bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intestinal schistosomiasis masquerading as intestinal polyps
Authors: Zhu Xiu Li , Song Ji Zhong , Yu Wen Yong , Hua Li Qun , Zhang Ming Li 
Published: May 2021

Abstract
Background
Schistosomiasis is very common in the southern part of the Yangtze River Basin in China. It is mainly manifested as appendicitis, ulcers, hematomas, and thickening of the intestinal tract. Schistosomiasis of the appendix is rare, mainly manifested as appendicitis, which is easy to be misdiagnosed.

Case presentation
Here we report a rare case of a Chinese female whose intestinal mass manifested as intestinal polyps and was eventually diagnosed pathologically as schistosomiasis infection (appendix schistosomiasis). So far, there are rare relevant cases reported.

Conclusions
Intestinal schistosomiasis is easily misdiagnosed, and appendix schistosomiasis is rare. The final diagnosis requires pathology, especially surgical pathology.
Cytomegalovirus in urinary sediment in patients with acute kidney injury
Authors: Pajenda Sahra , Kapps Sebastian , Gerges Daniela , Hoermann Gregor , Wagner Ludwig , Buchtele Nina , Geist Barbara , Strassl Robert , Schmidt Alice , Winnicki Wolfgang 
Published: May 2021

AbstractBackgroundImmunosuppression in solid organ transplantation is associated with frequent infections. Renal allograft recipients are susceptible to opportunistic infections and can acquire human cytomegalovirus (HCMV) infections even within the allograft. There, HCMV can be found in both the glomerulus and tubular cells, but is mostly restricted to specific and circumscribed sites. Therefore, not all organ infections are identifiable by immunohistology for HCMV proteins in fine needle core biopsies. Thus, we performed a urinalysis study to search for HCMV-specific RNA transcripts in the urine sediment of patients with acute kidney injury.MethodsUrinary sediment of 90 patients with acute kidney injury (AKI), including 48 renal transplant recipients (RTX) and 42 non-transplant recipients (nRTX), was collected from morning urine for RNA extraction and reverse transcription. The copy number of HCMV transcripts was evaluated using a UL132 HCMV-specific probe set and by real-time quantitative polymerase chain reaction (RT-qPCR).ResultsOf the 48 RTX patients, ten showed HCMV copies in their urine sediment cells. Within this group, three recipients had negative HCMV serology and received an allograft from an HCMV-seropositive donor. In addition, all three RTX patients on a belatacept-based immunosuppressive regimen had HCMV transcripts in their urine. Of the 42 nRTX patients, only two had detectable HCMV transcripts in urine sediment cells and both were under immunosuppression.ConclusionsTen immunosuppressed renal allograft recipients and two immunosuppressed non-transplant patients with AKI showed HCMV copies in urine sediment. Thus, HCMV positivity in urinary sediment appears to be associated with immunosuppression. This study describes a novel noninvasive method for detection of HCMV in urinary sediment. Whether all HCMV infections can be detected or only those with viral replication warrants further investigation.
Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report
Authors: Yan Zhizhong , Shi Zhonghua , Wang Yuhai , Zhang Chunlei , Liu Huize , Cai Jin , Zhang Xin 
Published: May 2021

Abstract
Background
Abnormal hypoperfusion on the surgical side after carotid artery stenting is rare. Neurological deterioration caused by it is deceptive, which can easily lead to misdiagnosis. The mechanism of hypoperfusion has rarely been demonstrated. We present here a fully studied case with a high probability of intracerebral steal phenomenon.

Case presentation
A 68-year-old male with severe right internal carotid artery stenosis and left internal carotid artery occlusion underwent right stenosis stent implantation. Restlessness and left limb hemiplegia occurred within 24 h after the procedure, which was similar to hyperperfusion syndrome. However, postoperative computerized tomography perfusion (CTP) revealed abnormal hypoperfusion in the right hemisphere. Transcranial Doppler (TCD) also showed decreased flow velocity in the right middle cerebral artery, and increased flow velocity in the right anterior cerebral artery. We considered that intracerebral steal phenomenon might be the cause, then hypervolemic therapy was accepted and the symptoms completely resolved after 3 days.

Conclusions
Ipsilateral hypoperfusion is rarely seen after carotid artery stenting. Intracerebral steal phenomenon may be the underlying mechanism. CTP or TCD is helpful for the early detection of this adverse event.
Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Authors: Wang Wei , Xie Xin , Yuan Ting , Wang Yanyan , Zhao Fei , Zhou Zhangjian , Zhang Hao 
Published: May 2021

Abstract
Background
Relevant studies focusing on epidemiological of profiles hypertensive disorders of pregnancy from global data that report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index are still limited.

Methods
For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared at regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study, covering populations from 204 countries and territories. Estimates are reported with uncertainty intervals to exhibit the changing trends during a specific period.

Results
The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92 % from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percent change of -0.68 (95 % confidence interval [CI] -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019, representing a 30.05 % decrease from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25–29 years, followed by the groups aged 30–34 and 20–24 years, while the lowest estimated incidence rate was observed in the group aged 25–29 years and higher incidence rates were observed in the youngest and oldest groups. Positive associations between incidence rates and the sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.

Conclusions
Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence rates are decreasing in most countries and all regions except for those with low sociodemographic and human development indexes. This difference is mainly due to the increasing attention to prenatal examinations and health education. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.
Reconstructive outcome analysis of the impact of neoadjuvant chemotherapy on immediate breast reconstruction: a retrospective cross-sectional study
Authors: Yang Jia-Ruei , Kuo Wen-Ling , Yu Chi-Chang , Chen Shin-Cheh , Huang Jung-Ju 
Published: May 2021

Abstract
Background
Neoadjuvant chemotherapy (NACT) was initially applied to locally advanced breast cancer to convert advanced lesions to an operable status. Currently, its application has been expanded to enhance overall oncological results, especially in patients with triple-negative or HER-2-positive breast cancer. With more NACT being applied, the role and impact of this approach on breast reconstruction needs to be determined. This study aimed to perform a complete reconstructive outcome analysis of patients receiving NACT who underwent immediate breast reconstruction.

Methods
A retrospective review of a single reconstructive surgeon’s immediate breast reconstructions performed from July 2008 to December 2018 was undertaken. The results were stratified by the use of NACT. Patient demographics, delivery of NACT, adjuvant treatment, incidence of surgical complications, and postoperative photographs were analyzed.

Results
A total of 269 patients were included. The mean follow-up was 46.3 months. Forty-six out of 269 patients received NACT and were included in the NACT group. The other patients were included in the non-NACT group. When implant-based reconstruction was planned, the NACT group had a higher rate of two-stage tissue expander-implant reconstruction than direct-to-implant reconstruction (p < 0.001). The requirement for postmastectomy radiotherapy was higher in the NACT group (p < 0.001). The surgical complication rates were similar between groups after adjusting for confounding factors. The objective aesthetic outcomes assessed by 6 plastic surgeons were also similar between groups.

Conclusions
Immediate breast reconstruction is a safe and reliable procedure, with an acceptable reconstructive complication rate and satisfactory aesthetic outcomes, for patients treated with NACT.
Comparison of dose-dense vs. 3-weekly paclitaxel and carboplatin in the first-line treatment of ovarian cancer in a propensity score-matched cohort
Authors: Pirolli Rafaela , de Alencar Viviane Teixeira Loiola , Estati Felipe Leonardo , Ribeiro Adriana Regina Gonçalves , Honda Daniella Yumi Tsuji , de Oliveira Mariana , da Silveira Nogueira Lima Joao Paulo , dos Santos Elizabeth Santana , Guimarães Andrea Paiva Gadelha , Baiocchi Glauco , da Costa Alexandre André Balieiro Anastácio 
Published: May 2021

Abstract
Background
Benefit of carboplatin and dose-dense weekly paclitaxel (ddCT) in first line treatment of ovarian cancer patients has been different in Western and Asian studies. In the present study we compare progression-free survival (PFS) of ddCT to three-weekly carboplatin and paclitaxel (CT) in first-line treatment of ovarian carcinoma in a single institution in a Western population.

Materials and methods
We conducted a retrospective review of medical records from patients with ovarian carcinoma treated in a tertiary cancer center from 2007 to 2018. All patients treated with ddCT or CT in the first-line setting were included. Patients who received first-line bevacizumab were not included. PFS and overall survival (OS) were compared in a propensity score-matched cohort to address selection bias. Patients were matched according to age, ECOG performance status, CA 125, FIGO stage, residual disease, and histological subtype, in a 1:2 ratio.

Results
Five hundred eighty-eight patients were eligible for propensity score matching, the final cohort consisted of 69 patients treated with ddCT and 138 CT group. Baseline characteristics were well-balanced. After a median follow-up of 65.1 months, median PFS was 29.3 vs 20.0 months, favouring ddCT treatment (p = 0.035). In the multivariate cox regression ddCT showed a 18% lower risk of progression (HR 0.82, 95% CI 0.68–0.99, p = 0.04). Overall survival data is immature, but suggested better outcomes for ddCT (not reached versus 78.8 months; p = 0.07).

Conclusion
Our retrospective study has shown superior PFS of ddCT over CT regimen in first-line treatment of ovarian carcinoma in a Western population not treated with bevacizumab.
Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction
Authors: Shin Da Young , Hwang Ho Sik , Kim Hyun Seung , Kim Man Soo , Kim Eun Chul 
Published: May 2021

Abstract
Background
The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D).

Methods
We performed a retrospective chart review for patients with corneal astigmatism > 1.5D who underwent cataract surgery and their target refraction is -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.

Results
The near UCVA of the toric IOL group (0.26 ± 0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48 ± 0.32) (p = 0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. In the toric IOL group, postoperative refractive astigmatism was − 0.80 ± 0.46D and postoperative corneal astigmatism was − 1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were − 1.65 ± 0.77D and − 1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications.

Conclusions
When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.
Evaluation of health care providers’ use of the ‘Exercise and Depression Toolkit’: a case study
Authors: Glowacki Krista , Zumrawi Daniah , Michalak Erin , Faulkner Guy 
Published: May 2021

Abstract
Background
Exercise is now recommended as a primary treatment for mild-moderate depression in Canada. The ‘Exercise and Depression Toolkit’ was developed to help health care providers (HCP) integrate these treatment guidelines into practice. The purpose of this study was to evaluate acceptability and perceived effectiveness of the toolkit in practice by HCPs working with individuals with depression.

Methods
A case study design was utilized. The toolkit was given to 6 HCPs to use in practice for 4 weeks. Pre- and post-intervention phone interviews were conducted, and weekly logs were provided to track use and satisfaction of interactions with individuals with depression when using the toolkit. The study was conceptually guided by a hybrid theoretical approach using the Diffusion of Innovation Theory and the Theoretical Framework of Acceptability.

Results
All HCPs used the toolkit at least once. Participants viewed their interactions when using the toolkit to be successful (considering individuals’ receptiveness, its usefulness and general satisfaction.) The average success score for all participants was 5.5/7. HCPs found the toolkit to be acceptable. All participants (n = 6) viewed the toolkit as having relative advantage in helping them to discuss exercise with individuals with depression, and as relatively simple and easy to use (not complex) and adaptable to their practice needs (having trialability). Participants liked the toolkit and had mostly positive things to say about it. Participants had mixed feelings about whether changes in the people they worked with (such as mood and activity levels) could be observed (observability) and whether the toolkit changed their belief in their ability to recommend or discuss exercise (self-efficacy). Recommended dissemination strategies were adopted in promoting the toolkit.

Conclusions
Future work should address observability and the ability for health care providers to see other providers using it, as well as effectiveness considering outcomes for people with depression such as mood and activity changes. The results of this initial evaluation seem promising for uptake and future adoption of the toolkit by health care providers working with adults with depression in Canada.
Temporal dynamic in the impact of COVID− 19 outbreak on cause-specific mortality in Guangzhou, China
Authors: Li Li , Hang Dong , Dong Han , Yuan-Yuan Chen , Bo-Heng Liang , Ze-Lin Yan , Zhou Yang , Chun-Quan Ou , Peng-Zhe Qin 
Published: May 2021

Abstract
Background
Studies related to the SARS-CoV-2 spikes in the past few months, while there are limited studies on the entire outbreak-suppressed cycle of COVID-19. We estimate the cause-specific excess mortality during the complete circle of COVID-19 outbreak in Guangzhou, China, stratified by sociodemographic status.

Methods
Guangzhou Center for Disease Control Prevention provided the individual data of deaths in Guangzhou from 1 January 2018 through 30 June 2020. We applied Poisson regression models to daily cause-specific mortality between 1 January 2018 and 20 January 2020, accounting for effects of population size, calendar time, holiday, ambient temperature and PM2.5. Expected mortality was estimated for the period from 21 January through 30 June 2020 assuming that the effects of factors aforementioned remained the same as described in the models. Excess mortality was defined as the difference between the observed mortality and the expected mortality. Subgroup analyses were performed by place of death, age group, sex, marital status and occupation class.

Results
From 21 January (the date on which the first COVID-19 case occurred in Guangzhou) through 30 June 2020, there were three stages of COVID-19: first wave, second wave, and recovery stage, starting on 21 January, 11 March, and 17 May 2020, respectively. Mortality deficits were seen from late February through early April and in most of the time in the recovery stage. Excesses in hypertension deaths occurred immediately after the starting weeks of the two waves. Overall, we estimated a deficit of 1051 (95% eCI: 580, 1558) in all-cause deaths. Particularly, comparing with the expected mortality in the absence of COVID-19 outbreak, the observed deaths from pneumonia and influenza substantially decreased by 49.2%, while deaths due to hypertension and myocardial infarction increased by 14.5 and 8.6%, respectively. In-hospital all-cause deaths dropped by 10.2%. There were discrepancies by age, marital status and occupation class in the excess mortality during the COVID-19 outbreak.

Conclusions
The excess deaths during the COVID-19 outbreak varied by cause of death and changed temporally. Overall, there was a deficit in deaths during the study period. Our findings can inform preparedness measures in different stages of the outbreak.
Clinical implications of bronchoscopy for immune checkpoint inhibitor-related pneumonitis in patients with non-small cell lung cancer
Authors: Nishiyama Osamu , Shimizu Shigeki , Haratani Koji , Isomoto Kosuke , Tanizaki Junko , Hayashi Hidetoshi , Yamazaki Ryo , Oomori Takashi , Nishikawa Yusaku , Sano Akiko , Nakagawa Kazuhiko , Tohda Yuji 
Published: May 2021

Abstract
Background
The utility of bronchoscopy for patients with suspected immune checkpoint inhibitor (ICI)-related pneumonitis is currently debatable. The purpose of this study was to examine the findings of bronchoalveolar lavage (BAL) analysis and transbronchial lung biopsy (TBLB) in non-small cell lung cancer (NSCLC) patients with ICI-related pneumonitis, and to elucidate the clinical significance of bronchoscopy for this health condition.

Patients and methods
Consecutive NSCLC patients treated with ICIs, diagnosed with ICI-related pneumonitis after undergoing bronchoscopy between October 2015 and March 2019 were retrospectively screened. Findings of BAL fluid analysis and/or TBLB specimen histology were reviewed.

Results
Twelve patients underwent bronchoscopy for the diagnosis of ICI-related pneumonitis, ten of whom underwent BAL. An increase in the proportion of lymphocytes higher than 20% was observed in all ten patients. An increase in the proportion of neutrophils (> 10%) and eosinophils (> 10%) was observed in two and one patient, respectively. TBLB specimens were analyzed for eight patients. Major histologic findings included alveolitis in seven (87.5%) and organizing pneumonia (OP) in five (62.5%) patients. Other findings included acute lung injury and fibrosis. All twelve patients demonstrated favorable outcomes.

Conclusion
A major characteristic of BAL analysis in ICI-related pneumonitis with NSCLC was an increased proportion of lymphocytes. The histologic features of lung tissue included alveolitis and/or OP. Acute lung injury and fibrosis were observed. Although the necessity of bronchoscopy should be determined on a case-by-case basis, it is necessary to assess these parameters when proper differential diagnosis is needed.
Efficacy and safety of a single intra-articular injection of 6 ml Hylan G-F 20 compared to placebo in Chinese patients with symptomatic knee osteoarthritis
Authors: Ke Yan , Jiang Wenxue , Xu Yongsheng , Chen Yajun , Zhang Qingsong , Xue Qingyun , Lin Jianhao , Ngai Wilson , Nian Gaowei , Fazeli Mir Sohail , Xie Yao , Zhu Zhenan 
Published: May 2021

Abstract
Background
Single 6 ml Hylan G-F 20 injection, is indicated for knee osteoarthritis patients who have failed to respond to non-pharmacologic therapy and/or simple analgesics. To obtain more thorough understanding of the clinical efficacy and safety, a randomized clinical trial was conducted comparing intra-articular (IA) administration of single 6 ml Hylan G-F 20 injection versus placebo in knee OA patients of Chinese ethnicity.

Methods
This was a randomized, multi-center, double-blind, placebo-controlled clinical trial conducted in 21 centers across China. Four hundred forty adults with knee OA received a single 6 ml Hylan G-F 20 or placebo injection and were evaluated for clinical efficacy and safety outcomes over 26 weeks. Western Ontario and McMaster Universities OA (WOMAC) A1 index, treatment-emergent adverse events (TEAEs) and standard safety parameters were measured at pre-injection, and at weeks 1, 4, 8, 12, 16, 20 and 26 post-injection.

Results
Four hundred forty patients (male: 98 [22.3%]; female: 342 [77.7%]) were randomized. The mean age [standard deviation (SD)] was 61.5 (7.9) years. All patients were of East Asian ethnicity. Mean WOMAC A1 score at baseline was 5.3 (1.2) and 5.2 (1.3) in single 6 ml Hylan G-F 20 injection and placebo groups, respectively. Significant reductions of WOMAC A1 score were observed in both treatment groups when compared to baseline at 26 weeks post-injection, with the mean reduction of [standard error (SE)/percentage] -2.146 (0.108)/− 40.5% and − 2.271 (0.110) /− 43.7% in the single 6 ml Hylan G-F 20 injection and the placebo groups, respectively. Additionally, clinically important reductions in pain at 26 weeks was reported in 67.0 and 68.2% in single 6 ml Hylan G-F 20 injection and placebo groups (p = 0.36). Regarding safety, TEAEs were similar between the two treatment groups (hylan G-F 20 single: 61.5%; placebo: 64.5%).

Conclusions
While the magnitude of the effect of a single 6 ml Hylan G-F 20 injection in this study is consistent with previously published literature with respect to the efficacy and safety of the drug, the current study shows a strong IA placebo effect and did not established superiority of single 6 ml Hylan G-F 20 injection over IA placebo in Chinese knee OA patients.

Trial registration
Prospectively registered Jun 16, 2017 at www.clinicaltrials.gov (NCT03190369).