bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell Type-Specific Arousal-Dependent Modulation of Thalamic Activity in the Lateral Geniculate Nucleus
Authors: Molnár Benedek , Sere Péter , Bordé Sándor , Koós Krisztián , Zsigri Nikolett , Horváth Péter , Lőrincz Magor L 
Published: March 2021

Abstract
State-dependent thalamocortical activity is important for sensory coding, oscillations, and cognition. The lateral geniculate nucleus (LGN) relays visual information to the cortex, but the state-dependent spontaneous activity of LGN neurons in awake behaving animals remains controversial. Using a combination of pupillometry, extracellular, and intracellular recordings from identified LGN neurons in behaving mice, we show that thalamocortical (TC) neurons and interneurons are distinctly correlated to arousal forming two complementary coalitions. Intracellular recordings indicated that the membrane potential of LGN TC neurons was tightly correlated to fluctuations in pupil size. Inactivating the corticothalamic feedback to the LGN suppressed the arousal dependency of LGN neurons. Taken together, our results show that LGN neuronal membrane potential and action potential output are dynamically linked to arousal-dependent brain states in awake mice, and this might have important functional implications.
Increased Reimbursement for Surgical Fixation of Hip Fractures: The Difference Between the Hospital and the Surgeon
Authors: Chen Dennis Q. , Quinlan Nicole D. , Browne James A. , Werner Brian C. 
Published: March 2021

Objectives:
To evaluate trends and variations in hospital charges and payments relative to surgeon charges and payments for surgical treatment of hip fractures in the US Medicare population.

Methods:
Hospital and surgeon charges and payments after treatment of hip fractures by closed reduction and percutaneous pinning (CRPP), open reduction internal fixation (ORIF), or intramedullary nail (IMN), along with corresponding patient demographics, 90-day and 1-year mortality, Charlson Comorbidity Index (CCI), and length of stay (LOS) from 2005 to 2014 were captured from the 5% Medicare Standard Analytic Files. The ratio of hospital to surgeon charges (CM: Charge Multiplier) and the ratio of hospital to surgeon payments (PM: Payment Multiplier) were calculated for each year and region of the United States and trended over time. Correlations between the CM and PM and LOS were evaluated using a Pearson correlation coefficient (r).

Results:
Three thousand twenty-eight patients who underwent CRPP and 25,341 patients who underwent ORIF/IMN were included. The CM for CRPP increased from 10.1 to 15.6, P < 0.0001. The CM for ORIF/IMN increased from 11.9 to 17.2, P < 0.0001. The PM for CRPP increased from 15.1 to 19.2, P < 0.0001. The PM for ORIF/IMN increased from 11.5 to 17.4, P < 0.0001.

Conclusions:
Hospital charges and payments have continually increased relative to surgeon charges and payments for treatment of hip fractures despite decreasing LOS.
Effective Reduction in Opioid Prescriptions for Ambulatory Lesion Excisions in Pediatric Patients
Authors: McKenna Rachel A. , Lee Alfred , Yan Chen , Vu Giap H. , Jantzen Ellen C. , Brennan Patrick J. , Watson Adam , Burlingame Caroline , Lin Ines C. 
Published: March 2021

Background:
Childhood opioid consumption is potentially deleterious to cognitive development and may predispose children to later addiction. Opioids are frequently prescribed for outpatient surgery but may not be necessary for adequate pain control. We aimed to reduce opioid prescriptions for outpatient pediatric skin and soft tissue lesion excisions using quality improvement (QI) methods.

Methods:
A multidisciplinary team identified drivers for opioid prescriptions. Interventions were provider education, improving computer order set defaults, and promoting non-narcotic pain control strategies and patient-family education. Outcomes included percentage of patients receiving opioid prescriptions and patient-satisfaction scores. Data were retrospectively collected for 3 years before the QI project and prospectively tracked over the 8-month QI period and the following 18 months.

Results:
The percentage of patients receiving an opioid prescription after outpatient skin or soft tissue excision dropped significantly from 18% before intervention to 6% at the end of the intervention period. Patient-reported satisfaction with pain control improved following the QI intervention. Satisfaction with postoperative pain control was independent of closure size or receipt of a postoperative opioid prescription. Intraoperative use of lidocaine or bupivacaine significantly decreased the incidence of postoperative opioid prescription in both bivariate and multivariate analyses. Results were maintained at 18 months after the conclusion of the QI project.

Conclusion:
Raising provider awareness, educating patients on expected postoperative pain management options, and prioritizing non-narcotic medications postoperatively successfully reduced opioid prescription rates in children undergoing skin and soft tissue lesion excisions and simultaneously improved patient-satisfaction scores.
Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
Authors: Stoehr Jenna Rose , Chappell Ava G. , Dumanian Gregory A. 
Published: March 2021

Summary:
Abdominal wall pain can be challenging to diagnose and treat, as many etiologies can have similar presentations. Anterior cutaneous nerve entrapment syndrome has been reported to be a significant cause of AWP. Here, we report the case of a patient who was initially diagnosed with anterior cutaneous nerve entrapment syndrome and ultimately found to have intercostal neuromas-in-continuity. The patient was a healthy 36-year-old man who presented with debilitating, chronic abdominal wall pain. The pain began after a time period when the patient was regularly kiteboarding, and it impacted the ability to exercise and perform activities of daily living. The patient had undergone extensive testing and attempted many treatments, including medication, nerve blocks, and anterior cutaneous nerve entrapment syndrome surgery. Examination was significant for 2 near-symmetric areas that were persistently tender to palpation in the subcostal abdomen. The patient underwent excision and reconstruction with two 2-cm segments of processed nerve allograft. At 1-year follow-up, the patient reported complete alleviation of the pain, discontinuation of pain medication, and a return to all normal activities. While managing patients with abdominal wall pain, physicians must consider neuroma in their differential diagnoses and be aware of its treatment options, as the patient underwent a substantial delay in treatment. Kiteboarding is a unique mechanism of peripheral nerve injury that has not been previously reported in the literature. This report demonstrates the efficacy of processed nerve allograft in the management of neuromas-in-continuity of the abdominal wall, as well as the importance of being aware of unusual manners of nerve injury.
Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected children
Authors: Li Ying , Wang Haizhou , Wang Fan , Lu Xiaoxia , Du Hui , Xu Jiali , Han Feng , Zhang Liqiong , Zhang Maorong 
Published: March 2021

Abstract
Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to summarize and investigate the co-infection of SARS-CoV-2 in children.
We retrospectively reviewed the clinical manifestations, laboratory findings, and imaging characteristics of COVID-19 patients in co-infection group (CI, n = 27) and single infection group (SI, n = 54). Samples were tested for multiple pathogens.
A high incidence (27/81, 33%) of co-infection in children with COVID-19 was revealed. The most frequent co-infected pathogen was mycoplasma pneumoniae (MP, 20/81, 25%), followed by virus (6/81, 7%), and bacteria (4/81, 5%). No significant difference in clinical characteristics, laboratory examinations, or hospital stay was observed between the patients with co-infections and those with monomicrobial, only lower in white blood cell counts (CI: 5.54 ± 0.36 vs SI: 7.38 ± 0.37, P = .002), neutrophil counts (CI: 2.20 ± 0.20 vs SI: 2.92 ± 0.23, P = .024) and lymphocyte counts (CI: 2.72 ± 0.024 vs SI: 3.87 ± 0.28, P = .006). Compared with the patients with monomicrobial, chest imaging of those with co-infections showed consolidation in more cases (CI: 29.6% vs SI: 11.1%, P = .038) and duration of positive in nucleic acid was shorter (CI: 6.69 ± 0.82 vs SI: 9.69 ± 0.74, P = .015).
Co-infection was relatively common in children with COVID-19, almost 1/3 had co-infection, most commonly caused by MP. Co-infection did not cause a significant exacerbation in clinical manifestations.
Brain metastasis with subtype conversion in a patient with male breast cancer
Authors: Oh Byeong Ho , Woo Chang Gok , Lee Youn Joo , Park Young Seok 
Published: March 2021

Abstract

Rationale:
Brain metastasis of male breast cancer is extremely rare, and the pathological changes between the primary tumor and the metastatic brain tumor have not been reported. Herein, we report for the first time a case of male breast cancer with metastasis to the parietal lobe with subtype conversion after metastasis.

Patient concerns:
we describe a 45-year-old male patient admitted for an incidentally found brain tumor after a motorcycle accident. The patient had been treated for breast cancer 5 years previously. The primary tumor was an invasive ductal carcinoma classified as pT1N1M0 with hormone receptor positivity (estrogen receptor ++, progesterone receptor +++, human epidermal growth factor receptor-type2 (HER2) +) and was treated with surgery, adjuvant chemotherapy, radiation therapy and endocrine therapy (tamoxifen).

Diagnoses:
Magnetic resonance imaging revealed a well enhanced focal solid tumor in the right parietal lobe (5.0 × 4.2 cm in size), Immunohistochemical staining revealed cerebral metastases of breast cancer with HER2 subtype conversion (estrogen receptor +++, progesterone receptor +++, HER2 −).

Interventions:
The patient was successfully treated with surgery and whole brain irradiation (3 Gy × 10 fractions).

Outcomes:
There was no additional complication after the surgery and the patient transferred to oncology department for chemotherapy. 2 years later, he had gamma knife radiosurgery due to the recurred brain lesion and after that he discontinued the treatment and opted for hospice care.

Lessons:
Male breast cancer with metastasis to the brain is an extremely rare condition. Although a few similar cases have been reported, subtype conversion in similar cases has not been reported. Therefore, we report this case of a male patient with brain metastasis of invasive ductal carcinoma with HER2 status conversion after metastasis.
Prenatal and postnatal exposure to Tangshan earthquake and CRHR1 gene polymorphism influence risk of sleep disturbance in adulthood
Authors: Chen Ya-Nan , An Cui-Xia , Wang Ran , Wang Lan , Song Mei , Yu Lu-Lu , Sun Fei-Fei , Wang Xue-Yi 
Published: March 2021

Abstract
To determine the effect of earthquake on sleep quality of adults who had experienced Tangshan Earthquake either as infants or fetuses and also investigate whether CRHR1 polymorphism influenced sleep quality in subjects exposed to seismic stress.
Totally 556 subjects were enrolled in the current study and were divided into 3 groups, those who had experienced Tangshan Earthquake as infants (group I) or fetuses (group II), and those who had not experienced Tangshan Earthquake (group III). Sleep was evaluated using the Pittsburgh Sleep Quality Index (PQSI). Three single nucleotide polymorphisms of the CRHR1 gene were analyzed.
Fifty two (9.4%) subjects had sleep disturbance, including 17 (9.9%) subjects in group I, 24 (13.4%) subjects in group II, and 11 (5.3%) subjects in group III (χ2 = 7.373, P = .025). Moreover, subjects with CRHR1 genotype T/T had a significantly lower rate of sleep disturbance (7.8%) than subjects with genotype C/T and C/C (14.7%; χ2 = 4.845, P
= .028). Furthermore, subjects with rs7209436 genotype C had an approximately 2-fold increase in the risk of sleep disturbance versus those who were not genotype C (OR = 1.978, 95% CI (1.045, 3.744).
Prenatal and postnatal exposure to seismic stress significantly increases subsequent risk of sleep disturbance in adulthood.
Lung adenocarcinoma organoids harboring EGFR 19Del and L643V double mutations respond to osimertinib and gefitinib
Authors: Bie Yanan , Wang Jin , Xiong Linmin , Wang Dong , Liao Jing , Zhang Yelin , Lin Hang 
Published: March 2021

Abstract

Introduction:
It has been well reported that non-small-cell lung cancer (NSCLC) patients with single epithelial growth factor receptor (EGFR) activating mutation have high objective response rate when treated with EGFR-TKIs. However, due to rarity of cases, the response of patients with EGFR double or multiple mutations is not yet well understood. Patient-derived organoid technology has become to a powerful tool in cancer personalized medicine.

Patient concerns:
A 60-year-old nonsmoking female was admitted to hospital for lung cancer after Chest CT.

Diagnoses:
The patient had no obvious clinical symptoms. Postoperative pathology confirmed a stage I of NSCLC. An EGFR double mutation 19Del/L643V was detected in the sequence of patient's cancer specimen.

Interventions:
The patient was in good condition after surgical resection, with no sign of lung cancer recurrence. The patient has not yet started on targeted medicine.

Outcomes:
A lung cancer organoid culture was established from the cancer tissue of the patient, which recapitulated the morphological and molecular characteristics of cancer tissue. The drug sensitivity test showed that the cancer organoids that retained original mutations were sensitive to anticancer agents osimertinib and gefitinib, while resistant to erlotinib and icotinib.

Conclusion:
The uncommon EGFR double mutation exhibits distinctive sensitivities towards different target drugs of EGFR-TKIs. Our findings provide a better understanding of EGFR-TKIs’ effects on patient-derived cancer organoids harboring uncommon EGFR double mutation(s).
Clinical features and viral RNA shedding of imported and local cases with COVID-19 in Wenzhou, China
Authors: He Guiqing , Wu Jing , Huang Jianping , Schieffelin John S. , Dai Jianyi , Gamber Michelle , Hu Xingzhong , Chen Quelu , Si Yang , Sun Wenjie , Cai Jing 
Published: March 2021

Abstract
Wenzhou had the highest number of confirmed novel coronavirus 2019 (COVID-19) cases outside the Hubei province. The aim of this study was to identify the difference in clinical features and viral RNA shedding between the imported and local COVID-19 cases in Wenzhou.
All patients with confirmed COVID-19 admitted to Wenzhou Sixth People's Hospital, Wenzhou Central Hospital Medical Group, from January 17 to February 11, 2020, were enrolled in this study. Data was analyzed and compared for the imported and local cases with regard to epidemiological, demographic, clinical, radiological features, and laboratory findings. Outcomes for the enrolled participants were followed up until May 7, 2020.
Of the 136 cases, 50 were imported from Wuhan. The median age was 45 years and 73 (53.7%) were men. The most common symptoms at onset were fever (104 [76.5%]) and cough (85[62.5%]). Pleural effusion was more common among imported cases compared to local cases. The white blood cell count, neutrophil count, lymphocyte count and platelet count of the imported cases were significantly lower than those of the local cases, while the prothrombin time was significantly longer than that of the local cases. Severe and critically ill patients accounted for 15.4% and 2.9%, respectively. The median duration of SARS-CoV-2 RNA shedding from symptom onset was 26 days (IQR 17–32.3 days) and there were no significant differences in duration of viral RNA shedding between the two groups.
The study findings suggest that imported cases from Wuhan were more likely to be severe compared to the local cases in Wenzhou. However, there was no difference between imported and local cases on the viral shedding among the COVID patients.
Study of item text in the Chinese Symptom Checklist-90
Authors: Zhou Jian , Yu Jian’er , Zhou Yuanyuan , Qiu Jianxia 
Published: March 2021

Abstract
Symptom Checklist-90 (SCL-90) is the popular and widely used instrument, whether in mental health screening, psychological consultation, or the diagnosis and estimate of mental illness. In 1984, it was translated from theEnglish version into Chinese and then SCL-90 has been widely used in China. It is a pity that the item text of Chinese version has not been revised since the birth of it until today. We analyzed the Chinese version of the 90-item text from 3 new perspectives: translation, semantic, and cross-cultural, and thought that 18 items should be revised. This study’ results have taken one step forward on the basis of previous studies, which will play an important role in improving the quality of Chinese version SCL-90 and improving the mental health level of Chinese people.
Comparison of efficacy and safety of traditional Chinese patent medicine in the treatment of vitiligo in children or adults
Authors: Yang Meng , Du Mengmeng , Tang Zhikun , Han Guanqing , Dong Wenyao , Chen Zhaoyu , Song Yeqiang 
Published: March 2021

Abstract

Background:
Vitiligo is a common depigmented skin disease in children or adults, which usually causes considerable psychological burden to life and work for the reason that it affects appearance. The conventional therapies, including external 308 nm excimer laser therapy along with oral administration of western medicine, are associated with distinct disadvantages. Notably, traditional Chinese patent medicine (TCPM) exerts a vital part in treating vitiligo. Currently, no existing research has examined the effectiveness and safety of different TCPMs in treating vitiligo among either child or adult patients. As a result, the present network meta-analysis was carried out for the systematic comparison of the effectiveness of different TCPMs in treating vitiligo.

Methods:
The electronic databases, like PubMed, Web of Science, EMBASE, The Cochrane Library, Chinese Scientific Journals Database, China National Knowledge Infrastructure, Wanfang database and China BioMedical Literature, were searched systemically by 2 reviewers independently from inception to August 2020 to identify relevant randomized controlled trial (RCTs) according to our study inclusion criteria. In data extraction, risk of bias among those enrolled articles was also detected. Besides, the Bayesian network meta-analysis method was utilized to evaluate the evidence and data collected. This adopted the STATA and Win BUGS software for analysis.

Results:
The present work assessed the safety and efficacy of different TCPMs in treating vitiligo among child or adult patients.

Conclusion:
Our findings can shed precious lights on applying TCPMs in clinic and help the clinicians to formulate the efficient diagnostic and therapeutic strategies.

Ethics and dissemination:
No ethical approval was needed in this study.

INPLASY registration number:
INPLASY2020120050.
The risk factors of children acquiring refractory mycoplasma pneumoniae pneumonia
Authors: Gong Hui , Sun Baijun , Chen Ye , Chen Huijie 
Published: March 2021

Abstract

Objectives:
Refractory mycoplasma pneumoniae pneumonia (RMPP) in children has been increasing worldwide. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of RMPP to provide suggestions on prevention and controlling for children.

Methods:
Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0.

Results:
We conducted a meta-analysis of 15 separate studies. Fever for more than 10 days (odds ratio [OR] 3.965, 95% confidence interval [CI] 2.109–7.456), pleural effusion (OR 6.922, 95% CI 2.058–23.282), extra-pulmonary complications (OR 17.762, 95% CI 11.146–28.305), pulmonary X-ray consolidation ≥2/3 (OR 8.245, 95% CI 1.990–34.153), CRP >40 mg/L (OR 4.975, 95% CI 2.116–11.697) were significantly related to the risk of RMPP. We did not find an association between male sex (OR 0.808, 95% CI 0.548–1.189), LDH >410IU/L (OR 1.033, 95% CI 0.979–1.091) and the risk of RMPP.

Conclusions:
Fever for more than 10 days, pleural effusion, extra-pulmonary complications, pulmonary X-ray consolidation≥ 2/3 and CRP >40 mg/L are risk factors for early evaluation of RMPP.
Breast tubular carcinoma at parasternal and retro-nipple area
Authors: Shi Junhua , Shi Junli , Yang Shengbo 
Published: March 2021

Abstract

Introduction:
Breast tubular carcinoma (TC) is a well-differentiated infiltrating ductal carcinoma, common in postmenopausal women.

Patient concerns:
Two patients concerned their abnormality of their breasts, one at deep parasternal higher chest wall in a 74-year-old female and the other behind the nipple in a 39- year-old female.

Diagnosis:
These masses were detected by mammography, ultrasound and magnetic resonance imaging (MRI) examinations. The parasternal mass identified by mammography showed long spicules along the edges of the mass. Ultrasound examination revealed that these masses had solid irregular hypoechoic nodules. The color Doppler ultrasound of the retro-nipple mass presented with increased blood flow resistance index. The dynamic contrast-enhanced MRI examination of the retro-nipple nodule demonstrated an intensely enhancing mass with a plateau-type time-signal intensity curve.

Interventions:
Two cases were surgically removed by local resection of foci under ultrasound guidance.

Outcomes:
These imaging examinations strongly suggest possible breast tubular carcinoma, which was confirmed by the pathological evaluation of frozen sections from surgically removed masses.

Conclusion:
Although uncommon, breast tubular carcinoma may be considered in the differential diagnosis of small solid masses with long spicules at parasternal breast or behind the nipples in adult women.
Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation
Authors: Jiang Changchun , Li Yuechun , Hao Fei , Yang Junfeng , Wang Baojun , Fan Yu 
Published: March 2021

Abstract

Rationale:
Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization.

Patient concerns:
A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission.

Diagnoses:
Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA.

Interventions:
Thrombectomy with 3 passes of the Solitaire FR device (Medtronic, Minneapolis, MN) was unsuccessful. Two stent retrievers were inserted in parallel by one microcatheter access point to each M2 branch, and then both stents were gradually retrieved out of the catheter while continuous suction was maintained.

Outcomes:
After thrombectomy, subsequent follow-up angiograms showed mTICI 3 reperfusion of MCA. The patient has mRS 2 at discharge and the 3-month mRS score after stroke is 1 score.

Lessons:
The presented Y-configuration double-stent-retriever thrombectomy technique constitutes a safe and effective rescue treatment method for refractory thrombus in MCA bifurcation.