bluuebunny/crossref_metadata_2025_split huggingface dataset:
The progressive fibrotic phenotype in current clinical practice
Authors: Wells Athol U. , Brown Kevin K. , Cottin Vincent 
Published: July 2021

Purpose of review
The progressive fibrotic phenotype (PFP), a term that covers large sub-groups of patients with fibrotic lung diseases that clinically progress despite appropriate usual management, is now an everyday problem for patients and clinicians alike. This review covers recent data that are relevant to major clinical uncertainties.

Recent findings
The clinical relevance of the PFP is covered by a brief review of data from which this entity was constructed. Estimates of the prevalence of the PFP are cited. The importance of an accurate initial diagnosis is emphasized – with refutation of the belief that diagnosis now matters less because of recent antifibrotic trial data. Pivotal trials are reviewed briefly with emphasis on the range of diseases studied and the efficacy signals. Included in this section are analyses of treatment effects in individual diseases and data that validate the progression criteria that define the PFP.

Summary
Clinicians can now implement the findings from recent antifibrotic trials in non-idiopathic pulmonary fibrosis lung diseases. However, the appropriate application of recent data requires an understanding of the critical importance of initial diagnosis, key measures of disease progression and knowledge of the strengths and weaknesses of trial data. Important clinical uncertainties not informed by current data include the evaluation of the adequacy of traditional management (before antifibrotic therapy is introduced) and agreement on the exact definition of disease progression that should trigger consideration of antifibrotic therapy.
Case reports of one-lung ventilation using Fuji Uniblocker bronchial blockers for infants under one-year-old in uniportal video-assisted thoracoscopic surgery
Authors: Chang Szu-Ling , Lai Chih-Hung , Chen Guan-Yu , Chou Chia-Man , Huang Sheng-Yang , Chen Yung-Ming , Liu Tsun-Jui , Lai Hui-Chin 
Published: July 2021

Abstract

Introduction:
Uniportal video-assisted thoracoscopic surgery (VATS) for various pulmonary diseases provides advantages of less postoperative pain and earlier post-operative recovery over traditional open surgery. The inherent limitation of this surgical modality in manipulation of surgical instruments renders intra-operative one-lung ventilation a requisite to increase the substantially restricted working space and thus visibility of the surgical filed.

Patient concerns:
Patient 1, an 8-month-old, 9-kg, and 70 cm-in-height male infant was diagnosed as congenital pulmonary airway malformation (CPAM) over left lower lobe.
Patient 2, a 9-month-old, 8-kg and 72 cm-in-height male infant was diagnosed as CPAM over right lower lobe.
Patient 3, an 8-month-old, 8-kg and 67 cm-in-height female infant was diagnosed as CPAM over left lower lobe.
This facilitating one-lung ventilation yet was rarely conducted in infants under one year of age for the extremely small body size, the unavailability of dedicated tools, and therein the very tough techniques demanded.

Diagnosis:
Infants with congenital cystic adenomatoid malformation

Interventions:
Here we report three infants of less than one year of age in whom one-lung ventilation was successfully achieved by intraluminal use of 5-Fr Fuji Uniblocker Bronchial Blocker devices and in turn assisted the completion of uniportal VATS for congenital cystic adenomatoid malformation in unilateral lungs.

Outcomes:
Three infants received VATS under uniblocker smoothly. Patient 1 had two episode of balloon dislodgement and desaturation and solved by re-insertion. And he had subglottic tracheal stenosis which treatment with laser coagulation. Patient 2 had overall blood loss 80 ml. Patient 3 had one episode of desaturation after stapling the bronchus and fiberoptic bronchoscope revealed obstruction by blood and secretion which solved by suction.

Conclusion:
In conclusion, OLV in infants undergoing uniportal VATs could be successfully achieved by Fuji 5 Fr Uniblocker bronchial blockers for as long as 4 hours, as exemplified by our three cases, and balloon poor sealing and dislodgment can be immediately solved by bronchoscope-guided re-positioning without compromising surgical proceeding or outcome.
Effects of nonpharmacological intervention on sleep quality in hemodialysis patients
Authors: Li Hui , Zuo Long , Long Siyu , Li Baifei 
Published: July 2021

Abstract

Background:
Nonpharmacological intervention can improve the sleep quality of hemodialysis patients. However, there are many types of nonpharmacological interventions, which makes it difficult to determine the best one. Therefore, this study carried out network meta-analysis to evaluate the effects of nonpharmacological intervention on sleep quality of hemodialysis patients, so as to provide evidence for the selection of the optimal nonpharmacological intervention for the improvement of sleep quality of hemodialysis patients clinically.

Methods:
Randomized controlled trials on the effects of nonpharmaceutical interventions on sleep quality in hemodialysis patients were conducted by searching English databases (PubMed, Cochrane Library, EMBASE, and Web of Science) and Chinese databases (Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, and China Biomedical Literature Database) on computer. The retrieval time was from the establishment of the database to May 2021. Literature screening, data extraction, and evaluation of the risk of bias in the included studies were conducted independently by two researchers. Data analysis was performed with STATA14.0 and GEMTC 0.14.3 software.

Results:
We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.

Conclusions:
This study will provide the best evidence-based evidence to support the effects of non-pharmacological interventions on sleep quality in hemodialysis patients.

Ethics and dissemination:
Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations.

OSF REGISTRATION NUMBER:
DOI 10.17605/OSF.IO/4BPKT.
Epidemiological analysis of single center of acute poisoning cases based on poisoning treatment platform
Authors: Jun-hua Shen , Jin-song Zhang , Li Qiao , Lei Wang , Bao-feng Zhu , Jia Li , Ying Liu , Jian-Rong Cheng 
Published: July 2021

Abstract
To studied epidemiological characteristics of 493 cases of acute poisoning in Nantong city, Jiangsu province.
Based on the analysis platform of poisoning treatment, adopted single center and prospective investigation method, analyzed data of acute poisoning patients from May 2015 to December 2018 in the second affiliated hospital of Nantong University.
Among 493 patients with acute poisoning, men 227 (46.04%), women 266 (53.96%). Age ranged from 12 to 89 years old, average age 41.6 years. In the occupational distribution, farmers were 30.02%; 351 cases (71.20%) visited the hospital within 6 hours after exposure. Oral exposure poisoning 415 cases (84.18%). Pesticide poisoning accounted for 45.45% of deaths.
Using the poisoning treatment platform to analyze the clinical characteristic had accurately and reliably in Nantong. The fatality rate of pesticide poisoning in cases of acute poisoning is high. Management of highly toxic pesticides should be continued and effective health education on pesticide use should be carried out.
Beta-lactam allergy labeling in intensive care units
Authors: Leone Marc , Zunino Claire , Pauly Vanessa , Mathieu Calypso , Antonini François , Orlean Veronica , Cassir Nadim , Pradel Vincent , Bourenne Jérémy , Boussen Salah , Hraiech Sami , Lagier David , Vitte Joana , Wiramus Sandrine , Zieleskiewicz Laurent , Papazian Laurent , Boyer Laurent 
Published: July 2021

Abstract
This retrospective study aimed to describe the association between the “β-lactam allergy” labeling (BLAL) and the outcomes of a cohort of intensive care unit (ICU) patients.
Retrospective cohort study.
Seven ICU of the Aix Marseille University Hospitals from Marseille in France.
We collected the uses of the label “β-lactam allergy” in the electronic medical files of patients aged 18 years or more who required more than 48 hours in the ICU with mechanical ventilation and/or vasopressors admitted to 7 ICUs of a single institution.
We retrospectively compared the patients with this labeling (BLAL group) with those without this labeling (control group).
The primary outcome was the duration of ICU stay. Among the 7146 patients included in the analysis, 440 and 6706 patients were classified in the BLAL group and the control group, respectively. The prevalence of BLAL was 6.2%. In univariate and multivariate analyses, BLAL was weakly or not associated with the duration of ICU and hospital stays (respectively, 6 [3–14] vs 6 [3–14] days, standardized beta −0.09, P = .046; and 18 [10–29] vs 15 [8–28] days, standardized beta −0.09, P = .344). In multivariate analysis, the ICU and 28-day mortality rates were both lower in the BLAL group than in the control group (aOR 0.79 95% CI [0.64–0.98] P = .032 and 0.79 [0.63–0.99] P = .042). Antibiotic use differed between the 2 groups, but the outcomes were similar in the subgroups of septic patients in the BLAL group and the control group.
In our cohort, the labeling of a β-lactam allergy was not associated with prolonged ICU and hospital stays. An association was found between the labeling of a β-lactam allergy and lower ICU and 28-day mortality rates.
Trial registration: Retrospectively registered.
Intrapulmonary lymph node (stations 13 and 14) metastasis in peripheral non-small cell lung cancer
Authors: Bi Lei , Zhang Hong , Ge Mingjian , Lv Zhongzhu , Deng Yiping , Rong Tenghao , Liu Chaolun 
Published: July 2021

Abstract
It remains unknown whether dissecting the intrapulmonary lymph nodes (stations 13 and 14) when resecting peripheral non-small cell lung cancer (NSCLC) is necessary for accurate tumor node metastasis (TNM) staging. This study investigated intrapulmonary lymph node dissection (stations 13 and 14) on the pathological staging of peripheral NSCLC and the metastatic pattern of the lymph nodes.
This retrospective study included patients with primary peripheral NSCLC who underwent radical dissection between January 2013 and December 2015. The clinical data of patients and examination results of intrapulmonary stations 12, 13, and 14 lymph nodes were analyzed.
Of 3019 resected lymph nodes in a total of 234 patients (12.9/patient), 263 (8.7%) had metastasis. Ninety-nine patients had lymph node metastasis (42.3%): 40 (17.1%) were N1, 11 (4.7%) were N2, 48 (20.5%) were both N1 and N2, and 135 (57.7%) had no N1 or N2 metastasis. Sixteen (6.8%) patients had metastasis of stations 13 and/or 14. Metastasis in N1 positive patients of stations 10, 11, 12, 13, and 14 were 2.7%, 10.5%, 9.8%, 10.4%, and 8.5%, respectively. Missed detection without station 13 and 14 dissection was up to 6.8% (16/234).
Dissection of stations 13 and 14 could be helpful for the identification of lymph node metastasis and for the accurate TNM staging of primary NSCLC.
The lowest effective plasma concentration of atomoxetine in pediatric patients with attention deficit/hyperactivity disorder
Authors: Sugimoto Atsunori , Suzuki Yutaro , Orime Naoki , Hayashi Taketsugu , Yoshinaga Kiyohiro , Egawa Jun , Ono Shin , Sugai Takuro , Inoue Yoshimasa , Someya Toshiyuki 
Published: July 2021

Abstract

Background:
Atomoxetine (ATX) is used as a first-line, non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD), although no studies have systematically examined the relationship between plasma concentration and clinical efficacy. We conducted this non-randomized prospective interventional study to examine the relationship between plasma concentration of ATX and clinical efficacy.

Methods:
Forty-three ADHD pediatric patients received ATX, and the steady-state through plasma concentration of the last daily dose that was maintained for at least 4 weeks were determined by high-performance liquid chromatography.

Results:
The receiver operating characteristic curve suggested that when plasma concentration exceeded 64.60 ng/mL, scores on the ADHD-Rating Scale improved by 50% or more (P = .14). Although 6 of the 8 final responders were unresponsive at the initial dose (.72 ± .04 mg/kg [mean ± standard deviation]), they responded after increasing the ATX dose to the final dose (1.52 ± .31 mg/kg). Excluding 7 outlier participants, the concentration was 83.3 ± 32.3 ng/mL in 7 responders and was significantly higher than 29.5 ± 23.9 ng/mL (P < .01) for the 29 non-responders.

Conclusions:
These results suggest that a minimum effective plasma concentration of ATX is required to achieve sufficient clinical efficacy. We hypothesized a mechanism that results in the realization of a clinical effect when the plasma concentration exceeds a certain threshold in the potential response group, whereas will not improve even if the plasma concentration is increased in the unqualified non-responder group.
Expression and prognostic analyses of HDACs in human gastric cancer based on bioinformatic analysis
Authors: Chen Luting , Fei Yuchang , Zhao Yurong , Chen Quan , Chen Peifeng , Pan Lei 
Published: July 2021

Abstract
Gastric cancer (GC) is a common cancerous tumor, and is the third leading cause of cancer mortality worldwide. Although comprehensive therapies of GC have been widely used in clinical set ups, advanced gastric cancer carries is characterized by poor prognosis, probably due to lack of effective prognostic biomarkers. Mammalian histone deacetylase family, histone deacetylases (HDACs), play significant roles in initiation and progression of tumors. Aberrant expression of HDACs is reported in many cancer types including gastric cancer, and may serve as candidate biomarkers or therapeutic targets for GC patients.
Gene Expression Profiling Interactive Analysis was used to explore mRNA levels of HDACs in GC. Kaplan–Meier plotter was used to determine the prognostic value of HDACs mRNA expression in GC. Genomic profiles including mutations of HDACs were retrieved from cBioPortal webserver. A protein–protein interaction network was constructed using STRING database. GeneMANIA was used to retrieve additional genes or proteins related to HDACs. R software was used for functional enrichment analyses.
Analysis of mRNA levels of HDAC1/2/4/8/9 showed that they were upregulated in GC tissues, whereas HDAC6/10 was downregulated in GC tissues. Aberrant expression of HDAC1/3/4/5/6/7/8/10/11 was all correlated with prognosis in GC. In addition, expression levels of HDACs were correlated with different Lauren classifications, and clinical stages, lymph node status, treatment, and human epidermal growth factor receptor 2 status in GC.
The findings of this study showed that HDAC members are potential biomarkers for diagnosis or prognosis of gastric cancer. However, further studies should be conducted to validate these findings.
Contrast-enhanced CT radiomics features to predict recurrence of locally advanced oesophageal squamous cell cancer within 2 years after trimodal therapy
Authors: Tang Sun , Ou Jing , Wu Yu-Ping , Li Rui , Chen Tian-Wu , Zhang Xiao-Ming 
Published: July 2021

Abstract
Radiomics transforms the medical images into high-dimensional quantitative features and provides potential information about tumor phenotypes and heterogeneity. We conducted a retrospective analysis to explore and validate radiomics model based on contrast-enhanced computed tomography (CECT) to predict recurrence of locally advanced oesophageal squamous cell cancer (SCC) within 2 years after trimodal therapy. This study collected CECT and clinical data of consecutive 220 patients with pathology-confirmed locally advanced oesophageal SCC (154 in the training cohort and 66 in the validation cohort). Univariate statistical test and the least absolute shrinkage and selection operator method were performed to select the optimal radiomics features. Logistic regression was conducted to build radiomics model, clinical model, and combined model of both the radiomics and clinical features. Predictive performance was judged by the area under receiver operating characteristics curve (AUC), accuracy, and F1-score in the training and validation cohorts. Ten optimal radiomics features and/or 7 clinical features were selected to build radiomics model, clinical model, and the combined model. The integrated model of radiomics and clinical features was superior to radiomics model or clinical model in predicting recurrence of locally advanced oesophageal SCC within 2 years in the training (AUC: 0.879 vs 0.815 or 0.763; accuracy: 0.844 vs 0.773 or 0.740; and F1-score: 0.886 vs 0.839 or 0.815, respectively) and validation (AUC: 0.857 vs 0.720 or 0.750; accuracy: 0.788 vs 0.700 or 0.697; and F1-score: 0.851 vs 0.800 or 0.787, respectively) cohorts. The combined model of radiomics and clinical features shows better performance than the radiomics or clinical model to predict the recurrence of locally advanced oesophageal SCC within 2 years after trimodal therapy.
Anterolateral thigh free flaps with T-shaped pedicles and multiple venous anastomosis for extremity reconstruction
Authors: Lee Jun Ho , Choi Hwan Jun , Kwak Si Hyun , Lee Da Woon , Tak Min Sung , Kang Jin Seok 
Published: July 2021

Abstract
The anterolateral thigh free flap is one of the most preferred options for reconstructing soft tissues of the extremities and vascular anastomosis is one of the most important factors for flaps survival. T-anastomosis and double venous anastomosis have been widely used for increasing flap survival. This report shows both application of T-shape pedicle and multiple venous anastomosis to each 43 cases for extremity reconstruction that have not been described so far in the literature and it showed the necessity of multiple anastomosis. The locations of the lesions were 8 upper extremities (4 hands, 3 forearms, and 1 upper arm) and 35 lower extremities (5 forefeet, 6 dorsal feet, 4 plantar feet, 11 ankles, and 9 lower legs). We applied T-shaped arterial pedicle to limited anatomical area that had 2 or more major arterial communication sites to overcome the obstruction by reverse flow from communication vessels when 1 of the 2 anastomosis was obstructed. We classified multiple venous anastomosis according to flow direction and the vascular connections between the superficial and deep veins. In result, 37 cases survived completely but 2 flaps developed severe necrosis (>50%) because of infection and hematoma and 4 flaps developed partial necrosis due to wound infection. In conclusion, T-shaped pedicle and multiple venous anastomosis is a method to improve free flap survival and useful in cases where sacrificing a dominant vessel is inevitable or those in which only 1 vessel remains.
Severe bacterial infection in young infants with pyrexia admitted to the emergency department
Authors: Chen Yin-Ting , Chang Yu-Jun , Liu Bang-Yan , Lee En-Pei , Wu Han-Ping 
Published: July 2021

Abstract
The objectives of this study were to understand the clinical presentations of febrile young infants with severe bacterial infection (SBI), and to investigate the pathogen variations throughout the vaccine era and after antenatal group B Streptococcus (GBS) screening.
All infants < 90 days old with a body temperature of ≥38.0°C and admitted to the emergency department were retrospectively enrolled in our study. SBI was defined as a positive culture of urine, blood, or cerebrospinal fluid. All clinical variables were analyzed and compared between the SBI group and the non-SBI group, to identify the relevant risk factors for SBI in infants with pyrexia.
A total of 498 infants were studied, 279 of whom (56%) had SBI. The body temperature at triage was higher in the SBI group, and the difference was highly obvious in the neonatal group. White blood cell count and C-reactive protein levels were both significantly higher in the SBI group (P < .05), whereas neutrophil percentage and band percentage demonstrated no significant differences. Escherichia coli was the most common pathogen and plasmid-mediated extended-spectrum lactamases were detected in up to 9.1%. GBS was detected in 16 cases of bacteremia (6 cases with concurrent meningitis).
The body temperature at triage may provide a clue for differentiating sick babies, especially in the neonatal group. Complete serum analysis is required for infection survey, especially white blood cell and C-reactive protein. Escherichia coli is the most common pathogen, and clinician should raise awareness of drug resistance in some patients. The prevalence of GBS infection in the young infant group remains high after routine antenatal GBS screening
Acute interstitial nephritis associated with ingesting a Momordica charantia extract
Authors: Bae Wooram , Kim Seongmin , Choi Jungyoon , Lee Tae Won , Bae Eunjin , Jang Ha Nee , Jung Sehyun , Lee Seunghye , Chang Se-Ho , Park Dong Jun 
Published: July 2021

AbstractRationale:Momordica charantiais often used to treat type 2 diabetes mellitus in Korea. Drug-induced acute interstitial nephritis (AIN) accounts for 60% to 70% of AIN cases. However, only 1 case of AIN associated with ingestingM charantiahas been reported in the English literature. We report an extremely rare case of AIN that occurred after a patient ingested a pureM charantiaextract over 7 months.Patient concerns:A 60-year-old Korean woman was admitted to our hospital for a renal biopsy. Her renal function had decreased gradually over the last 9 months without symptoms or signs.Diagnosis:Her blood urea nitrogen and serum creatinine levels were 29.7 mg/dL (range: 8.0–20.0 mg/dL) and 1.45 mg/dL (range: 0.51–0.95 mg/dL) on admission. Renal histology indicated AIN; there was immune cell infiltration into the interstitium, tubulitis, and epithelial casts, although the glomeruli were largely intact.Interventions:M charantiawas discontinued and prednisolone was prescribed.Outcomes:The value of serum creatinine has almost been restored to the baseline level after 3 months.Conclusions: This is the first case report of AIN associated with the ingestion of a pureM charantiaextract. Recognition of the possible adverse effects of these agents by physicians is very important for early diagnosis and appropriate management.