bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstructive ureteric calculus with superimposed infections causing reversible posterior leukoencephalopathy syndrome
Authors: Xie Fei , Cai Yanli , Huang Lin , Hao Jianqiang , Ling Tianjin , Richard Seidu A. 
Published: April 2021

Abstract

Rationale:
Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinicoradiological phenomenon first observed 2 decades ago. Reversibility is the hallmark of this rare clinical phenomenon once the triggering pathology is aptly and adequately treated. Tinnitus preceding bilateral hearing loss as a symptomatology of RPLS has not been reported in the literature. Furthermore, chronic obstructive ureteric calculus with superimposed infections as a cause of RPLS has not been reported in the literature.

Patient concerns:
A 57-year-old female was admitted at our facility because of 2 days history of hearing loss in both ears. She experienced tinnitus in both ears 2 weeks prior to the hearing loss. She is a known hypertensive. She has also undergone multiple surgical treatments for urinary calculi.

Diagnosis:
Computed tomography (CT) scan of the urinary system revealed a calculus at the right ureter. Magnetic resonance imaging (MRI) showed abnormal signals at both temporo-parieto-occipital (TPO) cortices, the subcortical area, as well as the left hippocampus which was consistent with the diagnosis of RPLS.

Interventions:
While on antibiotics for treatment of infections, the patient went into hypertensive encephalopathy and pneumonia was also established necessitating intensive care.

Outcomes:
We observed a resolution of the patient's temperature and hypertension when the right ureteric stone finally descended into the bladder. Also, we observed disappearance of the abnormal signals at both TPO cortices, the subcortical area, as well as the left hippocampus. Two years follow-up revealed no recurrence of her symptomatology.

Lesions:
Patients who present with hypertensive encephalopathy maybe more prone to developing RPLS. Renal insufficiency alone or hypertension alone may not be single predisposing entities to RPLS but rather multiple predisposing factors.
Analysis of individualized antiplatelet therapy for patients of acute coronary syndrome after percutaneous coronary intervention under the guidance of platelet function
Authors: Dang Wenxi , Wang Jiajia , Zhang Qing , Liu Nairong , Li Wenting , Yao Zhuhua 
Published: April 2021

Abstract
There is controversy in clinical application of antiplatelet drugs by monitoring platelet function. Therefore, we explored whether early and dynamic medication could bring better clinical outcomes for patients under the guidance of platelet function tests (PFT).
In this retrospective cohort study, we analyzed the prognostic events of 1550 patients with acute coronary syndrome (ACS) at Tianjin People's Hospital in China. They received dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) from January 2017 to December 2018. The primary endpoint was based on the Bleeding Academic Research Consortium (BARC) 3 or 5 major bleeding. Secondary endpoints included MACCE (all-cause death, nonfatal myocardial infarction, stroke, stent thrombosis, and unplanned target vessel reconstruction) and BARC 1 to 2 minor bleeding. The endpoint events within 1 year after PCI were recorded. Patients were divided into a guided group and a control group according to the drug adjustment by PFT results. After the propensity scores matched, the end points of 2 groups were compared, and subgroup analysis was performed on major bleeding events.
After propensity score matching, there were 511 cases in the guided group and the control group, respectively. The primary endpoint events occurred in 10 patients (1.96%) in the guided group and 23 patients (4.5%) in the control group (HR: 0.45; 95% CI, 0.21–0.95; P = .037). After the guided group adjusted drug doses, the risk of major bleeding was lower than standard DAPT of the control group. Although some patients in the guided group reduced doses earlier, the incidence of MACCE events did not increase in the guided group compared with the control group (4.89% vs 6.07%; P = .41). There was no statistical difference in BARC 1 to 2 minor bleeding (P = .22). Subgroup analysis showed that PFT was more effective in patients with diabetes and multivessel disease.
Early observation of dynamic PFT in ACS patients after PCI can guide individualized antiplatelet therapy to reduce the risk of major bleeding without increasing the risk of ischemia.
Identification and validation of a risk signature based on extracellular matrix-related genes in gliomas
Authors: Liu Jia , Li Guilin 
Published: April 2021

Abstract
Gliomas have the highest incidence among primary brain tumors, and the extracellular matrix (ECM) plays a vital role in tumor progression. We constructed a risk signature using ECM-related genes to predict the prognosis of patients with gliomas.
mRNA and clinical data from glioma patients were downloaded from The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx) and Chinese Glioma Genome Atlas (CGGA) databases. Differentially expressed ECM-related genes were screened, and a risk signature was built using least absolute shrinkage and selection operator (LASSO) Cox regression. Cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT) was used to assess immune infiltration in different risk groups. Gene set enrichment analysis (GSEA) was performed to explore the molecular mechanisms of the genes employed in the risk score.
Differentially expressed ECM-related genes were identified, and their associated regulatory mechanisms were predicted via analysis of protein–protein interaction (PPI), transcription factor (TF) regulatory and TF coexpression networks. The established risk signature considered 17 ECM-related genes. The prognosis of the high-risk group was significantly worse than that of the low-risk group. We used the CGGA database to validate the signature. CIBERSORT indicated that the levels of naive B cells, activated memory CD4 T cells, regulatory T cells, gamma delta T cells, activated NK cells, monocytes, activated dendritic cells and activated mast cells were higher in the high-risk group. The levels of plasma cells, CD8 T cells, naive CD4 T cells, resting memory CD4 T cells, M0 macrophages, M1 macrophages, resting mast cells, and neutrophils were lower in the high-risk group. Ultimately, GSEA showed that the terms intestinal immune network for IgA production, primary immunodeficiency, and ECM receptor interaction were the top 3 terms enriched in the high-risk group. The terms Wnt signaling pathway, ErbB signaling pathway, mTOR signaling pathway, and calcium signaling pathway were enriched in the low-risk group.
We built a risk signature to predict glioma prognosis using ECM-related genes. By evaluating immune infiltration and biofunctions, we gained a further understanding of this risk signature. This risk signature could be an effective tool for predicting glioma prognosis.
This study did not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.
Comparison of acupuncture and pinaverium bromide in the treatment of irritable bowel syndrome
Authors: Li Huaiyu , Chen Yun , Hu Ziyi , Yi Ying , Ye Jing , Zhou Yuliang , Yu Zhiying , Tang Haiyi 
Published: April 2021

Abstract

Background:
Irritable bowel syndrome (IBS) is one of the most common chronic gastrointestinal diseases, and the current diagnosis of IBS is still based on symptoms and examination. Pinaverium bromide is commonly used as an antispasmodic in the treatment of IBS. But adverse effects of pinaverium bromide are common. Meta-analyses show that acupuncture has a positive therapeutic effect on IBS.

Methods:
Randomized controlled trials of comparing the efficacy of acupuncture and pinaverium bromide in the treatment of IBS will be searched in the relevant database: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies selected will be exported to EndNote V.9.1 software. Data will be carried out independently from the selected articles by 2 reviewers. Any disagreement will be solved in consultation with a third reviewer.

Results:
Our study aims to compare the efficacy of acupuncture and pinaverium bromide in the treatment of IBS and to fill the lack of relevant evidence.

Conclusion:
Through the inclusion of relevant literature, the overall efficacy of acupuncture and pinaverium bromide in the treatment of IBS will be evaluated, and the gap between various acupuncture treatment measures will be further analyzed.

INPLASY registration number:
INPLASY 202130068.
The clinical course of critically ill COVID-19 patients receiving invasive mechanical ventilation with subsequent terminal weaning
Authors: Liu Yulan , Xie Wenjie , Meng Yang , Sun Lifang , Yan Juanjuan , Dong Weiguo , Zhou Chenliang , Yu Zhui 
Published: April 2021

Abstract
The coronavirus disease (COVID-19) outbreak was first reported in December 2019 in Wuhan, China. Specific information about critically ill COVID-19 patients receiving invasive mechanical ventilation (IMV) is rare.
To describe the clinical course and complications of critically ill patients with COVID-19 who received IMV and were successfully weaned from it.
This retrospective study included patients admitted to 3 intensive care units (ICUs) and 1 sub-ICU of Renmin Hospital of Wuhan University and Wuhan Jin Yin-tan Hospital between December 24, 2019, and March 12, 2020. Eleven patients who had been diagnosed with critically ill COVID-19 according to the World Health Organization interim guidance, received invasive ventilation, and were finally successfully weaned from it, were enrolled in our study. Their presenting symptoms, comorbidity conditions, laboratory values, ICU course, ventilator parameters, treatments, and relative complications were recorded.
Of 108 critically ill COVID-19 patients who received invasive ventilation, 11 patients who underwent tracheal extubation or terminal weaning were included. The mean age of the 11 patients was 52.8 years (range, 38–70 years), 8 (72.7%) were male, and 2 were health care workers. The median time from onset of symptoms to dyspnea was 6.6 days (range, 3–13 days), and the median duration of IMV was 15.7 days (range, 6–29 days). All 11 patients presented with acute severe hypoxemic respiratory failure and received IMV, and 1 patient switched to extracorporeal membrane oxygenation assistance. A lung-protective strategy with lower tidal volume ventilation and proper driving pressure is the main strategy of IMV. All patients had extrapulmonary manifestations, including acute kidney injury, hepatic dysfunction, myocardial damage, and/or lymphopenia. Hospital-acquired infections occurred in 7 (63.6%) patients.
Critical COVID-19 illness is characterized by acute hypoxemic respiratory failure and subsequent dysfunction of other organs with a high mortality rate. Correct ventilation strategies and other clinical strategies to improve oxygenation based on the skilled trained group and the availability of equipment are the key methods to rescue lives.
Differences in microbiota between acute and chronic perianal eczema
Authors: Ma Ming , Lu Hongmei , Yang Zuozhen , Chen Li , Li Yingru , Zhang Xiu 
Published: April 2021

Abstract
Microbiota has been suggested to play a role in patients with intestinal and cutaneous diseases. However, the profiling of perianal eczema microbiota has not been described. We have explored the general profile and possible differences between acute and chronic perianal eczema. A total of 101 acute perianal eczema (APE) and 156 chronic perianal eczema (CPE) patients were enrolled in this study and the perianal microbiota was profiled via Illumina sequencing of the 16S rRNA V4 region.
The microbial α-diversity and structure are similar in APE and CPE patients; however, the perianal microbiota of the APE patients had a higher content of Staphylococcus (22.2%, P < .01) than that of CPE patients. Top10 genera accounting for more than 60% (68.81% for APE and 65.47% for CPE) of the whole microbiota, including Prevotella, Streptococcus, and Bifidobacterium, show an upregulation trend in the case of APE without reaching statistically significant differences. This study compared the microbiota profiles of acute and chronic perianal eczema. Our results suggest that the microbiota of acute perianal eczema patients is enriched in Staphylococcus compared with that in the chronic group. Our findings provide data for further studies.
Research on medical system based on blockchain technology
Authors: Jia Qu 
Published: April 2021

Abstract
Medical data sharing, anti-tampering, and leakage prevention have always been severe problems that plagued the pharmaceutical industry. When a patient is referred, he often cannot provide information about previous visits because the medical information of each hospital cannot be shared in most cases, but only through Medical records, test sheets, and other easily lost paper information are used to share some medical information. At the same time, patient medical information is easily leaked, and the medical information provided in the event of a medical dispute cannot guarantee authenticity and impartiality. This article designs a consortium medical blockchain system based on a Possible Byzantine Fault Tolerance algorithm. This system is a medical system that is maintained and shared by multiple nodes and can prevent medical data from being tampered with or leaked. It can be used to solve these medical problems. Compared with the existing medical blockchain system, this system has certain advantages and better applicability.
Presentation and management of nasal foreign bodies in a Chinese metro area
Authors: Yan Shang , Zeng Nan , Chen Guowei , Chen Yongchao , Wu Zebin , Pan Hongguang , Teng Yishu , Ma Xiangyu , Li Lan 
Published: April 2021

Abstract
Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.
Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children's Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.
Nasal foreign bodies were common in children between 1 and 5 years of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1 day. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.
The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.
Alteration of brain connectivity in neurologically asymptomatic patients with chronic kidney disease
Authors: Lee Yoo Jin , Yoon Eunjae , Park Sihyung , Kim Yang Wook , Kim Si Eun , Ko Junghae , Park Jin Han , Park Kang Min , Kim Il Hwan , Park Bong Soo 
Published: April 2021

Abstract
Our previous study demonstrated that patients with end-stage renal disease had decreased structural and functional brain connectivity, and there was a significant association between brain connectivity and cognitive function. The aim of this study was to evaluate the alterations of structural and functional connectivity using graph theoretical analysis in neurologically asymptomatic patients with relatively early-stage chronic kidney disease (CKD).
We enrolled 18 neurologically asymptomatic patients with early CKD and 28 healthy controls. All the subjects underwent diffusion-tension imaging and resting functional magnetic resonance imaging. We calculated structural and functional connectivity based on diffusion-tension imaging and resting functional magnetic resonance imaging using a graph theoretical analysis. Then, we investigated differences of structural and functional connectivity between the CKD patients and the healthy controls.
All the measures of structural connectivity were significantly different between the patients with CKD and healthy controls. The global efficiency, local efficiency, mean clustering coefficient, and small-worldness index were decreased, whereas the characteristic path length was increased in the patients with CKD compared with healthy controls. The structural betweenness centrality of the left calcarine and right posterior cingulum was also significantly different from that in healthy participants. However, all the measures of global functional connectivity in patients with CKD were not different from those in healthy controls. In patients with CKD, the functional betweenness centrality of the right insular cortex, right occipital pole, and right thalamus was significantly different from that in healthy participants.
There are significant alterations of the global structural connectivity between the patients with CKD and the healthy subjects, whereas the global functional connectivity of the brain network is preserved. We find that the efficiency of the structural brain network is decreased in the patients with CKD.
Evaluation of a deep learning-based computer-aided detection algorithm on chest radiographs
Authors: Choi Soo Yun , Park Sunggyun , Kim Minchul , Park Jongchan , Choi Ye Ra , Jin Kwang Nam 
Published: April 2021

Abstract
Along with recent developments in deep learning techniques, computer-aided diagnosis (CAD) has been growing rapidly in the medical imaging field. In this work, we evaluate the deep learning-based CAD algorithm (DCAD) for detecting and localizing 3 major thoracic abnormalities visible on chest radiographs (CR) and to compare the performance of physicians with and without the assistance of the algorithm. A subset of 244 subjects (60% abnormal CRs) was evaluated. Abnormal findings included mass/nodules (55%), consolidation (21%), and pneumothorax (24%). Observer performance tests were conducted to assess whether the performance of physicians could be enhanced with the algorithm. The area under the receiver operating characteristic (ROC) curve (AUC) and the area under the jackknife alternative free-response ROC (JAFROC) were measured to evaluate the performance of the algorithm and physicians in image classification and lesion detection, respectively. The AUCs for nodule/mass, consolidation, and pneumothorax were 0.9883, 1.000, and 0.9997, respectively. For the image classification, the overall AUC of the pooled physicians was 0.8679 without DCAD and 0.9112 with DCAD. Regarding lesion detection, the pooled observers exhibited a weighted JAFROC figure of merit (FOM) of 0.8426 without DCAD and 0.9112 with DCAD. DCAD for CRs could enhance physicians’ performance in the detection of 3 major thoracic abnormalities.
Loneliness and Current Environmental Context Are Associated With False Perceptions Regarding Social Relations
Authors: Reed Phil , Tshering Sherlyn , Wahab Siti 
Published: April 2021

Abstract
The consequences of loneliness include anxiety, depression, and chronic illnesses, but little is known about its association with cognitive distortions. Three experiments investigated the effect of loneliness, and current context, on the content of false perceptions. A total of 446 participants completed psychometric tests (University of California, Los Angeles Loneliness Scale, Hospital Anxiety and Depression Scale, and a Schizotypy Scale) and a word detection task. The word detection task explored the effects of “lonely” and “neutral” contexts (experiments 1 and 2), as well as “positive social” contexts (experiment 3), on false perceptions. In all experiments, participants reporting higher loneliness reported more false perceptions with a lonely content, but only when in a context reflecting a lonely theme. The results show current environmental context and individuals' psychological state combine to affect false perception content. That such findings are found with loneliness, when controlling for depression, anxiety, and schizotypy, show the degree to which this state can distort cognition and perception.
Timing of Diagnosis of Complex Lower Urinary Tract Injury in the 30-Day Postoperative Period Following Benign Hysterectomy
Authors: Luchristt Douglas , Brown Oluwateniola , Geynisman-Tan Julia , Mueller Margaret G. , Kenton Kimberly , Bretschneider C. Emi 
Published: April 2021

(Abstracted from Am J Obstet Gynecol 2020; doi: 10.1016/j.ajog.2020.10.050)
Complex lower urinary tract injury (cLUTI) resulting from hysterectomy is a rare but potentially devastating complication. A number of risk factors for cLUTI at the time of hysterectomy have been identified.
The Association of Maternal Hypertensive Disorders With Neonatal Congenital Heart Disease: Analysis of a United States Cohort
Authors: Sanapo Laura , Donofrio Mary T. , Ahmadzia Homa K. , Gimovsky Alexis C. , Mohamed Mohamed A. 
Published: April 2021

(Abstracted from J Perinatol 2020;40(11):1617–1624)
One of the more common causes of maternal and perinatal mortality is hypertensive disorders of pregnancy (HDPs). Hypertension affects up to 10% of pregnancies and has been associated with an increased risk of congenital heart disease (CHD) in offspring.
SARS-CoV-2 in First Trimester Pregnancy: A Cohort Study
Authors: la Cour Freiesleben N. , Egerup P. , Hviid K. V. R. , Severinsen E. R. , Kolte A. M. , Westergaard D. , Olsen L. Fich , Prætorius L. , Zedeler A. , Christiansen A.-M. H. , Nielsen J. R. , Bang D. , Berntsen S. , Ollé-López J. , Ingham A. , Bello-Rodríguez J. , Storm D. M. , Ethelberg-Findsen J. , Hoffmann E. R. , Wilken-Jensen C. , Jørgensen F. S. , Westh H. , Jørgensen H. L. , Nielsen H. S. 
Published: April 2021

(Abstracted from Hum Reprod 2021;36(1):40–47)
Pregnant women are at an increased risk of viral infections and increased risk of serious morbidity such as severe pneumonia, particularly during the first trimester. COVID-19 (coronavirus disease 2019) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).