bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creatinine increase following initiation of antihypertensives is associated with cardiovascular risk: a nationwide cohort study
Authors: Schytz Philip Andreas , Nissen Anders Bonde , Torp-Pedersen Christian , Gislason Gunnar H. , Nelveg-Kristensen Karl Emil , Hommel Kristine , Gerds Thomas A. , Carlson Nicholas 
Published: July 2020

Objective:
Abrupt decline in renal function following initiation of renin–angiotensin system inhibitor is associated with increased risk of cardiovascular disease, but studies of other antihypertensive drugs are sparse. We investigated the risk of cardiovascular event associated with increased plasma creatinine after initiating first-line antihypertensive treatment.

Methods:
In a nationwide cohort study, we identified adult Danish primary care patients initiating either renin–angiotensin system inhibitor, calcium channel blocker or thiazide, between 2008 and mid-2018. Patients with prior end-stage renal disease, renal transplantation, or cardiovascular disease were excluded. Percentual plasma creatinine increase was calculated between the nearest creatinine measurement up to 1 year before redeeming the prescription (baseline), and the nearest measurement 90 days or less after (index). Multiple logistic regression and restricted cubic splines were applied to estimate the 6-month absolute risk of cardiovascular event (ischemic heart disease, heart failure or stroke) associated with this creatinine increase.

Results:
We included 20 789 patients. Within the first 6 months of follow-up, 283 (1.4%) cardiovascular events and 93 (0.4%) all-cause deaths were registered. With a creatinine increase of 0 and 30%, 6-month absolute risk [CI] of cardiovascular event was 1.4% [1.1–1.9] and 3.5% [2.4–5.2], respectively (in men aged 50–79 years with estimated glomerular filtration rate at least 60 ml/min per 1.73 m2 and no diabetes). Higher age and reduced renal function, but not the type of antihypertensive treatment, were associated with higher cardiovascular risk.

Conclusion:
In primary care, patients initiating first-line antihypertensive treatment, an increase in plasma creatinine above 30% was associated with increased absolute 6-month risk of cardiovascular event.
DENSIRON 68 HEAVY SILICONE OIL AS A SHORT-TERM INTRAOCULAR TAMPONADE FOR MACULA-ON INFERIOR RETINAL DETACHMENTS—A CASE SERIES
Authors: Hostovsky Avner , Yap Joel , Mandelcorn Mark S. , Mandelcorn Efrem D. 
Published: July 2020

Purpose:
To describe our experience using short-term heavy silicone oil (Densiron 68) for macula-on inferior rhegmatogenous retinal detachments with inferior retinal breaks.

Methods:
Retrospective, consecutive, observational case series. Data were retrospectively collected from the medical records of patients who underwent pars plana vitrectomy and Densiron 68 endotamponade for macula-on rhegmatogenous retinal detachment repair.

Results:
Eight patients were included in the study. The mean patient age was 57.1 ± 12.3 (±SD) years. The mean time to Densiron 68 removal was 57.8 ± 17.8 (±SD) days (ranging from 24 to 83 days). One patient (12.5%) detached three weeks after Densiron 68 removal and required further surgery. All patients were attached at last follow-up with a mean follow-up of 192 days. The mean final best-corrected visual acuity was 20 of 40 (0.29 logarithm of the minimum angle of resolution) similar to the 20 of 45 preoperative best-corrected visual acuity (0.35 logarithm of the minimum angle of resolution, P = 0.501). No significant emulsification was noted before or during the removal of the Densiron 68. Two patients developed an increase in intraocular pressure before Densiron 68 removal that resolved after removal. One patient developed cystoid macular edema that resolved with a short course of topical medications, and one patient had persistent CME that required an intravitreal triamcinolone acetate 1% injection.

Conclusion:
The high anatomic success rate, good visual outcomes, and minimal complications suggest that Densiron 68 can be considered as a short-term tamponade for macula-on retinal detachments with inferior pathology.
Artificial intelligence in ophthalmology during COVID-19 and in the post COVID-19 era
Authors: Hallak Joelle A. , Scanzera Angelica C. , Azar Dimitri T. , Chan R.V. Paul 
Published: July 2020

Purpose of review
To highlight artificial intelligence applications in ophthalmology during the COVID-19 pandemic that can be used to: describe ocular findings and changes correlated with COVID-19; extract information from scholarly articles on SARS-CoV-2 and COVID-19 specific to ophthalmology; and implement efficient patient triage and telemedicine care.

Recent findings
Ophthalmology has been leading in artificial intelligence and technology applications. With medical imaging analysis, pixel-annotated distinguishable features on COVID-19 patients may help with noninvasive diagnosis and severity outcome predictions. Using natural language processing (NLP) and data integration methods, topic modeling on more than 200 ophthalmology-related articles on COVID-19 can summarize ocular manifestations, viral transmission, treatment strategies, and patient care and practice management. Artificial intelligence for telemedicine applications can address the high demand, prioritize and triage patients, as well as improve at home-monitoring devices and secure data transfers.

Summary
COVID-19 is significantly impacting the way we are delivering healthcare. Given the already successful implementation of artificial intelligence applications and telemedicine in ophthalmology, we expect that these systems will be embraced more as tools for research, education, and patient care.
Mapping the network underpinnings of central poststroke pain and analgesic neuromodulation
Authors: Elias Gavin J.B. , De Vloo Philippe , Germann Jürgen , Boutet Alexandre , Gramer Robert M. , Joel Suresh E. , Morlion Bart , Nuttin Bart , Lozano Andres M. 
Published: July 2020

Abstract
Central poststroke pain (CPSP) is a debilitating and often treatment-refractory condition that affects numerous stroke patients. The location of lesions most likely to cause pain and the identity of the functional brain networks that they impinge upon remain incompletely understood. We aimed to (1) elucidate which lesion locations are most frequently accompanied by pain; (2) explore CPSP-associated functional networks; and (3) examine how neuromodulation interacts with these networks. This multisite study investigated 17 CPSP patients who received deep brain stimulation (DBS; n = 12) or motor cortex stimulation (MCS; n = 5). Pain-causing lesions were manually segmented and normalized to standard space. To identify areas linked to high risk of pain, the locations of CPSP lesions and 220 control lesions were compared using voxelwise odds ratio mapping. The functional connectivity of pain-causing lesions was obtained using a large (n = 1000) normative resting-state functional MRI connectome and compared to that of control lesions and therapeutic DBS activation volumes. Brain regions most associated with CPSP risk (highest value = 63 times) were located along the ascending somatosensory pathways. These areas and the majority of individual CPSP lesions were functionally connected to anterior/middle cingulate cortex, insula, thalamus, and inferior parietal lobule (P
Bonferroni < 0.05). The extent of connectivity to the thalamus, inferior parietal lobule, and precuneus also differed between CPSP and control lesions (P
Bonferroni < 0.05). Posterior insula and thalamus shared connectivity with both CPSP lesions and pain-alleviating DBS activation volumes (P
Bonferroni < 0.05). These findings further clarify the topography and functional connectivity of pain-causing brain lesions, and provide new insights into the network-level mechanism of CPSP neuromodulation.
Association between obesity indicators and cardiovascular risk factors among adults in low-income Han Chinese from southwest China
Authors: Wang Ke , Pan Li , Wang Dingming , Dong Fen , Yu Yangwen , Wang Li , Li Ling , Liu Tao , Sun Liangxian , Zhu Guangjin , Feng Kui , Xu Ke , Pang Xinglong , Chen Ting , Pan Hui , Ma Jin , Zhong Yong , Shan Guangliang 
Published: July 2020

Abstract
There may be differences in optimal anthropometric cut-offs for diagnosing obesity among different regions of China. However, there has been little studies about choosing effective obesity indicators in Han People of low-income Chinese adults in southwest China. The purpose of this study was to compare and evaluate the associations between different obesity indicators and cardiovascular disease risk factors (CVDRF) and choose the optimal cut-off values.
A cross-sectional study was carried out in southwest of China, with multi-stage sampling enrolling 2112 subjects aged 20 to 80 years old. Anthropometric measurements included Body mass index (BMI), waist circumference (WC), Hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We measured the percentage of body fat (PBF) by bioelectrical impedance analyzer to assess the body composition. The validity of different obesity indicators in assessing CVDRF risk were assessed through comparison area under curve of different indicators in assessing CVDRF risk in different gender. Logistic regression models were used to evaluate the association between the obesity indicators and CVDRF.
When both male and female were considered, the optimal indicators were WHtR and percentage of body fat PBF for hypertension, WHR and WHtR for dyslipidemia. Both WC and WHtR were optimal indicators in assessing metabolic syndrome risk for both genders. When both disease and gender were considered, WHtR was the best associated indicators with various CVDRF. The cut-off of BMI and WC were consistent to the definition of obesity in Working Group of China. The WHtR positively correlated with the CVDRF. The cut-off of WHtR to do what was approximately 0.50 for adults in both genders in southwest of China.
WHtR may be the best associated indicators for obesity-related CVDRF among the others (BMI, WC, Hip circumference, PBF, and WHR) in southwest of China. The cut-off of WHtR was approximately 0.50 for adults in both genders in southwest of China.
Prognostic value of CD44v9 expression in human cancers: Retraction
Authors: Zeng Li , Chen Yitian , Chen Ligang , Tang Chengwei 
Published: July 2020

Abstract

Background:
The prognostic significance of CD44 variant-9 (CD44v9) expression in human cancers has been investigated in several studies, however, definite conclusion has not be reached. The aim of this systematic review and meta-analysis was to evaluate the prognostic significance of CD44v9 expression in various cancers.

Methods:
Three common databases were searched and retrieved studies were assessed using the inclusion and exclusion criteria. The further analyses for overall survival (OS), recurrence-free survival (RFS), and clinicopathological parameters were performed.

Results:
Fifteen studies containing 1633 cancer patients were included into this research. Patients with positive CD44v9 expression tended to have shorter OS (hazard ratio [HR] = 1.93, 95% confidence interval [CI] = 1.48–2.52, P < .01) and RFS (HR = 3.60, 95% CI = 1.52–8.53, P < .01) when compared with patients with negative CD44v9 expression. Positive CD44v9 expression was associated with larger tumor size (P = .04), deeper tumor invasion (P < .01), earlier lymph node metastasis (P < .01), and more advanced clinical stage (P < .01) when compared with negative CD44v9 expression.

Conclusion:
Positive CD44v9 expression predicted worse prognosis in human cancers compared with negative CD44v9 expression. CD44v9 expression could serve as a prognostic factor of human cancers.
Controversies in the application of corticosteroids for pediatric septic shock treatment: a preferred reporting items for systematic reviews and meta-analysis-compliant updated meta-analysis
Authors: Yang Jing , Sun Shaobo 
Published: July 2020

Abstract

Objectives:
Septic shock is the major cause of childhood mortality. However, the application of corticosteroids remains controversial. This work aimed to analyze the source of controversy based on existing data and recent randomized controlled trials by meta-analysis and to assess whether it can avoid these factors to guide clinical treatment.

Methods:
We searched the public databases up to 8 June 2019 and included only randomized controlled trials. The primary outcome was mortality. Sensitivity analysis, subgroup analysis, and dose-response meta-analysis were performed in this work.

Results:
We included twelve studies consisting of 701 children in the meta-analysis. For primary outcome, the fixed-effect model showed steroids could significantly reduce the mortality compared to the control (Odds Ratio: 0.67; 95% confidence interval: 0.46–0.98; P = .041). However, the random-effect model showed a negative result (Odds Ratio: 0.69; 95% confidence interval: 0.32–1.51; P = .252). None of the subgroup results rejected the null hypothesis that the overall effect equaled zero. Dose-response effect analysis showed that increased dosage at a low dosage might reduce the mortality, while at a high dosage, increasing the dose might increase the mortality. Moreover, the grading of recommendations assessment, development, and evaluation level of evidence is low for mortality.

Conclusions:
Corticosteroid application is not recommended for septic shock children under current medical conditions.
A hybrid therapeutic approach for decreasing postoperative complications in patients with adult lumbar degenerative scoliosis
Authors: Zhao Yongfei , Liang Yan , Wang Tianhao , Wang Zheng , Lu Ning 
Published: July 2020

Abstract
To decrease postoperative complications in patients with adult lumbar degenerative scoliosis (ALDS), short-segment fusion surgery was used in this study. However, the incidence of adjacent segment disease was found to be remarkable. Therefore, we applied the hybrid treatment (short-segment fusion for responsibility levels plus nonfusion stabilization of lumbar segments, which was called the Wallis system, for the proximal level) to patients enrolled into this study. The purpose of this study was to investigate the feasibility of a novel hybrid therapeutic approach for treating patients with ALDS.
From January 2011 to January 2017, a retrospective study was conducted consisting of 16 patients with ALDS who were treated with hybrid treatment. All patients were treated with short-segment decompression and fusion for responsibility levels and nonfusion stabilization of lumbar segments for the proximal levels. The imaging outcomes were evaluated preoperatively and at the time of follow-up.
The mean visual analog score for back pain decreased from 6.1 ± 2.0 preoperatively to 2.1 ± 0.7 at 2-year follow-up (P < .05), and the mean visual analog score for leg pain reduced from 8.1 ± 0.6 preoperatively to 1.3 ± 0.8 at 2-year follow-up (P < .05). The Oswestry disability index scores improved from 65.4 ± 16.3% preoperatively to 18.3 ± 5.6% at 2-year follow-up (P < .05). The mean Cobb angle was 22.1 ± 6.2° preoperatively, and 13.8 ± 6.8° at 2-year follow-up (P < .05). The lumbar lordosis changed from −40.4 ± 14.8° to −43.5 ± 11.2° at 2-year follow-up (P < .05). Solid fusion was achieved in all the patients, and no incidence of adjacent segment disease was noted as well.
The proposed hybrid treatment for patients with ALDS can achieve favorable clinical outcomes and a lower incidence of ALDS. However, the correction of deformity is still limited that highlights the necessity of further study.
Relationship between arterial stiffness and variability of home blood pressure monitoring
Authors: Park Jin-Sun , Shin Joon-Han , Park Jeong-Bae , Choi Dong-Ju , Youn Ho-Joong , Park Chang-Gyu , Kwan Jun , Ahn Youngkeun , Kim Dong-Woon , Rim Se-Joong , Park Seung-Woo , Sung Jidong , Bae Jang-Ho 
Published: July 2020

Abstract
Variability of blood pressure (BP) is known as a prognostic value for the subsequent target organ damage in hypertensive patients. Arterial stiffness is a risk factor for cardiovascular morbidity and mortality. The relationship between the arterial stiffness and the BP variability has been controversial. The objective of the present study was to investigate the relationship between arterial stiffness and home BP variability in patients with high normal BP and new onset hypertension (HTN).
Four hundred sixty three patients (252 males, 49 ± 12 year-old) with high normal BP or HTN were enrolled. Using radial applanation tonometry, pulse wave analysis (PWA) was performed for evaluation of systemic arterial stiffness. All patients underwent both home BP monitoring (HBPM) and PWA. Home BP variability was calculated as the standard deviation (SD) of 7 measurements of HBPM. Multiple linear regression analysis was performed to estimate and test the independent effects of home BP variability on the arterial stiffness.
Mutivariate analysis showed that both systolic and diastolic morning BP variabilities were correlated with arterial stiffness expressed as augmentation pressure (AP, β-coefficient = 1.622, P = .01 and β-coefficient = 1.07, P = .035). The SDs of systolic and diastolic BP of evening were also associated with AP (β-coefficient = 1.843, P = .001 and β-coefficient = 1.088, P = .036). The SDs of morning and evening systolic BP were associated with augmentation index (AI, β-coefficient = 1.583, P = .02 and β-coefficient = 1.792, P = .001) and heart rate (75 bpm) adjusted AI (β-coefficient = 1.592, P = .001 and β-coefficient = 1.792, P = .001).
In present study, the variability of systolic BP was closely related with arterial stiffness. The home BP variability might be important indicator of arterial stiffness.
A nationwide analysis of desmoplastic small round cell tumor
Authors: Xiang Tao , Zhang Shu-Yang , Wang Sai-Sai , Fei Ru-Shan , Li Hui 
Published: July 2020

Abstract
This study aim is to enhance the understanding, diagnosis and treatment of desmoplastic small round cell tumor (DSRCT) and to determine what factors can affect survival of the disease in China.
We report here 8 patients with DSRCT in our center who received a variety of treatment methods. By reviewing the literature published from Chinese database (CNKI, WANGFAN, VIP, CBM, CMCC) in 2000 to 2015 with the terms of “dsrct”, “desmoplastic” and “small round-cell tumor”,104 eligible cases of DSRCT(including 8 cases in our hospital) were retrospectively analyzed.
Among the 104 patients, Median age was 24 years with a range of 15 to 54 years. The main primary tumor site was the abdomen and/or pelvis in 92/104 patients (88.5%). Only 25% of patients had localized disease. Most of the patients had received adjuvant chemotherapy (87.5%) and 76.9% patients had not experienced adjuvant radiotherapy. One-fourth of the patients underwent grossly complete surgical resection, and 33.7% and 41.3% patients received no surgery and incomplete surgical resection, respectively. Median overall survival for all patients was 26 months (95% CI: 20.29–31.71). Multivariate analysis revealed that Metastatic status (HR: 2.327, 95% CI: 1.136–4.768, P = .021), Surgical patterns (HR: 0.673, 95% CI: 0.487–0.928, P = .016), and Adjuvant chemotherapy (HR: 0.337, 95% CI: 0.167–0.678, P = .002) were significant independent prognostic factors for longer overall survival. It was noteworthy that CD99 were significantly associated with OS (P = .002).
Here, we identified the prognostic factors which may facilitate risk-adapted treatments for this rare DSRCT group, which should be further investigated.
Focal nodular hyperplasia on an accessory liver lobe
Authors: Su Na , Chen Cheng , Dai Qing , Wang Liang , Yang Meng , Xia Yu , Jiang Yuxin , Lv Ke 
Published: July 2020

Abstract

Introduction:
Accessory liver lobe (ALL), an autonomous island of normal liver parenchyma, is a rare congenital anomaly that is difficult for preoperative diagnosis and often identified incidentally. It can also be accompanied with benign or malignant diseases, which is extremely rare. There are only 3 cases of focal nodular hyperplasia (FNH) detected on ALL reported by previous literature.

Patient concerns:
A 33-year-old woman was incidentally diagnosed with a mass in left upper quadrant abdomen by a routine ultrasound examination. Doppler ultrasound revealed that the mass was attached to left liver lobe with a vascular pedicle. A spoke-wheel artery with diffuse enhancement during hepatic arterial phase was visualized on contrast-enhanced ultrasound, and the mass was continuously hyper-enhanced with a hypo-enhanced intralesional scar during the portal and delayed phase. And contrast-enhanced computed tomography showed a similar enhancement mode of the mass.

Diagnosis:
The mass was resected and postoperative histopathologic result of the lesion revealed a nodular hyperplastic parenchyma with a central fibrous scar, without tumor cells. And a final diagnosis of FNH on ALL was determined accordingly.

Interventions:
Mass resection was conducted according to patient's demand.

Outcome:
After general postoperative administration, the patient was discharged. Then, she had been undergoing regular serological tests and imaging examinations in our hospital for 24 months.

Conclusion:
The finding of a mass connecting with liver by a stalk should alert the clinician of the possibility of ALL, as well as benign or malignancies on an ALL. This is the first case of FNH on ALL preoperatively confirmed by contrast-enhanced ultrasound. We suggest that an integrated radiologic approach is crucial to evaluate an incidentally detected, asymptomatic abdominal focal mass.
Patients with spontaneous pneumothorax have a higher risk of developing lung cancer
Authors: Chen Chien-Kuang , Chang Yen-Jung , Fang Hsin-Yuan 
Published: July 2020

Abstract
Lung cancer is a common malignancy worldwide, and risk factors include bronchitis, asthma, tuberculosis, smoking, and air pollution. These are also risk factors for spontaneous pneumothorax, a benign disease. We hypothesized that patients who experience a spontaneous pneumothorax have a greater risk to develop lung cancer, and designed a study to determine if this is so.
We used the population-based Taiwan Health Insurance Research Database to perform a retrospective cohort study. The database includes more than 99% of the population of Taiwan. We established a 27,405-person pneumothorax cohort and a 109,620 person comparison cohort with data from 2000 to 2009 to evaluate the relationship between spontaneous pneumothorax and lung cancer.
Multivariable analysis showed that patients who have had a spontaneous pneumothorax have a greater relative risk to develop lung cancer. The overall hazard ratio was 2.09 (95% confidence interval 1.69-2.58) adjusted by age, gender, hypertension, diabetes mellitus, and chronic lung diseases such as chronic obstructive pulmonary disease, tuberculosis, asthma, bronchitis, and emphysema. A dose effect was present; a high frequency of spontaneous pneumothorax was associated with a greater relative risk to develop lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the hazard ratio was 34.09 (95% confidence interval 22.74-51.10)
Patients with spontaneous pneumothorax have an increased relative risk to develop lung cancer, especially among patients 35 to 49 years of age. The more frequent the occurrence of spontaneous pneumothorax, the greater the relative risk of lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the increase in risk of lung cancer was more than 30-fold.