bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhabdomyolysis in a Patient with Severe Hypothyroidism: A Case Report
Authors: Welch Mikayla , Gharaibeh Naser 
Published: October 2020

Abstract
BackgroundHashimoto’s thyroiditis is typically diagnosed incidentally from elevated TSH or after evaluation of suggestive symptoms, including weight gain and fatigue. Rarely, patients present with an initial hyperthyroid state, Hashitoxicosis, that lasts weeks to months. Through a review of the current literature, it became apparent that this case is unique in several ways: the patient’s age, lack of comorbid conditions, the unique presentation of her thyroid disease, as well as the development of acute kidney injury while hospitalized.Case PresentationHere we present the case of a 26-year-old female who was referred to the Endocrinology office in July 2019 with symptoms of hyperthyroidism. She has a positive family history of Graves’ disease (GD) in her mother and thyroid malignancy in her maternal aunt. On her initial visit, TSH was suppressed, free thyroid hormones were increased, and both TPO and TSI antibodies were elevated. It was determined that this was likely a presentation of GD, and the patient was started on methimazole. She was instructed to follow-up every four weeks for monitoring of symptoms and labs. Three months following the initial visit, the patient failed to follow-up in office. During this time, she was seen by her primary care physician, diagnosed with hyperlipidemia, and started on statin therapy. One month later, on a subsequent follow-up with endocrinology, the patient complained of new onset back pain, muscle cramps, weight gain, and cold intolerance. She was sent to the emergency department for work-up. Evaluation revealed rhabdomyolysis in the setting of severe hypothyroidism, complicated by acute kidney injury. Her final diagnosis was found to be Hashitoxicosis with subsequent hypothyroidism.ConclusionsHyper- and hypothyroidism are two extremes on the spectrum of autoimmune thyroid disease, and the presentation can vary from patient-to-patient. Rarely, severe hypothyroidism can present with rhabdomyolysis with increased risk in patients on statin therapy. Thus, it is important to ensure patients are clinically and biochemically euthyroid prior to initiation of statin therapy. This case emphasizes the need for communication among physicians and the importance of patient adherence to treatment plans.
Identification of Risk Factors For Mortality and Delayed Oral Dietary Intake In Patients With Open Drainage Due To Deep Neck Infections: A Nationwide Study Using A Japanese Inpatient Database
Authors: Hidaka Hiroshi , Tarasawa Kunio , Fujimori Kenji , Obara Taku , Fushimi Kiyohide , Sakagami Masafumi , Yagi Masao , Iwai Hiroshi 
Published: October 2020

Abstract
Backgrounds: Data on risk factors for deep neck infection (DNI) including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was to identify the factors related to patient death and delay in recovering oral intake.Methods: We retrospective reviewed a Japanese inpatient database between 2012 and 2017, and data of 4,949 patients with DNM and DNI were extracted. The main outcome was survival at discharge. In a subgroup analysis of the 4,791 patients with survival at discharge, the second outcome was delay in the interval between admission and full recovery of oral intake. In both of the setting, logistic regression analyses were conducted to determine the risk factors.Results: Regarding survival at discharge, logistic regression analysis showed that age (≥75 years), comorbid diabetes mellitus, sepsis, receiving mechanical ventilation, and duration of empirical antibiotic therapy were significantly associated with mortality [adjusted-odds ratios (ORs) (95% confidence intervals (CIs)] as follows: 5.57 (2.80-11.1), 2.47 (1.69-3.62), 3.32 (2.29-4.82), 3.96 (2.51-6.23), and 1.00 (1.00-1.02), respectively. In a subgroup analysis of the 4,791 patients with survival at discharge, logistic regression analysis showed the following factors to be significantly associated with delayed oral dietary intake (>9 days), as follows [adjusted OR (95% CIs)]: age ≥75 years 1.89 (1.48-2.41); body mass index (BMI) <18.5 kg/m2 1.39 (1.13-1.71); DNM 1.41 (1.04-1.92); repeated surgical interventions 1.70 (1.16-2.48); tracheotomy 1.70 (1.44-2.00); mechanical ventilation 1.92 (1.53-2.41); intensive care unit (ICU) admission 1.54 (1.22-1.93); rehabilitation for oral dietary intake 2.05 (1.44-2.92); and duration of empirical antibiotic therapy 1.18 (1.17-1.20).Conclusions: In this study, a few factors (advanced age, ventilation) were associated with both mortality and delayed oral dietary intake. Conversely, several factors including DNM and repeated surgery were significantly related only to delayed oral dietary intake. Although DNM was not necessarily related to mortality, patients with DNM should receive postoperative care with careful attention to avoid delayed oral dietary intake.
Mortality and Morbidity of Curative and Palliative Anticancer Treatments during the COVID-19 Pandemic: A Multicenter Population-Based Retrospective Study
Authors: Tashkandi Emad , Basulaiman Bassam , Alsharm Abdullah , Al-Hajeili Marwan , Alshadadi Faisal , Halawani Lamis , Al-Mansour Mubarak , AlQuzi Bushra , Barnawi Samar , Alghamdi Mohammed , Abdelaziz Nashwa , Azher Ruqayya , Alabdulwahab Amal 
Published: October 2020

Abstract
Background: Administration of effective anticancer treatments should continue during pandemics. However, the outcomes of curative and palliative anticancer treatments during the coronavirus disease (COVID-19) pandemic remain unclear. This study aimed to determine the 30-day mortality and morbidity of curative and palliative anticancer treatments during the COVID-19 pandemic.Methods: This is a retrospective observational study. We included all adults with solid and hematological malignancies irrespective of cancer stage and type of anticancer treatments in five large comprehensive cancer centers in Saudi Arabia.Results: From March 1 to June 30, 2020, we included 2504 patients for analysis. The 30-day mortality was 5.1% (n=127) for all patients receiving anticancer treatment, 1.8% (n=24) for curative intent, 8.6% (n=103) for palliative intent, and 13.4% (n=12) for COVID-19 cases. The 30-day morbidity was 28.2% (n=705) for all patients, 17.9% (n=234) for curative intent, 39.3% (n=470) for palliative intent, and 75% (n=77) for COVID-19 cases. The 30-day mortality significantly increased with male sex (odds ratio [OR] 2.011, 95% confidence interval [CI] 1.141-3.546; p=0.016), body mass index (BMI)<25 (OR 1.997, 95% CI 1.292-3.087; p=0.002), hormone therapy (OR 6.315, 95% CI 0.074-2.068; p=0.001), and number of cycles (OR 2.110, CI 0.830-0.948; p=0.001), but decreased with Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0-1 (OR 0.157, 95% CI 0.098-0.256; p=0.001), stage I-II cancer (OR 0.254, 95% CI 0.069-0.934; p=0.039), and curative intent (OR 0.217, CI 0.106-0.443; p=0.001). Meanwhile, the 30-day morbidity significantly increased with age>65 years (OR 1.420, 95% CI 1.075-1.877; p=0.014), BMI<25 (OR 1.484, 95% CI 1.194-1.845; p=0.001), chemotherapy (OR 1.397, 1.089-5.438; p=0.032), hormone therapy (OR 1.527, 95% CI 0.211-1.322; p=0.038), and immunotherapy (OR 1.859, 95% CI 0.648-4.287; p=0.038), but decreased with ECOG-PS of 0-1 (OR 0.502, 95% CI 0.399-0.632; p=0.001), breast cancer (OR 0.569, 95% CI 0.387-0.836; p=0.004), urologic cancer (OR 0.505, 95% CI 0.255-0.999; p=0.050), and curative intent (OR 0.410, 95% CI 0.296-0.586; p=0.001).Conclusions: The mortality risk was lowest with curative treatments, and hence, such treatments should not be delayed. The morbidity risk doubled with palliative treatments and was highest among COVID-19 cases. Mortality appeared to be driven by male sex, BMI<25, hormonal therapy, and number of cycles, while morbidity increased with age>65 years, BMI<25, chemotherapy, hormonal therapy, and immunotherapy. Thus, oncologists need to select the most effective anticancer treatments based on the above factors.
Evaluation of Hybrid&nbsp;PET/MRI&nbsp;for Gross Tumor Volume (GTV) Delineation in Liver Cancer Radiotherapy
Authors: Zhang Yan-Nan , Lu Xin , Lu Zhen-Guo , Fu Li-Ping , Zhao Jun , Xiang Zuo-Lin 
Published: October 2020

Abstract
Background: Hybrid 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) has been increasingly incorporated into the practice of radiation oncologists since it contains both anatomical and biological data and may bring about personalized radiation plans for each patient. The objective of this study was to evaluate the feasibility of gross tumor volume (GTV) delineation from hybrid PET/MRI compared with that from current-practice MRI during radiotherapy planning in patients with liver cancer. Methods: Twelve patients (eighteen lesions) with liver cancer were enrolled in this study. We chose one of the most popular delineating methods—the visual method—in this study, and three physicians delineated the target volume of each lesion from MRI, PET, and hybrid PET/MRI images. The difference and correlation of GTV values obtained by MRI, PET and hybrid PET/MRI were subjected to statistical analysis. In addition, the Dice similarity coefficient (DSC) was calculated to assess the spatial overlap. GTV-MRI was set as a reference. Results: Most GTV-PET/MRI (83%) and 50% of GTV-PET were larger than the reference GTV-MRI. Statistical analysis revealed that GTV-PET/MRI (p=0.021) diverged statistically significantly from the reference GTV-MRI. In contrast, GTV-PET (p=0.266) was not significantly different from GTV-MRI. GTV-PET (r=0.991, p<0.001) and GTV-PET/MRI (r=0.997, p<0.001) were significantly related to GTV-MRI. The average DSC value between GTV-MRI and GTV-PET was 0.45 (range 0–0.90) and that between GTV-MRI and GTV-PET/MRI was 0.76 (range 0.43–0.90). Conclusions: With the database used, PET/MRI-based target volume delineation for liver cancer is feasible. The larger GTV-PET/MRI may allow adequate irradiation of the diseased tissue and improved treatment effect.
The Deviation between the Field Measurement and ENVI-met Outputs in Winter- A Cases Study in a Traditional Dwelling Settlement of China
Authors: Ma Xuan , Zhao Jingyuan , Zhang Lei , Wang Mengying , Cheng Zhi 
Published: October 2020

Abstract
Background: Numerical simulation has been used for assessing the process of outer environment performance calculations accurately. The ENVI-met has been used in studies in simulating the microclimate and energy cost in hot summer. On 27th November,2019, the latest ENVI-met v4.4.4 has been published, which is the first edition for forecasting the outdoor microclimate in winter, therefore, its accuracy is still needed to be discussed.Methods: This study aims at evaluating the effectiveness of the latest edition on the prediction of the thermal environment of courtyard and outdoor space in a traditional dwelling settlement in cold climate zone of northern China by means of validating the measured results against simulated results. Results: The final result shows a small deviation between simulated and measured results for assessing the microclimate in the research site. Conclusions: For this reason, the new ENVI-met v4.4.4 can be a reliable tool for forecasting the winter microclimate in northern China, and also this study also provides a basic database for improving resident’s thermal comfort in cold climate zone of China in future studies.
Experiences of Community-Dwelling Older People With Dementia Participating In A Person-Centered Multidimensional Interdisciplinary Rehabilitation Program&nbsp;
Authors: Sondell Anna , Lampinen Josefine , Conradsson Mia , Littbrand Håkan , Englund Undis , Nilsson Ingeborg , Lindelöf Nina 
Published: October 2020

Abstract
Background: There is a great need for the development of feasible rehabilitation interventions for older people with dementia. An increased understanding of this population’s experiences of rehabilitation program participation is therefore important. The purpose of this study was to explore how community-dwelling older people with dementia experienced their participation in a person-centered multidimensional interdisciplinary rehabilitation program.Methods: Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team followed by a rehabilitation period of 16 weeks among people with dementia and their informal primary caregivers. The interviews were conducted in close conjunction with the rehabilitation visits and analysed with qualitative content analysis.Results: The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy. Conclusion: A person-centered multidimensional interdisciplinary rehabilitation program seems feasible among community-dwelling older people with dementia according to reported experiences. The participants seemed empowered through the rehabilitation and reported mostly positive experiences and perceived improvements, which seemed to affect their wellbeing and daily life. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation. Trial registration: ISRCTN, ISRCTN59155421.http://www.isrctn.com/ISRCTN59155421. Registered November 3 2015.
“A Good Death But There Was All This Tension Around” - Perspectives of Residential Managers on the Experiences and Challenges of Delivering end of Life Care for People Living with Dementia.
Authors: Borbasi Jessica , Tong Allison , Ritchie Alison , Poulos Christopher J , Clayton Josephine M 
Published: October 2020

Abstract
Background End of life care for residents with advanced dementia in the aged care setting is complex because there is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia from the coalface to the broader policy context. Methods Focus groups and semi-structured interviews were conducted with 20 residential managers from 11 aged care homes in Australia. Transcripts were analysed using thematic analysis. Results Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding.
Forest Allocation, Benefit Sharing, and Management Practice in the KOBO Community Forest Among the Sheka People
Authors: Shoddo Getaneh Haile 
Published: October 2020

Abstract
Background: Sheka people have the right to forest allocation, benefit sharing, and management practice that they possess due to traditional ownership or other traditional occupation. Locally, these forests are known as KOBO. There is a scarcity of documented information on the KOBO culture of forest allocation, benefit sharing, and management practice among Sheka people. A study was conducted in Sheka zone southwestern Ethiopia.Methods: A framework based on ethnographic information is proposed in this paper; accordingly, qualitative indicators are suggested for different variables relating to indigenous forest allocation, benefit sharing, and management practice. A representative sample of 20 volunteered research participants were chosen. Observational and interview surveys were done by the first author through personal visits. Results: The analysis of data shows the KOBO culture is productive and efficient for forest management, and this useful culture has demonstrated its significance in the protection of various forest types and tree species, contributing to the conservation of biodiversity. These results lend support to the idea that the KOBO forest conservation culture is illustrated in the Sheka people forest utilization, protection, and management provide important insights into the protection of various forest types and tree species, contributing to the conservation of biodiversity.Conclusions: Understanding, the current KOBO culture of forest allocation, benefit sharing, and management practices could substantially enhance sustainable forest management and social and economic development of the Sheka people.
The Treatment of Wrist Ganglion Cyst by the Chinese Acupotomy and Crisscross Thread
Authors: Zhang Shuliang , Xu Bin , Lao Yangjun , Lu Di 
Published: October 2020

Abstract
Background: The current treatments of wrist ganglion have considerable recurrence rate, we developed a new treatment for ganglion cysts in our clinical practice, which combined acupotomy with crisscross thread method, so we now to compare the clinical effectiveness of Chinese acupotomy and crisscross thread with aspiration followed by injection of steroid and open excision for ganglion cysts treatment. Methods: Recruited patients with wrist ganglion were divided into three groups according to the treatments. Among them, 27 patients who were treated by a new combined treatment of Chinese acupotomy and crisscross thread method in group A, 30 patients who were treated by aspiration followed by steroid injection in group B, and 28 patients who were treated by open excision in group C. The data of age, gender, weight, size of ganglion cysts, visual analogue scale (VAS) , cost were recorded and compared by One-way analysis of variance, followed by an LSD (Least Significant Difference)test. The recurrence rates were recorded were analysed by chi-square test.Results: At the first day and one week after treatment, VAS score of group A was similar to group B with no statistic difference. VAS score of group C was higher than group A and B with statistic difference. Six months later, there was no statistic difference among the three groups about VAS. The recurrence rate was 3.7% in group A and 36.7% in group B and 10.7% in group C. No patient infected in three groups. The cost of group A was more than group B with no statistic difference. The cost of group A was much less than group C with statistic difference.Conclusions: The combination of Chinese acupotomy and crisscross thread method was a simple, economical and effective procedure for wrist ganglion cysts.
AQP0 is a novel surface marker for deciphering abnormal erythropoiesis
Authors: Wang Tso-Fu , Lin Guan-Ling , Chu Sung-Chao , Chen Chang-Chi , Liou Yu-Shan , Chang Hsin-Hou , Sun Der-Shan 
Published: October 2020

Abstract
BackgroundHematopoiesis occurs in the bone marrow, producing whole spectrum of blood cells to maintain homeostasis. In addition to light microscopy, chromosome analysis, and polymerase chain reaction, flow cytometry is a feasible, fast, and quantitative analysis method to examine hematological diseases. However, because the lack of sufficient specific cell markers, dyserythropoiesis diseases are not easy to be identified by flow cytometry. Methods: Bone marrow samples from C57BL/B6 mice and one healthy donor were analyzed using traditional 2-marker (CD71 and glycophorin A) flow cytometry analysis. After cell sorting, gene expression of membrane proteins in early and late erythropoiesis precursors and in non-erythroid cells were characterized using microarray analysis. Results Among characterized gene candidates, aquaporin 0 (AQP0) expresses as a surface protein in early and late stage erythropoiesis precursors and is not expressed on non-erythroid cells. In this present study, with assistant of AQP0 staining, we can define up to 5 stages of erythropoiesis in both mice and human bone marrow using flow cytometry. In addition, because patients with dyserythropoiesis generally displayed a reduced population of APQ0 high cells as compared to the normal subjects, analyses results also suggested that the levels of APQ0 high cells in the early erythropoiesis may serve as novel biomarker to distinguish normal versus dysregulated erythropoiesis. ConclusionsAQP0 was successfully demonstrated as an erythroid differentiation marker. The expression levels of AQP0 are down-regulated in patients with dyserythropoiesis, implicating a critical and functional role of AQP0 in erythropoiesis. Accordingly, the levels of AQP0 high population in early erythroid precursor cells may serve as a reference parameter for diagnosing diseases associating with dyserythropoiesis.