bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated 3D video analysis of lower limb movements during REM sleep: a new diagnostic tool for isolated REM sleep behavior disorder
Authors: Waser Markus , Stefani Ambra , Holzknecht Evi , Kohn Bernhard , Hackner Heinz , Brandauer Elisabeth , Bergmann Melanie , Taupe Philip , Gall Markus , Garn Heinrich , Högl Birgit
Published: June 2020

Study Objectives

The differentiation of isolated rapid eye movement (REM) sleep behavior disorder (iRBD) or its prodromal phase (prodromal RBD) from other disorders with motor activity during sleep is critical for identifying α-synucleinopathy in an early stage. Currently, definite RBD diagnosis requires video polysomnography (vPSG). The aim of this study was to evaluate automated 3D video analysis of leg movements during REM sleep as objective diagnostic tool for iRBD.

Methods

A total of 122 participants (40 iRBD, 18 prodromal RBD, 64 participants with other disorders with motor activity during sleep) were recruited among patients undergoing vPSG at the Sleep Disorders Unit, Department of Neurology, Medical University of Innsbruck. 3D videos synchronous to vPSG were recorded. Lower limb movements rate, duration, extent, and intensity were computed using a newly developed software.

Results

The analyzed 3D movement features were significantly increased in subjects with iRBD compared to prodromal RBD and other disorders with motor activity during sleep. Minor leg jerks with a duration < 2 seconds discriminated with the highest accuracy (90.4%) iRBD from other motor activity during sleep. Automatic 3D analysis did not differentiate between prodromal RBD and other disorders with motor activity during sleep.

Conclusions

Automated 3D video analysis of leg movements during REM sleep is a promising diagnostic tool for identifying subjects with iRBD in a sleep laboratory population and is able to distinguish iRBD from subjects with other motor activities during sleep. For future application as a screening, further studies should investigate usefulness of this tool when no information about sleep stages from vPSG is available and in the home environment.
Adherence to Screening for Anemia in 9-Month-Old Full-Term Infants in Bangkok, Thailand
Authors: Chienwittayakun Kwanchanok , Suteerojntrakool Orapa , Techavichit Piti , Bongsebandhu-Phubhakdi Chansuda , Subchartanan Jarujan , Tempark Therdpong
Published: June 2020

Objectives

To determine adherence to the screening for anemia in 9-month-old full-term infants and factors associated with non-adherence to the screening for anemia.

Methods

A descriptive cross-sectional study was conducted in 9-month-old full-term healthy infants who visited the General Pediatric and Well Child Care Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Demographic data, adherence to the screening, and factors associated with non-adherence to the screening were analyzed using percentage, χ2 test, and bivariate logistic regression.

Results

A total of 234 full-term infants, aged 9 months, were included in the study between January and December 2019. The prevalence of adherence to the screening for anemia was 76.1% (95% CI 0.70–0.81). The most common cause of non-adherence to the screening was the waiting time for laboratory results (39.3%). Factors associated with non-adherence to the screening were low education of caregiver (AOR 2.684; 95% CI 1.451–4.966), low socio-economic status (AOR 2.26; 95% CI 1.568–3.258), and inadequate complementary food (AOR 1.961; 95% CI 1.107–3.473).

Conclusion

The most common cause of non-adherence to the screening for anemia is the waiting time for laboratory results. Pediatricians and general practitioners should ensure the importance of anemia screening in infants and plan on anemia screening with parents.
Root Crown Response to Fungal Root Rot in Phaseolus vulgaris Middle American × Andean Lines
Authors: Haus Miranda J. , Wang Weijia , Jacobs Janette L. , Peplinski Hannah , Chilvers Martin I. , Buell C. Robin , Cichy Karen
Published: June 2020

Fusarium root rot (FRR) is a global limiter of dry bean (Phaseolus vulgaris L.) production. In common bean and other legumes, resistance to FRR is related to both root development and root architecture, providing a breeding strategy for FRR resistance. Here, we describe the relationships between root traits and FRR disease symptoms. Using “shovelomics” techniques, a subset of recombinant inbred lines was phenotyped for root architecture traits and disease symptoms across three Michigan fields, including one field with artificially increased Fusarium brasiliense disease pressure. At the early growth stages, stem diameter, basal root number, and distribution of hypocotyl-borne adventitious roots were all significantly related to FRR disease scores. These results demonstrate that root architecture is a component of resistance to FRR in the field at early growth stages (first expanded trifoliate) complementing previous studies that evaluated root traits at later developmental stages (flowering, pod fill, etc.). Correlation matrices of root traits indicate that resistant and susceptible lines have statistically different root systems and show that basal root number is a key feature in resistant root systems while adventitious root distribution is an important feature in susceptible root systems. Based on the results of this study, selection for increased basal root number, increased adventitious root number, and even distribution of adventitious roots in early growth stages (first expanded trifoliate) would positively impact resistance to FRR.
Different Responses in Mandarin Cultivars Uncover a Role of Cuticular Waxes in the Resistance to Citrus Canker
Authors: Favaro María A. , Molina María C. , Roeschlin Roxana A. , Gadea José , Gariglio Norberto , Marano María R.
Published: June 2020

‘Okitsu’ is a mandarin cultivar showing substantial resistance to X. citri subsp. citri (X. citri). We have previously shown that this cultivar has significantly lower canker incidence and severity than ‘Clemenules’, particularly during early stages of leaf development in the field. This differential response is only seen when the leaves are inoculated by spraying, suggesting that leaf surface contributes to resistance. In this work, we have studied structural and chemical properties of leaf surface barriers of both cultivars. Ultrastructural analysis showed a thicker cuticle covering epidermal surface and guard cells in young ‘Okitsu’ leaves than in ‘Clemenules’. This thicker cuticle was associated with a smaller stomatal aperture and reduced cuticle permeability. These findings correlated with an accumulation of cuticular wax components, including primary alcohols, alkanes, and fatty acids. None of these differences were observed in mature leaves, where both cultivars are equally resistant to the bacterium. Remarkably, mechanical alteration of cuticular thickness of young ‘Okitsu’ leaves allows canker development. Furthermore, cuticular waxes extracted from young ‘Okitsu’ leaves have higher antibacterial activity against X. citri than ‘Clemenules’. Taken together, these data suggest that a faster development of epicuticular waxes in ‘Okitsu’ leaves play a central role in its resistance to X. citri.
Urticaria and the gut
Authors: Chu Chia-Yu , Zuberbier Torsten
Published: June 2020

Purpose of review

To review recent evidence on the association of urticaria and the gut diseases, focusing on the roles of chronic inflammation with or without Helicobacter pylori (H. Pylori) infection.

Recent findings

The connection between the gut and urticaria has been discussed for a long time. Some publications have shown that H. pylori can induce chronic spontaneous urticaria (CSU). Recently, it was reported that upper gastrointestinal inflammatory disorders can cause CSU and trigger exacerbations independently of H. pylori.

Gastritis and especially H. pylori-induced gastritis has been implicated as potential trigger of CSU. Chronic parasite infection and inflammation of the gut are relevant comorbidities and also potential inducing factors for the development of urticaria.
Biological agents for severe asthma: the evolution of the at-home self-injection approach
Authors: Lombardi Carlo , Bagnasco Diego , Passalacqua Giovanni
Published: June 2020

Purpose of review

New biological agents, in addition to the well-established omalizumab, have been nowadays introduced into clinical practice for severe asthma. This suggested the possibility of an at-home self-administration, as currently happening for other biological agents for immune-mediated diseases.

Recent findings

In the very recent years, there were structured clinical trials investigating the self at home administrations of biologicals for severe asthma, showing with different principles, a possible advantage and convenience for the patient, and a socioeconomic saving.

The literature analysis currently shows that the at-home self-administration of biologicals for severe asthma is a promising approach to improve the treatment of such disease.
Age at first childbirth in relation to oral health later in life
Authors: Lee Seonah , Park Sangshin
Published: June 2020

Objective:

This study aimed to examine the relationship between age at first childbirth and oral health. The mediation effect of body mass index (BMI) on this relationship was also determined.

Methods:

This study analyzed data of 2,506 parous postmenopausal women aged 50 or older from the Korea National Health and Nutrition Examination Survey 2013-2015. Chewing inconvenience was investigated by an oral interview. Periodontitis and dental caries were determined through dental examinations. Multivariable logistic regression analysis was performed to examine the relationship between age at first childbirth and oral health, and mediation analysis was performed to examine the contribution of BMI on the relationship between age at first childbirth and oral health.

Results:

Women who underwent their first delivery between the age of 26 and 46 years had significantly decreased odds of chewing inconvenience (odds ratio [OR] = 0.72, 95% confidence interval [95% CI] = 0.56-0.93, P = 0.010) compared with the odds of those women whose first delivery was between at the age of 15 and 22 years. We also found a significant linear relationships between age at first childbirth and odds of chewing inconvenience (OR = 0.83, 95% CI = 0.74-0.95, P = 0.017) and dental caries (OR = 0.84, 95% CI = 0.74-0.96, P = 0.025). BMI accounted for 12.9% of the relationship between age at first childbirth and dental caries. Age at first childbirth was only indirectly associated with periodontitis through BMI (OR = 0.98, 95% CI = 0.96-0.99, P = 0.003).

Conclusions:

Women whose first delivery occurred at a young age had significantly increased odds of chewing inconvenience and dental caries. BMI mediated the relationships between age at first childbirth and periodontitis and dental caries.
Perimenopausal vasomotor symptoms and the cortisol awakening response
Authors: Sauer Tianna , Tottenham Laurie Sykes , Ethier Ashley , Gordon Jennifer L.
Published: June 2020

Objective:

Vasomotor symptoms (VMS) are associated with a poorer cardiovascular risk profile. Although the mechanisms underlying this relationship are poorly understood, alterations of the hypothalamic-pituitary-adrenal (HPA) stress axis have been hypothesized to play a role. This study examined the within- and between-subject relationship between VMS and cortisol in a sample of healthy perimenopausal women.

Methods:

A total of 101 perimenopausal women, ages 45 to 55 years, were included in the study. Once a week for 12 weeks, participants completed a 24-hour hot flash diary assessing frequency and severity of VMS. They also provided two saliva samples for the measurement of the cortisol awakening response (CAR) – immediately upon waking and 30 minutes postwaking – and collected a urine sample for the measurement of a urinary metabolite of estradiol and progesterone: estrone-3-glucuronide and pregnanediol glucuronide, respectively. General linear models examined the between-subject relationship between mean VMS symptoms and mean CAR, whereas multilevel modeling was used to examine the relationship between within-person weekly changes on weekly CAR.

Results:

Within-subject weekly change in VMS bother, frequency, and severity were not significantly related to weekly CAR. Several significant between-subject effects of VMS on the CAR were, however, observed such that total number of hot flashes, overall VMS severity, and VMS bother, were each associated with a blunted CAR. Results remained significant despite statistically adjusting for levels of estrone-3-glucuronide, pregnanediol glucuronide, and self-reported sleep quality.

Conclusion:

Findings suggest that women who suffer from more severe and bothersome perimenopausal VMS exhibit alterations in HPA axis activity. Within an individual, short-term changes in VMS are, however, not associated with concurrent changes in HPA axis functioning. Further research investigating the role of the HPA axis in linking VMS and increased cardiovascular disease risk is warranted.

Video Summary:http://links.lww.com/MENO/A607.
Prediction of no-reflow phenomenon in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
Authors: Yang Li , Cong Hongliang , Lu Yali , Chen Xiaolin , Liu Yin
Published: June 2020

No-reflow is an important complication among patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

A retrospective study of 1658 STEMI patients undergoing direct PCI was performed. Patients were randomly assigned at a 7:3 ratio into development cohort and validation cohort and into no-reflow and normal blood flow groups. Clinical data and laboratory examinations were compared to identify independent risk factors and establish a no-reflow risk scoring system.

In the development cohort (n = 1122), 331 (29.5%) had no-reflow. Multivariate analysis showed age ≥ 65 years (OR = 1.766, 95% confidence interval (CI): 1.313–2.376, P < .001), not using angiotonase inhibitor/angiotensin receptor antagonists (OR = 1.454, 95%CI: 1.084–1.951, P = .013), collateral circulation <grade 2 (OR = 3.056, 95%CI: 1.566–5.961, P = .001), thrombosis burden ≥4 points (OR = 2.033, 95%CI: 1.370–3.018, P < .001), diameter of target lesion ≥3.5 mm (OR = 1.511, 95%CI: 1.087–2.100, P = .014), thrombosis aspiration (OR = 1.422, 95%CI: 1.042–1.941, P = .026), and blood glucose >8 mmol/L (OR = 1.386, 95%CI: 1.007–1.908, P = .045) were related to no-reflow. Receiver operating characteristic (ROC) area under the curve was 0.648 (95%CI: 0.609–0.86). At 0.349 cutoff sensitivity was 42.0%, specificity was 79.3%, positive predictive value (PPV) was 44.7%, negative predictive value (NPV) was 77.4%, P < .001. The resulting risk scoring system was tested in the validation cohort (n = 536), with 30.1% incidence of no-reflow. The area under the ROC curve was 0.637 (95%CI: 0.582–0.692). At a cutoff of 0.349 sensitivity was 53.2% and specificity was 66.7%, PPV was 41.2%, NPV was 76.4%, P < .001.

The no-reflow risk scoring system was effective in identifying high-risk patients.
Combined effects of AKT serine/threonine kinase 1 polymorphisms and environment on congenital heart disease risk
Authors: Zhao Jianxun , Zeng Zhi
Published: June 2020

This study aimed to explore the combined association between AKT serine/threonine kinase 1 (AKT1) polymorphisms and congenital heart disease (CHD) risk, meanwhile, the role ofAKT1single polymorphism on CHD was also analyzed.

In the first,AKT1polymorphisms were genotyped in 130 CHD patients and 145 healthy people with the way of polymerase chain reaction-direct sequencing. The clinical data and genotypes, alleles between 2 groups were compared byχ2test and the genotype distributions in the control group were checked by Hardy-Weinberg equilibrium. The relative risk strength of disease based on genetic variant was revealed using odds ratio (OR) with 95% confidence interval (95%CI).

In 3 polymorphisms ofAKT1(rs1130214, rs2494732, rs3803300), the GT/TT genotype of rs1130214 in cases and controls had a significant frequency difference (P = .04) and was 1.71 times risk developing CHD, compared with AA (OR = 1.71, 95%CI = 1.02–2.86), and T allele had 1.63 times risk for carriers (OR = 1.63, 95%CI = 1.05–2.54). Similarly, both rs3803300 GG genotype and G allele had obvious differences between case and control groups (P < .05) and it was closely associated with CHD susceptibility. At the same time, the combined effects of rs1130214, rs3803300 and family history, smoking were found in our study.

AKT1rs1130214, rs3803300 polymorphisms are associated with the increased susceptibility to CHD. Environmental factors are found the interaction withAKT1polymorphisms. Further study is needed to verify this conclusion.
Efficacy of shoulder arthroscopic surgery for the treatment of rotator cuff injury
Authors: Zong Long-ze , Duan Ming-ming , Yuan Wei-wei , Lu Hao-dong
Published: June 2020

Background:

This study will investigate the efficacy and safety of shoulder arthroscopic surgery (SAS) for patients with rotator cuff injury (RCI).

Methods:

We will systematically search for randomized controlled trials in the electronic databases of PUBMED, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All above databases will be searched from their beginning to March 1, 2020 without language restrictions. Two reviewers will independently scan retrieved records, evaluate study quality and extract data. If possible, we will synthesize the data and conduct a meta-analysis by RevMan 5.3 software.

Results:

This systematic review will summarize the most recent evidence to explore the efficacy and safety of SAS for patients with RCI.

Conclusion:

The findings of this study will help to provide a genuine understanding of perspective from a scientific basis on the efficacy and safety of SAS for patients with RCI.

PROSPERO registration number:

PROSPERO CRD42020170009.
Does citalopram effectively treat post-stroke depression?
Authors: Hu Jing , Ma Li , Yang Zeng-ye
Published: June 2020

Background:

This study aims to assess the efficacy and safety of citalopram for the treatment of patients with post-stroke depression (PSD).

Methods:

We will comprehensively search Cochrane Library, PUBEMD, EMBASE, WorldSciNet, Web of Science, VIP Database, CBM database, and China National Knowledge Infrastructure. The search period is limited from the construction of each database to the February 1, 2020. No language and publication status are limited. Two investigators will independently carry out study choosing, data extraction, study methodological quality assessment, and quality of evidence. A third investigator will help to resolve any disagreements between 2 investigators. RevMan 5.3 software will be employed for statistical analysis.

Results:

This study will summarize the up-to-date evidence and synthesize the data to explore the efficacy and safety of citalopram for patients with PSD.

Conclusions:

The results of this study may present helpful evidence to determine whether citalopram is an effective management for patients with PSD.

PROSPERO registration number:

PROSPERO CRD42020171015.
Effect of arsenic trioxide on the Tregs ratio and the levels of IFN-γ, IL-4, IL-17 and TGF-β1 in the peripheral blood of severe aplastic anemia patients
Authors: Zhao Juanjuan , Song Yongping , Liu Lina , Yang Shiwei , Fang Baijun
Published: June 2020

Previous studies have suggested that the anticancer agent, arsenic trioxide (ATO), could attenuate T cell mediated immunity by not only inhibiting the proliferative response of T cells but by also increasing the frequency of regulatory T cells (Tregs). Furthermore, ATO represents a reasonable salvage treatment in some patients with refractory severe aplastic anemia (SAA). The current study aimed to evaluate the function of ATO on the Tregs percentage and cytokines changes in the peripheral blood mononuclear cells (PBMCs) of SAA patients.

PBMCs were collected from 20 newly diagnosed SAA patients in Henan Cancer Hospital and treated with different concentrations of ATO (0, 1, 2.5, and 5 μmol/L). Then we investigated the efficacy of ATO on Tregs ratio and the levels of interferon (IFN)-γ, interleukin (IL)-4, IL-17 and transforming growth factor (TGF)-β1 in the peripheral blood of SAA patients in vitro.

The results showed that ATO significantly increased the proportion of Tregs (P < .001) at 2.5 and 5 μmol/L concentrations, and the proportion of Tregs was increased with increasing ATO concentration (r = 0.524). At 1 (P = .03), 2.5 (P < .001) and 5 μmol/L (P < .001), ATO significantly up-regulated the expression levels of Foxp3 mRNA, which was positively and linearly correlated with the increase of Tregs cell-frequency (r = 0.52, 95%CI, 0.37–0.67). In addition, ATO significantly reduced the levels of IFN-γ (at 1, 2.5 and 5 μmol/L, P < .001), IL-4 (at 2.5 μmol/L, P = .009; at 5 μmol/L, P < .001), and IL-17 (at 2.5, P = .016; at 5 μmol/L, P < .001). ATO significantly reduced the levels of TGF-β1 at 5 μmol/L (P = .03), but showed no significant effects at 1 and 2.5 μmol/L (P > .05).

ATO could mediate the immune regulation, which might contribute to improve hematopoietic recovery in SAA patients.
High expression of ghrelin and obestatin prepropeptide in tumor tissues predicted adverse overall survival in gastric carcinoma patients
Authors: Wu Xiandan , Wu Yongning , Ye Binhua , Wu Fubin , Wang Peien
Published: June 2020

Background:

Gastric cancer (GC) is the most prevailing digestive tract malignant tumor worldwide with high mortality and recurrence rates. However, its potential molecular mechanism and prognostic biomarkers are still not fully understood. We aim to screen novel prognostic biomarkers related to GC prognosis using comprehensive bioinformatic tools.

Methods:

Four gene expression microarray data were downloaded from the Gene Expression Omnibus (GEO) database (GSE26942, GSE33335, GSE63089, and GSE79973). Differentially expressed genes (DEGs) between gastric carcinoma and normal gastric tissue samples were identified by an integrated bioinformatic analysis. Gene Ontology (GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed using statistical software R. STRING and Cytoscape software were employed to construct protein–protein interaction (PPI) networks. Hub genes with a high score of connectivity identified from the PPI network were identified. Prognostic values of hub genes were evaluated in GSE15459 dataset. Hub genes related to GC overall survival were further validated in GEPIA (Gene Expression Profiling Interactive Analysis) online tool.

Results:

A total of 12 upregulated DEGs and 59 downregulated DEGs were identified when the 4 microarray data overlapped. Among them, 10 hub genes with a high score of connectivity were identified. High expression of ghrelin and obestatin prepropeptide (GHRL), BGN, TIMP metallopeptidase inhibitor 1, thrombospondin 2, secreted phosphoprotein 1, and low expression of CHGA were associated with a poor overall survival of gastric cancer (all log rank P < .05). After validation in GEPIA database, only GHRL was confirmed associated with a poor overall survival of gastric cancer (log rank P = .04).

Conclusions:

GHRL could be used as a novel biomarker for the prediction of a poor overall survival of gastric cancer, and could be a novel therapeutic target for gastric cancer treatment. However, future experimental studies are still required to validate these findings.
Association between pentraxin-3 and the risk of preeclampsia
Authors: Xiong Zhihui , Wang Xinchen , Jiang Sicong , Jin Meiyuan , Chen Wenzeng
Published: June 2020

An association between circulating pentraxin-3 (PTX3) and the risk of preeclampsia (PE) remains to be established. We performed a meta-analysis of observational studies to evaluate their relationship.

The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang databases were searched for related observational studies evaluating PTX3 and PE risk. A random-effects or a fixed-effects model was used in the meta-analysis, depending on the heterogeneity among the included studies.

Nine case–control studies were included, with 396 PE patients and 438 controls. The results showed that PTX3 was significantly higher in pregnant women with PE as compared to those without PE (standardized mean difference [SMD] = 2.48, P < .001), with significant heterogeneity (I2 = 98%), particularly for those over 30 years old (SMD = 3.75, P < .001). Subsequent analyses showed that patients with severe or early-onset PE had higher PTX3 levels compared to those with mild or late-onset PE (SMD = 0.93, P = .01), suggesting that PTX3 may be a marker of PE severity. The association between PTX3 and PE was not significantly affected by the statistical method used. Sensitivity analyses by omitting one study at a time did not significantly affect the results. However, the funnel plots were asymmetric, suggesting the potential existence of publication bias.

PTX3 may be related to the risk and severity of PE in pregnant women. These results should be evaluated and confirmed in cohort studies.
Effects of hepatic arterial infusion chemotherapy in the treatment of hepatocellular carcinoma
Authors: Long Guan-Bao , Xiao Chao-Wen , Zhao Xin-Yang , Zhang Jun , Li Xin
Published: June 2020

Background:

The potential benefits and safety of hepatic arterial infusion chemotherapy (HAIC) for the treatment of patients with hepatocellular carcinoma (HCC) remains inconsistent. Therefore, we conducted this meta-analysis of evaluate the efficacy and safety of HAIC in the treatment of HCC.

Methods:

A comprehensive literature search was performed using PubMed, Embase, Web of Science, and the Cochrane library to identify eligible studies that compared HAIC with other therapies for patients with HCC. The main outcomes of our interest, including overall survival (OS), disease free survival (DFS), objective response rate (ORR), disease control rate (DCR), and adverse events, were calculated using the meta-analysis. The pooled estimates were expressed with hazard ratio (HR) with 95%confidence intervals (95%CIs) or risk ratio (RR) with 95%CIs.

Results:

A total of 13 studies met the inclusion criteria and were included in this meta-analysis. Pooled estimates showed that, HAIC was associated with significantly improved OS (HR = 0.61, 95%CI: 0.48, 0.77; P < .001) and DFS (HR = 0.66, 95%CI: 0.52, 0.84; P = .001) as compared with other therapies. The ORR (RR = 2.28, 95%CI: 1.77, 2.94; P < .001) and DCR (RR = 1.47, 95%CI: 1.23, 1.77; P < .001) were also significantly higher in HAIC group than in control group. Most of the common adverse events were comparably occurred in the 2 groups, except for nausea/vomiting, hypoalbuminemia, pain, anemia and hepatic toxicity. Subgroup analysis suggested that, the improved OS and DFS associated with HAIC were only observed in patients with colorectal liver metastases (CRLM), or advanced HCC, but not in those with unresectable HCC or pancreatic liver metastases.

Conclusion:

Based on the present data, HAIC showed benefit effect in HCC patients, with pronged OS and DFS, as well as increased ORR and DCR. These benefit effects were more obvious in CRLM or advanced HCC patients. However, considering the potential limitations, more large-scale, randomized trials are needed to verify our findings.
Effect of Xingnaojing injection for the treatment of acute alcoholism
Authors: Wu Xian , Yang Li-jie , Gao Peng , Qiao Zhi-li , Xu Dan , Zhang Fu-hua
Published: June 2020

Background

This study will assess the effect of Xingnaojing injection (XNJI) for the treatment of acute alcoholism (AAH).

Methods:

The bibliographic literature sources will be systematically searched in MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure Database, Wan fang Database, and VIP Science Technology Periodical Database. All above electronic databases will be sought from inception to the April 1, 2020. We will not apply any limitations to language and publication time. In addition, we will also search other literature sources. Two reviewers will carry out study selection, data extraction, and methodological quality evaluation, respectively. Any divergences will be resolved by a third reviewer through discussion. We will use RevMan 5.3 software to analyze data analysis.

Results:

This study will summarize present evidence to assess the effect of XNJI for the treatment of AAH.

Conclusion:

This study will investigate whether XNJI is effective and safety for AAH.

Systematic review registration:

INPLASY202040197.
Efficacy of deep convolutional neural network algorithm for the identification and classification of dental implant systems, using panoramic and periapical radiographs
Authors: Lee Jae-Hong , Jeong Seong-Nyum
Published: June 2020

Convolutional neural networks (CNNs), a particular type of deep learning architecture, are positioned to become one of the most transformative technologies for medical applications. The aim of the current study was to evaluate the efficacy of deep CNN algorithm for the identification and classification of dental implant systems.

A total of 5390 panoramic and 5380 periapical radiographic images from 3 types of dental implant systems, with similar shape and internal conical connection, were randomly divided into training and validation dataset (80%) and a test dataset (20%). We performed image preprocessing and transfer learning techniques, based on fine-tuned and pre-trained deep CNN architecture (GoogLeNet Inception-v3). The test dataset was used to assess the accuracy, sensitivity, specificity, receiver operating characteristic curve, area under the receiver operating characteristic curve (AUC), and confusion matrix compared between deep CNN and periodontal specialist.

We found that the deep CNN architecture (AUC = 0.971, 95% confidence interval 0.963–0.978) and board-certified periodontist (AUC = 0.925, 95% confidence interval 0.913–0.935) showed reliable classification accuracies.

This study demonstrated that deep CNN architecture is useful for the identification and classification of dental implant systems using panoramic and periapical radiographic images.
Clinical effects of slim-diet, with lifestyle modification for childhood obesity in community-based healthcare program
Authors: Kim Koh-Woon , Kim So-Jin , Kim Hojun , Shin Seung-Uoo , Song Jaechul , Chung Won-Seok
Published: June 2020

Rationale:

Although there are several reports on the effect of herbal medicine on weight loss in adults, evidence supporting its efficacy and safety in obese pediatrics is insufficient. Herein, we clinically investigated the preliminary experience of community-based healthcare program in cases of childhood obesity treated with an herbal complex, Slim-diet (SD), along with lifestyle modification.

Patient concerns:

Seventeen subjects with childhood obesity participated in a community-based healthcare program, which consisted of twice-a-week play type physical activity and dietary counseling program with simultaneous twice-a-day administration of SD for 4 weeks.

Diagnoses:

The data of 13 obese pediatrics (body mass index [BMI] ≥ the 95th percentile for children of the same age and sex) in their 3rd to 6th grade who finally completed at least 6 visits out of a total of 8 visits of the program including baseline and endpoint assessments were analyzed.

Interventions:

Participants received 20 g of SD daily. Simultaneously, play-type physical activity program with an exercise therapist and dietary counseling with a dietitian for lifestyle modification were conducted at every visit. Body composition, blood chemistry, the Korean Youth Physical Activity Questionnaire (KYPAQ) score, and the preference for salt density and sugar content were assessed at baseline and endpoint.

Outcomes:

After SD administration, body mass index decreased from 26.74 ± 2.11 kg/m2 to 26.50 ± 2.20 kg/m2 (P < .05) with statistically significant increases in height, weight, and skeletal muscle mass. The results of blood chemistry and the KYPAQ score showed no significant change. The preferences for salt density were improved in 8, maintained in 2, and worsened in 3 participants and those for sugar content were improved in 6 and maintained in 7 participants with no worsening.

Lessons:

In the present study, we showed the clinical effects of SD with lifestyle modification in patients with childhood obesity who participated in community-based healthcare program. Further clinical studies investigating the effects of SD are required.
Gout and the risk of epilepsy
Authors: Chen Hung-Lin , Hsu Yi-Chao , Chen Chang-Hsu , Wang Pei-Jen , Lin Cheng-Li , Cheng Sheng-Han , Chang Kuang-Hsi
Published: June 2020

Gout is a chronic disease related to uric acid metabolism. It involves crystals of uric acid accumulating in the joints, causing joint pain and releasing cytokines that trigger inflammation. Inflammation is a key component in the pathogenesis of epilepsy. Thus, we conducted a cohort study to investigate if epilepsy is associated with gout and determine the risk of epilepsy in patients with gout.

The gout cohort was obtained from the Registry of Catastrophic Illnesses Patient Database (RCIPD). We identified 104,238 patients who were aged 20 years or more and newly diagnosed with gout between 2000 and 2011 and 3 outpatient visits or history of gout-specific hospitalization between 2000 and 2011. Patients without gout were frequency matched with the gout cohort at a 2:1 ratio according to age, sex, comorbidities, and year of gout diagnosis.

The gout cohort showed a 1.27-fold higher overall crude hazard ratio (HR) for epilepsy compared with the control cohort. After we adjusted the analyses by age, sex, and comorbidities the gout patients displayed an increased risk of epilepsy compared with the control group (adjusted HR = 1.25, 95% confidence interval = 1.15–1.36).

This study revealed a significantly higher risk of epilepsy in patients with gout. It provides further evidence for the debate around the effect of gout on brain health.
Effects of ipratropium bromide on the occurrence of postoperative respiratory complications in craniectomy patients with COPD
Authors: Du Zhuoying , Huang Xiaoqian , Feng Yi , Yan Wei , Xu Dan , Sun Xiaoou , Wu Chao , Zheng Yongke , Zeng Longhuan , Xiong Xiaowei , Liu Yuankun , Zhang Chenbo , Luo Jianfeng , Hu Jin
Published: June 2020

Introduction:

Postoperative pulmonary complications (PPCs) are common and associated with increased morbidity, mortality, and medical cost. They are gaining increasing concerns among patients receiving neurological surgery. Chronic obstructive pulmonary disease (COPD) affect a large section of whole population and is also one of the risk factors of PPCs in the perioperative setting. Ipratropium bromide is the inhalation solution for the treatment of COPD. Studies showed the perioperative nebulization of ipratropium bromide could increase the lung function and decrease the incidence of postoperative pneumonia in COPD patients underwent thoracic surgery. The purpose of this study is to investigate the effect of perioperative nebulization of ipratropium bromide on PPCs in COPD patients underwent neurosurgical surgery.

Methods and analysis:

This study is a multicenter retrospective study in China. Patients who meet the inclusion/exclusion criteria are selected from 7 neurosurgical centers in China. According to whether ipratropium bromide is used in perioperative period, the patients are divided into exposure group and control group. The primary outcome is the incidence of postoperative pneumonia. Secondary outcomes are unplanned intubation, postoperative mechanical ventilation ≥ 48 hours, respiratory failure, atelectasis, death, and length of stay.

Ethics and dissemination:

This study was approved by the ethics committee (EC) of the School of Public Health, Fudan University, Shanghai, China. Waived by the ethics committee, no written consent form was obtained since we used the registry data. The study results will be communicated via publication.

Trial Registration Number:

ChiCTR1900022552.
Spontaneous subepithelial hemorrhage of renal pelvis and ureter (Antopol-Goldman lesion) in hemophilia A patient with inhibitor
Authors: Sahin Taha Koray , Aladag Elifcan , Setterzade Emil , Guven Gulay Sain , Haznedaroglu Ibrahim Celalettin , Aksu Salih
Published: June 2020

Introduction:

The Antopol-Goldman lesion (AGL), which expresses subepithelial hemorrhage in the renal pelvis, was first defined by Antopol and Goldman in 1948. The objective of this study is to report the first case of AGL in patients with congenital hemophilia and review the relevant literature.

Patient concerns:

A 32-year-old male patient diagnosed with congenital hemophilia A (FVIII = %4) with high responding inhibitors (7.4 BU) was admitted to our emergency department with gross hematuria and sudden onset flank pain.

Diagnosis:

Abdominal computed tomography (CT-scan) presented a hyperdense lesion in the left ureteropelvic junction with Hounsfield Units of 56 compatibles with hemorrhage.

Interventions:

The patient was given 4500 IU of factor eight inhibitor bypass activity (FEIBA) intravenously twice daily for 5 days. Subsequently, 4500 IU of FEIBA was administrated once a day for 2 days.

Outcomes:

The patient's complaints disappeared on the fourth day of treatment. Macroscopic and microscopic hematuria was not seen in the following days. Follow-up CT was done 3 months after discharge and showed normal left renal pelvis without hyperdenosis. Follow-up CT was performed 3 months after discharge and presented normal left renal pelvis with no hyperdense lesion.

Conclusion:

Although very rare, AGL should be kept in mind in the differential diagnosis of renal pelvic hemorrhage. In the patient who has an underlying history of coagulopathy nephrectomy can be avoided when there is awareness of AGL.
A combination of bimalleolar fracture and fracture on talar body and neck
Authors: Chen Kuan-Ju , Ko Chih-Yuan , Ho Tsung-Yu , Chen Hsien-Te , Hsu Horng-Chaung , Hung Chih-Hung
Published: June 2020

Rationale:

Talar fracture accompanied with malleolar fracture is rare, and its management is complex. Ankle soft tissue is much thinner than other parts of the human body, and the shape of the ankle makes wounds difficult to close immediately after surgery, which may result in poor skin condition if the wound tension is too high. However, joint congruity and osteonecrosis are the main concerns of talar fracture.

Patient concerns:

A 57-year-old man presented at the emergency department following a motorcycle accident.

Diagnoses:

Physical examination revealed swelling and tenderness of the left ankle and midfoot. The patient had comminuted talar fracture and was indicated for dual-screw fixation or even plate with screw fixation.

Interventions:

We performed single screw fixation after assessing the soft tissue condition and employed a technique of using continuous longitudinal force to bring together fracture fragments (ankle ligamentotaxis) during surgery. Open reduction with a mini-hook plate and tension band wire was used for bimalleolar fracture repair using the combined anteromedial and anterolateral approach with extension of the incision. Kirschner wire for temporary fixation was performed using ligamentotaxis, and a 2.4 headless screw was inserted from the posteromedial to the anterolateral direction.

Outcomes:

The patient was discharged with a standard short leg splint and was instructed not to bear weight on the affected ankle for 2 months. The patient walked well without discomfort, and the Hawkins sign was clearly visible. Single screw fixation preserves the integrity of the talus bone as minimal space is used for this operative technique. Single screw fixation preserves more bony stock when most of the internal fixator is located within the bone. Additionally, surgery time is shorter than multiple implantations even when performing the same procedure; as a result, there was less ankle soft tissue swelling.

Lessons:

This case provides evidence of using the single screw fixation technique for addressing both malleolar and talar fractures, and that talar fracture management can be less aggressive with limited weight bearing and initial limited range of motion given the presence of malleolar fracture. The alignment and stability of bony fragments also benefit from ankle ligamentotaxis.
Clinical massage therapy for patients with exercise-induced fatigue
Authors: Zhou Ke-Lin , Dong Shuo , Wang Kang , Fu Guo-Bing , Cui Shu-Sheng , Guo Sheng
Published: June 2020

Background:

Exercise-induced fatigue (EF) has been a major area of interest within the field of sports and clinical medicine. Implemented on people's skin, muscles, and joints as an important part of complementary and alternative medicine , massage therapy has a positive effect on the recovery of EF and sports injuries. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with EF.

Methods:

We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating EF: China National Knowledge Infrastructure, Wanfang and PubMed Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, and Medical Literature Analysis and Retrieval System Online. Each database will be searched from inception to May 2020. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses.

Results:

This proposed study will evaluate the effectiveness and safety of massage therapy for patients with EF. The outcomes will include change in fatigue relief and adverse effect.

Conclusions:

This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with EF.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.
Titration of extra-PEEP against intrinsic-PEEP in severe asthma by electrical impedance tomography
Authors: He Huaiwu , Yuan Siyi , Yi Chi , Long Yun , Zhang Rui , Zhao Zhanqi
Published: June 2020

Rationale:

The use of extra-positive end-expiratory pressure (PEEP) at a level of 80% intrinsic-PEEP (iPEEP) to improve ventilation in severe asthma patients with control ventilation remains controversial. Electrical impedance tomography (EIT) may provide regional information for determining the optimal extra-PEEP to overcome gas trapping and distribution. Moreover, the experience of using EIT to determine extra-PEEP in severe asthma patients with controlled ventilation is limited.

Patients concerns:

A severe asthma patient had 12-cmH2O iPEEP using the end-expiratory airway occlusion method at Zero positive end-expiratory pressures (ZEEP). How to titrate the extra-PEEP to against iPEEP at bedside?

Diagnoses and Interventions:

An incremental PEEP titration was performed in the severe asthma patient with mechanical ventilation. An occult pendelluft phenomenon of the ventral and dorsal regions was found during the early and late expiration periods when the extra-PEEP was set to <6 cmH2O. If the extra-PEEP was elevated from 4 to 6 cmH2O, a decrease in the end-expiratory lung impedance (EELI) and a disappearance of the pendelluft phenomenon were observed during the PEEP titration. Moreover, there was broad disagreement as to the “best” extra-PEEP settings according to the various EIT parameters. The regional ventilation delay had the lowest extra-PEEP value (10 cmH2O), whereas the value was 12 cmH2O for the lung collapse/overdistension index and 14 cmH2O for global inhomogeneity.

Outcomes:

The extra-PEEP was set at 6 cmH2O, and the severe whistling sound was improved. The patient's condition further became better under the integrated therapy.

Lessons:

A broad literature review shows that this was the 3rd case of using EIT to titrate an extra-PEEP to against PEEPi. Importantly, the visualization of occult pendelluft and possible air release during incremental PEEP titration was documented for the first time during incremental PEEP titration in patients with severe asthma. Examining the presence of the occult pendelluft phenomenon and changes in the EELI by EIT might be an alternative means for determining an individual's extra-PEEP.
Concurrent vitrectomy for persistent pupillary membrane complicated by severe myopia and vitreomacular traction syndrome
Authors: Nishi Hiroyuki , Kohmoto Ryohsuke , Mimura Masashi , Fukumoto Masanori , Sato Takaki , Kida Teruyo , Ikeda Tsunehiko
Published: June 2020

Introduction:

In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia.

Patient concerns:

This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity.

Diagnoses:

Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye.

Interventions:

In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed.

Outcomes:

After surgery, the patient's visual acuity improved in both eyes.

Conclusion:

The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.