bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of efficacy and safety of complementary and alternative therapies for primary trigeminal neuralgia
Authors: Zhang Tianqi , Zhang Tiefeng , Li Chuancheng , Zhai Xixi , Huo Qing 
Published: January 2021

AbstractBackground:Primary trigeminal neuralgia (PTN) is a type of peripheral neuralgia that seriously affects people's lives. In recent years, complementary therapies and alternative therapies have played a significant role in treating PTN. However, there is a lack of comparison among all the complementary and alternative therapies at present. Thus, the aim of this study is to discuss the efficacy and safety of diverse complementary and alternative therapies by Bayesian network meta-analysis (NMA).Methods:We will retrieve the Chinese and English databases to gather related randomized controlled trials (RCTs) of complementary and alternative therapies for treating PTN. The deadline is November 2020. Two independent researchers will be in charge of screening qualified literature, extracting data, and independently evaluating bias risks involved in the research. Pairwise meta-analysis and Bayesian network meta-analysis will be performed to assess all evidence. Then, we will use STATA16.0 as well as WinBUGS1.4.3 software for data analysis. Besides, the quality of NMA evidence will be classified by grading of recommendations assessment development and evaluation (GRADE).Results:This study will compare and rank the efficacy and safety of different complementary and alternative therapies in treating primary trigeminal neuralgia.Conclusion:Complementary and alternative therapies play an essential role in treating primary trigeminal neuralgia. We expect our study will furnish meaningful evidence support for clinicians and patients.Protocol registration number:INPLASY2020120026.Ethical approval:Since the study is based on published or registered RCTs, ethical approval and patient informed consent are abandoned.
Prenatal detection of a 3q29 microdeletion in a fetus with ventricular septum defect
Authors: Yue Fagui , Deng Shu , Xi Qi , Jiang Yuting , He Jing , Zhang Hongguo , Liu Ruizhi 
Published: January 2021

Abstract

Rationale:
Chromosomal 3q deletion is a recurrent genomic alternation, which is rarely reported in clinic.

Patient concerns:
A 27-year-old woman underwent amniocentesis for cytogenetic analysis and single nucleotide polymorphism (SNP) array analysis at 27 weeks of gestation, due to ventricular septum defect in prenatal ultrasound findings.

Diagnoses:
G-banding analysis showed the karyotype of the fetus was normal and the couple also had normal karyotypes. However, SNP array detected a 1.71 Mb microdelection in 3q29, which was described as arr[hg19]3q29(194184392–195887205) × 1. There are 12 genes located in this locus.

Interventions:
The couple refused SNP array to testify the 3q29 microdeletion was inherited or de novo and they chose termination of pregnancy.

Outcomes:
The deleted region in the fetus overlapped with part 3q29 microdeletion syndrome, which was characterized by learning disability, speech delay, mental deficiency, ocular abnormalities and craniofacial features. In addition, no similar/overlapping 3q29 microdeletion cases were reported according to the published literature and database.

Lessons:
For the chromosomal microscopic imbalances partially overlapping with the defined pathogenic syndrome, deleted/duplicated size, genetic materials and phenotypic diversity should be taken into consideration when genetic counseling is offered by the clinicians.
Effect of Nusinersen in a late onset spinal muscular atrophy patient for 14 months
Authors: Park Jin-Mo , Min Yu-Sun , Park Donghwi , Park Jin-Sung 
Published: January 2021

Abstract

Rationale:
Spinal muscular atrophy (SMA) is a genetic disorder caused by genetic defect of SMN1 gene. SMA was an untreatable disease until 2016, when Nusinersen an antisense oligonucleotide therapy was approved for treatment. We report the effect of Nusinersen in a late onset SMA for 14 months.

Patient concerns:
A 13-year-old boy who was diagnosed as SMA with progressive proximal limb weakness was treated with intrathecal injection of Nusinersen.

Diagnosis:
The patient had progressive proximal limb weakness after 2 years of age. The patient had elevated creatine kinase level and shoed neurogenic changes in the needle electromyography study. After genetic analysis, homozygous deletion in Exon 7 and 8 of SMN1 protein was found and he was diagnosed as late onset SMA.

Interventions:
Intrathecal Nusinersen was administered per protocol.

Outcomes:
After 14 months of treatment, the patient showed significant clinical improvement in the revised Hammersmith functional rating scale and 6-minute walk test.

Lessons:
Although there is limited data on the effect of Nusinersen in late onset SMA patients, our case adds on the effectiveness even in late onset SMA. More studies are needed to consolidate the effects and adverse events of Nusinersen in late onset SMA.
Awake endovascular coiling of a dissected intracranial aneurysm in a third-trimester twin pregnancy
Authors: Xie Fei , Hao Jianqiang , Richard Seidu A. , Yang Yuanli , Zou Wuchun , Liu Hong-Bin , Deng Min , Zhang Changwei 
Published: January 2021

Abstract

Rationale:
Subarachnoid hemorrhages (SAHs) from ruptured intracranial aneurysms are very rare during pregnancy. Management of ruptured intracranial aneurysms with SAH in pregnancy is often challenging because of the risks to the fetus and the mother. We present the first successful awake endovascular coiling of a dissected intracranial aneurysm in a third trimester twin pregnancy.

Patient concerns:
A 28 years’ old pregnant woman was admitted at the obstetric department of our hospital on account of very severe headaches associated with nausea and vomiting.

Diagnosis:
Emergency obstetric ultrasound scan done confirmed 32 weeks’ twin gestation, whereas magnetic resonance imaging established hemorrhage in the suprasellar cistern and the subarachnoid space. Magnetic resonance angiography revealed a dissected aneurysm in the ophthalmic segment of the left internal carotid artery.

Interventions:
Awake cerebral angiography as well as embolization of the aneurysm with coils was done via the transarterial route and the twins were delivered via caesarean section at 37 weeks’ gestation.

Outcomes:
Two years’ follow-up indicated no complications and children as well as their mother are healthy.

Lesions:
Awake endovascular coiling was very beneficial in our case because we avoided general anesthesia and the use of osmotic diuretics which are potentially hazardous during pregnancy.
Pneumocystis jiroveci pneumonia, Nocardia brasiliensis, and Mycobacterium tuberculosis co-infection in a myasthenia gravis patient
Authors: Hou Jiahui , Cao Junmin , Tan Panli , Yu Ying 
Published: January 2021

Abstract

Rationale:
Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junctions that leads to fluctuating weakness and disabling fatigability. Due to difficulty in breathing caused by weakness of the respiratory muscles, patients with MG are more susceptible to pneumonia and other respiratory infections. As many patients with MG are given immunosuppressive therapy, this makes them more prone to infections. However, coinfection with 3 pathogens is very rare.

Patient concerns:
Here, we report the case of a 41-year-old gentleman with MG who was receiving long-term steroid therapy. He presented with a cough with pale brown expectoration that occurred without obvious inducement, severe pain in the scapula, as well as swelling and weakness of both legs. Despite undergoing treatment, but his symptoms did not improve, prompting two additional hospital admissions over a period of several months.

Diagnosis:
Bronchoscopy and bronchoalveolar lavage (BAL) were performed, revealing the presence of Pneumocystis jirovecii , Nocardia brasiliensis, and Mycobacterium tuberculosis (MTB). N brasiliensis was identified by positive modified acid-fast Kinyoun staining as well as a positive colony culture identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry from the BAL sample. MTB was confirmed using GeneXpert, and due to the limitations of the culture conditions, methenamine silver stain was used to confirm Pneumocystis jirovecii. Next-generation sequencing (NGS) assay of the BAL samples also confirmed these pathogens.

Interventions:
The patient was transferred to a designated tuberculosis hospital and received anti-infective and anti-TB treatment.

Outcomes:
During treatment at the designated hospital, the patient developed gastrointestinal bleeding and impaired liver function. One month later, he developed multiple organ failure, consolidation of the left lower lung, and pan-drug resistant bacteremia. He refused further treatment and was discharged

Conclusion:
In conclusion, physicians should be aware of the predisposition of MG patients to co-infections, especially patients with metabolic disorders, to avoid inadequate treatment and poor patient outcomes. Due to the limitations of culture conditions, NGS should be considered as a new technique for identifying pathogens.
Complementary and alternative therapies for precancerous lesions of gastric cancer
Authors: Zhang Tianqi , Zhang Tiefeng , Li Chuancheng , Zhai Xixi , Huo Qing 
Published: January 2021

Abstract

Background:
Gastric cancer is one of the most common malignant tumors, which seriously affect peoples quality of life and threaten people's health. Precancerous lesions of gastric cancer (PLGC) are a critical stage in the occurrence and development of gastric cancer. Early effective intervention is an important means to prevent and control gastric cancer. In this study, we will evaluate the efficacy and safety of complementary and alternative therapies in the treatment of PLGC by Bayesian network meta-analysis (NMA).

Methods:
We will search PubMed, Cochrane Library, CNKI and other databases to gather randomized controlled trials (RCTs) on the treatment of PLGC with complementary and alternative therapies. Two reviewers will screen the literature and extract the data according to the inclusion and exclusion criteria, and then assess the quality and bias risk according to Cochrane's Risk of Bias Assessment Tool. Bayesian network meta-analysis will be conducted by Stata16.0 and WinBUGS1.4.3.

Results:
This study will compare and rank the efficacy and safety of different complementary and alternative therapies for PLGC.

Conclusion:
This study can provide reliable evidence for the efficacy and safety of complementary and alternative therapies in treatment of PLGC. We expect to provide scientific and rigorous evidence support for clinicians and patients, and then assist them to choose the optimum treatment.

Protocol registration number:
INPLASY2020120077.
Applicability of ultrasonography for detection of marginal sinus placenta previa
Authors: Ishibashi Hiroki , Miyamoto Morikazu , Shinmoto Hiroshi , Soga Shigeyoshi , Iwahashi Hideki , Kakimoto Soichiro , Matsuura Hiroko , Sakamoto Takahiro , Hada Taira , Suzuki Rie , Takano Masashi 
Published: January 2021

Abstract
This study aimed to examine whether marginal sinus placenta previa, defined as when the marginal sinus just reaches the internal cervical os and placental parenchyma might be >2 cm from the internal cervical os, can be diagnosed using ultrasonography (US). We identified the placenta previa cases that underwent both US and magnetic resonance imaging (MRI) between April 2010 and December 2018 at our institution. The diagnostic discrepancies for marginal sinus placenta previa between US and MRI were examined retrospectively. Of the 183 cases of placenta previa, 28 (15.3%) cases were diagnosed as marginal sinus placenta previa using MRI. Among them, 18 cases (64.3%) could also be diagnosed using US. The sensitivity and specificity of the diagnosis of marginal sinus placenta previa using US were 64.3% and 92.9%, respectively. A change in US diagnosis occurred in 10 (35.7%) cases, all of which were diagnosed with low-lying placenta previa or marginal placenta previa and did not develop any serious miserable obstetrical outcomes. In conclusion, the diagnostic accuracy of US for detecting marginal sinus placenta previa was not significant. MRI examination may be required to accurately categorize the types of placenta previa.
Efficacy and safety of mechanical thrombectomy for cardioembolic stroke
Authors: Zhang Ziqu , Wang Chenjin , Xia Wengang , Li Jingwei , Wang Yali , Liu Yong 
Published: January 2021

Abstract

Background:
Several randomized clinical trials have demonstrated the safety and efficiency of mechanical thrombectomy in the management of acute ischaemic stroke caused by larger vessel occlusion. According to the trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, acute ischaemic stroke can be divided into cardioembolic stroke and non-cardioembolic stroke. Previous studies have shown that mechanical thrombectomy in cardioembolic stroke with intracranial large artery occlusion has a poor prognosis. The reason may be that the old emboli are hard, making it difficult to remove. However, recent evidence shows that mechanical thrombectomy is also effective and safe in patients with cardioembolic stroke. Therefore, the aim of this study is to evaluate the efficacy and safety of mechanical thrombectomy for cardioembolic stroke.

Methods:
The electronic database, including PubMed, Cochrane Library, EMBASE, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP database, and Wan-fang database, were thoroughly retrieved from inception to December 1, 2021, without language restrictions. All randomized controlled trials that evaluated the efficacy and safety of mechanical thrombectomy in the treatment of cardioembolic stroke will be included. Primary outcomes will include vascular recanalization rate and score scale. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals and continuous variables will be summarized as mean difference or standard mean difference with 95% confidence intervals.

Results:
This review will be to assess the efficacy and safety of mechanical thrombectomy for cardioembolic stroke.

Conclusions:
The results of our findings may be helpful for clinicians and health professionals to re-examine the clinical decision-making in the treatment of cardioembolic stroke, promising way for treatment of patients with cardioembolic stroke.

Systematic review registration number:
INPLASY2020120035
Gender Differences in Recovery Needs After a Suicide Attempt
Authors: Denneson Lauren M. , Tompkins Kyla J. , McDonald Katie L. , Britton Peter C. , Hoffmire Claire A. , Smolenski Derek J. , Carlson Kathleen F. , Dobscha Steven K. 
Published: January 2021

Background:
Appropriate after-care for the estimated 1.4 million people with nonfatal suicide attempts each year in the United States is critical, yet little research has focused on recovery needs after an attempt and whether important gender differences in those needs may exist. In this study, we examined gender differences in recovery needs after a suicide attempt among a national sample of women and men veterans.

Methods:
We interviewed 25 women and 25 men veterans from Veterans Health Administration health care systems across the country. Purposive sampling was used to obtain a demographically and clinically diverse sample. Transcripts were analyzed using thematic analysis.

Results:
Although some recovery topics were similar between genders, the participants’ primary recovery needs, or goals, differed by gender. Women focused on developing connections with others and wanted to increase their self-knowledge and self-worth. Men were focused on trying to live up to their ideal selves by living and doing “right.” Men also wanted to feel like they were needed by others. Both women and men also wanted to feel a stronger sense of purpose in their lives.

Conclusions:
Findings suggest that recovery needs among veterans after a nonfatal suicide attempt vary by gender: women may benefit more from psychoeducational approaches in group settings with other women, whereas men may benefit more from approaches that help them focus on making changes in their lives towards becoming their ideal selves.
Machine Learning to Differentiate Risk of Suicide Attempt and Self-harm After General Medical Hospitalization of Women With Mental Illness
Authors: Edgcomb Juliet B. , Thiruvalluru Rohith , Pathak Jyotishman , Brooks John O. 
Published: January 2021

Background:
Suicide prevention is a public health priority, but risk factors for suicide after medical hospitalization remain understudied. This problem is critical for women, for whom suicide rates in the United States are disproportionately increasing.

Objective:
To differentiate the risk of suicide attempt and self-harm following general medical hospitalization among women with depression, bipolar disorder, and chronic psychosis.

Methods:
We developed a machine learning algorithm that identified risk factors of suicide attempt and self-harm after general hospitalization using electronic health record data from 1628 women in the University of California Los Angeles Integrated Clinical and Research Data Repository. To assess replicability, we applied the algorithm to a larger sample of 140,848 women in the New York City Clinical Data Research Network.

Results:
The classification tree algorithm identified risk groups in University of California Los Angeles Integrated Clinical and Research Data Repository (area under the curve 0.73, sensitivity 73.4, specificity 84.1, accuracy 0.84), and predictor combinations characterizing key risk groups were replicated in New York City Clinical Data Research Network (area under the curve 0.71, sensitivity 83.3, specificity 82.2, and accuracy 0.84). Predictors included medical comorbidity, history of pregnancy-related mental illness, age, and history of suicide-related behavior. Women with antecedent medical illness and history of pregnancy-related mental illness were at high risk (6.9%–17.2% readmitted for suicide-related behavior), as were women below 55 years old without antecedent medical illness (4.0%–7.5% readmitted).

Conclusions:
Prevention of suicide attempt and self-harm among women following acute medical illness may be improved by screening for sex-specific predictors including perinatal mental health history.
Cerebral hemodynamic response to a therapeutic bed for procedural pain management in preterm infants in the NICU: a randomized controlled trial
Authors: Ranger Manon , Albert Arianne , MacLean Karon , Holsti Liisa 
Published: January 2021

Abstract

Introduction:
We developed a novel device, Calmer, that mimics key components of skin-to-skin holding to reduce stress in preterm infants. Our feasibility trial showed that Calmer worked 50% better than no treatment and no differently from our standard of care, facilitated tucking (FT), for reducing pain scores during a heel lance in preterm infants in the neonatal intensive care unit.

Objective:
We compared the effects of Calmer on regional cerebral hemodynamic activity during a noxious stimulation to FT.

Methods:
During a clinically required heel lance, we measured frontal cortex tissue oxygenation in a subsample of 29 preterm infants (27–33 weeks gestational age) from our larger randomized controlled trial. Infants were randomized to either FT (n = 16) or Calmer treatment (n = 12). The outcome measure, obtained using near-infrared spectroscopy, was a change in the tissue oxygenation index (TSI) across study phases (Baseline, Heel Lance, Recovery; median duration 517 seconds [421–906 seconds]).

Results:
No statistically significant differences were found between groups in the median TSI during any of the study phases. In response to the heel lance, 7 infants (27.6%) had a TSI that dipped below the 60% threshold (3 in the Calmer group 25% and 4 in the FT group 25%); none below 50%.

Conclusions:
Infants on Calmer maintained normal regional cerebral oxygen levels (55%–85%) no differently from infants receiving a human touch intervention during blood collection. Parental skin-to-skin holding is one of the most effective strategies to relieve procedural pain in preterm infants. When parents or FT are not available, Calmer shows potential for filling this gap in care.
Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents
Authors:   The RESPOND Study Group∗
Published: January 2021

Objective:
To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts.

Methods:
Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first.

Results:
Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6–3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0–201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59–0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15–1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00–1.43) and raltegravir (1.24; CI 1.02–1.51), but lower with rilpivirine (0.77; CI 0.63–0.94).

Conclusion:
In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.