bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of low fat mass with nontuberculous mycobacterial infection in patients with bronchiectasis
Authors: Lim Sung Yoon , Lee Yeon Joo , Park Jong Sun , Cho Young-Jae , Yoon Ho Il , Lee Choon-Taek , Lee Jae Ho 
Published: April 2021

Abstract
The incidence of pulmonary nontuberculous mycobacterial (NTM) infection is high in patients with underlying lung disease such as bronchiectasis. Although previous studies have reported many risk factors contributing to the development of NTM-lung disease (LD), only a few reports on the relationship of the characteristics of patients, such as body mass index (BMI), skeletal mass, and fat mass, with NTM-LD have been published. We aimed to investigate the association between these parameters and NTM-LD in patients with bronchiectasis.
A monocentric retrospective study in a university hospital was conducted over 4 years (2013–2016). Parameters including BMI, skeletal mass, and fat mass were measured using bioelectrical impedance analysis in noncystic fibrosis bronchiectasis patients. Patients were grouped by the presence or absence of NTM-LD, and the differences in BMI, skeletal mass, and fat mass between the 2 groups were compared. In the NTM-LD group, the progression of disease was also followed.
Two hundred forty-five patients with bronchiectasis were enrolled in the study. One hundred six subjects (48%) had NTM-LD. These patients with NTM-LD were predominantly female, and had a significantly lower body weight (58.20 ± 8.84 vs 54.16 ± 8.99, P < .001), BMI (22.67 ± 3.04 vs 21.20 ± 2.59 kg/m2, P < .001), fat mass (16.19 ± 6.60 vs 14.23 ± 5.79, P = .013), and fat mass index (FMI; 6.79 ± 2.70 vs 5.57 ± 2.27 kg/m2, P < .001). Multivariate regression analysis showed that both female sex and lower FMI but not skeletal muscle index were independent risk factors for NTM-LD after adjusting for age, bronchiectasis severity index, and BMI (odds ratio 3.86 (1.99–7.78); 0.72 (0.63–0.82), P < .001, respectively).
Our results suggest that lower FMI may contribute to susceptibility to NTM infection in patients with bronchiectasis, independent of age or its severity.
Staged vs simultaneous bilateral unicompartmental knee arthroplasty for clinical outcomes
Authors: Chen Wang , Sun Jianning , Zhang Ye , Hu Zhenghao , Chen Xiang-Yang , Feng Shuo 
Published: April 2021

Abstract

Background:
Bilateral unicompartmental knee arthroplasty (UKA) can be divided into one or two stages clinically. Compared with staged bilateral UKA, whether simultaneous bilateral UKA has better clinical efficacy remains to be verified.

Methods:
PubMed, EBSCO, and Web of Science were searched by us for meta-analysis. Studies were considered eligible for inclusion if they included simultaneous and staged UKA. We excluded studies unrelated to the research question, studies in non-selected languages, and studies where the full-text was not available. The data were extracted by two independent investigators, and disagreements were resolved through discussions with a third party. If important data or information about the content of the paper were not available, authors were contacted. Publication bias in studies has been assessed. Meta-analysis was done using Review Manager 5.3.

Results:
The systematic review and meta-analysis identified 3370 trials, of which 8 studies (963 patients) compared simultaneous with staged bilateral UKA. The meta-analysis showed that the clinical outcomes of simultaneous bilateral UKA goes down in operating time (weighted mean difference [WMD] = −19.34, 95% confidence interval [CI] −22.44 to −16.25, P < .00001), postoperative hemoglobin (Std. mean difference [SMD] = −0.46, 95% CI −0.71 to −0.20, P = .0004), length of stay (LOS) (WMD = −4.73, 95% CI −6.39 to −3.06, P < .00001), hospital cost (SMD = −5.42, 95% CI −6.54 to −4.30, P < .00001). There were no significant difference in blood transfusion, venous thrombosis, infection, cardiac complications, pulmonary complications, Oxford Knee Score (OKS) between simultaneous and staged bilateral UKA.

Conclusion:
Simultaneous bilateral UKA can effectively reduce the operating time, LOS, and hospital cost without increasing postoperative complications compared to stage bilateral UKA.

Registration number:
CRD42020160056 (www.crd.york.ac.uk/prospero/).
Immune-related adverse events with immune checkpoint inhibitors
Authors: Hirata Aya , Saraya Takeshi , Kobayashi Fumi , Noda Akinari , Aso Kaori , Sakuma Sho , Kurokawa Nozomi , Inoue Manami , Mikura Sunao , Oda Miku , Ishida Manabu , Honda Kojiro , Nakamoto Keitaro , Tamura Masaki , Takata Saori , Ishii Haruyuki , Takizawa Hajime 
Published: April 2021

Abstract
Immune checkpoint inhibitors (ICIs) have emerged as evolutionary treatments for malignant diseases. Although ICIs can cause immune-related adverse events (irAEs) in various organs, precise timing after ICI initiation has been scarcely reported. Elucidating the effects of irAEs, such as time to onset, involvement of major organs, influence on progression-free survival (PFS), and overall survival (OS), are critical issues for physicians. Furthermore, lung-irAE as a whole is not well known.
We conducted a retrospective study of 156 patients who were treated with ICIs and compared 82 irAE patients with 74 non-irAE patients.
This study clearly demonstrated that the preferred period after induction of ICIs was significantly longer in lung-irAE than in other major organs (skin, digestive tract, and endocrine). The effect of irAEs on PFS and OS was evident PFS in the irAE group (n = 82) (median 128 days, interquartile range [IQR] 62–269 days, P = .002) was significantly longer than that in the non-irAE group (n = 74) (median 53 days, IQR 33–151 days). Similarly, OS was significantly longer in the irAE group (median 578 days, IQR 274–1027 days, P = .007) than in the non-irAE group (median 464 days, IQR: 209–842 days). However, this positive effect of irAEs in the lungs was not proportional to the extent of severity.
Lung-irAEs can occur at a later phase than non-lung-irAEs and seemed not to prolong OS and PFS. However, further studies are needed to support these findings.
Maternal and neonatal outcomes after energy-restricted diet for women with gestational diabetes mellitus
Authors: Feng Yaofang , Zhao Zengcai , Fu Dayin , Gao Wen , Zhang Fei 
Published: April 2021

Abstract

Background:
Gestational diabetes mellitus (GDM) affects 1% to 14% of pregnant women annually worldwide and is one of the most common pregnancy complications.

Objective:
We reviewed studies on maternal and neonatal outcomes after dietary managements for women with GDM comparing caloric-restricted (intervention group) and unrestricted diets (control group).

Methods:
We systematically searched online databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until September 2019. We performed a meta-analysis with random-effects model and reported pooled risk ratios (RRs) or pooled mean differences (MD) with 95% confidence intervals (CIs).

Results:
We analyzed data from 6 randomized controlled trials including 1300 participants, most of them with high bias risks. We found that the women in the intervention group achieved slightly better glycemic control (pooled MD, −0.72 mg/dL; 95% CI, −7.10 to 5.66 mg/dL) and overall pregnancy outcomes (except neonatal hypoglycemia) than the women in the control group.

Conclusion:
An energy-restricted diet does not seem superior to the usual/standard GDM diet based on maternal or neonatal outcomes. But, clinical recommendations cannot be made as the evidence is inconclusive.
Low central blood pressure and sympathetic activity predispose for the development of intradialytic hypotension
Authors: Wu Han-Kuei , Chang Ming-Yang , Cheng Hao-Min , Hsu Po-Chi , Lo Lun-Chien , Chen Li-Chuan , Lin Kang-Ping , Chang Hen-Hong 
Published: April 2021

Abstract
Intradialytic hypotension (IDH) may lead to a poor life quality and was associated with cardiovascular mortality in patients under hemodialysis. This study investigated the autonomic nerve and cardiovascular function in the IDH episodes.
In this case-control study, 70 end stage renal disease patients (198 visits) were recruited. Pulse wave analysis and heart rate variability were evaluated before hemodialysis. Two definitions of IDH were confirmed by medical records. IDH-f indicated a drop of systolic blood pressure or mean arterial pressure, accompanied with symptoms; IDH-n indicated a low nadir systolic pressure during the hemodialysis. All parameters were evaluated for the possible predisposing factors under each definition.
A total of 24 IDH-f and 37 IDH-n were noted in 177 visits. For both definitions, central pulse pressure seemed to be a consistent predisposing factor. Furthermore, lower sympathetic activity (odds ratio [OR] 0.55; 95% confidence interval [CI] 0.35–0.87), lower pulse pressure (OR 0.95; 95% CI 0.92–0.98), and higher augmentation index (OR 17.36; 95% CI 1.48–204.10) were the possible predisposing factors for IDH-f. On the contrary, lower mean arterial pressure (OR 0.87; 95% CI 0.78–0.98) was identified as the possible factor for IDH-n.
It was suggested that the lower central pulse pressure and sympathetic activity might be involved in the development of IDH.
Correlations between chest-CT and laboratory parameters in SARS-CoV-2 pneumonia
Authors: Orlacchio Antonio , Gasparrini Fulvio , Roma Silvia , Ravà Matteo Santangelo , Salvatori Eva , Morosetti Daniele , Cossu Elsa , Legramante Jacopo Maria , Paganelli Carla , Bernardini Sergio , Minieri Marilena 
Published: April 2021

Abstract
To investigate the relationship between damaged lung assessed by chest computed tomography (CT) scan and laboratory biochemical parameters with the aim of finding other diagnostic tools.
Patients who underwent chest CT for suspected Corona Virus Disease-2019 (COVID-19) pneumonia at the emergency department admission in the first phase of COVID-19 epidemic in Italy were retrospectively analyzed. Patients with both negative chest CT and absence of the novel coronavirus in nasopharyngeal or oropharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) swabs were excluded from the study. A total of 462 patients with positive CT scans for interstitial pneumonia were included in the study (250 males and 212 females, mean age 57 ± 17 years, range 18–89). Of these, 344 were positive to RT-PCR test, 118 were negative to double RT-PCR tests.
CTs were analyzed for quantification of affected lung volume visually and by dedicated software. Statistical analysis to evaluate the relationship between laboratory analyses and CT patterns and amount of damaged lung related with COVID-19 pneumonia was performed in 2 groups of patients: positive RT-PCR COVID-19 group and negative RT-PCR COVID-19 group, but both with positive CT scans for interstitial pneumonia.
Lymphocytopenia, C-reactive protein (CRP), lactate dehydrogenase (LDH), d-dimer, and fibrinogen increased levels occurred in most patients without statistically significant differences between the 2 groups with CT scans suggestive for COVID-19. In fact, in both groups the volume of lung damage was strongly associated with altered laboratory test results, even for patients with negative RT-PCR test.
The decreased number of lymphocytes, and the increased levels of CRP, LDH, d-dimer, and fibrinogen levels are associated with SARS-CoV 2 related pneumonia. This may be useful as an additional diagnostic tool in patients with double negative RT-PCR assay and with highly suspected clinic and chest CT features for COVID-19 to isolate patients in a pandemic period.
A systematic review and meta-analysis of the safety and efficacy of remifentanil and dexmedetomidine for awake fiberoptic endoscope intubation
Authors: Tang Zhi-hang , Chen Qi , Wang Xia , Su Nan , Xia Zhengyuan , Wang Yong , Ma Wu-hua 
Published: April 2021

Abstract

Background:
Awake fiberoptic endoscope intubation (AFOI) is the primary strategy for managing anticipated difficult airways. Adequate sedation, most commonly being achieved with remifentanil and dexmedetomidine, is integral to this procedure. This meta-analysis aimed to compare the safety and efficacy of these 2 sedatives.

Methods:
We conducted electronic searches in Embase, Web of Science, PubMed, Google Scholar, Medline, Springer, and Web of Science with no language restrictions. Studies comparing safety and efficacy between the sole use of remifentanil and dexmedetomidine among patients who underwent AFOI were included. Eight randomized controlled trials, comprising 412 patients, met the inclusion criteria. The primary outcomes were first attempt intubation success rate and incidence of hypoxia. The secondary outcomes were the Ramsay Sedation Scale score at intubation, memory recall of endoscopy, and unstable hemodynamic parameters during intubation.

Results:
Dexmedetomidine significantly reduced the incidence of hypoxemia during AFOI (risk ratio: 2.47; 95% confidence [CI]: 1.32–4.64]) compared with remifentanil; however, the first intubation success rates were equivalent (risk ratio: 1.12; 95% CI: 0.87–1.46]. No significant differences between the 2 sedatives were found for the Ramsay Sedation Scale score at intubation (mean difference: −0.14; 95% CI: −0.66–0.38) or unstable hemodynamic parameters during intubation (risk ratio: 0.83; 95% CI: 0.59–1.17). Dexmedetomidine reduced memory recall of endoscopy (risk ratio: 1.39; 95% CI: 1.13–1.72).

Conclusions:
While both remifentanil and dexmedetomidine are effective for AFOI and well-tolerated, dexmedetomidine may be more effective in reducing the incidence of hypoxemia and memory recall of endoscopy.

PROSPERP registration number:
CRD42020169612.
Systemic immune-inflammation index predicts postoperative acute kidney injury in hepatocellular carcinoma patients after hepatectomy
Authors: Xu Jianjun , Hu Shaobo , Li Suzhen , Wang Weimin , Wu Yuzhe , Su Zhe , Zhou Xing , Gao Yang , Cheng Xiang , Zheng Qichang 
Published: April 2021

Abstract
The systemic immune-inflammation index (SII) is an independent prognostic predictor of hepatocellular carcinoma (HCC). The present investigation examined whether an association exists between preoperative SII value and postoperative acute kidney injury (pAKI) in HCC patients.
The study included 479 hepatitis B virus (HBV)-associated HCC patients undergoing hepatectomy. The SII was calculated as P × N/L, where P, N, and L represent the counts of platelets, neutrophils, and lymphocytes in routine blood test, respectively. After propensity score matching, logistic regression analysis was used to explore independent predictors of pAKI in HCC patients.
pAKI was confirmed in 51 patients (10.8%). The average SII value was higher in patients with pAKI than patients without pAKI. After multivariate logistic regression analysis, SII, history of hypertension, and tumor size, among others, were found to be predictors of pAKI. The optimal threshold value of SII for predicting pAKI was found to be 547.84 × 109/L. Multivariate analysis performed after propensity score matching confirmed that SII ≥ 547.84 × 109/L was an independent predictor of pAKI.
The preoperative SII qualifies as a novel, independent predictor of pAKI in HCC patients with HBV infection who underwent hepatectomy.
What are the predictors for recurrence of Crohn's disease after surgery?
Authors: Ozgur Ilker , Kulle Cemil Burak , Buyuk Melek , Ormeci Asli , Akyuz Filiz , Balik Emre , Bulut Turker , Keskin Metin 
Published: April 2021

Abstract
Surgical resection is an unavoidable part of the current treatment options for Crohn's disease (CD), and more than half of patients develop recurrence. The aim of this study was to investigate the predictors for recurrence in the long-term follow-up of CD patients after surgery.
Medical records of consecutive CD patients who were operated on between January 2003 and January 2015 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients were recorded. Recurrence was evaluated based on the Crohn's Disease Activity Index or endoscopic findings.
The majority of 112 patients were males (n = 64, 57.1%), and 61 (54.4%) of them were active smokers. The median follow-up was 113 (range: 61–197) months. Disease recurrence occurred in 16 (14.3%) patients at a median of 13.5 months. The endoscopic recurrence rate was 8% (n = 9) at 1 year, 12.5% (n = 14) at 5 years, and 13.4% (n = 15) at 10 years. One (0.9%) patient underwent colonoscopic balloon dilatation at 1 year, and 7 (6.3%) patients needed re-resection at a median of 36 months. The age of the patient at the time of diagnosis (P = .033), penetrating disease behavior (P = .011), intra-abdominal abscess (P = 0.040) and, concomitant fistula and intra-abdominal abscess (P = .017) were associated with disease recurrence.
Our study results suggest that the patients’ age at the time of diagnosis, penetrating disease, intra-abdominal abscess, and concomitant fistula and abscess are the risk factors for CD recurrence after surgery.
Changes in the prefronto-thalamic tract following cranioplasty
Authors: Choi Eun Bi , Chang Chul Hoon , Jang Sung Ho 
Published: April 2021

Abstract

Rationale:
The prefrontothalamic tract (PTT) injury is associated with various neuropsychological impairments including cognitive impairment. We report on three women with hemorrhagic stroke who showed changes in the PTT following cranioplasty (C/P) using diffusion tensor tractography (DTT) images.

Patient concerns:
The 3 women with hemorrhagic stroke showed reductions of cognitive impairment following C/P. Mini-Mental State Examination scores (MMSE) were increased by 7-, 8-, and 5-point in patient 1, 2, and 3, respectively, after C/P compared with the patients’ pre-C/P MMSE scores.

Diagnosis:
Three patients were diagnosed with spontaneous intracerebral hemorrhage. Three patients underwent C/P using auto-bone at 7 (patient 1 and 3) and 13 (patient 2) weeks after onset.

Interventions:
Diffusion tensor imaging data were acquired within 3 days before and 21 days after C/P.

Outcomes:
The pre-C/P DTT results showed non-reconstruction of the dorsolateral prefrontal cortex (DLPFC; patient 2 and 3) on the contralateral operation (contra-OP) side and orbitofrontal cortex (OFC; patient 3) on both sides, but those were reconstructed on post-C/P DTT. Except for the contra-OP side OFC of patient 2, all fractional anisotropy values decreased on post-C/P DTT compared with pre-C/P DTT. The mean diffusivity values of the VLPFC and OFC were higher on post-C/P DTT except for the contra-OP side VLPFC of patient 1 and contra-OP side OFC of patient 2. The voxel numbers also increased except for the contra-OP side VLPFC of patient 1.

Lessons:
We demonstrated structural changes in the PTT along with concomitant reductions of cognitive impairments following C/P in 3 women with hemorrhagic stroke using DTT. The DTT changes suggest that C/P can affect the state of the PTT on both the OP and contra-OP sides. However, the limitation that DTT analysis may underestimate or overestimate fiber tract status due to regions of fiber complexity and crossing fiber should be considered.
Efficacy and safety of Shenling Atractylodes Powder in the treatment of ulcerative colitis
Authors: Zhang Quanhui , Deng Yongwen , Wang Jinlong , Haung Feihong , Zhou Yiduo , Jia Mingyan , Yi Haoran 
Published: April 2021

Abstract

Background:
Ulcerative colitis (UC) is a kind of chronic non-specific ulcerative colitis, which is characterized by repeated abdominal pain, diarrhea, and mucus purulent stool. The disease is more recurrent, easy to delay, and canceration, seriously affect the quality of life, increase the economic burden of patients and society, treatment is more difficult, the World Health Organization as one of the modern refractory diseases. Shenling Atractylodes Powder in the treatment of ulcerative colitis showed a strong advantage, the effect is accurate. Therefore, this paper will systematically evaluate and meta-analyze the efficacy and safety of heat-sensitive moxibustion in the treatment of ulcerative colitis.

Methods:
Eight electronic databases were searched, including the PubMed, Embase, Web of Science, Cochrane Library, China National knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Literature Database. We will search in the above electronic database from early 2021 to December without any language restrictions. Outcome indicators, including colonic mucosal symptom score Mayo colonoscopy grading, total effective rate, total incidence of adverse reactions, clinical symptom score, recurrence rate, laboratory indicators: IL-6, IL-9, TNF-α, IL-4, IL-10 inflammation-related factor levels. Rev Man5.3 software will be used for statistical analysis. The efficacy and safety results of Shenling Atractylodes Powder in the treatment of ulcerative colitis will be used as the average difference between the risk ratio of dichotomy data and the 95% co-card interval of continuous data.

Results:
When this research program is completed, the relevant results can be obtained.

Ethics and dissemination:
This article does not need to pass the ethics committee review, because this article does not involve the ethics question, only collates the related literature research. The results of this study will be disseminated in the form of a paper to help better guide the clinical practice of heat-sensitive moxibustion in the treatment of ulcerative colitis.

Registration Number:
INPLASY202120018.
A simple method for discrimination of carcinomatous meningitis using CEA, total protein, and total cell count in the cerebrospinal fluid of primary lung cancer patients
Authors: Ogawa Yukari , Saraya Takeshi , Noda Akinari , Kurokawa Nozomi , Sakuma Sho , Aso Kaori , Mikura Sunao , Oda Miku , Ishida Manabu , Honda Kojiro , Nakamoto Keitaro , Tamura Masaki , Takata Saori , Ishii Haruyuki , Takizawa Hajime 
Published: April 2021

Abstract
Carcinomatous meningitis (CM) is a critical issue for physicians. However, no study has reported a simple and useful diagnostic or predictive marker for CM.
This study aimed to elucidate the potential markers for diagnosing CM derived from cerebrospinal fluid (CSF).
We retrospectively enrolled 78 lung cancer patients with suspected CM during the clinical course, including 42 CM and 36 non-CM patients. We compared the clinical and CSF findings, including carcinoembryonic antigen (CEA), between CM and non-CM patients, and explored the diagnostic markers for early identification of CM as well as the contributing factors for mortality.
On CSF analysis, with cutoff values of CEA ≥5 ng/ml, total protein (TP) in CSF ≥45 g/dl, and total cell count (TCC) ≥7 cells/μL, the sensitivity, specificity, and area under the curve (AUC) for CM were 85.7%, 84.6%, and 0.887 (95% CI: 0.758–1.0, P < .001); 80.5%, 69.4%, and 0.755 (95% CI: 0.646–0.865, P < .001); and 56.1%, 100%, and 0.817 (95% CI: 0.722–0.912, P < .001), respectively. TP levels in CSF ≥the patients’ age had a sensitivity, specificity, and an AUC of 48.8%, 77.8%, and 0.633 (95% CI: 0.722–0.912, P = .045) for CM, respectively. Among CM patients, patients with ‘TP in CSF (>patients’ age)” (n = 19, P = .008) showed significantly shorter 90-day survival probability than the residual patients (n = 20). None of the CSF parameters could predict the risk of mortality on Cox regression analysis.
The cutoff value of CEA ≥5 ng/ml in CSF is a simple and useful method with a high diagnostic value for CM diagnosis, but not a suitable predicting factor for mortality. ‘TP in CSF >patients’ age” might be a novel factor for assessing short-term mortality.