bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insomnia diagnosis and management: an osteopathic approach
Authors: Homistek Cody , Doty Heather 
Published: November 2021

Insomnia affects a large percentage of American adults and is among the most commonly treated medical conditions in the outpatient clinical setting. The psychological, medical and financial impact of insomnia is substantial. Research indicates that pharmacologic treatment is associated with significant risk, and clinicians should consider other modalities including cognitive behavioral therapy before prescribing medications for the treatment of insomnia. Other complementary treatments including yoga, stress management and traditional Chinese medical therapies are promising, but more research is needed.
The osteopathic family physician plays an important role in diagnosis and management. An osteopathic approach to patient care is highly beneficial and includes a multifaceted evaluation when taking a patient history and osteopathic manipulative treatment (OMT) to balance autonomic tone and correct associated somatic dysfunction.
Fatores que podem contribuir para recessão gengival na clínica odontopediátrica: revisão narrativa de literatura
Authors: Gonzalez Karine Fausto , Santana Ariane Abdala , Martini Keller de , Rezende Karla Mayra 
Published: November 2021

As demandas por tratamentos odontológicos para recessões gengivais estão aumentando cada dia mais, o comprometimento estético e a hipersensibilidade causada por essa alteração no periodonto é algo que causa muito incômodo na população de forma geral. Apesar de existir uma maior frequência em adultos, alguns estudos têm demonstrado a ocorrência em criança. O objetivo deste trabalho foi realizar uma revisão narrativa e atual dos últimos 10 anos sobre os fatores que podem contribuir par recessão gengival em crianças. Buscas distintas foram realizadas na base de dados Pubmed/Medline. Os critérios de elegibilidade foram: estudos publicados na língua inglesa, recessão gengival, doença mucogengival, etiologia, prevalência em crianças, estudo de coorte, longitudinal e casos clínicos. Como critérios de exclusão foi idade (casos acima de 19 anos), revisão de literatura, textos fora do tema. Do total dos textos encontrados, apenas 9 cumpriram os critérios de inclusão. Concluímos que não houve, nestes últimos 10 anos, pesquisas sobre o tema na dentição decídua. As manifestações aqui descritas como: bruxismo, tratamento ortodôntico, doenças sistêmicas, maloclusões, freios labiais estavam relacionados em crianças, porém, na fase dentadura mista e ou permanentes.
Uso de derivados da cannabis sativa. L no tratamento adjuvante em pacientes oncológicos no município de Caruaru, Pernambuco
Authors: Costa Clara Caroline Camilo da , Silva Caio Ruan Moura da , Queiroz Evandro 
Published: November 2021

No contexto atual o uso medicinal de derivados da cannabis tem tomado proporções crescentes. Entretanto, embora o uso medicinal tenha obtido nos últimos anos um aumento significativo e aprovação judicial para o uso de forma legal no Brasil o conhecimento e utilização dessa opção terapêutica ainda não é uma realidade. Sendo um dos maiores entraves a burocracia para o acesso aos medicamentos ou produtos. Tendo em vista o cenário de ascensão terapêutica dos medicamentos e produtos derivados da Cannabis Sativa no Brasil e no mundo, esse artigo objetivou a realização de um levantamento através de um estudo de campo quantitativo-descritivo nos centros oncológicos do município de Caruaru-PE para averiguar o posicionamento dos médicos e da equipe multidisciplinar em relação aos produtos em questão para ajudar no tratamento ao câncer; qual o conhecimento dos mesmos sobre essa opção terapêutica bem como fazer um paralelo com as drogas já existentes e a burocracia para ter acesso aos derivados da Cannabis Sativa. Mediante aos resultados o uso da droga em questão apontou para uma neutralidade dos profissionais envolvidos na área oncológica.
New Autophagy-Ferroptosis Gene Signature Predicts Survival in Glioma
Authors: Zhou Liwei , Jiang Zhengye , Shi Zhongjie , Zhao Wenpeng , Lu Zhenwei , Xie Yuanyuan , Zhang Bingchang , Lu Hanwen , Tan Guowei , Wang Zhanxiang 
Published: November 2021

Background: Ferroptosis plays an important role in glioma and significantly affects the prognosis, but the specific mechanism has not yet been elucidated. Recent studies suggest that autophagy regulates the process of ferroptosis. This study aimed to find potential autophagy-ferroptosis genes and explore the prognostic significance in glioma.Methods: Ferroptosis and autophagy genes were obtained from two online databases (zhounan.org/ferrdb and autophagy.lu/). The RNAseq data and clinical information were obtained from the Chinese Glioma Genome Atlas (CGGA) database (http://www.cgga.org.cn/). Univariate, multivariate, lasso and Cox regression analysis screened out prognosis-related genes, and a risk model was constructed. Receiver operating characteristic (ROC) curve analysis evaluated the predictive efficiency of the model. Finally, a nomogram was constructed to more accurately predict the prognosis of glioma.Results: We developed a Venn diagram showing 23 autophagy-ferroptosis genes. A total of 660 cases (including RNA sequences and complete clinical information) from two different cohorts (training group n = 413, verification group n = 247) of the CGGA database was acquired. Cohorts were screened to include five prognosis-related genes (MTOR, BID, HSPA5, CDKN2A, GABARAPLA2). Kaplan-Meier curves showed that the risk model was a good prognostic indicator (p &lt; 0.001). ROC analysis showed good efficacy of the risk model. Multivariate Cox analysis also revealed that the risk model was suitable for clinical factors related to prognosis, including type of disease (primary, recurrence), grade (III-IV), age, temozolomide treatment, and 1p19q state. Using the five prognosis-related genes and the risk score, we constructed a nomogram assessed by C-index (0.7205) and a calibration plot that could more accurately predict glioma prognosis.Conclusion: Using a current database of autophagy and ferroptosis genes, we confirmed the prognostic significance of autophagy-ferroptosis genes in glioma, and we constructed a prognostic model to help guide treatment for high grade glioma in the future.
New Detrital Apatite Fission Track Thermochronological Constraints on the Meso-Cenozoic Tectono-Thermal Evolution of the Micangshan-Dabashan Tectonic Belt, Central China
Authors: Tian Tao , Yang Peng , Yao Jianming , Duan Zhonghui , Ren Zhanli , Fu Deliang , Yang Fu 
Published: November 2021

The Micangshan-Dabashan tectonic belt, located in the southern Qinling-Dabie Orogen near the northeastern Tibetan Plateau, is a crucial area for understanding the processes and mechanisms of orogenesis. Previous studies have been focused on the cooling process via thermochronology and the mechanism and process of basement uplift have been investigated. However, the coupling process of basement exhumation and sedimentary cap cooling is unclear. The tectono-thermal history constrained by the detrital apatite fission track (AFT) results could provide valuable information for understanding crustal evolution and the coupling process. In this study, we provided new detrital AFT thermochronology results from the Micangshan-Dabashan tectonic belt and obtained nine high-quality tectono-thermal models revealing the Meso-Cenozoic cooling histories. The AFT ages and lengths suggest that the cooling events in the Micangshan area were gradual from north (N) to south (S) and different uplift occurred on both sides of Micangshan massif. The cooling in Dabashan tectonic zone was gradual from northeast (NS) to southwest (SW). The thermal histories show that a relatively rapid cooling since ca. 160 Ma occurred in the Micangshan-Dabashan tectonic belt, which was a response to the event of Qinling orogenic belt entered the intracontinental orogenic deformation. This cooling event may relate to the northeastward dextral compression of the Yangtze Block. The sedimentary cap of Cambriano-Ordovician strata responded positively to this rapid cooling event and entered the PAZ since ca. 63 Ma. The deep buried samples may be limited affected by climate and water erosion and the accelerated cooling was not obvious in the Late Cenozoic. Collectively, the cooling processes of basement and sedimentary cap in Micangshan-Dabashan tectonic belt were inconsistent. The uplift of the sedimentary area is not completely consistent with that of the basement under thrust and nappe action. The rigid basement was not always continuous and rapidly uplifted or mainly showed as lateral migration in a certain stage because of the different intensities and modes of thrust and nappe action, and the plastic sedimentary strata rapidly uplifted due to intense folding deformation.
Transient Heat Transfer Characteristics of Twisted Structure Heated by Exponential Heat Flux
Authors: Wang Li , Liu Qiusheng 
Published: November 2021

This study was conducted to investigate the transient heat transfer characteristics of a twisted structure. The twisted structure was heated according to exponential function (Q=Q0×exp(t/τ), where Q0 is the initial heat generation rate, W/m3; t is time, s; and τ is the period of heat generation rate). A wide range of τ from 37 ms to 14 s was applied for the experimental study. A platinum plate with five pitches (each was 180° twisted with 20 mm in length) was used in the experiment. Helium gas with inlet temperature of 298 K under 500 kPa was used as the coolant. The heat transfer coefficient is found to increase with the decrease of τ, and the transition point was estimated to be at τ≈1s, which means that, when the increasing ratio of heat generation rate satisfies dQdt≥Q0⋅et, the heat transfer enhancement phenomenon will be observed. The response analysis for transient heat transfer at fluid-solid interface was conducted by applying the concept of penetration depth. It is considered that, when the penetration depth is smaller than the thermal boundary thickness, the heat transfer from the interface (wall surface) to the fluid domain is not fully developed during the disturbance.
Hepatotoxicity-Related Adverse Effects of Proton Pump Inhibitors: A Cross-Sectional Study of Signal Mining and Analysis of the FDA Adverse Event Report System Database
Authors: Zeng Yifan , Dai Ying , Zhou Ziye , Yu Xuben , Shi Dawei 
Published: November 2021

Background and Objectives: Mounting evidence demonstrates that proton pump inhibitors (PPIs) are associated with a number of adverse effects. However, the literatures about hepatotoxicity-related adverse effects (HRAEs) of PPIs are mostly case reports and a few clinical studies.Methods: We evaluated the association between PPIs and HAREs using the reporting odd ratio (ROR) for mining the adverse event report signals in the FDA Adverse Event Reporting System (FAERS) database.Results: There were 23,825 reports of PPIs as primary suspect drug or second suspect drug, of which 3,253 reports were HRAEs. The top five HRAE signals caused by PPIs were hepatitis cholestatic, cholestasis, fulminant hepatitis, subacute hepatic failure, and acute hepatitis. We also summarized the signals of the HRAEs caused by each PPI. The simultaneous signals were cholestasis and hepatitis cholestatic. For the cholestasis signal, esomeprazole showed an ROR of 21.556 (95% CI 17.592–26.413); pantoprazole showed the highest ROR of 22.611 (95% CI 17.794–28.733) in the hepatic cholestatic signal; lansoprazole was the only PPI with expression in the coma hepatic signal, with an ROR of 10.424 (95% CI 3.340–32.532). By analyzing the reports of pantoprazole-induced hepatic encephalopathy, we found that patients aged over 65 years and males reported the highest rate. And from the combination of drugs and indications of drugs, no significant results were obtained.Conclusions: The RORs of signals of “cholestasis” were generally higher than those of “hepatocellular injury.” And the signals about “cholestasis” in HRAE caused by PPIs are more reported.
Impact of Cumulative Fluid Balance During Continuous Renal Replacement Therapy on Mortality in Patients With Septic Acute Kidney Injury: A Retrospective Cohort Study
Authors: Lin Jin , Zhuang Hai Zhou , Zhi De Yuan , Qi Zhili , Bai Jing , Dong Lei , Liu Shuai , Duan Meili 
Published: November 2021

Background: The clinicians often use continuous renal replacement therapy (CRRT) for the fluid management of patients with septic acute kidney injury (AKI). However, there is limited knowledge of the effects of changes in fluid balance (FB) on CRRT and its association with outcomes in patients with septic AKI.Objective: This study aimed to determine the association of cumulative FB (CFB) during treatment with 28-day all-cause mortality in the patients with septic AKI who require CRRT.Methods: This retrospective observational study examined patients who received CRRT due to septic AKI in a mixed intensive care unit (ICU) of a tertiary teaching hospital between January 2015 and December 2018. The patients were divided into three groups—negative FB, even FB, and positive FB—based on the CFB during CRRT. The primary outcome was 28-day all-cause mortality.Results: We examined 227 eligible patients and the mean age was 62.4 ± 18.3 years. The even FB group had a significantly lower 28-day mortality (43.0%, p = 0.007) than the positive FB group (72.7%) and the negative FB group (54.8%). The unadjusted and adjusted Cox regression models indicated that the positive FB group had an increased risk for 28-day all-cause mortality relative to the even FB group. A restricted cubic splines model indicated a J-shaped association between the CFB and 28-day all-cause mortality in the unadjusted model.Conclusion: Among the critically ill patients with septic AKI who require CRRT, those with positive FB had a higher mortality rate than those with even FB.
Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke
Authors: Yu Fan , Bai Xuesong , Sha Arman , Zhang Miao , Shan Yi , Guo Daode , Dmytriw Adam A. , Ma Qingfeng , Jiao Liqun , Lu Jie 
Published: November 2021

Background: Multimodal CT imaging can evaluate cerebral hemodynamics and stroke etiology, playing an important role in predicting prognosis. This study aimed to summarize the comprehensive image characteristics of wake-up stroke (WUS), and to explore its value in prognostication.Methods: WUS patients with anterior circulation large vessel occlusion were recruited into this prospective study. According to the 90-day modified Rankin Scale (mRS), all patients were divided into good outcome (mRS 0–2) or bad (mRS 3–6). Baseline clinical information, multimodal CT imaging characteristics including NECT ASPECTS, clot burden score (CBS), collateral score, volume of penumbra and ischemic core on perfusion were compared. Multivariate logistic regression analysis was further used to analyze predictive factors for good prognosis. Area under curve (AUC) was calculated from the receiver operating characteristic (ROC) curve to assess prognostic value.Results: Forty WUS were analyzed in this study, with 20 (50%) achieving good outcome. Upon univariable analysis, the good outcome group demonstrated higher ASPECTS, higher CBS, higher rate of good collateral filling and lower penumbra volume when compared with the poor outcome group. Upon logistic regression analysis, poor outcome significantly correlated with penumbra volume (OR: 1.023, 95% CI = 1.003–1.043) and collateral score (OR: 0.140, 95% CI = 0.030–0.664). AUC was 0.715 for penumbra volume (95% CI, 0.550–0.846) and 0.825 for good collaterals (95% CI, 0.672–0.927) in predicting outcome.Conclusions:Penumbra volume and collateral score are the most relevant baseline imaging characters in predicting outcome of WUS patients. These imaging characteristics might be instructive to treatment selection. As the small sample size of current study, further studies with larger sample size are needed to confirm these observations.
Effects of Early vs. Late Time-Restricted Eating on Cardiometabolic Health, Inflammation, and Sleep in Overweight and Obese Women: A Study Protocol for the ChronoFast Trial
Authors: Peters Beeke , Koppold-Liebscher Daniela A. , Schuppelius Bettina , Steckhan Nico , Pfeiffer Andreas F. H. , Kramer Achim , Michalsen Andreas , Pivovarova-Ramich Olga 
Published: November 2021

Background: Time-restricted eating is a promising dietary strategy for weight loss, glucose and lipid metabolism improvements, and overall well-being. However, human studies demonstrated contradictory results for the restriction of food intake to the beginning (early TRE, eTRE) or to the end of the day (late TRE, lTRE) suggesting that more carefully controlled studies are needed.Objective: The aim of the ChronoFast trial study is to determine whether eTRE or lTRE is a better dietary approach to improve cardiometabolic health upon minimized calorie deficits and nearly stable body weight.Methods: Here, we present the study protocol of the randomized cross-over ChronoFast clinical trial comparing effects of 2 week eTRE (8:00 to 16:00 h) and lTRE (13:00 to 21:00 h) on insulin sensitivity and other glycemic traits, blood lipids, inflammation, and sleep quality in 30 women with overweight or obesity and increased risk of type 2 diabetes. To ensure timely compliance and unchanged dietary composition, and to minimize possible calorie deficits, real-time monitoring of dietary intake and body weight using a smartphone application, and extensive nutritional counseling are performed. Continuous glucose monitoring, oral glucose tolerance test, 24 h activity tracking, questionnaires, and gene expression analysis in adipose tissue and blood monocytes will be used for assessment of study outcomes.Discussion: The trial will determine whether eTRE or lTRE is more effective to improve cardiometabolic health, elucidate underlying mechanisms, and contribute to the development of recommendations for medical practice and the wider population.Clinical Trial Registration:www.ClinicalTrials.gov, Identifier [NCT04351672]
Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest
Authors: Zhang Jing , Liu Xun , Zheng Mo , Yin Jing , Xing Weibin 
Published: November 2021

This article aims to explain the use of a variety of noninvasive of minimally invasive examinations to obtain reliable diagnostic clues. The choice of treatment methods and repair techniques for wound defects are also critical in terms of the prognosis. Here, we describe the case of a 53-year-old male patient who visited our dermatology clinic due to a red plaque on the inner side of his left nipple without any symptoms for more than 30 years. He was given dermoscopy, high-frequency ultrasound (HFUS), Color Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) examinations. Currently, there are no literatures on these auxiliary examinations for this disease. Dermoscopy revealed that there were abundant blood vessels on the periphery of the skin lesion with obvious dilation. HFUS revealed an inhomegeneous hypoechoic solid mass in the dermis with clear borders and irregular shape. CDFI indicated that there are abundant blood flow signals in the periphery and central of the tumor. CEUS showed a mixed inhomogeneous, grid-like high-enhancement pattern. Based on the above auxiliary findings, the possibility of malignant lesion was suspected. Therefore, the patient was given a pathological examination, which showed that many luminal structures of the dermis layer were embedded in the hyperplastic fibrous tissue. The atypical cells were not obvious but showed an infiltrating growth pattern. Immunohistochemistry showed positive reaction for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA) and a weak positive results was obtained for S-100. There was also a negative result for CK20, gross cystic disease fluid protein 15 (GCDFP-15), and P63. As a result, the patient was diagnosed with “syringoid eccrine carcinoma.” The treatment was surgical excision. Mohs microsurgery was combined with the looped, broad, and deep-buried suturing technique (LBD tension-reduced suturing technique). This technique directly sutures the wound instead of carrying out traditional skin grafting or flap transfer. The postoperative follow-up results were satisfactory as no obvious keloid formed on the wound during the follow-ups. In conclusion, ultrasound is greatly advantageous in tumor morphology and hemodynamics. It orients the therapeutic management and assesses the therapeutic efficacy and the tumoral prognosis. In surgical treatments, a less-traumatic operation should be selected to reduce the patient’s pain.
Near-Infrared Imaging With Indocyanine Green for the Treatment of Endometriosis: Results From the Gre-Endo Trial
Authors: Turco Luigi Carlo , Vizzielli Giuseppe , Vargiu Virginia , Gueli Alletti Salvatore , De Ninno Maria , Ferrandina Gabriella , Pedone Anchora Luigi , Scambia Giovanni , Cosentino Francesco 
Published: November 2021

IntroductionA current challenge for endometriosis surgery is to correctly identify the localizations of disease, especially when small or hidden (occult endometriosis), and to exactly define their real extension. The use of near-infrared radiation imaging (NIR) after injection of indocyanine green (ICG) represents one of the most encouraging method. The aim of this study is to assess the diagnostic value of NIR-ICG imaging in the surgical treatment of endometriosis compared with the standard of treatment.Material and MethodsThe Gre-Endo trial is a prospective, single-arm study (NCT03332004). After exploring the operatory field using the white light (WL) mode, patients were injected with ICG and then observed in NIR mode. All suspected areas were classified and chronicled according to lesions visualized only in WL, NIR-ICG, or in the combination of both. Lesion not visualized in WL was considered as suspect occult lesion (s-OcL). In addition, a random control biopsy from an apparent negative peritoneum visualized in WL and NIR-ICG imaging was taken for all patients (control cases). All lesions removed were considered “suspect endometriosis” until pathology.ResultsFifty-one patients were enrolled between January 2016 and October 2019. A total of 240 suspected lesions have been identified with both methods (WL + NIR-ICG). Two hundred and seven (86.2%) lesions out of the overall 240 were visualized with WL imaging, and 200 were confirmed to be pathologic (true positive for WL). The remaining 33/240 (13.75%) (false negative for WL) lesions were identified only with NIR-ICG imaging and collected as s-OcL. All 33 s-OcLs removed were confirmed to be pathologic (c-OcL = 100%). NIR-ICG vision showed PPV of 98.5%, NPV of 87.1%, Se of 87%, and Sp of 98.5%, confirming that this kind of imaging is an excellent diagnostic and screening test (p = 0.001 and p = 0.835, according to McNemar’s and Cohen’s kappa tests, respectively).ConclusionsThe use of NIR-ICG vision alone and combined with WL showed good results in intraoperative detection rate and fluorescence-guided surgery of endometriosis. Furthermore, NIR-ICG allowed surgeons to remove occult lesions that otherwise would remain, leading to possible greater postoperative pain and a higher risk of persistence and relapse.