bluuebunny/crossref_metadata_2025_split huggingface dataset:
All-Cause and Overdose Mortality Risk Among People Prescribed Opioids: A Systematic Review and Meta-analysis
Authors: Larney Sarah , Peacock Amy , Tran Lucy T , Stockings Emily , Santomauro Damian , Santo Thomas , Degenhardt Louisa 
Published: May 2020

Abstract

Objective
To estimate all-cause and overdose crude mortality rates and standardized mortality ratios among people prescribed opioids for chronic noncancer pain and risk of overdose death in this population relative to people with similar clinical profiles but not prescribed opioids.

Design
Systematic review and meta-analysis.

Methods
Medline, Embase, and PsycINFO were searched in February 2018 and October 2019 for articles published beginning 2009. Due to limitations in published studies, we revised our inclusion criteria to include cohort studies of people prescribed opioids, excluding those studies where people were explicitly prescribed opioids for the treatment of opioid use disorder or acute cancer or palliative pain. We estimated pooled all-cause and overdose crude mortality rates using random effects meta-analysis models. No studies reported standardized mortality ratios or relative risks.

Results
We included 13 cohorts with 6,029,810 participants. The pooled all-cause crude mortality rate, based on 10 cohorts, was 28.8 per 1000 person-years (95% CI = 17.9–46.4), with substantial heterogeneity (I2 = 99.9%). The pooled overdose crude mortality rate, based on six cohorts, was 1.1 per 1000 person-years (95% CI = 0.4–3.4), with substantial heterogeneity (I2 = 99.5%), but indications for opioid prescribing and opioid exposure were poorly ascertained. We were unable to estimate mortality in this population relative to clinically similar populations not prescribed opioids.

Conclusions
Methodological limitations in the identified literature complicate efforts to determine the overdose mortality risk of people prescribed opioids. There is a need for large-scale clinical trials to assess adverse outcomes in opioid prescribing, especially for chronic noncancer pain.
Aging-Related Hypometabolism in the Anterior Cingulate Cortex of Cognitively Intact, Amyloid-Negative Seniors at Rest Mediates the Relationship between Age and Executive Function but Not Memory
Authors: Pardo José V , Nyabwari Shantal M , Lee Joel T ,   Alzheimer’s Disease Neuroimaging Initiative
Published: May 2020

Abstract
The anterior cingulate cortex (ACC) shows the most aging-related brain metabolic dysfunction that correlates with decreasing executive processing in otherwise healthy, cognitively intact volunteers. Here, data from ADNI are used to elucidate potential pathophysiological mechanisms involved in cognitive aging, that is, age-related decline in cognitive performance in the absence of known neurodegenerative disease. Amyloid-negative volunteers showed statistically significant mediation of ACC metabolism in the relationship between age and verbal fluency. A nonlinguistic task of executive function, Trails B, showed also negative correlation between performance and age, albeit weaker, but was not significant in the mediation analysis. Recall of story items, minimizing attentional demands compared with learning of word lists, did not correlate with age. ADNI subjects selected for low vascular risks also showed correlation between age and declining ACC metabolism. In the whole-brain amyloid-negative subset, ACC amyloid was not correlated with age. As expected, the metabolism in an arbitrary region such as motor cortex that was not expected to decline with cognitive aging showed no correlation with age or ACC metabolism suggesting regional specificity. These findings motivate the search for the pathophysiology of aging-related ACC dysfunction to prevent, diagnose, and treat the decline in executive function associated with cognitive aging.
Clinical Efficacy of Immediate Manual Meibomian Gland Expression After Thermal Pulsation (LipiFlow) for Obstructive Meibomian Gland Dysfunction: Comparison With Thermal Pulsation
Authors: Kim Hye Jee , Park Jin Hyoung 
Published: May 2020

Purpose:
To evaluate the clinical efficacy and safety of immediate manual meibomian gland expression (MGX) after LipiFlow thermal pulsation (TearScience Inc, Morrisville, NC) for obstructive meibomian gland dysfunction and to compare the LipiFlow only and MGX after LipiFlow.

Methods:
Patients who underwent immediate manual MGX after LipiFlow or who received only LipiFlow treatment were included. Thirty eyes from 15 patients were enrolled in each group. All patients underwent 3 treatments at monthly intervals. All patients were followed up for 6 months after treatment. All patients were examined before and at 3 and 6 months after treatment. Examinations included the Ocular Surface Disease Index score, noninvasive tear film breakup time (NIBUT), lipid layer thickness (LLT), corneal and conjunctival staining, and tear meniscus height.

Results:
The Ocular Surface Disease Index scores improved in both groups during the follow-up periods (P = 0.001 and P = 0.001). In the LipiFlow-only group, the NIBUT and LLT significantly improved at 3 months (P < 0.001 and P = 0.006) but deteriorated at 6 months. In the MGX after LipiFlow group, the NIBUT and LLT improved at 3 months (P < 0.001 and P < 0.001), and this improvement was maintained at 6 months. The improvement of NIBUT at 3 months was greater in the MGX after LipiFlow group (3.24 ± 1.16 to 9.25 ± 1.36 s) than in the LipiFlow-only group (3.78 ± 1.75 to 7.18 ± 2.70 s), and the improvements of the LLT at 6 months were greater in the MGX after LipiFlow group (30.27 ± 10.74 to 46.93 ± 20.81 μm) than in the LipiFlow-only group (34.70 ± 10.79 to 38.73 ± 14.70 μm).

Conclusions:
Both LipiFlow only and MGX after LipiFlow were clinically effective for obstructive meibomian gland dysfunction. However, the efficacy and persistence of treatment were greater in patients who received MGX after LipiFlow.
Endophthalmitis in Advanced Microbial Keratitis: Risk Factors and Examination Findings
Authors: Christopher Karen L. , Hood Christopher T. , Mian Shahzad I. , Ayres Bernadete 
Published: May 2020

Purpose:
To evaluate clinical and ultrasonographic findings associated with advanced microbial keratitis with concurrent endophthalmitis.

Methods:
We performed a retrospective analytical study of patients with severe microbial keratitis who underwent ocular ultrasonography for possible endophthalmitis at our institution over a 5-year period. Ocular and medical history, ocular examination findings, microbiology results, and ultrasonographic features were collected.

Results:
Of the 81 included eyes, 15 were diagnosed with endophthalmitis based on clinical findings and evidence of vitritis on ultrasound. Historical factors and physical examination findings more common in the endophthalmitis group than the keratitis-only group include presenting vision of light perception or no light perception (73.3% vs. 31.8%, P = 0.003), history of cataract surgery (80.0% vs. 45.5%, P = 0.02), and full thickness ulcer or perforation (33.3% vs. 9.1%, P = 0.03). Gram-positive organisms were more common in the endophthalmitis group (60.0% vs. 30.3%, P = 0.04). Ultrasound findings of choroidal thickening and retinal detachment were more common in the endophthalmitis group (26.7% vs. 3.4%, P = 0.01 and 13.3% vs. 8.4%, P = 0.04) in addition to the expected preponderance of membranous and dispersed vitreous opacities in that group. Final visual acuity was worse in the endophthalmitis group (2.3 vs. 3.5 LogMAR, P = 0.02).

Conclusions:
Diagnosing endophthalmitis can be difficult in eyes with advanced microbial keratitis, and the visual outcomes are often extremely poor. Clinicians should have a particularly high index of suspicion in eyes presenting with light perception or no light perception vision, history of cataract extraction, full thickness ulcer or perforation, or choroidal thickening or retinal detachment on ultrasound.
Transport and Preservation Comparison of Preloaded and Prestripped-Only DMEK Grafts
Authors: Català Pere , Vermeulen Wessel , Rademakers Timo , van den Bogaerdt Antoon , Kruijt Pieter Jan , Nuijts Rudy M. M. A. , LaPointe Vanessa L. S. , Dickman Mor M. 
Published: May 2020

Purpose:
This study compares the effect of the transport of conventionally prestripped Descemet membrane endothelial keratoplasty (DMEK) tissue with the DMEK revolutionary advanced Preloadable Injection Device (RAPID) preloaded transport system from Geuder AG (Heidelberg, Germany). Endothelial cell loss, tissue integrity, endothelial cell phenotype, and viability were assessed and compared.

Methods:
Twelve DMEK grafts were prestripped by the cornea bank and transported using the following 2 conditions: conventional flask (n = 6) or a preloaded transport cartridge (DMEK RAPID, n = 6). After transport, tissues were analyzed for cell density; denuded areas; immunolocalization of corneal endothelial markers, such as ZO-1, CD166, and Na+/K+ ATPase; histology analysis; and cell viability staining with Hoechst, calcein AM, and ethidium homodimer.

Results:
Endothelial cell loss (10.35% vs. 9.15%) did not differ between transport conditions. Histological analysis confirmed the integrity of the Descemet membrane and endothelial cell layer with both transport conditions. Similarly, the corneal endothelial cell mosaic was conserved in both conditions. The ZO-1 tight junctions confirmed the integrity of the confluent corneal endothelial cell monolayer. CD166 and Na+/K+ ATPase detection with immunofluorescence was also comparable. A similar percentage of dead cells was reported in both conditions (18.1% vs. 16.73%). Moreover, the surface covered with calcein-positive cells (59.02% vs. 61.95%) did not differ between transport conditions.

Conclusions:
Our results suggest that DMEK grafts can be prestripped or preloaded into a novel transport cartridge and shipped to the clinic with comparable endothelial cell loss, phenotypical marker expression, and viability to the conventional prestripped donor tissue.
Korean language specific dysarthria associated with idiopathic peripheral facial palsy
Authors: Lee Dong-Woo , Oh Ja-Young , Han Mi-Hyang , Kim Da-Ye , Lee Jae-Woo , Jang Dae-Hyun 
Published: May 2020

Abstract
To investigate the patterns of dysarthria in Korean patients with idiopathic peripheral facial palsy.
Seventy-eight patients diagnosed with idiopathic peripheral facial palsy within the onset of symptom to 7 day time frame were prospectively enrolled. The initial symptom of facial palsy was examined by the House-Brackmann scale. All patients were tested by Urimal-Test of Articulation and Phonology-2 (U-TAP-2), which is specialized for the evaluation of dysarthria in Korean language - Hangeul - when the patients first visited and were followed up at 4 weeks after the onset, respectively. The facial electromyography was performed after 7 days, since the presentation of the first symptom. Electric stimulation therapy and simple facial exercise education were performed in all patients as routine treatments for facial palsy with or without dysarthria. The patterns of dysarthria were analyzed by initial and follow-up U-TAP-2 results, respectively.
Among 78 patients, 50 patients (64.1%) had dysarthria in the first assessment. The 6 consonants and 3 vowels were errored in U-TAP-2 test. The bilabial consonants “&#x3143;”[p] or “&#x0314D;” [ph] were substituted with labiodental consonant [f], and palate-alveolar consonants were replaced by alveolar consonants - “&#x314A;”[t

JOURNAL/medi/04.03/00005792-202005220-00004/inline-graphic1/v/2024-05-21T181312Z/r/image-tiff

h] to “&#x314C;”[th]. Bilabial consonant “&#x3141;”[m] was replaced by velar nasal consonant “&#x3147;”[ŋ]. Liquid consonant was altered to nasal sound. For example, “&#x3139;”[r] is replace by “&#x3134;”[n]. The velar consonant “&#x3132;”[k] was pronounced as “&#x314B;” [kh]. The diphthong vowels “&#x315F;”[ɥi], “&#x315A;”[ø], or “&#x3158;”[wa] were pronounced as monothong “&#x3163;” [i], “&#x3150;”[ε], or “&#x314F;”[a], and “&#xBABB;”[mot] is slowly pronounced. After 4 weeks, 14 patients still showed pronunciation errors in 5 consonants and 3 vowels. The most common error was substitution.
Among 78 patients with idiopathic peripheral facial palsy, 50 patients had dysarthria and 14 out of 50 patients with dysarthria lasted more than 4 weeks. Five consonants (“&#x3141;”, “&#x314A;”, “&#x314D;”, “&#x3139;”, “&#x3132;”) and 3 vowels (“&#x3158;”, “&#x3157;”, “&#x315F; or &#x315A;”) were still mispronounced after 4 weeks, and most common error was substitution. Therefore, speech evaluation and speech therapy specialized for errors in high frequency of consonants and vowels are needed in patients with idiopathic peripheral facial palsy, in Korea.
Treatment of Type 2 diabetes with Tianqi Jiangtang Capsule
Authors: Piao Chunli , Zhang Qi , Jin De , Shao Mengsu , Bi Chaoran , Wang Li , Tang Cheng , Lian Fengmei , Tong Xiaolin 
Published: May 2020

Abstract

Background:
Tianqi Jiangtang Capsule is a commonly used Chinese patent medicine for the treatment of type 2 diabetes mellitus (T2DM) in China. The purpose of this study is to systematically evaluate the clinical efficacy and safety of Tianqi Jiangtang Capsule in the treatment of type 2 diabetes mellitus.

Methods:
Randomized controlled trials (RCTs) of Tianqi Jiangtang Capsule in the treatment of type 2 diabetes mellitus were retrieved. According to the requirements of Cochrane Manual, the included literature was assessed and meta-analyzed with RevMan 5.3 software.

Results:
(1) Meta-analysis included 8 RCTs and 1029 participants.
(2) There were two studies on adverse reactions.
(3) Meta-analysis showed that Tianqi Jiangtang Capsule could significantly reduce HbA1c (n = 1029; MD, −0.31; 95% CI, [−0.43 to −0.19]; P < .00001; I2 = 0%). FBG (Z = 4.28 (P < .0001), MD = 0.78, 95%CI[−1.14 to −0.43]). 2hPG [OR = −1.25, 95% CI [−1.25 to −0.65], Z = 6.26 (P < .00001)] compared with the control group.

Conclusions:
According to the results of this study, Tianqi Jiangtang Capsule combined with antidiabetic agents may have a better therapeutic effect on diabetes mellitus than antidiabetic agents alone, but due to the low methodological quality and limited number of studies, more high-quality studies are needed to verify it.
Dynesys system vs posterior decompression and fusion for the treatment of lumbar degenerative diseases
Authors: Wang Hongbo , Peng Jun , Zeng Qingshen , Zhong Yanchun , Xiao Chunlin , Ye Yongjun , Huang Weimin , Liu Wuyang , Luo Jiaquan 
Published: May 2020

Abstract

Background:
The Dynesys dynamic stabilization system is an alternative to rigid instrumentation and fusion for the treatment of lumbar degenerative disease. The purpose of this study is to evaluate the clinical efficacy between Dynesys and posterior decompression and fusion for lumbar degenerative diseases.

Methods:
The computer was used to retrieve the Cochrane library, Medline, Embase, CNKI, Wanfang database and Chinese biomedical literature database; and the references and main Chinese and English Department of orthopedics journals were manually searched. All the prospective or retrospective comparative studies on the clinical efficacy and safety of Dynesys and posterior decompression and fusion were collected, so as to evaluate the methodological quality of the study and to extract the data. The RevMan 5.2 software was used for data analysis.

Results:
A total of 17 studies were included in the meta-analysis. There were no significant differences in Oswestry disability index and visual analogue score for leg pain, visual analogue score for back pain, L2–S1 ROM between Dynesys and fusion group. Operation time, blood loss, length of stay and complications in the Dynesys group were significantly less than that in the fusion group. Adjacent-segment degeneration in the fusion group was significantly higher than that in the Dynesys group. In addition, postoperative operated segment ROM was significantly less in the fusion group as compared to the Dynesys group.

Conclusions:
Our meta-analysis suggests that Dynesys system acquires comparable clinical outcomes compared to fusion in the treatment of lumbar degenerative diseases. Moreover, compared with fusion, Dynesys could remain ROM of surgical segments with less operation time, blood loss, length of stay, adjacent-segment degeneration, and lower complication. Further studies with large samples, long term follow up and well-designed are needed to assess the two procedures in the future.
Successful rescue using tracheal intubation cannula for severe central airway stenosis after tracheotomy
Authors: Li Hai-Feng , Xing Bao-Peng , Song Li-Sha , Wang Wei , Liu Bao-Hua 
Published: May 2020

Abstract

Introduction:
Central airway stenosis is a life-threating requiring immediate medical intervention. There are several options for treating central airway stenosis, including rigid bronchoscopy, bronchoscopic high-power laser therapy, high-frequency electric needle knife, and balloon-expanding stents. However, interventional techniques may be unavailable in an emergent situation or at smaller local hospitals. In this case report, we publicly demonstrate for the first time that a tracheal intubation catheter may be applied as a temporary alternative to interventional bronchoscopic treatment.

Patient concerns:
A 72-year old male patient was admitted with a 1-year history of intermittent dyspnea, which was exacerbated for one day. One day prior to admission to our hospital, the patient presented with cyanosis due to an exacerbation of dyspnea.
A tracheotomy was performed and the patient had been carrying a tracheotomy cannula for 6 months.

Diagnosis:
The ventilator alarm indicated high airway resistance and the nurses were unable to insert the suction pipes into the airway. Immediate fiberoptic bronchoscopy showed diffuse edema and stenosis of the inferior tracheal airways.

Interventions:
Tracheal intubation was used to temporarily replace the tracheotomy cannula, which successfully expanded the narrowed airways.

Outcomes:
The blood oxygen saturation returned to normal, and dyspnea was quickly relieved.

Conclusion:
In emergent situations, tracheal intubation catheters may be used in patients with post-tracheotomy central airway stenosis, not only for surviving the most dangerous phase but for also prolonging the survival time for further treatments.
Antidepressant use and colorectal cancer morbidity and mortality
Authors: Chen Lin , Li Xun , Li Chengbin , Zou Chuanxin 
Published: May 2020

Abstract
The risk of colorectal cancer associated to antidepressant use remains unclear. The purpose of this meta-analysis was to investigate the risk of colorectal cancer associated to antidepressant use.
Medline, Embase, Web of Science, and Cochrane Database were accessed from the dates of their establishment to October 2018, to collect study of antidepressant use and colorectal cancer morbidity and mortality. Then a meta-analysis was conducted using Stata 12.0 software.
A total of 11 publications involving 109,506 participants were included. The meta-analysis showed that antidepressant use was not associated with colorectal cancer morbidity (relevant risk (RR): 0.97; 95% confidence interval (CI): 0.94–1.01) and mortality (RR: 1.08; 95% CI: 0.99–1.17). Subgroup analysis showed selective serotonin reuptake inhibitor (RR: 0.99; 95% CI: 0.96–1.03) or serotonin norepinephrine reuptake inhibitor (RR: 1.04; 95% CI: 0.86–1.26) were not associated with colorectal cancer risk; however, TCA was associated with colorectal cancer risk decrement (RR: 0.92; 95% CI: 0.87–0.98). Furthermore, the results also showed that antidepressant use was not associated with colorectal cancer risk in Europe and North America (RR: 0.97; 95% CI: 0.92–1.02) and Asia (RR: 1.00; 95% CI: 0.95–1.26). Additionally, a dose-response showed per 1 year of duration of antidepressant use incremental increase was not associated with colorectal cancer risk (RR: 0.96; 95% CI: 0.87–1.09).
Evidence suggests that antidepressant use was not associated with colorectal cancer morbidity and mortality. The cumulative duration of antidepressant use did not utilized played critical roles.
Role of long non-coding RNA NEAT1 in the prognosis of prostate cancer patients
Authors: Bai Junchao , Huang Guangyi 
Published: May 2020

Abstract
Prostate cancer is the second leading cause of cancer-related deaths among male population worldwide, its incidence and lethality steadily increase. Nuclear enriched abundant transcript 1 (NEAT1) is a long non-coding RNA (ncRNA), located on chromatin 11. It has been found to function as an oncogene in different kinds of cancer. However, until now, the clinical significance of NEAT1 has not been investigated in prostate cancer.
Paired tissue specimens of prostate cancer and matched normal prostate tissues were obtained from 130 patients with prostate cancer between 2014 and 2019 at The Fourth Affiliated Hospital Zhejiang University, School of Medicine. Group means were compared using the Student t test. Chi-Squared test was used for analyzing the correlation of the expression of NEAT1 with clinicopathologic features of prostate cancer patients. Survival data was analyzed using the Kaplan–Meier estimate and log-rank P was calculated. Cox regression model was used for univariate and multivariate analysis for factors related to overall survival.
The expression of NEAT1 was increased significantly in prostate cancer tissues, compared with adjacent normal prostate tissues (P < .001). NEAT1 expression was significantly associated with TNM stage (P = .005), lymph nodes metastasis (P = .005), distant metastasis(P = .003), and Gleason score (P = .001). Overall survival rate was significantly lower for prostate cancer patients with a high expression level of NEAT1 than those with a low NEAT1a expression level (P = .048). In multivariate analysis, the results showed that the expression of NEAT1 was an independent prognostic factor for overall patient survival (HR: 2.111, CI: 1.735–10.295, P = .039).
In the present study, NEAT1 is identified as an important lncRNA that may predict the prognosis of patients with prostate cancer.
Diagnosis and treatment of pure arterial malformation
Authors: Liu Tian-Yi , Xu Ning , Wan Zheng , Zhang Zhe-Ming , Xu Jian-Jun , Meng Hao , Wang Hong-lei 
Published: May 2020

Abstract

Rationale:
The incidence of pure arterial malformations is relatively low, and few cases have been reported. Only 2 cases with pure arterial malformation have been reported to receive surgery or endovascular treatment.

Patient concerns:
We report 3 cases and review the relevant literatures. The head examinations of the patients suggested the presence of high-density shadows in front of the pons and midbrain, the dilation of the supraclinoid segment of the right internal carotid artery, and moyamoya in the left brain with an aneurysm-like expansion located on the left posterior communicating artery respectively. After admission, head digital subtraction angiography (DSA) was performed.

Diagnoses:
Digital subtraction angiography (DSA) for these 3 patients showed that the left posterior communicating artery, the supraclinoid segment of the right internal carotid artery, and the left posterior communicating artery appeared dilated, tortuous, and spirally elongated. In addition, the lesions in the latter 2 patients were accompanied with local aneurysmal changes.

Interventions:
Two patients were given conservative treatment, and another patient was given endovascular treatment. A head DSA was reviewed 6 months after therapy.

Outcomes:
The prognosis status of the 3 patients was good. Two patients in the conservative treatment group showed no changes in the lesions on head DSA examination. The DSA examination of the third patient indicated that the vascular remodeling of the diseased vessels was good, the blood vessels were unobstructed, and the aneurysms had disappeared.

Lessons:
Pure arterial malformations mostly occur in young women and may involve any blood vessels in the brain. It can be accompanied with local aneurysms and calcification. The patients are often given conservative treatment but need to be reviewed regularly. However, it is beneficial to give endovascular treatment to the patients with local aneurysms.