bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic inflammatory demyelinating polyradiculoneuropathy relapse after mexiletine withdrawal in a patient with concomitant myotonia congenita
Authors: Portaro Simona , Biasini Fiammetta , Bramanti Placido , Naro Antonino , Calabrò Rocco Salvatore 
Published: July 2020

Abstract

Introduction:
we report on the first case of a woman affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and recessive myotonia congenita (MC), treated with mexiletine. We aimed at describing the possible role of mexiletine in CIDP management.

Patient Concerns:
A 44-year-old female affected by CIDP and MC, gained beneficial effects for CIDP symptoms (muscle weakness, cramps, and fatigue) and relapses, after mexiletine intake (200 mg twice a day). The patient presented with detrimental effects after mexiletine drop out, with a worsening of CIDP symptoms.

Interventions:
The patient reported a nearly complete remission of muscle stiffness and weakness up to 3 years since mexiletine intake. Then, she developed an allergic reaction with glottis edema, maybe related to mexiletine intake, as per emergency room doctors’ evaluation, who suggested withdrawing the drug.

Outcomes:
The patient significantly worsened after the medication drop out concerning both CIDP and MC symptoms.

Conclusion:
This is the first report on the association of CIDP and MC in the same patient. Such diseases may share some clinical symptoms related to a persistent sodium currents increase, which maybe due either to the over-expression of sodium channels following axonal damage due to demyelination or to the chloride channel genes mutations. This is the possible reason why mexiletine maybe promising to treat CIDP symptoms.
Exploring the efficacy and safety of herbal medicine on Korean obese women with or without metabolic syndrome risk factors
Authors: Ko Youme , Kim Hyun-Ju , Kim Hojun , Choi Jin-Bong , Kwon Young-Dal , Jung Won-Seok , Jang Bo-Hyoung , Kim NamKwen , Song Yun-Kyung , Ko Seong-Gyu 
Published: July 2020

Abstract

Background:
The prevalence of obesity among women is increasing. Obesity is associated with various metabolic syndromes; conventional treatments are limited and may induce serious adverse events due to polytherapy regimens. Currently, demands for complementary and alternative medicine that has a proven safety profile for the treatment of obesity with or without metabolic risk factors are increasing.
Our team of preclinical experts reported a significant anti-obesity effect of the Korean herbal medicine, Galgeun-tang (GGT). Thus, we designed this trial to explore the effects of GGT among obese women to accumulate optimal clinical evidence.
Obesity is not only a component of metabolic syndrome and a factor associated with an increased risk of cardiovascular disease but is also related to insulin resistance. Previous research has confirmed that an increasing body mass index is highly related with increased risk of metabolic syndrome among overweight and obese individuals. The effectiveness of the Korean medicine herbal formula, GGT on obesity has been previously reported. The objective of this study is to assess the efficacy and safety of GGT for weight loss among obese Korean women with or without high risk for metabolic syndrome.

Methods/design:
This study is a randomized, double-blinded, placebo-controlled, multi-center clinical trial. A total of 160 participants will be randomly distributed in 2 groups, the GGT group or the placebo group in a 1:1 ratio using a web-based randomization system. Each group will be administered GGT or placebo 3 times a day for 12 weeks. The primary endpoint is to assess the change in weight from baseline. The secondary endpoints are the following: the changes in body composition measurements, anthropomorphic measurements, obesity screening Laboratory tests, patient self-reported questionnaires, and economic evaluation outcomes. Adverse events will also be reported.

Discussion:
The findings of this study will confirm methodologies regarding the efficacy and safety of GGT for weight loss among obese Korean women with or without metabolic risk factors.
Clinical diagnosis and endoscopic analysis of 10 cases of intestinal tuberculosis
Authors: Lu Shuangshuang , Fu Jinjin , Guo Yongxin , Huang Jin 
Published: July 2020

Abstract
To analyze the clinical characteristics of intestinal tuberculosis (ITB), pay attention to the diagnostic value of endoscopy and mucosal biopsy, improve the recognition of atypical manifestations of ITB under endoscopy, and reduce misdiagnosis and missed diagnosis.
The clinical data of 10 patients who were hospitalized in Changzhou second people's Hospital and finally diagnosed as ITB from January 1, 2015 to present were analyzed retrospectively. The basic information, medical history, clinical manifestations and computed tomography (CT), endoscopy of the patients was analyzed retrospectively. The results of pathological examination were analyzed and sorted out.
Among the 10 patients, the ratio of male to female was 7:3, 10 (100%) had abdominal pain, 3 (30%) had diarrhea and 2 (20%) had bloody stool. The positive rate of tuberculosis T cell test was 75% (6/8), the diagnostic rate of chest high resolution CT was 60%, and the abnormal rate of abdominal high-resolution CT was 66.7% (6/9). Colonoscopy showed that the lesions mainly involved ileocecum (70%) and ascending colon (60%). Most of the lesions were intestinal stenosis (60%) and circular ulcer (50%). In a few cases, cold abscess (20%) and scar diverticulum (10%). Most of the pathological manifestations were granuloma formation and multinucleated giant cells (60%). The detection rate of caseous granuloma was 20%.
The general condition and clinical manifestations of patients with ITB are not specific. Endoscopy and mucosal biopsy are of great significance for its diagnosis. The clinical manifestations and endoscopy of some patients showed atypical signs. Therefore, the combination of multi-disciplinary team models and the enhancement of clinician's recognition of the characteristics of endoscopic examination of ITB can improve us the diagnosis level of ITB.
Comparison of cervical muscle activity and spinal curvatures in the sitting position with 3 different sloping seats
Authors: Yim JongEun , Park Junhyuck , Lohman Everett , Do KwangSun 
Published: July 2020

Abstract
Lumbar and pelvic alignment may have a huge impact on the posture of the spine and other parts. The aim of this study were to compare the spinal curvature of the cervical, thoracic, and lumbar spine and the muscle activity of the cervical erector spinae muscle, upper trapezius muscle, and thoracic erector spinae muscle when sitting at 3 different sloped, seating surfaces. A 10° wedge was used as the seating surface and we compared a forward sloping seat surface, a flat seating surface, and a rear sloping seat surface, in that order. Twenty healthy officers were recruited for this study. The subjects sat on the seat of 3 different slopes and watched a total of 3 videos, 10 minutes each. The rest time was 10 minutes. Subjects were photographed while viewing videos and muscle activity was measured. There were significant differences in cervical, thoracic, lumbar curvatures, and muscle activity in the 3 different sitting positions according to seat tilt (P < .05). Among the 3 slopes, the forward slope decreased forward head posture and cervical erector spinae muscle activity (P < .05). The activity of the cervical erector spinae muscle was 2.67% with a forward sloping seat, 5.45% with a flat sloping seat, and 6.77% with a rear sloping seat, revealing a significant difference (P < .05). This suggests that a forward sloping seat surface was effective in maintaining a neutral alignment of the spine, and this decreased the cervical spine erector muscle activity. Based on this result, equipment and chair development to incline seats forward may improve posture and health, and prevent chronic pain.
The efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments
Authors: Huang Kuei-Yu , Chang Ching-Hao , Hsu Chung-Hua 
Published: July 2020

Abstract

Background
Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease, which is pandemic, infectious, and high mortality. Many commonly discussed medications being used to treat COVID-19 are not without potentially harmful side effects such as heart, liver, kidney problems, or other clinical symptoms. Acupuncture is a nonpharmacological method. When a needle is inserted into an acupuncture point, traumatic physical stimulation occurs, and then the neuroendocrine immune regulation network is activated. This study aimed to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments.

Methods
From their inception to December 10, 2020, the following electronic databases will be searched to identify relevant studies: MEDLINE, PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM), without any language restrictions. Randomized controlled trials and credible clinical observations without randomization include patients diagnosed with COVID-19, and receiving western medicine treatments or acupuncture, with no restrictions on disease stage, age, sex, or ethnicity. Primary outcomes would be used to evaluate the mortality rate, C-reactive protein (CRP), creatine, troponin, liver enzymes (aspartate aminotransferase and alanine aminotransferase), blood pressure, clinical symptoms (including fever, fatigue, myalgia, cough, skin rash, nausea, vomiting, and diarrhea), and serum cytokine levels. Secondary outcome would be used to evaluate the adverse events of acupuncture. Risk of bias will be assessed by 2 review authors independently according to the guidelines set out in the Cochrane Handbook for Systematic Reviews of Interventions.

Discussion
This is the first to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments. A longer follow-up should be considered in future studies.

Conclusion
This systematic review and meta-analysis would provide evidence of acupuncture specifically focused on its effectiveness and safety for patients with COVID-19 western medications adverse effects.

Registration:
Registered in the PROSPERO database (CRD42020189494).
Genetic polymorphisms in serine protease inhibitor Kazal-type 5 and risk of atopic dermatitis
Authors: Li Yunling , Li Yin , Li Wei , Guo Xiaoxuan , Zhou Sha , Zheng Huiwen 
Published: July 2020

Abstract

Background:
This study aimed to investigate the role of serine protease inhibitor Kazal-type 5 (SPINK5) polymorphisms (Asn368Ser, Asp386Asn and Glu420Lys) and the risk of atopic dermatitis (AD).

Methods:
Studies associated with SPINK5 mutations and AD risk were searched from three databases, including PubMed, Embase, and Cochrane library, with a retrieval deadline of April 22, 2019. An odds ratio (OR) with a 95% confidence interval (95% CI) was chosen as the effect size. Egger's linear regression test was enrolled to assess the level of publication bias.

Results:
Overall, 6 studies met the inclusion criteria for meta-analysis. Significantly statistical differences were calculated between patients with AD and healthy individuals on Asn368Ser polymorphism in the allele model (G vs A: OR = 1.2643, 95% CI = 1.0666–1.4987, P = .0069), co-dominant model (GG vs AA: OR = 1.6609, 95% CI = 1.1736–2.3505, P = .0042; GA vs AA: OR = 1.5448, 95% CI = 1.1263–2.1189, P = .0070), and dominant model (GG+GA vs AA: OR = 1.5700, 95% CI = 1.1656–2.1146, P
= .0030). However, no statistically significant difference was found in the recessive model for Asn368Ser and other genetic models for Asp386Asn and Glu420Lys (all P > .05). No significant publication bias was found.

Conclusion:
The SPINK5 Asn368Ser polymorphism may be a risk factor for AD.
Influence of Socioeconomic Bias on Emergency Medicine Resident Decision Making and Patient Care
Authors: Fasano Heather T. , McCarter Maggie S. J. , Simonis Jacquelyn M. , Hoelscher Gretchen L. , Bullard Mark J. 
Published: July 2020

Introduction
Physician bias impacts clinical decision making, resulting in disparities in patient care. Most existing studies focus on sex and racial bias. This study aimed to investigate disparities in physician decision making among patients of varying socioeconomic status (SES).

Methods
Emergency medicine residents (n = 31) participated in 3 consecutive scenarios of similar disease acuity but with standardized patients of varying SES. Following the scenarios, residents met with a standardized participant acting as an attending physician for a handoff to recount their decision-making processes and care recommendations. Blinded raters evaluated clinical performance using an objective assessment tool. We assessed associations between patient SES and resident-ordered imaging, ordered medication, patient-perceived empathy, and clinical performance. We used qualitative analyses to study residents' decision-making processes.

Results
Quantitative analyses revealed no significant relationship between SES and resident-ordered imaging, ordered medications, patient-perceived empathy, and clinical performance. Qualitative analyses revealed 3 themes regarding clinical decision making: (1) overt diagnostic focus, (2) discharge planning, and (3) risk and exposure.

Conclusions
Although quantitative analyses showed that SES did not affect clinical behavior within simulated scenarios, qualitative analyses uncovered 3 themes believed important to physician decision-making processes. Overt diagnostic focus may have resulted from the study environment in addition to organizational factors, policies, and training. Discharge planning, which was not explicitly studied, was often tailored to SES with emphasis placed on risks for patients of low SES. Further research is needed to uncover the nuances of bias, SES, and physician decision making throughout the patient care continuum and within various clinical environments.
Establishing a Cost-Effective 3-Dimensional Printing Laboratory for Anatomical Modeling and Simulation
Authors: Clifton William , Damon Aaron , Nottmeier Eric , Pichelmann Mark 
Published: July 2020

Summary Statement
Three-dimensional (3D) printing is rapidly growing in popularity for anatomical modeling and simulation for medical organizations across the world. Although this technology provides a powerful means of creating accurately representative models of anatomic structures, there remains formidable financial and workforce barriers to understanding the fundamentals of technology use, as well as establishing a cost- and time-effective system for standardized incorporation into a workflow for simulator design and anatomical modeling. There are many factors to consider when choosing the appropriate printer and accompanying software to succeed in accomplishing the desired goals of the executing team. The authors have successfully used open-access software and desktop fused deposition modeling 3D printing methods to produce more than 1000 models for anatomical modeling and procedural simulation in a cost-effective manner. It is our aim to share our experience and thought processes of implementing 3D printing into our anatomical modeling and simulation workflow to encourage other institutions to comfortably adopt this technology into their daily routines.
Colon Involvement in Necrotizing Pancreatitis
Authors: Maatman Thomas K. , Nicolas Megan E. , Roch Alexandra M. , Lewellen Kyle A. , Al-Azzawi Hayder H. , Ceppa Eugene P. , House Michael G. , Nakeeb Attila , Schmidt Christian M. , Zyromski Nicholas J. 
Published: July 2020

Objective:
To investigate the incidence, risk factors, and outcomes of colon involvement in patients with necrotizing pancreatitis.

Summary/Background Data:
Necrotizing pancreatitis is characterized by a profound inflammatory response with local and systemic implications. Mesocolic involvement can compromise colonic blood supply leading to ischemic complications; however, few data exist regarding this problem. We hypothesized that the development of colon involvement in necrotizing pancreatitis (NP) negatively affects morbidity and mortality.

Methods:
Six hundred forty-seven NP patients treated between 2005 and 2017 were retrospectively reviewed to identify patients with colon complications, including ischemia, perforation, fistula, stricture/obstruction, and fulminant Clostridium difficile colitis. Clinical characteristics were analyzed to identify risk factors and effect of colon involvement on morbidity and mortality.

Results:
Colon involvement was seen in 11% (69/647) of NP patients. Ischemia was the most common pathology (n = 29) followed by perforation (n = 18), fistula (n = 12), inflammatory stricture (n = 7), and fulminant C difficile colitis (n = 3). Statistically significant risk factors for developing colon pathology include tobacco use (odds ratio (OR), 2.0; 95% confidence interval (CI), 1.2–3.4, P = 0.009), coronary artery disease (OR, 1.9; 95% CI, 1.1–3.7; P = 0.04), and respiratory failure (OR, 4.7; 95% CI, 1.1–26.3; P = 0.049). When compared with patients without colon involvement, NP patients with colon involvement had significantly increased overall morbidity (86% vs 96%, P = 0.03) and mortality (8% vs 19%, P = 0.002).

Conclusion:
Colon involvement in necrotizing pancreatitis is common; clinical deterioration should prompt its evaluation. Risk factors include tobacco use, coronary artery disease, and respiratory failure. Colon involvement in necrotizing pancreatitis is associated with substantial morbidity and mortality.
Benchmarking Accomplishments of Leaders in American Surgery and Justification for Enhancing Diversity and Inclusion
Authors: Butler Paris D. , Pugh Carla M. , Meer Elana , Lett Elle , Tilahun Estifanos D. , Sanfey Hilary A. , Berry Cherisse , Stain Steven C. , DeMatteo Ronald P. , Vickers Selwyn M. , Britt L. D. , Martin Colin A. 
Published: July 2020

Objective:
To comprehensively assess the level of achievement and demographics of national surgical society presidents.

Background:
Data on the accomplishments needed to rise to positions of national surgical leadership is scarce and merit alone does not always yield such opportunities. Recognizing the shortcomings of sex and ethnic diversity within academic surgical leadership, the American College of Surgeon (ACS), American Surgical Association (ASA), Association of Women Surgeons (AWS), and the Society of Black Academic Surgeons (SBAS) partnered to address these challenges by performing a comprehensive assessment of their presidents over the last 16 years.

Methods:
ACS, ASA, AWS, and SBAS presidents’ CVs, at the time of their presidential term, were assessed for demographics and scholastic achievements. Regression analyses controlling for age were performed to determine relative differences across societies.

Results:
A total of 62 of the 64 presidents’ CVs were received and assessed (97% response rate). There was a large discrepancy in the average age in years of ACS (70) and ASA (66) presidents compared to the AWS (51) and SBAS (53) presidents. For the ACS and ASA cohort, 87% were male and 83% were White, collectively. After controlling for age (52), the AWS and SBAS presidents’ scholastic achievements were comparable to the ACS (and ASA) cohort in 9 and 12 of the 15 accessed metrics, respectively.

Conclusion:
The ACS and ASA presidents’ CVs displayed unsurpassed scholastic achievement, and although not equivalent, both the AWS and the SBAS presidents had comparable attainment. These findings further substantiate that women and ethnic minority surgeons are deserving of additional national leadership consideration as organized medicine pursues a more diverse and reflective physician workforce.
The IDEAL Reporting Guidelines
Authors: Bilbro Nicole A. , Hirst Allison , Paez Arsenio , Vasey Baptiste , Pufulete Maria , Sedrakyan Art , McCulloch Peter 
Published: July 2020

Objective:
The aim of this study was to define reporting standards for IDEAL format studies.

Background:
The IDEAL Framework and Recommendations establish an integrated pathway for evaluation of new surgical techniques and complex therapeutic technologies. However guidance on implementation has been incomplete, and incorrect use is commonly seen. We describe the consensus development of reporting guidelines for the IDEAL stages, and plans for their dissemination and evaluation.

Methods:
Using the EQUATOR Network recommendations, participants with knowledge of IDEAL were surveyed to determine which IDEAL stages needed reporting guidelines. Draft checklists for stages 1, 2a, 2b, and 4 were subsequently developed by 3 researchers (N.B., A.H., P.M.), and revised through a 2-round Delphi consensus process. A final consensus teleconference resolved outstanding disagreements and clarified wording for checklist items.

Results:
Sixty-one participants completed the initial survey, a clear majority indicating that new reporting guidelines were needed for IDEAL Stage 1 (69.5%), Stage 2a (78%), Stage 2b (74.6%), and Stage 4 (66%). A proposed set of checklists was modified by survey participants in 2 online Delphi rounds (n = 54 and n = 47, respectively), resulting in a penultimate checklist for each stage. Fourteen expert working group members finalized the checklist items and successfully resolved any outstanding areas without agreement on a consensus call.

Conclusions:
Participants familiar with IDEAL called for reporting guidelines for studies in all IDEAL stages except stage 3. The checklists developed have the potential to improve standards of reporting and thereby advance the quality of research on surgery and complex interventions and technologies, but require further evaluation in use.
New perspectives on the calculation of bioaccumulation metrics for active substances in living organisms
Authors: Ratier Aude , Lopes Christelle , Multari Gauthier , Mazerolles Vanessa , Carpentier Patrice , Charles Sandrine 
Published: July 2020

ABSTRACTToday, only few ready-to-use and convenient decision-making tools are available in ecotoxicology concerning accumulation and effects of chemical substances on organisms, accounting for exposure situations that are known to be complex (routes of exposure, metabolism, mixtures, etc.). This paper presents new perspectives on the generic calculation of bioaccumulation metrics via the innovative web tool MOSAICbioacc(http://mosaic.univ-lyon1.fr/bioacc). MOSAICbioaccprovides all kind of bioaccumulation metrics associated with their uncertainty whatever the species-compound combination. MOSAICbioaccexpects accumulation-depuration data as inputs, even with complex exposure and clearance patterns, to quickly perform their relevant analysis. MOSAICbioaccintends to facilitate the daily work of regulators, or any ecotoxicologist, who will freely benefit from a user-friendly on-line interface that automatically fits toxicokinetic models without needs for users to invest in the technical aspects to get bioaccumulation metrics estimates. MOSAICbioaccalso provides all results in a fully transparent way to ensure reproducibility.