bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcomes of 170 brain arteriovenous malformations treated by frameless image-guided robotic stereotactic radiosurgery
Authors: Punyawai Pritsana , Radomsutthikul Nicha , Dhanachai Mantana , Kobkitsuksakul Chai , Hansasuta Ake 
Published: May 2021

Abstract
This study was conducted to report long-term outcomes of the frameless robotic stereotactic radiosurgery (SRS) for brain arteriovenous malformation (AVM) at Ramathibodi Hospital.
Retrospective data of patients with brain AVM (bAVM), who underwent CyberKnife SRS (CKSRS) at Ramathibodi Hospital from 2009 to 2014, were examined. Exclusion criteria were insufficient follow-up time (<36 months) or incomplete information. Patients’ demographics, clinical presentation, treatment parameters, and results were analyzed. Excellent outcome was defined as AVM obliteration without a new neurological deficit. Risk factors for achieving excellent outcome were assessed.
From a total of 277 CKSRS treatments for bAVM during the 6 years, 170 AVMs in 166 patients met the inclusion criteria. One hundred and thirty-nine cases (81.76%) presented with hemorrhages from ruptured bAVMs. Almost two-thirds underwent embolization before radiosurgery. With the median AVM volume of 4.17 mL, three-quarters of the cohort had single-fraction CKSRS, utilizing the median prescribed dose of 15 Gray (Gy). In the multisession group (25.29%), the median prescribed dose and the AVM volume were 27.5 Gy and 22.3 mL, respectively. An overall excellent outcome, at a median follow-up period of 72.45 months, was observed in 99 cases (58.24%). Seven AVMs (4.12%) ruptured after CKSRS but 1 patient suffered a new neurological deficit. Two patients (1.18%) were classified into the poor outcome category but there were no deaths. Negative factors for excellent outcome, by multivariate regression analysis, were the male sex and multisession SRS delivery, but not age, history of AVM rupture, previous embolization, or AVM volume.
Despite relatively larger bAVM and utilizing a lower prescribed radiation dose, the excellent outcome was within the reported range from previous literature. This study offers one of the longest follow-ups and the largest cohorts from the frameless image-guided robotic SRS community.
Five-year clinical outcomes of the first Korean-made sirolimus-eluting coronary stent with abluminal biodegradable polymer
Authors: Seo Kyoung-Woo , Yang Hyoung-Mo , Yoon Junghan , Kim Hyo-Soo , Chang Kiyuk , Lim Hong-Seok , Choi Byoung-Joo , Choi So-Yeon , Yoon Myeong-Ho , Lee Seung-Hwan , Ahn Sung Gyun , Youn Young Jin , Lee Jun-Won , Koo Bon-Kwon , Park Kyung Woo , Yang Han-Mo , Han Jung-Kyu , Chung Wook-Sung , Park Hun-Jun , Hwang Byung-Hee , Choo Eun-Ho , Oh Gyu-Chul , Tahk Seung-Jea 
Published: May 2021

Abstract
This study evaluated the 5-year clinical outcomes of the Genoss DES, the first Korean-made sirolimus-eluting coronary stent with abluminal biodegradable polymer.
We previously conducted the first-in-patient prospective, multicenter, randomized trial with a 1:1 ratio of patients using the Genoss DES and Promus Element stents; the angiographic and clinical outcomes of the Genoss DES stent were comparable to those of the Promus Element stent. The primary endpoint was major adverse cardiac events (MACE), which was a composite of death, myocardial infarction (MI), and target lesion revascularization (TLR) at 5 years.
We enrolled 38 patients in the Genoss DES group and 39 in the Promus Element group. Thirty-eight patients (100%) from the Genoss DES group and 38 (97.4%) from the Promus Element group were followed up at 5 years. The rates of MACE (5.3% vs 12.8%, P = .431), death (5.3% vs 10.3%, P = .675), TLR (2.6% vs 2.6%, P = 1.000), and target vessel revascularization (TVR) (7.9% vs 2.6%, P = .358) at 5 years did not differ significantly between the groups. No TLR or target vessel revascularization was reported from years 1 to 5 after the index procedure, and no MI or stent thrombosis occurred in either group during 5 years.
The biodegradable polymer Genoss DES and durable polymer Promus Element stents showed comparable low rates of MACE at the 5-year clinical follow-up.
Sintilimab induced diabetic ketoacidosis in a patient with small cell lung cancer
Authors: Huang Xiaofei , Yang Mei , Wang Liu , Li Libo , Zhong Xiaowei 
Published: May 2021

Abstract

Rationale:
Sintilimab is a novel programmed cell death receptor-1 (PD-1) inhibitor approved in the treatment of classical Hodgkin's lymphoma and undergoing clinical trials for various malignancies. As a PD-1 inhibitor, sintilimab is known to cause autoimmune adverse events similar to other PD-1 inhibitors. Diabetic ketoacidosis (DKA) is a rare but severe adverse event of this therapy.

Patient concerns:
We report a case of a 59-year-old man who developed DKA after 5 doses of sintilimab for small cell lung cancer. His fasting glycemia level was 14.07 mmol/L, urine ketone bodies were 4+, arterial blood pH was 7.271, bicarbonate was 12.3 mmol/L, and glycated hemoglobin (HbA1c) was 7.4%. Extended investigations revealed that fasting C-peptide was undetectable (<0.003 nmol/L).

Diagnosis:
These laboratory investigations supported the diagnosis of fulminant type 1 diabetes mellitus, but no β-cell related antibodies were positive.

Interventions:
After remission of DKA, he was treated with insulin therapy to acquire a normalization of glycemia and the disappearance of symptoms.

Outcomes:
Sintilimab was withheld after 6 cycles and was converted to durvalumab to sustain the therapeutic effect.

Lessons:
This case and associated literature review illustrate the importance of educating and monitoring patients who start PD-1 inhibitor therapy regarding this potentially life-threatening complication.
Magnetic resonance radiomics signatures for predicting poorly differentiated hepatocellular carcinoma
Authors: Yang Xiaozhen , Yuan Chunwang , Zhang Yinghua , Wang Zhenchang 
Published: May 2021

Abstract
Radiomics contributes to the extraction of undetectable features with the naked eye from high-throughput quantitative images. In this study, 2 predictive models were constructed, which allowed recognition of poorly differentiated hepatocellular carcinoma (HCC). In addition, the effectiveness of the as-constructed signature was investigated in HCC patients.
A retrospective study involving 188 patients (age, 29–85 years) enrolled from November 2010 to April 2018 was carried out. All patients were divided randomly into 2 cohorts, namely, the training cohort (n = 141) and the validation cohort (n = 47). The MRI images (DICOM) were collected from PACS before ablation; in addition, the radiomics features were extracted from the 3D tumor area on T1-weighted imaging (T1WI) scans, T2-weighted imaging (T2WI) scans, arterial images, portal images and delayed phase images. In total, 200 radiomics features were extracted. t test and Mann–Whitney U test were performed to exclude some radiomics signatures. Afterwards, a radiomics signature model was built through LASSO regression by RStudio Software. We constructed 2 support vector machine (SVM)-based models: 1 with a radiomics signature only (model 1) and 1 that integrated clinical and radiomics signatures (model 2). Then, the diagnostic performance of the radiomics signature was evaluated through receiver operating characteristic (ROC) analysis.
The classification accuracy in the training and validation cohorts was 80.9% and 72.3%, respectively, for model 1. In the training cohort, the area under the ROC curve (AUC) was 0.623, while it was 0.576 in the validation cohort. The classification accuracy in the training and validation cohorts were 79.4% and 74.5%, respectively, for model 2. In the training cohort, the AUC was 0.721, while it was 0.681 in the validation cohort.
The MRI-based radiomics signature and clinical model can distinguish HCC patients that belong in a low differentiation group from other patients, which helps in the performance of personal medical protocols.
Combined therapy of hypertensive nephropathy with ginkgo leaf extract and dipyridamole injection and antihypertensive drugs
Authors: Jialiken Dinala , Qian Lichao , Ren Shuai , Wu Lihua , Xu Junyao , Zou Chong 
Published: May 2021

Abstract

Background:
In recent years, the incidence rate of hypertensive nephropathy has been increasing quickly, which has been a major threat to people's health. Renin-angiotensin-aldosterone system blockers have certain curative effects. However, there are some patients having serious adverse reactions, and the benefit population is limited, so the treatment of hypertensive renal damage is necessary to have beneficial supplement. More and more clinical studies have shown that ginkgo leaf extract and dipyridamole injection (GDI) combined with antihypertensive drugs has achieved good results in the treatment of hypertensive renal damage. It is supposed to be a supplementary treatment in hypertensive nephropathy.

Objectives:
To systematically assess the efficacy and safety of GDI combined with antihypertensive drugs on hypertensive renal injury.

Methods:
Seven databases including PubMed, Cochrane Library, Embase, Wanfang database, China biomedical literature service system (Sino Med), VIP Chinese Sci-tech journal database (VIP), and China national knowledge internet (CNKI) were retrieved to collect randomized controlled trials (RCTs) in the experimental group containing combined therapy of hypertensive nephropathy with GDI and antihypertensive drugs. The retrieval time was from the establishment of database to July 8, 2020. Two researchers independently selected literature, extracted data, and evaluated the risk of bias in the study. The methodological quality was evaluated with Cochrane handbook and meta-analysis was performed with Stata 14.0 software.

Results:
Eight studies were included in this study which involved 556 patients. The meta-analyses indicated that, compared with using antihypertensive drugs alone, combined treatment of GDI with antihypertensive drugs can decrease 24-hour urinary total protein (weighted mean difference [WMD] –0.61, 95% confidence interval [CI]: –0.82, –0.39; k = 6, P ≤ .001), blood urea nitrogen (WMD –1.27, 95% CI: –2.45, –0.10; k = 6, P = .033, serum creatinine (WMD –29.50, 95% CI: –56.44, –2.56; number of estimates [k] = 6, P = .032).

Conclusions:
Our meta-analyses showed that GDI combined with antihypertensive drugs can improve the renal function of hypertensive patients with renal injury.
Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis in a COVID-19 patient
Authors: Kogure Chio , Kikushima Wataru , Fukuda Yoshiko , Hasebe Yuka , Takahashi Toshiyuki , Shibuya Takashi , Sakurada Yoichi , Kashiwagi Kenji 
Published: May 2021

Abstract

Rationale:
Coronavirus disease 2019 (COVID-19) has spread worldwide. It involves multiple organs of infected individuals and encompasses diverse clinical manifestations. We report a case of acute optic neuritis (ON) associated with myelin oligodendrocyte glycoprotein (MOG) antibody possibly induced by COVID-19.

Patient concerns:
A 47-year-old man presented to our clinic with left eye pain and vision loss. Magnetic resonance imaging of the orbit revealed the bilateral high intensity of the optic nerve sheaths. He tested positive for COVID-19 by polymerase chain reaction (PCR) testing on the day of admission but he had no signs of respiratory illness. Laboratory testing revealed that MOG immunoglobulin G (MOG IgG) was positive, but other antibodies including aquaporin-4 were negative.

Diagnosis:
The patient was diagnosed with MOG antibody-positive acute ON possibly induced by COVID-19.

Interventions:
Steroid pulse therapy consisting of methylprednisolone 1 g/day for a total of 3 days, followed by an oral prednisolone taper was performed.

Outcomes:
His left eye pain was immediately relieved, and his decimal vision improved from 0.03 to 0.1 on the day of discharge. Outpatient follow-up 2 weeks later revealed left a decimal vision of 1.2, and a complete resolution of the left eye pain.

Lessons:
Our case indicated that COVID-19 might trigger an autoimmune response that leads to MOG antibody-associated ON, similar to other pathogens that were reported in the past. The treatment response to steroid pulse therapy was preferable following a typical course of MOG antibody-positive ON.
Efficacy and safety of massage therapy for autism spectrum disorders
Authors: Guo Sheng , Zhou Ke-Lin , Dong Shuo , Xue Xiao-Na , Wei Pei-Dong , Yang Jing-Yi , Fu Guo-Bing , Liu Zhen-Bo , Cui Xia 
Published: May 2021

Abstract

Background
Autism spectrum disorder is a neurodevelopmental disorder with increasing incidence. At present, the global incidence of the disease is on the rise, and the cause is unknown. There is no specific treatment for this disease at present, mainly education and training. Traditional Chinese medicine treatment has a certain effect on the improvement of the symptoms of the disease. The treatment methods are mainly oral Chinese medicine and acupuncture, but children are often not easy to cooperate. As a safe and effective green therapy, massage is easy to be accepted by children.

Methods
We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating autism spectrum disorders: Wanfang and PubMed Database, China National Knowledge Infrastructure Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and Excerpta Medica database. Each database will be searched from inception to March 2021. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses.

Results
This proposed study will evaluate the effectiveness and safety of massage therapy for patients with autism spectrum disorders. The outcomes will include changes in autism spectrum disorder relief and adverse effect.

Conclusion
This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with autism spectrum disorders.

Dissemination and ethics
The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.
Relationship between ABO blood group and gestational diabetes mellitus
Authors: Chen Dongyun , Lin Lili , Hong Qiong , Li Xiaohong 
Published: May 2021

Abstract

Background:
Gestational diabetes mellitus (GDM) is a common metabolic disorder syndrome in women during pregnancy. If effective measures are not taken to intervene in the early stage of GDM, severe effects will damage maternal and infant health. ABO is the most important human blood group system. A large number of studies have displayed that ABO blood group is associated with many diseases. At present, the risk relationship between ABO blood group and GDM is controversial. The purpose of this study is to explore the risk relationship between ABO blood group and GDM by meta-analysis, thus providing basis for the prevention and treatment of GDM.

Methods:
An electronic database, including Embase, Cochrane Library, Pubmed, Chinese databases SinoMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journals Database and Wanfang Data, will be used to search for studies of ABO blood group and GDM. The language will be limited to Chinese and English. The two reviewers will be responsible for the selection of the study, the extraction of data and the evaluation of the quality of the research. All statistical analyses will be carried out using Review Manager 5.3.

Results:
The results of this meta-analysis will be published in peer-reviewed journals.

Conclusion:
This study will provide evidence to support the relationship between ABO blood group and the risk of GDM

Ethics and dissemination:
The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:
DOI 10.17605/OSF.IO/W6QSX.
Physical activity and risk of sudden cardiac death in individuals at high risk for cardiovascular disease
Authors: Wu Qinqin , Li Fanghui , Jia Yu , Liu Yi , Zeng Rui 
Published: May 2021

Abstract

Background:
Regular physical exercise is recommended for lowering the risk of coronary events and all-cause mortality. However, there is a variety of exercise options, and their relative effectiveness and hierarchy remain unclear. Herein, we present a systematic review and meta-analysis protocol that aims to compare the impact of different types of physical activity on the risk of sudden cardiac death.

Methods and analysis:
English language articles reporting on randomized controlled trials will be searched in MEDLINE, Cochrane Library, CINAHL, and PubMed databases by two reviewers. A snowball approach will be used for literature retrieval. Reviewers will independently screen the literature, extract data, evaluate study quality and risk of bias, and perform a meta-analysis. In the presence of heterogeneity, a random effects model will be used for meta-analysis; otherwise, a fixed effect model will be used.

Ethics and dissemination:
This study is a secondary analysis and does not require ethical review. The results of this study will be disseminated through peer-reviewed publications, journals, and academic conferences and other forms of exchange.

Systematic review registration number:
INPLASY202140033
National early warning score on admission as risk factor for invasive mechanical ventilation in COVID-19 patients
Authors: Chang Min Cheol , Kim Tae Uk , Park Donghwi 
Published: May 2021

Abstract
The coronavirus disease (COVID-19) has become a global pandemic. Invasive mechanical ventilation is recommended for the management of patients with COVID-19 who have severe respiratory symptoms. However, various complications can develop after its use. The efficient and appropriate management of patients requires the identification of factors associated with an aggravation of COVID-19 respiratory symptoms to a degree where invasive mechanical ventilation becomes necessary, thereby enabling clinicians to prevent such ventilation. This retrospective study included 138 inpatients with COVID-19 at a tertiary hospital. We evaluated the differences in the demographic and clinical data between 27 patients who required invasive mechanical ventilation and 111 patients who did not. Multivariate logistic regression analysis indicated that the duration of fever, national early warning score (NEWS), and lactate dehydrogenase (LDH) levels on admission were significantly associated with invasive mechanical ventilation in this cohort. The optimal cut-off values were: fever duration ≥1 day (sensitivity 100.0%, specificity 54.95%), NEWS ≥7 (sensitivity 72.73%, specificity 92.52%), and LDH >810 mg/dL (sensitivity 56.0%, specificity 90.29%). These findings can assist in the early identification of patients who will require invasive mechanical ventilation. Further studies in larger patient populations are recommended to validate our findings.
Survey and enlightenment on the wearing of protective equipment of nurses working on the front line against COVID-19
Authors: Wu Maojie , Zhang Lin , Ning Ning , Liu Li , Liu Xiaoyan 
Published: May 2021

Abstract
At present, coronavirus disease 2019 (COVID-19) remains a significant challenge for health workers around the world. This survey aims to highlight the status of the implementation of occupational protection measures for nurses working on the front line against COVID-19, and to analyze the problems in the process of wearing protective equipment.
This cross-sectional study was conducted among 165 nurses who worked in COVID-19-stricken areas in China in March 2020. The questionnaire covered 3 aspects, namely: general information, the current condition of protective equipment wearing, and the wearing experience of protective equipment.
A total of 160 (96.97%) valid questionnaires were collected. The average time of wearing protective equipment for the nurses surveyed was 6.38 ± 3.30 hours per working day. For first-line nurses with low risk of infection, repeated wear of protective equipment was as follows: medical protective mask 30.77%, double latex gloves 8.46%, goggles/protective mask 15.38%, protective suit 15.38%; less wear of protective equipment were as follows: work cap 7.69%, surgical mask 7.69%, single layer latex gloves 30.77%, goggles/protective mask 30.77%, and isolation gown 46.15%. For nurses who were at moderate risk of infection, repeated wear of protective equipment was as follows: surgical mask 62.22%, goggles/protective mask 68.89%, and isolation gown 65.56%; less wear: work cap 3.33%, medical protective mask 15.56%, latex gloves 15.56%, goggles/protective mask 5.56%, and protective suit 16.67%. For front-line nurses with high risk of infection, repeated wear of protective equipment was as follows: surgical mask 64.91%, more than double latex gloves 8.77%, goggles/protective mask 75.44%, isolation gown 75.44%; less wear: work cap 1.75%, medical protective mask 1.75%, latex gloves 26.32%, goggles/ protective mask 1.75%, protective suit 1.75%. The main discomforts of wearing protective equipment were poor vision due to fogging (81.88%), stuffiness (79.38%), poor mobility (74.38%), sweating (72.5%), and skin damage (61.25%).
More detailed personal protection standards should be developed, and the work load of nurses should be reduced. Actions should be taken to ensure the scientific implementation of personal protective measures. To solve practical clinical problems, future protective equipment may focus on the research and development of protective equipment applicable for different risk levels, as well as the research on integrated design, fabric innovation, and reusability.
Cecal intubation time in screening colonoscopy
Authors: Kim Hyun Young 
Published: May 2021

Abstract
The time required to intubate the cecum varies. The aim of this study was to determine whether demographic and anthropometric factors, such as body mass index (BMI), percent body fat, muscle mass, and fat mass, affect the cecal intubation time (CIT) during complete colonoscopy.
A retrospective chart review of 1229 patients (aged 40–80 years) was performed. These patients underwent average-risk screening colonoscopies performed by expert gastroenterologists at Health Check-up Center, Seoul National University Bundang Hospital, during a health check-up. We collected data on age, sex, BMI, percent body fat, muscle mass, fat mass, history of prior abdominal or pelvic surgery, CIT, and bowel preparation quality (Boston Bowel Preparation Scale [BBPS] score).
Of the 1229 patients, 62% were men. The mean age was 55 years, and the mean BMI was 24 kg/m2. The median CIT was 5 min. The patients were categorized into two groups according to CIT: easy colonoscopy (CIT ≤ 10 min) and difficult colonoscopy (CIT > 10 min). In univariate analysis, CIT was prolonged by the following factors: older age, poor bowel preparation, lower BMI, lower percent body fat, and less fat mass. Multivariate analysis showed that anthropometric indices including BMI, percent body fat, muscle mass, and fat mass were not significant factors for CIT. Older age (≥ 70 years) (odds ratio [OR]: 2.272, 95% confidence interval [CI]: 1.056–4.890, P = .036) and poor bowel preparation (BBPS score ≤ 5) (OR: 3.817, 95% CI: 1.866–7.808, P = .000) were found to be correlated with difficult colonoscopy.
Our study suggests that anthropometric indices including BMI, percent body fat, muscle mass, and fat mass are not associated with significantly different CIT. Furthermore, sex and prior abdominal or pelvic surgery are not useful factors for a prolonged CIT. Older age (≥ 70 years) and poor bowel preparation (BBPS score ≤ 5) are significant variables predicting the CIT of expert gastroenterologists.