huang Youliang
Published: October 2022

Background:

Advances in next-generation sequencing technologies are changing the ways cancer diagnosis and treatment, which leads to a new branch of precision medicine: “Precision Oncology”. This study aims to deliver a structured overview to carry out a bibliometric analysis of precision oncology research over the past 10 years retrospectively.

Methods:

Bibliometric methods including clustering analysis and co-occurrence visualized study were conducted based on publications of academic databases Web of Science Main Collection from 1st January 2012, to 31st December 2021. This study analyzed the information about related research outputs, countries, institutions, authors, cited papers, and hot topics.

Results:

7163 papers related to precision oncology were identified. Since 2014, the number of articles has proliferated, and oncology precision has attracted significant attention from scholars worldwide in recent years. The USA leads the research in this field, and the League of European Research Universities is the primary research institution. Research institutions from Asia paid more attention to this field through high-level international cooperation. Besides, there are still many issues expected to be explored and evaluated correctly. Such as the considerable uncertainty that pharmacogenomic methods have no significant influence on patient outcomes.

Conclusions:

Precision oncology serves as an essential method in clinical treatment, and is closely related to biological study, including biochemistry, molecular and genetics, advanced technology, and pharmacology discovery. The future research prospect would be the broad involvement of social participation and global cooperation in oncology precision research to acquire better results via the balance of technology and public health policy.
Prophylactic melatonin for delirium in critically ill patients: A systematic review and meta-analysis with trial sequential analysis
Authors: Yan Wenqing , Li Chen , Song Xin , Zhou Wenqiang , Chen Zhi
Published: October 2022

Background:

Up to 80% of patients in the intensive care unit (ICU) suffer from delirium. Studies on the preventative use of melatonin in the ICU have produced mixed results. We performed a systematic review and meta-analysis to evaluate whether early administration of melatonin reduces the prevalence of delirium in critically ill patients.

Methods:

We searched Medline, Embase, and the Cochrane Library for randomized controlled trials comparing melatonin or melatonin agonists to placebo in ICU setting. The population included adult patients in the ICU. The primary outcome was the prevalence of delirium. Secondary outcomes included duration of delirium, delirium-free day, serum melatonin concentration, need for sedation, duration of mechanical ventilation, hospital and ICU length of stay (LOS), all-cause mortality, sleep quality, and adverse events. Trial sequential analysis (TSA) was performed on the primary outcome to prevent the risk of random error and multiplicity phenomenon as a result of repeated significance testing across all the included trials.

Results:

Twelve trials with a total of 2538 patients were analyzed. When all trials were pooled, the incidence of delirium in ICU patients who received melatonin was significantly lower than in those who received placebo (risk ratio, 0.77; 95% confidence interval: 0.61–0.96; I
2 = 56%). There were no significant differences in secondary outcomes including duration of delirium, duration of mechanical ventilation, ICU LOS, hospital LOS, and mortality. TSA indicated that Z-curve crossed the traditional boundary, but did not cross the monitoring boundary for benefit, which indicated that it is still inconclusive that melatonin affects the incidence of delirium.

Conclusions:

This meta-analysis found that early administration of melatonin may result in a decreased delirium prevalence in critically ill patients. However, the sensitivity analysis of high-quality studies did not support this finding. In addition, TSA demonstrated that the result may have false-positive error. Therefore, this finding should be interpreted with caution. Further studies are needed to examine the effectiveness of prophylactic melatonin on the prevalence and duration of ICU delirium in the future.
Effect of metformin on nonalcoholic fatty liver based on meta-analysis and network pharmacology
Authors: Huang Yuanshe , Wang Xiaodong , Yan Chen , Li Chen , Zhang Lidan , Zhang Lai , Liang E , Liu Tianlei , Mao Jingxin
Published: October 2022

Background:

Whether metformin is related to nonalcoholic fatty liver disease (NAFLD) is controversial. Our aim was to investigate the relationship between metformin and NAFLD that may predict the metformin potential of these lesions and new prevention strategies in NAFLD patients.

Methods:

The meta-analysis was analyzed by Revman 5.3 softwares systematically searched for works published through July 29, 2022. Network pharmacology research based on databases, Cytoscape 3.7.1 software and R software respectively.

Results:

The following variables were associated with metformin in NAFLD patients: decreased of alanine aminotransferase (ALT) level (mean difference [MD] = −10.84, 95% confidence interval [CI] = −21.85 to 0.16, P = .05); decreased of aspartate amino transferase (AST) level (MD = −4.82, 95% CI = −9.33 to −0.30, P = .04); decreased of triglyceride (TG) level (MD = −0.17, 95% CI = −0.26 to −0.08, P = .0002); decreased of total cholesterol (TC) level (MD = −0.29, 95% CI = −0.47 to −0.10, P = .003); decreased of insulin resistance (IR) level (MD = −0.42, 95% CI = −0.82 to −0.02, P = .04). In addition, body mass index (BMI) (MD = −0.65, 95% CI = −1.46 to 0.16, P = .12) had no association with metformin in NAFLD patients. 181 metformin targets and 868 NAFLD disease targets were interaction analyzed, 15 core targets of metformin for the treatment of NAFLD were obtained. The effect of metformin on NAFLD mainly related to cytoplasm and protein binding, NAFLD, hepatitis B, pathway in cancer, toll like receptor signaling pathway and type 2 diabetes mellitus (T2DM). The proteins of hypoxia inducible factor-1 (HIF1A), nuclear factor erythroid 2-related factor (NFE2L2), nitric oxide synthase 3 (NOS3), nuclear receptor subfamily 3 group C member 1 (NR3C1), PI3K catalytic subunit alpha (PIK3CA), and silencing information regulator 2 related enzyme 1 (SIRT1) may the core targets of metformin for the treatment of NAFLD.

Conclusion:

Metformin might be a candidate drug for the treatment of NAFLD which exhibits therapeutic effect on NAFLD patients associated with ALT, AST, TG, TC and IR while was not correlated with BMI. HIF1A, NFE2L2, NOS3, NR3C1, PIK3CA, and SIRT1 might be core targets of metformin for the treatment of NAFLD.
Effect of vitamin and mineral supplementation on nutritional status in children with chronic kidney disease: Protocol for a systematic review and meta-analysis
Authors: Mutsuddi Archi , Das Jyoti , Tashrik Symom , Ara Rifat , Hawlader Mohammad Delwer Hossain
Published: October 2022

Background:

Persistent kidney illness in children and those on dialysis therapy, risk of vitamin and mineral deficiencies due to abnormal renal metabolism, anorexia, inadequate intake, poor gastrointestinal absorption, drug-nutrient interaction, and dialysis-related losses. Adequate nutritional management is essential to achieve and maintain an optimal nutritional status for the usual pattern of growth, sexual and neurocognitive development, metabolic abnormalities, and ultimately reducing the risk of chronic mortality and morbidity in adulthood. The purpose of this paper is to describe a protocol for a systematic review to assess the effects of vitamin and mineral supplementation in children with chronic renal disease.

Methods:

This systematic review protocol is developed according to the Preferred Reporting Item for Systematic Review and Meta-Analysis Protocols (PRISMA-P) as well as the Cochrane group guidelines. Comprehensive searching for all possible relevant works of literature- such as PubMed, Google Scholar, MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Science-Direct, Scopus, Research-Gate, Clinical Trials for all randomized controlled studies, full paper articles, and articles written in English will be considered. The primary outcome of this review will be measuring any changes (such as changes in body mass, BMI, and overall Z-score) in the nutritional status of the children (age < 18 years) with chronic kidney disease following vitamin and mineral supplementations. This review will help better understand the effects of vitamin and mineral supplementation to improve nutritional status in CKD children and will create a guideline to determine the applicability of these interventions in different feasible settings.

Conclusion:

The systematic review protocol has been evaluated and approved by the institutional review board of North South University. Finding will be shared using traditional approaches, including scientific presentations, open-access peer-reviewed platforms.

PROSPERO registered number

CRD42022341339
The prevalence of constipation in end-stage kidney disease patients: A cross-sectional observation study
Authors: Zhang Liuping , Tang Fang , Wang Fengmei , Xie Qinglei , Xia Meixia , Jiang Liangyunzi , Wang Ze-Mu , Wang Bin
Published: October 2022

The aim of our study was to determine the prevalence, distribution, and risk factors for constipation in peritoneal dialysis (PD) and hemodialysis (HD) patients in our center. In this cross-sectional study, 858 dialysis patients over 18 years of age (681 HD cases and 177 PD cases from our hospital) were enrolled. A constipation assessment scale (CAS) questionnaire was used to evaluate constipation status. Logistic regression analysis was performed to define independent risk factors for CAS scores. The prevalence of constipation in HD and PD patients was 52.7% and 77.4%, respectively. The mean CAS score in HD and PD patients was 1.73 ± 2.31 and 2.42 ± 2.34, respectively. Age ≥ 65 and diabetic kidney disease for renal failure were independent risk factors associated with constipation in the HD population (OR = 1.67, 95% CI: 1.15–2.90, P = .019; OR = 3.31, 95% CI: 1.65–6.11, P < .001, respectively). In the PD population, only serum prealbumin was independently associated with constipation (OR = 0.88, 95% CI: 0.79–0.96, P = .007). The multivariable logistic regression analysis demonstrated that PD modality, age ≥ 65 and diabetic kidney disease for renal failure were independent risk factors for constipation (OR = 2.15, 95% CI: 1.41–3.32, P < .001; OR = 1.65, 95% CI: 1.13–2.33, P = .003; OR = 3.19, 95% CI: 1.76–5.093, P < .001, respectively). The prevalence of constipation in PD patients was higher than that in HD patients in our center. PD modality for renal replacement therapy, age ≥ 65 and diabetic kidney disease for renal failure were closely associated with constipation in dialysis patients.
The 12 weeks, randomized, double-blinded, placebo-controlled human study to evaluate the effectiveness and safety of KGC deer antlers on the growth of children
Authors: Kim Sang Min , Lee Jin Yong , Chang Gyu Tae , Hwangbo Su Min , Lee Sun Haeng
Published: October 2022

Background:

Cervi parvum cornu is a dried section of the young horns of Cervus nippon Temminck, Cervus elaphus Linnaeus, or Cervus canadensis Erxleben. It is a representative yang-tonifying medicine that warms the viscera and bowels, activates the overall physiological function, and has effects such as tonifying kidney yang, replenishing essence and blood, and strengthening muscles and bones.

Objective:

This clinical study is aimed to evaluate the effectiveness of deer antler extract on child growth.

Methods:

This clinical trial is designed to be conducted on 100 children aged 3 to 12 years for 12 weeks (Trial registration code: KCT0007386). We will evaluate changes in height, height percentile, standard deviation score of height, weight, body mass index, waist circumference, hip circumference, bone age, predicted adult height estimated by bone age, human growth hormone level, insulin-like growth factor-1 (IGF-1) level, IGF-binding protein-3 (IGFBP-3) level, IGF-1/IGFBP-3 ratio, and estradiol level. Additionally, we also will evaluate the adverse events during the study.
Value of subcarinal lymph node dissection in esophageal cancer surgery: A case-control study
Authors: Xu Bindong , Chen Hao , Zhang Qiang , Chen Pengfei , Liu Qiuxia , Chen Mingyu
Published: October 2022

We investigated the value of subcarinal lymph node dissection in esophageal cancer surgery. Altogether, 240 patients with esophageal cancer admitted to our department between June 2012 and January 2016 were prospectively assigned to an experimental group (subcarinal lymph node dissection group, n = 120 cases) and a control group (uncleaned group, n = 120 cases). The number of subcarinal lymph nodes and the rate of subcarinal lymph node metastasis were determined, and the factors influencing subcarinal lymph node metastasis were analyzed using logistic regression in the experimental group. The operation time, postoperative complications, intraoperative blood loss, postoperative hospital stay, total postoperative hospital cost, and 5-year survival rate were compared between the 2 groups. In the experimental group, an average of 6.03 subcarinal lymph nodes were dissected, and the lymph node metastasis rate was 18.33%. The subcarinal lymph node metastasis rate in the experimental group was related to the size of the subcarinal lymph nodes, depth of tumor invasion, and tumor location. The 5-year survival rate was higher in the experimental group than in the control group (44.2% vs 30.0%, χ
2 = 6.407, P = .04). The subcarinal lymph node metastasis rate in patients with esophageal cancer is high. Patients with mid-thoracic esophageal cancers that infiltrate beyond the esophageal muscle layer with subcarinal lymph node size > 1.0 cm should undergo lymph node resection, despite increased operation time, incidence of postoperative pulmonary infection, hospitalization time, and total postoperative cost; lymph node resection may improve the 5-year survival rate.
Awareness and knowledge of the common features of inflammatory back pain among primary care physicians in the western region of Saudi Arabia
Authors: Aljohani Roaa , Barradah Noha , Kashkari Amnah
Published: October 2022

Often, there is a delay in the diagnosis of inflammatory back pain (IBP) in the primary care setting. This may be attributed to the inability of healthcare providers to distinguish between inflammatory and mechanical back pain. This study aimed to evaluate primary care physicians’ current practices for assessing patients with IBP using clinical, radiographic, and laboratory tests. A questionnaire-based survey was emailed to all primary care physicians in the western region of Saudi Arabia by the Saudi Commission of Health Specialists from February to May 2021. The questionnaire included data about axial spondyloarthropathy based on the Calin, Berlin, and European Spondyloarthropathy Study Group criteria. A total of 103 primary care physicians responded who represented around 24% of primary care physicians at primary healthcare. The most often perceived IBP symptoms include a response to NSAIDs, morning stiffness lasting >30 minutes, age of onset <45 years old, duration of back pain >3 months, and improvement with exercise. The most frequently questioned patient or family history conditions were peripheral arthritis (92.2%), family history of spondyloarthritis (83.5%), and inflammatory bowel disease (97.6%). The most-reported investigations were CRP/ESR (86.4%) and spinal radiography (66%). For treatment of IBP, NSAIDs were most prescribed (48.6%), followed by physiotherapy (45.6%) and disease-modifying anti-rheumatic drugs (41.7%). Primary care physicians were more confident in management of mechanical back pain than IBP (P < .001). Primary care physicians have good knowledge of IBP symptoms but not of disease-specific features and modest confidence in evaluating patients with IBP, indicating the need for educational programs and a more effective, feasible referral strategy.
Short-term recurrence of reversible cerebral vasoconstriction syndrome
Authors: Kobayashi Naoki , Miyamoto Nobukazu , Wakamori Ryo , Watanabe Kouzou , Hirai Takuya , Hira Kenichiro , Kijima Chikage , Ueno Yuji , Tamura Naoto , Hattori Nobutaka
Published: October 2022

Rationale:

Reversible cerebral vasoconstriction syndrome is considered a monophasic disease; however, a previous study reported that several patients had recurrent attacks. Herein, we report a rare case of reversible cerebral vasoconstriction syndrome that recurred within a short period at the same cerebral artery position.

Patient concerns:

A 47-year-old female with systemic sclerosis, idiopathic thrombocytopenia, and Sjögren syndrome presented with left limb weakness and headache, with stenosis of the M1 portion in the right middle cerebral artery.

Diagnoses:

Brain imaging revealed no ischemic lesion. Stenosis recovered a few days later. Therefore, we diagnosed reversible cerebral vasoconstriction syndrome. Reversible cerebral vasoconstriction syndrome occurred with steroid treatment used to treat idiopathic thrombocytopenia.

Intervention:

We started treatment with lomerizine, a calcium channel blocker, and hydration on every reversible cerebral vasoconstriction syndrome occurrence.

Outcome:

After starting treatment, her weakness/M1-stenosis improved.

Lessons:

Many drugs induce reversible cerebral vasoconstriction syndrome, including serotonergic antidepressants, glucocorticoids, and tacrolimus. In the present case, reversible cerebral vasoconstriction syndrome may have worsened with steroid administration and recurred within a short period. Magnetic resonance angiography revealed vasoconstriction in each recurrence.
Evaluating the Clinical Impact of a Novel Pediatric Emergency Medicine Curriculum on Asthma Outcomes in Belize
Authors: Kosoko Adeola A. , Khoei Amelia A. , Khose Swapnil , Genisca Alicia E. , Mackey Joy M.
Published: October 2022

Background

Respiratory-related complaints prompt most pediatric visits to Karl Heusner Memorial Hospital Authority's (KHMHA) Emergency Department (ED) in Belize. We developed and taught a novel pediatric respiratory emergencies module for generalist practitioners there. We assessed the curriculum's clinical impact on pediatric asthma emergency management.

Objective

This study assesses the clinical impact of a pediatric emergency medicine curriculum on management of pediatric asthma emergencies at KHMHA in Belize City, Belize.

Methods

We conducted a randomized chart review of pediatric (aged 2–16 y) visits for asthma-related diagnosis at the KHMHA ED between 2015 and 2018 to assess the training module's clinical impact. Primary outcomes included time to albuterol and steroids. Secondary outcomes included clinical scoring tool (Pediatric Respiratory Assessment Measure [PRAM]) usage, ED length of stay, usage of chest radiography, return visit within 7 days, and hospital admission rates. Kaplan-Meier survival analysis and Cox proportional hazard regression were used.

Results

Two hundred eighty-three pediatric asthma-related diagnoses met our inclusion criteria. The patients treated by trained and untrained physician groups were demographically and clinically similar. The time to albuterol was significantly faster in the trained (intervention) group compared with the untrained (control) physician group when evaluating baseline of the group posttraining (P < 0.05). However, the time to steroids did not reach statistical significance posttraining (P = 0.93). The PRAM score utilization significantly increased among both control group and intervention group. The untrained physician group was more likely to use chest radiography or admit patients. The trained physician group had higher return visit rates within 7 days and shorter ED length of stay, but this did not reach statistical significance.

Conclusions

The curriculum positively impacted clinical outcomes leading to earlier albuterol administration, increased PRAM score use, obtaining less chest radiographs, and decreased admission rates. The timeliness of systemic steroid administration was unaffected.