bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary biliary non-Hodgkin's lymphoma
Authors: Wu Jiamei , Zhou Yin , Li Qingshu , Zhang Jing , Mao Yun 
Published: June 2021

Abstract

Rationale:
Primary biliary non-Hodgkin's lymphoma (PBNHL) is a rare disease with only 41 cases reported since 1982. The incidence of PBNHL in patients with malignant cholangiocarcinoma was 0.6%, and PBNHL accounted for 0.4% of extranodal non-Hodgkin's lymphoma, and only 0.016% of all non-Hodgkin's lymphoma cases.

Patient concerns:
We present a rare case of PBNHL in a 59-year-old female who had jaundice for 3 days with weight loss and Epstein-Barr virus infection. Initial computed tomography and magnetic resonance imaging showed diffuse thickening wall of bile ducts with corresponding lumen stenosis, blurred fat space around the portal vein, lymphadenopathy, and a normal spleen. These manifestations and images were similar to hilar cholangiocarcinoma. So, the diagnosis of hilar cholangiocarcinoma was initially considered.

Diagnoses:
Postoperative pathology confirmed the final diagnosis was PBNHL.

Interventions:
The patient and her family requested to clarify the histologic diagnosis by laparotomy biopsy. Because the biopsy result could not be defined during operation, then right hemihepatectomy and choledochojejunostomy were performed. She did not receive any antitumor treatment.

Outcomes:
One month after the patient's first examination, both computed tomography and magnetic resonance images showed diminished stenosis of common bile duct and left hepatic duct, but a new mass in segment IV of liver was observed. Unfortunately, the patient died due to disease progression.

Lessons:
This case reminds us that although PBNHL is rare, making accurate diagnosis difficult preoperatively, PBNHL should be considered when encountering a case with Epstein-Barr virus infection and those typical imaging findings.
The effect of mind-body exercise on the cervical spine mobility of people with neck discomfort
Authors: Liao Xianhui , Ge Beihai , Chen Qiang 
Published: June 2021

Abstract

Background:
With the development of the economy and society, the pace of in-person work has gradually accelerated, resulting in longer and more intense work hours. Long-term and high-intensity work can lead to considerable discomfort in people's cervical spines.

Objectives:
This study aims to explore the effect of mind-body exercise intervention on the cervical spine mobility of people with neck discomfort through meta-analysis.

Methods:
This study's researchers will search a total of 5 research databases for data retrieval: China National Knowledge Infrastructure (from 1979), Web of Science (from 1950), PubMed (from 1965), Cochrane (from 1991), and EBSCO (from 1949) (Date of retrieval: March 10, 2021). Two authors will independently search literature records, scan titles, abstracts, and full texts, collect data, and assess materials for risk of bias. Stata14.0 software will be used for the data analysis.

Results:
The current study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed.

Discussion:
There is potential evidence that exercise can have a positive effect on the cervical spine mobility of people with cervical spine discomfort. In addition, direct evidence of the benefits of mind-body exercise intervention may be more important.

INPLASY Registration Number:
INPLASY202140126.
Effectiveness and safety of Liuhedan for treating cellulitis
Authors: Li Na , Zhang Li , Pan Pan , Cheng Tao , Xu Shu-Yun 
Published: June 2021

Abstract

Background:
Liuhedan is a famous traditional Chinese Medicine formula used to treat cellulitis in China. However, there are no systematic reviews for the evidence and the therapeutic effectiveness and safety of Liuhedan for treating cellulitis. The aim of this study is to summarize previous evidence, assessing the efficacy and safety of Liuhedan treating cellulitis.

Methods:
We will search the EMBASE, WANFANG DATA, Web of Knowledge, CNKI, PubMed, ClinicalTrials.gov, and Cochrane Library from inception to June 30, 2021 to retrieve relevant studies using the search strategy: (“Liuhedan” OR “Liuhe Pill” OR “Liu-He-Dan”) AND (“cellulitis” OR “phlegmon” OR “skin and soft tissue infection” OR “skin tissue infection” OR “soft tissue infection”). Two authors independently judged study eligibility and extracted data. Heterogeneity will be examined by computing the Q statistic and I
2 statistic.

Results:
This study assessed the efficiency and safety of Liuhedan for treating cellulitis.

Conclusions:
This study will provide reliable evidence-based evidence for the clinical application of Liuhedan for treating cellulitis.

Ethics and dissemination:
Ethical approval is unnecessary as this protocol is only for systematic review and does not involve privacy data. The findings of this study will be disseminated electronically through a peer-review publication or presented at a relevant conference.
Blood pressure measurement during cesarean delivery
Authors: Bobet Mathieu , Joachim Jona , Gayat Etienne , Bonnet Agnès , Sievert Kerstin , Barnichon Carole , Fischler Marc , Le Guen Morgan 
Published: June 2021

Abstract
Early detection of arterial hypotension during cesarean delivery under spinal anesthesia is important. This study aims to compare the validity of NexfinTM as beat-to-beat noninvasive blood pressure monitoring with conventional intermittent oscillometric measurement of blood pressure during elective cesarean delivery.
This open prospective observational bicentric study was performed between January 2013 and December 2015. We simultaneously recorded arterial blood pressure with both techniques in pregnant women undergoing elective cesarean delivery under spinal anesthesia. The primary outcome was a Bland–Altman analysis of systolic blood pressure measurement comparing NexfinTM and a conventional method. The secondary outcomes were the time to detect the first relevant hypotensive episode and the comparison of both devices using a four-quadrant graph.
One hundred and seventy-four parturients completed the study, and 2640 pairs of systolic blood pressure measurements were analyzed. Bias was -10 mmHg with upper and lower limits of agreement of -61 and +41 mmHg. In 73.9% of the cases, the two techniques provided the same information (normotension or hypotension), but the conventional method missed 20.8% of measurements, with NexfinTM detecting 16.2% more hypotensive measurements. The median [25–75 percentiles] duration to detect the first hypotensive measurement was 331 [206–480] seconds for NexfinTM and 440 [300–500] s for intermittent oscillometry (P < .001).
The agreement between NexfinTM and an intermittent method for the measurement of systolic blood pressure was not in an acceptable range during cesarean delivery, although NexfinTM may detect hypotension earlier than the standard method.
Trial registration: Clinicaltrials.gov identifier: NCT01732133; November 22, 2012
Acute pancreatitis associated with duodenal obstruction induced by groove pancreatitis
Authors: Li Jiayan , Liu Qianyi , Liu Zhishang , Cen Chuan , Yang Yuyu , Ye Jianming , Xu Li , Lu Xiji , Chen Dongfeng , Ruan Weishan 
Published: June 2021

Abstract

Rationale
Groove pancreatitis (GP) is a rare form of chronic pancreatitis. Since GP presents with nonspecific symptoms, it can be challenging to diagnose. Duodenal obstruction is often caused by malignant diseases; however, when associated with acute pancreatitis, it is rarely induced by groove pancreatitis.

Patient's concerns
A 56-year-old man who presented with acute pancreatitis complained of recurrent upper abdominal discomfort. His concomitant symptoms included abdominal pain, postprandial nausea, and vomiting. Contrast-enhanced computed tomography (CT) of the abdomen showed thickening of the duodenum wall. Gastrointestinal radiographs and upper gastrointestinal endoscopy showed an obstruction of the descending duodenum.

Diagnosis
The pathologic diagnosis was groove pancreatitis.

Interventions
The patient underwent gastrojejunostomy to relieve the obstruction.

Outcomes
The patient had an uneventful recovery with no complications.

Lessons
Groove pancreatitis should be considered in the differential diagnosis of patients presenting with acute pancreatitis and duodenal obstruction. These data can help to make a precise diagnosis and develop an appropriate treatment plan.
Successful treatment of acute promyelocytic leukemia in a 92-year-old man using all-trans retinoic acid combined with oral arsenic
Authors: Shi Xiaowei , Li Shuangyue , Tang Shanhao , Lu Ying 
Published: June 2021

Abstract

Rationale
Acute promyelocytic leukemia is a special subtype of acute myeloid leukemia. The incidence of early death and complications is high. An oral regimen of all-trans retinoic acid combined with the realgar-indigo naturalis formula (RIF) without chemotherapy has provided a new strategy for the treatment of these patients.

Patient concerns
A 92-year-old male patient was admitted to the hospital due to fatigue and oral bleeding. He had no fever or lung infection. Routine blood test showed white blood cell count 1.0 ×109/L, hemoglobin 100 g/L, and platelets 21 × 109/L. Coagulation function indicated fibrinogen 1.02 g/L and D-dimer 2360 ng/mL. And 28% abnormal promyelocytes were observed in peripheral blood.

Diagnosis
A bone marrow morphologic, immunophenotypic, cytogenetic, and molecular examination was performed. Routine bone marrow examination showed active proliferation of nucleated cells, with promyelocytes accounting for 91%; immunophenotyping revealed an early myeloid cell population, accounting for approximately 82.4% of all cells.

Interventions
From February 15, 2020, 25 mg/m2 all-trans retinoic acid was orally administered daily. After the fusion gene result was obtained, oral administration of 60 mg/kg RIF daily began since February 18, 2020. The combination of the 2 agents was given until March 16, 2020. Oral administration of 25 mg/m2 retinoic acid daily began from March 20, 2020 for 2 weeks, and oral administration of 60 mg/kg RIF daily lasted for 4 weeks as the consolidation therapy. During the treatment, the proportion of promyelocytes in peripheral blood, white blood cell count, platelets, coagulation function, liver function, and QT interval were monitored.

Outcomes
Oral retinoic acid and oral RIF were given without chemotherapy and the patient achieved bone marrow remission after 1 month, and molecular remission was achieved 2 months later. In the early stage of acute promyelocytic leukemia, combined thrombocytopenia and disseminated intravascular coagulation may develop. Platelet and fresh frozen plasma infusion were proactively given until platelets were stabilized above 30 × 109/L, and the coagulation function returned to normal.

Lessons
The regimen was safe and effective, and subsequent treatment did not require hospitalization, which helped to improve the patient's quality of life.
Thromboembolism after cardiac surgery in a patient with cancer-related thrombosis and severe thrombocytopenia
Authors: Kim Soo Yeon , Ro Soo Jin , Koh Su Rim , Lim Hyunyoung 
Published: June 2021

Abstract

Rationale:
Patients with cancer have elevated risk of both venous thromboembolism and bleeding compared with patients without cancer due to cancer- and patient-specific factors. Balancing the increased and competing risks of clotting and bleeding in these patients can be difficult because management of cancer-associated thrombosis requires anticoagulation despite its known increased risks for bleeding. The adjustment of blood transfusion or cessation of anticoagulants can be a challenge in surgical diagnosis or treatment of cancer patients with such an imbalanced coagulate status.

Patient concerns:
A 45-year-old woman with no underlying disease was suspected of ovarian cancer and was awaiting diagnostic laparoscopic exploration surgery.

Diagnoses:
While waiting for the surgery, the patient developed chest pain and underwent stent insertion under diagnosis of myocardial infarction. Two weeks later, endocarditis developed, and replacement of the aortic valve and mitral valve was planned. In addition, the patient developed multiple thromboembolisms and was administered anticoagulants to eliminate vegetation of valves and multiple thromboses. Her blood test showed anemia (7.4 g/dL) and severe thrombocytopenia (24 × 109/L).

Interventions:
The patient underwent double valve replacement.

Outcomes:
A color change of the left lower extremity was noted 5 hours after double valve replacement, and angiography was performed. Thrombectomy was performed under diagnosis of thrombosis in the left iliac artery. One month later, the patient underwent laparoscopic exploration surgery as scheduled.

Lessons:
This case will help establish the criteria of blood coagulation for surgical treatment of cancer patients with imbalanced clotting and bleeding.
The risk factors of postoperative delirium in general anesthesia patients with hip fracture
Authors: Chu Zhe , Wu Yixuan , Dai Xuanhui , Zhang Cuicui , He Qianfeng 
Published: June 2021

Abstract
Delirium is a common postoperative complication of patients with hip fracture, yet the risk factors for postoperative delirium in patients with hip fracture remain unclear. We aimed to evaluate the associated risk factors of postoperative delirium in patients with hip fracture, to provide evidence for formulating coping measures of postoperative delirium prevention and treatment in clinical practice.
Patients undergoing surgery for hip fracture from March 1, 2018 to September 30, 2020 in our hospital were included. The related characteristics and related lab examination results were reviewed and collected. The univariate and logistic regression analyses were performed to identify the potential risk factors.
A total of 462 patients were included, the incidence of postoperative delirium in patients with hip fracture was 16.02%. Logistic regression analyses indicated that history of delirium (OR = 4.38, 1.15–9.53), diabetes mellitus (OR = 5.31, 1.23–10.75), hypoalbuminemia (OR = 4.97, 1.37–9.86), postoperative hypoxemia (OR = 5.67, 2.24–13.42), and body mass index (BMI) (kg/m2) (OR = 3.03, 1.36–6.18) were the independent risk factors for the delirium in patients with hip fracture surgery (all P < 0.05). The cutoff value of postoperative blood sugar, albumin, and BMI for delirium prediction was 8.05 (mmol/L), 32.26 (g/L), and 19.35 (kg/m2), respectively, and the area under curve of postoperative blood sugar, albumin, and BMI was 0.792, 0.714, and 0.703, respectively.
Those patients with a history of delirium, postoperative hypoxemia, blood glucose ≥8.05 mmol/L, albumin ≤32.26 g/L, and BMI ≤19.35 kg/m2 particularly need the attention of healthcare providers for the prevention of delirium.
Differences in the clinicopathological features of pancreatic head carcinoma in dorsal and ventral pancreas
Authors: Wang Dasong , Zeng Qihui , Niu Xiaoya , Chen Xinghan , Ye Hui 
Published: June 2021

Abstract
The embryonic development of the pancreas originates from dorsal and ventral anlagen, and the pancreatic cancer arising from dorsal or ventral pancreas may have different clinical pathology features. This study aims to explore whether there are differences in clinicopathological features and prognosis of pancreatic head carcinoma arising from dorsal or ventral pancreas.
Between January 2014 and February 2018, 101 patients with resectable pancreatic head cancer who underwent pancreaticoduodenectomy in our institution were retrospectively reviewed. The patients were assigned into 2 groups according to tumor location on preoperative imaging materials (computed tomography/magnetic resonance imaging [CT/MRI]), and the clinicopathological features and prognosis were retrospectively analyzed in view of the embryonic development of the pancreas.
Among these patients with pancreatic head cancer, 42 patients had tumors arising from dorsal pancreas (D group) and 59 patients had tumors arising from ventral pancreas (V group). The frequency of lymph node (LN) metastasis around the common hepatic artery (CHA) and hepatoduodenal ligament lymph nodes in the D group was higher than that in the V group (45.2% vs 10.2%, P = .001). And the rate of LN metastasis in the superior mesenteric artery (SMA) region in the V group is higher than that in the D group (32.2% vs 4.8%, P = .002). The D group was more likely to invade the common bile duct (78.6% vs 59.3%, P = .042) and duodenum (71.4% vs 44.1%, P = .006) than the V group. In addition, the survival outcome of V group was better than D group (median overall survival [OS], 15.37 months vs 10.53 months, P = .048, median DFS 9.73 months vs 5.93 months, P = .046).
The clinicopathological features of pancreatic head carcinoma arising from dorsal or ventral pancreas are different, and the pancreatic head carcinoma arising from ventral pancreas has a better survival outcome.
Irrational career beliefs in agricultural education students, demographics, impacts, and rational career education intervention
Authors: Ifeanyieze Florence Obiageli , Ede Moses Onyemaechi , Ejiofor Tochukwu E. , Ekenta Lilian Ukamaka , Onah Ogechukwu , Okechukwu Favour C. , Isiwu Edward Chukwuka , Ogbonna Emeka , Azunku Francis , Nwankwo Clara Ukamaka , Ezebuiro Felicia , Onah Fredrick Chinedu , Mezieobi Daniel I. , Ede Kelechi R. , Onyeanusi Obiageli Calista , Asogwa Vincent O. , Omeje Benedicta , Abubakar Ibrahim , Samuel Mary 
Published: June 2021

Abstract

Background:
Studies have shown that a good number of students admitted into Agricultural Science Education program in Nigerian universities exhibit irrational career interest which affects their perceptions, feelings, and academic behaviors. This study, therefore, explored the effect of rational emotive career education on irrational career beliefs among students enrolled in agricultural education program in federal universities in Enugu state. Three null hypotheses guided the study.

Method:
Of the population (N = 79 students) targeted for the study and who underwent a screening exercise, 61 students were recruited as participants/sample size for the study. Sequence allocation software was used to assign 31 students into experimental groups and 30 into waitlisted control group. Participants in the intervention group received a rational emotive career education program that lasted for 12 sessions while those in waitlisted group did not receive the intervention. The participants in both groups were assessed at three points (Time 1, Time 2, and Time 3) using rational and irrational belief scale. A repeated measure (ANOVA) and partial eta square statistical tools were used to analyze the data collected.

Result:
This study result showed that rational emotive career education significantly reduced irrational career beliefs among students enrolled in Agricultural Science Education program exposed to intervention group compared to those in waitlisted control group. It also showed that there was time × group interaction for irrational career beliefs. The follow-up assessment indicated that the efficacy of rational emotive career education was sustained overtime.

Conclusion:
This study concluded that rational emotive career education is beneficial in reducing irrational career beliefs of university students enrolled in Agricultural Science Education program. Recommendations were also made in line with the results.
Appraisal of transthoracic echocardiography for opportunistic screening of abdominal aortic aneurysm
Authors: Celebi Ozlem Ozcan , Celebi Savas , Berkalp Berkten 
Published: June 2021

Abstract
Abdominal aortic aneurysm is a life threatening disease. Most of the patients diagnosed incidentally because of the asymptomatic nature of this disease. This study aimed to determine the frequency of abdominal aortic aneurysm and evaluate the value of opportunistic screening during transthoracic echocardiography.
A total of 5138 patients referred for echocardiographic evaluation for any reason were screened for abdominal aortic aneurysm between November 2014 to July 2019. The aneurysm was defined as an abdominal aorta with a diameter greater than 30 mm, or segmental dilatation of more than 50% of its size in non-dilated parts.
The overall frequency of abdominal aortic aneurysm was 2.2% (n = 109) in the study population. Male sex (P < .001), older age (P < .001), presence of diastolic dysfunction (P = .036), hypertension (P < .001), coronary artery disease (P < .001), and hyperlipidemia (P < .001) were associated with abdominal aortic aneurysm. Patients with aneurysm had significantly increased diameters of the aortic trunk (P < .001) and ascending aorta (P < .001), significantly thicker interventricular septum (P < .001) and posterior wall (P < .001), significantly increased end-diastolic diameter (P < .001) and enlarged left atrium (P < .001), and significantly decreased ejection fraction (P < .001). The mostly met criteria for screening abdominal aortic aneurysm in international guidelines was the age of the patients.
Based on the results of this study, screening patients over 60 years of age who undergo a transthoracic echocardiography for any reason would be beneficial to detect an asymptomatic abdominal aortic aneurysm in Turkish population.
Sagittal plane alignment affects the strength of pin fixation in supracondylar humerus fractures
Authors: Bitzer Alexander M. , Belkoff Stephen M. , LiBrizzi Christa L. , Chibututu Chimelie , Lee R. Jay 
Published: June 2021

Abstract
Closed reduction with percutaneous pin fixation is commonly used to treat pediatric supracondylar humerus fractures. Various pin configurations of varying biomechanical strength have been described. However, to our knowledge, no biomechanical study has focused on pin alignment in the sagittal plane. Our goal was to compare the stability of fixation using 3 different pin constructs: 3 lateral pins diverging in the coronal plane but parallel in the sagittal plane (3LDP), 3 lateral pins diverging in the coronal and sagittal planes (3LDD), and 2 crossed pins (1 medial and 1 lateral).
Transverse fractures were made through the olecranon fossa of 48 synthetic humeri, which were then reduced and pinned in the 3LDP, 3LDD, and crossed-pin configurations (16 specimens per group) using 1.6-mm Kirschner wires. The sagittal plane pin spread was significantly greater in the 3LDD group than in the 3LDP group, whereas we found no difference in the coronal plane. Sagittal extension testing was performed from 0° to 20° at 1°/s for 10 cycles using a mechanical torque stand. The torque required to extend the distal fragment 20° from neutral was compared between groups using one-way analysis of variance with multiple comparison post-hoc analysis. P values ≤.05 were considered significant.
The 3LDD configuration was more stable than the 3LDP and crossed-pin configurations. The mean torque required to displace the pinned fractures was 5.7 Nm in the 3LDD group versus 4.1 Nm in the 3LDP group and 3.7 Nm in the crossed-pin group (both, P < .01). We found no difference in stability between the 3LDP and crossed-pin groups (P = .45).
In a synthetic biomechanical model of supracondylar humerus fracture, sagittal alignment influenced pin construct stability, and greater pin spread in the sagittal plane increased construct stability when using 3 lateral pins. The lateral pin configurations were superior in stability to the crossed-pin configuration.

Level of Evidence: Level V.