bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet-to-lymphocyte ratio as a predictive index for delirium in critically ill patients
Authors: Jiang Xuandong , Shen Yanfei , Fang Qiang , Zhang Weimin , Cheng Xuping 
Published: October 2020

Abstract
Delirium is a neuropsychiatric syndrome commonly encountered in critically ill patients, and systemic inflammation has been strongly implicated to underlie its pathophysiology. This study aimed to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR) for delirium in the intensive care unit (ICU).In this retrospective observational study, we analyzed the clinical and laboratory data of 319 ICU patients from October 2016 to December 2017. Using the Locally Weighted Scatterplot Smoothing technique, a PLR knot was detected at a value of approximately 100. Logistic regression was used to investigate the association between the PLR and delirium.Of the 319 patients included in this study, 29 (9.1%) were diagnosed with delirium. In the delirium group, the duration of mechanical ventilation was significantly longer than that in the no-delirium group (40.2 ± 65.5 vs. 19.9 ± 26.5 hours, respectively; P < .001). A multiple logistic regression analysis showed that PLR > 100 (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.001–1.005), age (OR: 2.76, 95% CI: 1.110–6.861), and the ratio of arterial oxygen partial pressure to the inspired oxygen fraction (OR: 0.996, 95% CI: 0.992–0.999) were independent predictors of delirium.In our study, a high PLR value on ICU admission was associated with a higher incidence of delirium. Owing to easy calculability, the PLR could be a useful delirium predictive index in ICUs, thereby enabling early interventions to be implemented.
Assessment of IGF-1 expression in the peripheral blood of women with recurrent breast cancer
Authors: Costa-Silva Danylo Rafhael , Barros-Oliveira Maria da Conceição , Alves-Ribeiro Francisco Adelton , Campos-Verdes Larysse Cardoso , Nery Junior Elmo de Jesus , Vieira-Valença Samara Fernanda , Vasconcelos-Valença Rodrigo Jose de , Soares Veronica Mendes , Pinho-Sobral André Luiz , Sousa Emerson Brandão , Lopes-Costa Pedro Vitor , dos Santos Alesse Ribeiro , Viana Jackeline Lopes , Cardoso Arquimedes Cavalcante , Luz-Borges Victoria Maria , Pereira Renato de Oliveira , Tavares Cleciton Braga , Silva Vladimir Costa , Rodrigues-Junior Dorival Mendes , Gebrim Luiz Henrique , da Silva Benedito Borges 
Published: October 2020

Abstract
Breast cancer is the most common malignancy affecting women worldwide. The insulin-like growth factor 1 (IGF-1) gene encodes a protein responsible for a wide variety of physiological processes, including differentiation and cell proliferation. Despite several studies on tumor tissues, no study has evaluated IGF-1 expression in the peripheral blood of women with recurrent breast cancer.
In this cross-sectional study, IGF-1 expression in the peripheral blood of 146 women with breast cancer treated approximately 5 years ago was quantified by quantitative reverse transcription polymerase chain. The women were divided into 2 groups: non-recurrence (n = 85) and recurrence (n = 61). Statistical analysis of the data was performed using ANOVA, Mann–Whitney, and Chi-squared tests (P < .05).
The results showed no significant difference in IGF-1 expression between the non-recurrence and recurrence groups (P = .988). In the subgroups of patients with lymph node involvement, no statistically significant difference was observed in IGF-1 expression between women with recurrence and those non-recurrence (P = .113). In patients without lymph node metastases, IGF-1 messenger ribonucleic acid (mRNA) expression levels were significantly higher in the non-recurrence group than in the recurrence group (P = .019). Furthermore, using the median IGF-1 mRNA expression as the cutoff point, it was obtained a statistically significant difference in tumor histological grade among women with recurrent breast cancer (P = .042).
These data showed significantly higher IGF-1 expression in women without lymph node metastases in the non-recurrence group compared with the recurrence group. In addition, a significant difference was observed in median IGF-1 mRNA expression in relation to tumor histological grade in women with recurrent breast cancer.
Risk factors and outcomes of myocardial injury after non-cardiac surgery in high-risk patients who underwent radical cystectomy
Authors: Yu Jihion , Lim Bumjin , Lee Yongsoo , Park Jun-Young , Hong Bumsik , Hwang Jai-Hyun , Kim Young-Kug 
Published: October 2020

Abstract
Radical cystectomy is considered the standard treatment for patients with muscle-invasive bladder tumors and has high postoperative complication rates among urological surgeries. High-risk patients, defined as those ≥45 years of age with history of coronary artery disease, stroke, or peripheral artery disease or those ≥65 years of age, can have a higher incidence of cardiac complications. Therefore, we evaluated the incidence, risk factors, and outcomes of myocardial injury after non-cardiac surgery (MINS) in high-risk patients who underwent radical cystectomy.
This retrospective observational study analyzed 248 high-risk patients who underwent radical cystectomy. MINS was defined as serum troponin I concentration ≥0.04 mg/L within postoperative 3 days. The risk factors for MINS were evaluated by multivariate logistic regression analysis. Postoperative outcomes were evaluated. The 1-year survival after radical cystectomy was also compared between patients who developed MINS (MINS group) and those who did not (non-MINS group) by Kaplan–Meier analysis.
MINS occurred in 35 patients (14.1%). Multivariate logistic regression analysis showed that early diastolic transmitral filling velocity (E)/early diastolic septal mitral annular velocity (E’) ratio (odds ratio = 1.102, 95% confidence interval [1.009–1.203], P = .031) and large volume blood transfusion (odds ratio = 2.745, 95% confidence interval [1.131–6.664], P = .026) were significantly associated with MINS in high-risk patients who underwent radical cystectomy. Major adverse cardiac events and 1-year mortality were significantly higher in the MINS group than in the non-MINS group (17.1% vs 6.1%, P = .035; 28.6% vs 12.7%, P = .021, respectively). Kaplan–Meier analysis showed significantly lower 1-year survival in the MINS group than in the non-MINS group (P = .010).
MINS occurred in 14.1% of patients. High E/E’ ratio and large volume blood transfusion were risk factors for MINS in high-risk patients who underwent radical cystectomy. Postoperative major adverse cardiac events and 1-year mortality were significantly higher in the MINS group than in the non-MINS group. Preoperative evaluation of risk factors for MINS may provide useful information to detect cardiovascular complications after radical cystectomy in high-risk patients.
Decitabine-induced kidney thrombotic microangiopathy with glomerular crescents formation and tubular necrosis
Authors: Qin Ai-bo , Tan Ying , Su Tao 
Published: October 2020

Abstract

Introduction:
Chemotherapeutic agents of direct cell damage play a role in initiating thrombotic microangiopathy (TMA), however still being underdiagnosed. Decitabine (DAC) is a pyrimidine analogue of the nucleoside cytidine, which can lead to injury to endothelium. Biopsy-proven DAC-induced kidney injury is rare.

Patient concerns:
A 47-year-old Chinese man with membranous nephropathy presented recurrent edema and acute kidney injury after a 3-day course of low dose DAC infusion because of cyclophosphamide-relating thrombocytopenia.

Diagnosis:
Laboratory data revealed nephrotic syndrome, hematuria, renal glycosuria and hypokalemia with hyperchloridemia. Renal pathological findings revealed TMA with secondary glomerular crescents formation (28%), partial foot process effacement and acute tubular necrosis. A diagnosis of DAC-induced renal TMA was considered.

Interventions:
As DAC had been timely discontinued before admission, the patient only received supportive treatment.

Outcomes:
The patient achieved rapid remission of acute kidney injury after DAC withdrawal, and his serum creatinine further decreased to normal level after 6 months.

Conclusion:
Careful monitoring of renal function especially serum creatinine should be emphasized during DAC treatment.
Endoscopic ultrasound-guided cholecystostomy for resection of gallbladder polyps with lumen-apposing metal stent
Authors: Shen Yonghua , Cao Jun , Zhou Xiaoliang , Zhang Song , Li Juan , Xu Guifang , Zou Xiaoping , Lu Ying , Yao Yuling , Wang Lei 
Published: October 2020

Abstract
Laparoscopic cholecystectomy is the routine method to treat gallbladder polyps. Nowadays, endoscopic ultrasound (EUS)-guided cholecystostomy as a bridge for per-oral transmural endoscopic resection of gallbladder polyps is introduced because preservation of gallbladder is increasingly getting attention. The aim of our study was to evaluate the approach in the treatment of patients with gallbladder polyps and symptomatic gallstones.
EUS-guided cholecystostomy with the placement of a lumen-apposing metal stent (LAMS) was performed for those patients with accompanying gallbladder polyps and symptomatic gallstones. Several days after the cholecystostomy with LAMS, a gastroscope was introduced into the gallbladder to remove gallbladder polyps.
All patients were successfully performed with the procedures of EUS-guided cholecystoduodenostomy (n = 3) or cholecystogastrostomy (n = 1) and endoscopic resection of gallbladder polyps. One patient experienced severe peritonitis. During the follow-up at 3 months, 1 patient was performed with laparoscopic cholecystectomy because ultrasonography examination showed the reappeared gallstones. No stone recurrence was found in other patients. During the follow-up of 3 to 15 months, no polyp recurrence was found in all the patients.
The approach is novel for performing EUS-guided gallbladder fistulization, which can subsequently allow procedures of per-oral transmural endoscopic resection of gallbladder polyps to avoid cholecystectomy in the patients with gallbladder polyps and gallstones. However, further studies are needed before clinical recommendation because of the complications and stone recurrence.
Does acute promyelocytic leukemia patient with the STAT5B/RARa fusion gene respond well to decitabine?
Authors: Wang Lei , Yan Xiaojing , He Juan 
Published: October 2020

Abstract

Rationale:
Most acute promyelocytic leukemia (APL) patients respond to all-trans-retinoic acid (ATRA)and have a good prognosis. However, variants APL who carry PLZF/RARа, STAT5B/RARа, and STAT3/RARа are insensitive to ATRA and have poor prognoses. The standard treatment for variants APL is still unclear due to the small sample size.

Patient concerns:
Here we reported a Chinese male who was admitted to our hospital with the complaint of rib pain, dyspnea, and fever (37.5°C). Blood tests showed leukopenia (1.83 × 109/L), anemia (hemoglobin 73 g/L), and thrombocytopenia (54 × 109/L). Prothrombin time and activated partial thromboplastin time were normal.

Diagnoses:
The patient was diagnosed as STAT5b-RARa-positive APL based on the clinical and laboratory findings.

Interventions:
ATRA was used immediately for induction treatment, then he was treated with ATRA + arsenic trioxide and got the severe cardiac insufficiency. Subsequently, consolidation chemotherapy was added with ATRA + Huangdai tablets + idarubicin and decitabine, cytarabine, aclamycin (DCAG).

Outcomes:
The patient relapsed soon after his first molecular complete remission (CRm), fortunately, he got a second CRm with DCAG. He has survived for more than 9 months and remains CRm, now he is looking for a suitable donor to prepare for hematopoietic stem cell transplantation (HSCT).

Lessons:
APL patients with STAT5B-RARa is not only resistant to ATRA, but also to conventional combination chemotherapy such as daunorubicin and cytarabine/idarubicin and cytarabine or other regimens. Relapse and extramedullary infiltration is common, HSCT is a effective treatment, and the best time for HSCT is after the first CR. It should be noted that this patient got CRm with DCAG after relapse, so the role of decitabine in APL with STAT5B-RARa needs to be considered.
Polymyxin B-induced rhabdomyolysis
Authors: Ni Ming , Meng Xiangdong , Wang Limin , Zhao Yanan , Yu Min , Shi Sheng 
Published: October 2020

Abstract

Rationale:
Polymyxin B has been used to treat extensively drug-resistant gram-negative bacteria and shown a better antibacterial effect in the clinic at present. Meanwhile, polymyxin B is associated with several adverse effects. However, there is a lack of awareness that polymyxin B can cause rhabdomyolysis. In this study, we firstly report a case of polymyxin B-induced rhabdomyolysis during antiinfection therapy.

Patient concerns:
A 70-year-old woman suffering from rheumatic heart disease underwent aortic and mitral valve replacement at our institute. Subsequently, she developed bacteremia and pneumonia caused by extensively drug resistance-acinetobacter baumannii. Polymyxin B was administered for 5 days. During treatment, the patient complained of muscle pain and limb weakness, and her serum creatine phosphokinase and myoglobin levels rose.

Diagnosis:
The clinical symptoms and laboratory examination confirmed rhabdomyolysis, and polymyxin B-induced rhabdomyolysis was considered.

Intervention:
We ceased polymyxin B treatment and monitored the patient daily.

Outcomes:
Serum creatine phosphokinase levels returned to normal, myoglobin levels decreased, and muscle pain was significantly alleviated after cessation of polymyxin B. We identified this as a case of polymyxin B-induced rhabdomyolysis.

Lessons:
Here, we report the first reported case of rhabdomyolysis induced by polymyxin B administration. The awareness of rare adverse reaction helps ensure the clinical safety of polymyxin B treatment.
Apatinib and fractionated stereotactic radiotherapy for the treatment of limited brain metastases from primary lung mucoepidermoid carcinoma
Authors: Yan Hongxia , Li Xiaolu , Peng Yi , Zhang Pingping , Zou Ning , Liu Xiyou 
Published: October 2020

Abstract

Rationale:
Apatinib is a novel anti-angiogenic agent that targets vascular endothelial growth factor receptor-2, thereby inhibiting tumor angiogenesis, and is effective in the treatment of brain metastases (BM) and peritumoral brain edema (PTBE). There are no previous reports of combination therapy with apatinib and fractionated stereotactic radiotherapy (FSRT) for BM from primary lung mucoepidermoid carcinoma (MEC).

Patient Concerns:
A 63-year-old man underwent left lower lobectomy and mediastinal lymph node dissection in April 2018.

Diagnoses:
Postoperative pathology demonstrated high-grade MEC. The patient developed 3 BM with PTBE 3 months after undergoing surgery.

Interventions:
The patient received a combination of FSRT and apatinib (250–500 mg/d) as maintenance therapy.

Outcomes:
The 3 BM showed nearly complete responses, and the PTBE areas shrank visibly. A new BM lesion occurred 7 months after the first FSRT and was treated with a second dose of FSRT. The patient developed extensive metastasis and atelectasis 9 months later. He died of pulmonary infection in December 2019. The overall survival time was 20 months.

Lessons:
Limited BM from primary lung MEC may be treated effectively with combination therapy with apatinib and FSRT when chemotherapy alone is not effective or tolerated. Further studies are needed to investigate the clinical outcomes and toxicities associated with the treatment.
Tracheobronchial amyloidosis in primary Sjögren syndrome
Authors: Luo Jiangyun , Ge Yongpeng 
Published: October 2020

Abstract

Rationale:
Tracheobronchial amyloidosis (TBA) associated with Sjögren syndrome is very rare. Here, we describe a case with this phenomenon, in order to better understand the condition.

Patient concerns:
A 52-year-old woman presented after 6 months of coughing, sputum, and dyspnea. Chest computed tomography revealed thickened bronchial walls, which were irregular on the left side the trachea. She had a history of dry eye and dry mouth of at least 3 years’ duration.

Diagnoses:
Sjögren syndrome was diagnosed based on her symptoms, ophthalmological and parotid examination, and immunological and autoantibody tests. The diagnosis of TBA was confirmed by Congo red staining of a tracheal biopsy.

Interventions:
The patient was given glucocorticoids without any other immunosuppressants.

Outcomes:
The symptoms improved after 6 months.

Lessons:
TBA associated with Sjögren syndrome is a rare condition. TBA is characterized by amyloid deposition to the trachea in the absence of systemic amyloidosis. Diagnosis requires tissue biopsy with demonstration of amyloid deposition.
Influence of parental education levels on eating habits of pupils in Nigerian primary schools
Authors: Umoke MaryJoy , Umoke Prince C. I. , Onyeke Nkechi G. , Victor-Aigbodion Vera , Eseadi Chiedu , Ebizie Elizabeth N. , Obiweluozo Patience Enuma , Uzodinma Uchenna Eugenia , Chukwuone Chiamaka Adaobi , Dimelu Ifeoma Ngozi , Uwakwe Rowland C. , Uba Mercy Benedette Ifeoma , Elom Chinyere Ori , Folorunsho Raphael Oluwasina Babalola 
Published: October 2020

Abstract
This study investigated the eating habits of pupils in Nigerian primary schools based on the respective education levels of their parents.
Data were obtained using the Child Eating Behavior Questionnaire (CEBQ). Participants included a total of 144 pupils who were purposively selected from 6 primary schools. Based on responses, a cross-sectional analytic study design was implemented to investigate how parental education levels (PELs) influenced the eating habits of their children. Data assessment was performed using a one-way between-group analysis of variance at the .05 probability level.
PELs significantly affected the eating habits of participants, respectively. Specifically, low PEL was associated with more satiety responsiveness to food (F [2, 141] = 14.251, P < .001), higher responsiveness to food (F [2, 141] = 36.943, P = <.001) greater food enjoyment (F [2, 141] = 93.322, P < .001), greater drinking desires (F [2, 141] = 23.677, P < .001), and the tendency for emotional over-eating (F [2, 141] = 13.428, P < .001), while high PEL was associated with slower eating (F [2, 141] = 11.665, P < .001), fussier responses to food (F [2, 141] = 14.865, P < .001), and a higher tendency for emotional under-eating (F [2, 141] = 5.137, P < .01).
This study examined PELs in relation to the respective eating habits of their children, who were attending Nigerian primary schools. Data showed that children with parents who had high, middle, and low education levels tended to exhibit progressively worse eating habits, in descending order.
Effects of Bushen Huoxue method for female with decreased ovarian reserve
Authors: Xie Zhuoting , Li Yin , Chen Zehua , Cao Qiuyu , Zhang Chunren , Fei Yang , Li Kunyin , Guan Yongge 
Published: October 2020

Abstract

Background:
Decreased ovarian reserve (DOR) is a common reproductive barrier in female. Bushen Huoxue (BSHX) method of TCM is widely applied to treat DOR clinically. The purpose of this study is to provide a systemic and comprehensive evaluation of BSHX in the treatment of DOR.

Methods:
We have registered this protocol with OSF registry and the DOI is 10.17605/OSF.IO/QNUE2. We will search 4 English databases (PubMed, EMBASE, MEDLINE, Cochrane Library) and four Chinese databases (China national knowledge infrastructure database, Wanfang database, VIP and Superstar database) from their inception to August 10, 2020. Two authors will search and extract independently all related studies. RevMan 5.3 software will be applied to synthesize data.

Results:
The results of this study will be published in a scientific journal after peer-review.

Conclusion:
This systematic review will provide reliable evidences for clinicians, and help them make decisions in DOR management.
Twitter Engagement of U.S. Psychiatry Residency Programs with Black Lives Matter and Coronavirus Disease 2019 (COVID-19)
Authors: El-Gabalawy Osama , Kim Candice J. , Chen Amanda V. , Kamal Shaan 
Published: October 2020

AbstractSocial media have become popular platforms to disseminate information, especially related to politicized topics such as BLM and COVID-19. To better understand how medical institutions have engaged with the social media discourse on BLM and COVID-19, we examined psychiatry residency programs’ tweets in response to George Floyd’s murder and during the first 6 months of the COVID-19 pandemic in the U.S. Only 14% of the 249 evaluated psychiatry residency programs had Twitter accounts (we included programs with their own account or their affiliated psychiatry department account) indicating a substantial absence on social media. Of those programs, 78% tweeted at least once about COVID-19 (1,153 tweets) and 56% tweeted at least once about the BLM movement (117 tweets). The top three purposes of tweets were sharing media, posting about an event, and sharing a resource.
Computerized physical exercise improves the functional architecture of the brain in patients with Parkinson’s Disease: a network science resting-state EEG study
Authors: Xefteris Vasileios Rafail , Styliadis Charis , Anagnostopoulou Alexandra , Kartsidis Panagiotis , Paraskevopoulos Evangelos , Klados Manousos , Zilidou Vasiliki , Karagianni Maria , Bamidis Panagiotis D. 
Published: October 2020

AbstractPhysical exercise is an effective non-pharmaceutical treatment for Parkinson’s disease (PD) symptoms, both motor and non-motor. Despite the numerous reports on the neuroplastic role of physical exercise in patients with PD (PwPD), its effects have not been thoroughly explored via brain network science, which can provide a coherent framework for understanding brain functioning. We used resting-state EEG data to investigate the functional connectivity changes of the brain’s intrinsic cortical networks due to physical exercise. The brain activity of 14 PwPD before and after a ten-week protocol of computerized physical training was statistically compared to quantify changes in directed functional connectivity in conjunction with psychometric and somatometric assessments. PwPD showed a significant reorganization of the post-training brain network along with increases in their physical capacity. Specifically, our results revealed significant adjustments in clustering, increased characteristic path length, and decreased global efficiency, in correlation to the improved physical capacity. Our results go beyond previous findings by indicating a transition to a reparative network architecture of enhanced connectivity. We present a meaningful relationship between network characteristics and motor execution capacity which support the use of motor treatment in tandem with medication. This trial is registered withClinicalTrials.govIdentifierNCT04426903.Impact StatementThe effects of physical training (PT) on the neuroplasticity attributes of patients with Parkinson’s Disease (PwPD) have been well documented via neurophysiological evaluations. However, there is a knowledge gap on the role of training-induced neuroplasticity in whole-brain network organization. We investigated the PT effects on the brain network organization of 14 PwPD, using EEG and network indices coupled with psychosomatometric tests. We report evidence of reparative functional reorganization of the brain with more balanced integration and segregation abilities, in correlation to improved motor performance. The PD brain can repair and reestablish a better level of motor execution and control due to computer-empowered physical stimulation.