bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in the epidemiology of inflammatory bowel disease in Colombia by demographics and region using a nationally representative claims database and characterization of inflammatory bowel disease phenotype in a case series of Colombian patients
Authors: Juliao-Baños Fabian , Kock Joshua , Arrubla Mateo , Calixto Omar , Camargo Joselyn , Cruz Lina , Hurtado Juan , Clavijo Absalon , Donado Jorge , Schwartz Seth , Abreu Maria T. , Damas Oriana M. 
Published: February 2021

Abstract
The incidence of inflammatory bowel disease (IBD) is on the rise in Latin America. The aims of this study were to examine epidemiologic trends of IBD in Colombia by demographics, region, urbanicity, and to describe the IBD phenotype in a large well-characterized Colombian cohort.
We used a national database of 33 million adults encompassing 97.6% of the Colombian population in order to obtain epidemiologic trends of IBD using International Classification of Diseases 10codes for adults with ulcerative colitis (UC) and Crohn disease (CD). We calculated the incidence and prevalence of UC and CD from 2010–2017 and examined epidemiologic trends by urbanicity, demographics, and region. We then examined the IBD phenotype (using Montreal Classification), prevalence of IBD-related surgeries, and types of IBD-medications prescribed to adult patients attending a regional IBD clinic in Medellin, Colombia between 2001 and 2017.
The incidence of UC increased from 5.59/100,000 in 2010 to 6.3/100,000 in 2017 (relative risk [RR] 1.12, confidence interval (CI) (1.09–1.18), P < .0001). While CD incidence did not increase, the prevalence increased within this period. The Andes region had the highest incidence of IBD (5.56/100,000 in 2017). IBD was seen less in rural regions in Colombia (RR=.95, CI (0.92–0.97), p < .01). An increased risk of IBD was present in women, even after adjusting for age and diagnosis year (RR 1.06 (1.02–1.08), P = .0003). The highest IBD risk occurred in patients 40 to 59 years of age. In the clinic cohort, there were 649 IBD patients: 73.7% UC and 24.5% CD. Mean age of diagnosis in CD was 41.0 years and 39.9 years in UC. UC patients developed mostly pancolitis (43%). CD patients developed mostly ileocolonic disease and greater than a third of patients had an inflammatory, non-fistulizing phenotype (37.7%). A total of 16.7% of CD patients had perianal disease. CD patients received more biologics than UC patients (odds ratio: 3.20, 95% CI 2.19–4.69 P < .001).
Using both a national representative sample and a regional clinic cohort, we find that UC is more common in Colombia and is on the rise in urban regions; especially occurring in an older age cohort when compared to Western countries. Future studies are warranted to understand evolving environmental factors explaining this rise.
Prediction of age and sex from paranasal sinus images using a deep learning network
Authors: Kim Dong-Kyu , Cho Bum-Joo , Lee Myung-Je , Kim Ju Han 
Published: February 2021

Abstract
This study was conducted to develop a convolutional neural network (CNN)-based model to predict the sex and age of patients by identifying unique unknown features from paranasal sinus (PNS) X-ray images.
We employed a retrospective study design and used anonymized patient imaging data. Two CNN models, adopting ResNet-152 and DenseNet-169 architectures, were trained to predict sex and age groups (20–39, 40–59, 60+ years). The area under the curve (AUC), algorithm accuracy, sensitivity, and specificity were assessed. Class-activation map (CAM) was used to detect deterministic areas. A total of 4160 PNS X-ray images were collected from 4160 patients. The PNS X-ray images of patients aged ≥20 years were retrieved from the picture archiving and communication database system of our institution. The classification performances in predicting the sex (male vs female) and 3 age groups (20–39, 40–59, 60+ years) for each established CNN model were evaluated.
For sex prediction, ResNet-152 performed slightly better (accuracy = 98.0%, sensitivity = 96.9%, specificity = 98.7%, and AUC = 0.939) than DenseNet-169. CAM indicated that maxillary sinuses (males) and ethmoid sinuses (females) were major factors in identifying sex. Meanwhile, for age prediction, the DenseNet-169 model was slightly more accurate in predicting age groups (77.6 ± 1.5% vs 76.3 ± 1.1%). CAM suggested that the maxillary sinus and the periodontal area were primary factors in identifying age groups.
Our deep learning model could predict sex and age based on PNS X-ray images. Therefore, it can assist in reducing the risk of patient misidentification in clinics.
A nomogram predicting subclinical extension of cutaneous squamous cell carcinoma in Chinese individuals
Authors: Lin Pingping , Zhu Sainan , Zhang Guohong , Huang Yuanshen , Tu Ping , Yang Shuxia , Li Hang 
Published: February 2021

Abstract
Cutaneous squamous cell carcinoma usually extends beyond the visible margin. Little is known about the predictors for cutaneous squamous cell carcinoma with subclinical extension in Chinese individuals. This study aimed to construct a nomogram for predicting the probability of subclinical extension of cutaneous squamous cell carcinoma in Chinese patients.
A retrospective analysis was conducted using data from Mohs micrographic surgery-treated cutaneous squamous cell carcinoma patients at a single institution between December 1, 2009 and October 31, 2019. Subclinical extension was defined as a lesion requiring ≥ 2 Mohs stages or with final safe margins of ≥ 5 mm. A nomogram predicting the probability of subclinical extension was constructed using the predictors identified in multivariable analysis.
Of 274 patients included, 119 (43.4%) had subclinical extension. In multivariable analysis, male sex (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.40–4.29; P = .002), lesions on mucocutaneous areas (OR, 3.71; 95% CI, 1.34–10.32; P = .012) and extremities (OR, 2.40; 95% CI, 1.20–4.78; P = .013), maximum diameter of 10 to 19 mm (OR, 14.15; 95% CI, 4.24–47.28; P < .001), and 20 to 29 mm (OR, 9.21; 95% CI, 2.80–30.29; P < .001) were associated with subclinical extension. A nomogram incorporating these 3 variables demonstrated promising predictive ability (C statistics = 0.78; 95% CI, 0.67–0.89).
The nomogram incorporating sex, tumor location, and maximum diameter can provide individualized prediction for subclinical extension in Chinese patients with cutaneous squamous cell carcinoma. This information may help surgeons determine appropriate margins at the first Mohs stage.
Evaluation of perfusion changes using a 2D Parametric Parenchymal Blood Flow technique with automated vessel suppression following partial spleen embolization in patients with hypersplenism and portal hypertension
Authors: Meine Timo C. , Maschke Sabine K. , Kirstein Martha M. , Jaeckel Elmar , Lena Becker S. , Werncke Thomas , Dewald Cornelia L.A. , Wacker Frank K. , Meyer Bernhard C. , Hinrichs Jan B. 
Published: February 2021

Abstract
To evaluate the feasibility and potential value of 2D Parametric Parenchymal Blood Flow (2D-PPBF) for the assessment of perfusion changes following partial spleen embolization (PSE) in a retrospective observational study design.
Overall, 12 PSE procedures in 12 patients were included in this study. The outcome of the study was the platelet response (PR), calculated as the percentage increase of platelet count (PLT), following PSE. To quantify perfusion changes using 2D-PPBF, the acquired digital subtraction angiography series were post-processed. A reference region-of-interest (ROI) was placed in the afferent splenic artery and a target ROI was positioned on the embolization territory of the spleen on digital subtraction angiography series pre- and post-embolization. The ratios of the target ROIs to the reference ROIs were calculated for the Wash-In-Rate (WIR), the Time-To-Peak (TTP) and the Area-Under-the-Curve (AUC). Comparisons between pre- and post-embolization data were made using Wilcoxon signed-rank test and Spearman's rank correlation coefficient (r). Afterwards, the study population was divided by the median of the TTP before PSE to analyze its value for the prediction of PR following PSE.
Following PSE, PLT increased significantly from 43,000 ± 21,405 platelets/μL to 128,500 ± 66,083 platelets/μL with a PR of 255 ± 243% (P = .003). In the embolized splenic territory, the pre-/post-embolization 2D-PPBF parameter changed significantly: WIRpre-PSE 1.23 ± 2.42/WIRpost-PSE 0.09 ± 0.07; -64 ± 46% (p = 0.04), TTPpre-PSE 4.41 ± 0.99/TTPpost-PSE 5.67 ± 1.52 (P = .041); +34 ± 47% and AUCpost-PSE 0.81 ± 0.85/AUCpost-PSE 0.14 ± 0.08; -71 ± 18% (P = .002). A significant correlation of a 2D-PPBF parameter with the PLT was found for TTPpre-PSE/PLTpre-PSE r = -0.66 (P = .01). Subgroup analysis showed a significantly increased PR for the group with TTPpre-PSE >4.44 compared to the group with TTPpre-PSE ≤4.44 (404 ± 267% versus 107 ± 76%; P = .04).
2D-PPBF is an objective approach to analyze the perfusion reduction of embolized splenic tissue. TTP derived from 2D-PPBF has the potential to predict the extent of PR during PSE.
A rare case of primary sinonasal tuberculosis presented with phlyctenular keratoconjunctivitis in a pediatric patient
Authors: Wiriyachai Thakoon , Boonsathorn Sophida , Apiwattanakul Nopporn , Assawawiroonhakarn Surapat 
Published: February 2021

Abstract

Rationale:
Tuberculosis is a common cause of phlyctenular keratoconjunctivitis, especially for patients who live in a high endemic area of tuberculosis. We report a rare case of pediatric phlyctenular keratoconjunctivitis associated with primary sinonasal tuberculosis.

Patient concerns:
A 7-year-old boy presented with a 5-month history of redness of the left eye accompanied by mild visual impairment. Physical examination revealed elevated pinkish-white nodules with a circumcorneal hypervascularized lesion on the left conjunctiva.

Diagnosis:
Computed tomography revealed an enhancing soft tissue mass in the left maxillary sinus with bone destruction. Histopathology of maxillary tissue showed chronic inflammation without granuloma. Special stain, culture and polymerase chain reaction for mycobacterium were initially negative. Left maxillary sinus tuberculosis was diagnosed by positive Mycobacterium tuberculosis polymerase chain reaction from formalin-fixed paraffin-embedded maxillary tissue.

Interventions:
Two month of oral isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by 10 months of oral isoniazid and rifampicin without topical eye drops agent were prescribed.

Outcomes:
Two months after initiation of treatment, the phlyctenular lesion had significantly improved. A follow-up computed tomography showed a significant reduction in the size of the maxillary sinus lesion and the extent of adjacent bone destruction.

Lessons:
Primary sinonasal tuberculosis is an uncommon cause of phlyctenular keratoconjunctivitis in children. When microbiological and histopathological evidences are absent, polymerase chain reaction analysis has a crucial role in the diagnosis of tuberculosis, especially in patient with uncommon presentation.
Metachronous primary cancer of the tongue and malignant lymphoma of the small intestine
Authors: Sugimoto Keisuke , Uejima Shinji , Uchiyama Yumiko , Yasue Reita , Nambu Kazuya , Ishikawa Jun , Koma Yoshiro , Akita Takako , Toh Taketomo , Fujimoto Takehiro 
Published: February 2021

Abstract

Rationale:
Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma.

Patients concerns:
The patient was admitted to our department with the chief complaint of pain in the right tongue. Partial tongue resection and supraomohyoid neck dissection were performed. One year after surgery, the patient experienced abdominal pain and bloody stools.

Diagnosis:
Diffuse large B-cell lymphoma (DLBCL) was diagnosed via histological examination.

Interventions:
A terminal ileum resection was performed. Postoperatively, the patient received 6 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP).

Outcomes:
Five years after his initial diagnosis, there is no evidence of recurrence, metastasis, or other primary cancer.

Lessons:
Oral cancer patients should always be followed up owing to a possibility of malignant tumors in other areas.
Efficiency of free thyroxine in predicting severity and mortality of patients with acute pancreatitis
Authors: Cheng Tao , Xiao Bo-Jie , Liu Bo-Fu , Han Tian-Yong , Yu Hai-Fang 
Published: February 2021

Abstract

Background:
Previous studies suggest that free thyroxine may be used as a severity indicator of patients with acute pancreatitis (AP) in emergency department, helping determine the differential care of AP. However, there are no systematic reviews and the association between free thyroxine and AP is still not completely understood. Therefore, we will undertake a systematic review of the literature to summarize previous evidence regarding this topic, in order to clarify whether free thyroxine can help us pick out the mild AP cases.

Methods
: We will search the EMBASE, Web of Knowledge, PubMed, ClinicalTrials.gov, and Cochrane Library from inception to Mar 2021 to retrieve relevant studies using the search strategy: (“free thyroxine”) AND (pancreatitis OR pancreatitides). 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 proved the efficiency of free thyroxine in predicting the severity of patients with AP.

Conclusions
: This study will provide reliable evidence-based evidence for the clinical application of free thyroxine predicting the severity of patients with AP.

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.
Features of the gut microbiota in ulcerative colitis patients with depression
Authors: Chen De-Liang , Dai Yan-Cheng , Zheng Lie , Chen You-Lan , Zhang Ya-Li , Tang Zhi-Peng 
Published: February 2021

Abstract
Despite the establishment of the links between ulcerative colitis (UC) and depression, between UC and gut microbiota, few correlations between depression and gut microbiota have yet been demonstrated especially in ulcerative colitis patients. The objective of our study was therefore to determine whether the comorbidity of depressive disorder in ulcerative colitis patients correlate with alterations in the gut microbiota and to identify the specific microbiota signatures associated with depression.
Between March 2017 and February 2018, 31 healthy volunteers, 31 UC patients without depression, and 31 UC patients with depression from Longhua Hospital were enrolled. Clinical data and fecal samples were collected for each patient. Fecal bacteria were identified using 16 s rRNA sequencing. We compared microbial composition among the 3 groups using bioinformatic analysis.
Patients with UC with depression had higher disease severity (P < .05). The UC without depression group had moderate reduction of microbial abundance and uniformity compared to the control group. The UC with depression group had the lowest microbial abundance. With regard to the vital bacteria in the microbiota-gut-brain axis, patients with UC and depression had the lowest abundance of Firmicutes, Clostridia, and Clostridiales but the highest abundance of Proteobacteria, Gammaproteobacteria, and Bacilli.
The presence of depression in UC patients presented significant differences in the composition of gut microbiota compared with UC patients without depression, with increased abundance of Firmicutes and reduced abundance of Proteobacteria.
Electroacupuncture for patients with spasticity after stroke
Authors: Yang Kang , Zhang Hongshi , Hu Guanyu , Zhang Ye , Lou Huijuan , Meng Meng , Wang Yufeng , Cong Deyu 
Published: February 2021

Abstract

Background:
The purpose of this paper is to evaluate the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke.

Methods:
We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database from the date of creation to November 2020. In addition, we will manually retrieve other resources including the reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to electroacupuncture in the treatment of spasticity after stroke will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The modified Ashworth scale was the primary outcomes. Simplified Fugl–Meyer assessment scale (FMA), Stroke specific quality of life scale (SS-QOL) and adverse events will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta- analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results.

Results:
This study will provide a high-quality synthesis to assess the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke.

Conclusion:
This systematic review will provide evidence to judge whether electroacupuncture is an effective and safety intervention for patients with spasticity after stroke.

Ethics and dissemination:
The protocol of the systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences.

Systematic review registration:
CRD42021220300.
Review of economic analysis of available interventions on idiopathic short stature
Authors: Lee Boram , Kwon Chan-Young 
Published: February 2021

Abstract

Background:
Idiopathic short stature (ISS) causes a high economic burden worldwide. As part of a research project that synthesizes economic evidence for Korean medicine treatment of ISS, we describe the methods that will be used for the comprehensive review of articles that analyze health-related economic evaluation for available interventions for ISS using a systematic review methodology.

Methods:
Eight electronic English, Korean, and Chinese databases will be searched from their inception until December 2020 to identify studies on the economic evaluation of available interventions on ISS, without language, study design, or publication status restrictions. From the included studies, the effectiveness, utility, and cost data will be collected as the outcome measures by two researchers independently. Descriptive analysis of individual studies will be conducted. If it is judged that the interventions and outcomes of the included studies are sufficiently homogeneous, we will attempt a quantitative synthesis through meta-analysis using Review Manager version 5.4 software (Cochrane, London, UK).

Results:
This study will summarize the evidence regarding the economic evaluation of available interventions for ISS.

Conclusions:
The findings of this review will help clinicians and patients in evidence-based decision-making in clinical settings and help policy makers develop effective policies and distribute resources based on the available evidence.
Silver dressing in the treatment of diabetic foot
Authors: Huang Chunhua , Wang Ruiqi , Yan Zhangren 
Published: February 2021

Abstract

Background:
Diabetic foot (DF) is one of the most common and serious chronic complications of diabetes. At present, there are many dressings used in the treatment of the diabetic foot. Among them, silver dressings are widely used, but the conclusion has not yet been formed. The purpose of this study is to search for relevant studies on the treatment of DF with silver dressings through evidence-based medicine methods and to draw conclusions with higher levels of evidence to provide a basis for the clinical treatment of DF.

Methods:
Computer search of databases such as CNKI, SinoMed, VIP, Wanfang, PubMed, Embase, and Cochrane Library. The search time is from the establishment of the database to January 23, 2021. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The meta-analysis will be completed by RevMan 5.3 software.

Results:
This systematic review will provide an assessment of the current state of DF, aiming to assess the efficacy of silver dressings for patients with DF.

Conclusion:
This systematic review will provide a credible evidence-based for the clinical treatment of DF with silver dressings.
Genital Human Papillomavirus Infection in Indian HIV-Seropositive Men Who Have Sex With Men
Authors: Raghavendran Anantharam , Hernandez Alexandra L. , Lensing Shelly , Gnanamony Manu , Karthik Rajiv , Sivasubramanian Murgesan , Kannangai Rajesh , Abraham Priya , Mathai Dilip , Palefsky Joel M. 
Published: February 2021

Background
The incidence of penile cancer in Indian men is high. Little is known about genital human papillomavirus (HPV) infection in Indian HIV-seropositive men who have sex with men (MSM), a population that may be at particularly high risk for genital HPV infection and, potentially, penile cancer. In this study, we assessed the prevalence and risk factors for genital HPV infection in this population.

Design and Methods
Three hundred HIV-seropositive MSM were recruited from 2 clinical sites in India. They were tested for genital HPV infection using L1 HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. Participants received an interviewer-administered questionnaire that included questions on demographics and behaviors.

Results
Human papillomavirus data were available from 299 participants. The prevalence of any HPV type in the penis and scrotum was 55% and 54%, respectively. Human papillomavirus type 35 was the most common oncogenic HPV type followed by HPV-16. In multivariate analysis, being the insertive partner with 100+ male partners increased the odds of any penile HPV infection compared with not being insertive with any partners (odds ratio, 2.5; 95% confidence interval, 1.3–5.1). Circumcision was protective against penile HPV infection (odds ratio, 0.39; 95% confidence interval, 0.19–0.76).

Conclusions
The prevalence of penile and scrotal HPV infection was high among Indian HIV-seropositive MSM. The most common oncogenic HPV type in this population, HPV-35, is not included in any currently available HPV vaccines. Insertive anal sex with men and lack of circumcision were the primary risk factors for penile HPV infection in this population.