bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ipsilateral radial nerve, median nerve, and ulnar nerve injury caused by crush syndrome due to alcohol intoxication
Authors: Zhang Yuan-Wei , Ju Cheng , Ke Xue-Lei , Xiao Xin , Xiao Yan , Chen Xi , Zhang Su-Li , Ge Hong-Yan , Deng Liang 
Published: October 2019

Abstract

Rationale:
Autologous peripheral nerve injury caused by crush syndrome due to alcohol intoxication is relatively rare, and to our knowledge, the compression of 3 upper limb nerves at the same time has not been reported previously. If a compressive peripheral nerve injury is not treated in a timely manner, it is difficult to recover neurological function, and the prognosis is poor.

Patient concerns:
Here, we present a case of a 50-year-old man with ipsilateral radial nerve, median nerve, and ulnar nerve injuries caused by autogenous compression after drunkenness.

Diagnosis:
Electromyography and nerve conduction studies suggested peripheral nerve injury in the left upper limb. The diagnosis was injury to the radial nerve, median nerve, and ulnar nerve in the left upper arm.

Interventions:
Exploratory neurolysis surgery of the radial nerve, median nerve, and ulnar nerve was performed in the left upper arm. Postoperative oral neurotrophic drugs were administered, and functional exercise was performed.

Outcomes:
After timely diagnosis and treatment, the strength of the left upper arm muscle recovered, and the prognosis of neurological function was satisfactory during 3 years of follow-up sessions.

Lessons:
In the treatment of such patients, a comprehensive understanding of their medical history and a strict physical examination should be performed. Combined with neuroelectrophysiological and imaging examination, the diagnosis can be confirmed. After timely diagnosis and treatment, the prognosis is mostly excellent.
Psychological intervention and its immune effect in cancer patients
Authors: Zhang Ping , Mo Lin , Li Xia , Wang Qiyao 
Published: October 2019

Abstract

Objective:
To determine whether psychological intervention (PI) changes the levels of immune indicators in cancer patients.

Methods:
We conducted a systematic search published up to July 2018, followed by a manual search. Randomized controlled trials were included. Two reviewers independently screened and extracted data, which were analyzed using Review manager 5.3.

Results:
Twenty-nine studies were included including four kinds of PI. Only stress management didn’t result in immune changes; only cognitive behavior therapy affect NK cell activity. PI did not change immune indicators on cancer patients who completed therapy. Compared to patients not receiving PI, those received PI had significantly higher NK cell count and activity in whole blood; and serum levels of IL-2, IL-4, IFN-γ, lgA, and lgG. However, the differences in the serum levels of IL-6, IL-10, TNF-α, and IgM were not significant (P > .05), and the changes recorded for the CD3+, CD4+, and CD8+ cell count, and CD4+/CD8+ ratios were inconsistent.

Conclusions:
Although there are considerable evidences of PI's immune effect, but its magnitude was moderate. Therefore, it may be premature to conclude whether PI affects immunity of cancer patients. Further research is warranted, with special focus on the PI types and treatment methods.
Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation
Authors: Seak Chen-June , Goh Zhong Ning Leonard , Wong Alexis Ching , Seak Joanna Chen-Yeen , Seak Chen-Ken 
Published: October 2019

Abstract

Rationale
Abdominal pain in pregnancy represents a demanding diagnostic challenge in the emergency department (ED) due to the extensive list of differential diagnoses to be considered, coupled with the possibility of each disease having nonclassical, atypical signs and symptoms, resultant from the patient's pregnant state. Additionally, emergency physicians (EPs) face limitations on investigative imaging modalities because of the need to minimize fetal radiation exposure. EPs have to tackle this diagnostic challenge while performing a balancing act to maximize both maternal and fetal outcomes in a time-sensitive manner, becauser any delays in decision-making at the ED may threaten the safety of mother and child. Two common causes of abdominal pain in pregnancy presenting to the ED are acute appendicitis and ectopic pregnancy. The latter is almost always diagnosed by 10 weeks of gestation. Here, we report an extremely rare case of unilateral live spontaneous twin tubal ectopic pregnancy presenting past 12 weeks of gestation, diagnosed after magnetic resonance imaging (MRI) of the abdomen.

Patient concerns
A 37-year-old gravida 2 para 1 at 12 weeks and 6 days of gestation presented to our ED with a 2-day history of right iliac fossa pain, not associated with vaginal bleeding, fever, diarrhea, and vomiting. On examination, she was tachycardic (pulse rate 124 beats/min) and hypertensive (blood pressure 142/88 mm Hg). There was marked tenderness and guarding at the lower abdomen.

Diagnoses
Blood investigations were unremarkable, while abdominal ultrasonography found a live twin gestation with foetal heartbeats of 185 and 180 beats/min. MRI of the abdomen revealed an empty uterine cavity; 2 amniotic sacs and fetuses of diameter 10 cm, and a single placenta were noted in the right uterine adnexa. The patient was diagnosed with right live monochorionic diamniotic twin tubal pregnancy.

Intervention
Our patient underwent emergency laparoscopic right salpingectomy.

Outcomes
The operation was successful and her postoperative care remained uneventful up to discharge.

Lessons
Ectopic pregnancy cannot be ruled out based on prior normal antenatal examinations and gestational age of >10 weeks. EPs should not hesitate to order MRI scans for further evaluation if ultrasonography and laboratory findings are equivocal.
Effect of physical therapy for chronic obstructive pulmonary disease
Authors: Gao Hui , Gao Yuan , Sun Ping , Shen Jie , Yao Hui-juan , Fu Shi-dong , Meng Cheng 
Published: October 2019

AbstractBackground:Previous studies have reported that physical therapy (PT) can be used for the treatment of chronic obstructive pulmonary disease (COPD). However, its effectiveness is still inconclusive. This systematic review will aim to assess its effectiveness and safety for the treatment of patients with COPD.Methods:All randomized controlled trials (RCTs) literatures of PT for COPD will be searched from the databases of Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDILINE, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from inception to the present without any language restrictions. Two reviewers will independently perform the study selection, data extraction, and methodological quality assessment. A third reviewer will be invited to resolve any disagreements occurred between 2 reviewers.Results:The primary outcome is lung function. The secondary outcomes include symptoms, health-related quality of life, mortality, and adverse events. The outcome data will be pooled by using the models of random-effects or fixed-effects according to the detected heterogeneity.Conclusion:The findings of this study will provide up-todated summary evidence for assessing the effectiveness and safety of PT for COPD.
Efficacy of blood purification for severe pancreatitis and acute respiratory distress syndrome
Authors: Jin Yi-hua , Liu Yang 
Published: October 2019

Abstract

Background:
This study will assess the efficacy and safety of blood purification (BP) for severe pancreatitis (SP) and acute respiratory distress syndrome (ARDS).

Methods:
We will search the following electronic databases of Ovid MEDLINE, EMBASE, Web of Science, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANGFANG from inception to the present without language restriction. A systematic review and data synthesis will be carried out of randomized controlled trials of BP for the treatment of patients with SP and ARDS. RevMan 5.3 software will be used for statistical analysis.

Results:
This systematic review will evaluate the efficacy and safety of BP for the treatment of patients with SP and ARDS. The primary outcome includes respiratory indexes, blood biochemical and inflammatory factors. The secondary outcomes consist of complications, sepsis, abdominal hemorrhage, renal failure, length of hospital stay, and mortality.

Conclusion:
This study will provide up-to-date evidence of BP for the treatment of patients with SP and ARDS.

PROSPERO registration number:
PROSPERO CRD42019139467.
Bone health in adult trans persons: an update of the literature
Authors: Wiepjes Chantal M. , den Heijer Martin , T'Sjoen Guy G. 
Published: October 2019

Purpose of review
Hormonal treatment in trans persons can affect bone health. In this review, recent studies published on this topic in adults are discussed.

Recent findings
Before starting hormonal treatment, trans women were found to have lower bone mineral density than cis men, which seems to be related to lower vitamin D concentrations and lower lean body mass, whereas this was not found in trans men. Short-term and long-term studies show that hormonal treatment does not have detrimental effects on bone mineral density in trans women and trans men. Low estradiol concentrations were associated with a decrease in bone mineral density in trans women.

Summary
Based on the reassuring findings in these studies, regularly assessing bone mineral density during hormonal treatment does not seem necessary. This confirms the Endocrine Society Guideline stating that bone mineral density should be measured only when risk factors for osteoporosis exist, especially in people who stop hormonal treatment after gonadectomy. The relationship with estradiol concentrations indicate that hormone supplementation should be adequate and therapy compliance should be stimulated. As vitamin D deficiency frequently occurs, vitamin D supplementation should be considered. Future research should focus on fracture risk and long-term changes in bone geometry.
Treatment options for patients with mantle cell lymphoma post-transplantation
Authors: Cowley Emily C. , McFarlane Thomas R. 
Published: October 2019

Abstract
Mantle cell lymphoma is a rare subtype of B-cell lymphoma which carries with it a poor prognosis and is typically refractory to treatment. Autologous stem cell transplant (ASCT) has been shown to improve survival, but is not considered curative. There is currently no specific preferred regimen of treatment according to current guidelines for patients who fail ASCT. We undertook a systematic scoping review to examine the existing literature in this setting. A total of 3045 records were screened, yielding 40 full-text articles, 12 of which were included in the results. Ibrutinib and venetoclax appeared to produce the highest response rates and length of progression-free survival post-ASCT, however, there are serious gaps in the literature regarding what is actually known about the efficacy of treatment regiments for relapsed/refractory mantle cell lymphoma in post-ASCT patients and more randomized, controlled clinical trials are needed in this area.
Significance of the Marginal Mandibular Branch in Relation to Facial Palsy Reconstruction
Authors: Mandlik Veronika , Ruewe Marc , Engelmann Simon , Geis Sebastian , Taeger Christian , Kehrer Michael , Tamm Ernst R. , Bleys Ronald , Prantl Lukas , Kehrer Andreas 
Published: October 2019

Background
The marginal mandibular branch (MMB) of the facial nerve provides lower lip symmetry apparent during human smile or crying and is mandatory for vocal phonation. In treating facial palsy patients, so far, little attention is directed at the MMB in facial reanimation surgery. However, isolated paralysis may occur congenital, in Bell's palsy or iatrogenic during surgery, prone to its anatomical course. A variety of therapies address symmetry with either weakening of the functional side or reconstruction of the paralyzed side. To further clarify the histoanatomic basis of facial reanimation procedures using nerve transfers, we conducted a human cadaver study examining macroanatomical and microanatomical features of the MMB including its axonal capacity.

Methods
Nerve biopsies of the MMB were available from 96 facial halves. Histological processing, digitalization, nerve morphometry investigation, and semiautomated axonal quantification were performed. Statistical analysis was conducted with P < 0.05 as level of significance.

Results
The main branch of 96 specimens contained an average of 3.72 fascicles 1 to 12, and the axonal capacity was 1603 ± 849 (398–5110, n = 85). Differences were found for sex (P = 0.018), not for facial sides (P = 0.687). Diameters were measured with 1130 ± 327 μm (643–2139, n = 79). A significant difference was noted between sexes (P = 0.029), not for facial sides (P = 0.512.) One millimeter in diameter corresponded to 1480 ± 630 axons (n = 71). A number of 900 axons was correlated with 0.97 mm (specificity, 90%; sensitivity, 72%).

Conclusions
Our morphometric results for the MMB provide basic information for further investigations, among dealing with functional reconstructive procedures such as nerve transfers, nerve grafting for direct neurotization or babysitter procedures, and neurectomies to provide ideal power and authenticity.
Surgical Quality Assurance in COLOR III
Authors: Tsai Alice Y-C. , Mavroveli Stella , Miskovic Danilo , van Oostendorp Stefan , Adamina Michel , Hompes Roel , Aigner Felix , Spinelli Antonino , Warusavitarne Janindra , Knol Joep , Albert Matthew , Nassif George , Bemelman Willem , Boni Luigi , Ovesen Henrik , Austin Ralph , Muratore Andrea , Seitinger Gerald , Sietses Colin , Lacy Antonio M. , Tuynman Jurriaan B. , Bonjer H. Jaap , Hanna George B. 
Published: October 2019

Objective:
The aim of this study was to develop an objective and reliable surgical quality assurance system (SQA) for COLOR III, an international multicenter randomized controlled trial (RCT) comparing transanal total mesorectal excision (TaTME) with laparoscopic approach for rectal cancer.

Background of Summary Data:
SQA influences outcome measures in RCTs such as lymph nodes harvest, in-hospital mortality, and locoregional cancer recurrence. However, levels of SQA are variable.

Method:
Hierarchical task analysis of TaTME was performed. A 4-round Delphi methodology was applied for standardization of TaTME steps. Semistructured interviews were conducted in round 1 to identify key steps and tasks, which were rated as mandatory, optional, or prohibited in rounds 2 to 4 using questionnaires. Competency assessment tool (CAT) was developed and its content validity was examined by expert surgeons. Twenty unedited videos were assessed to test reliability using generalizability theory.

Results:
Eighty-three of 101 surgical tasks identified reached 70% agreement (26 mandatory, 56 optional, and 1 prohibited). An operative guide of standardized TaTME was created. CAT is matrix of 9 steps and 4 performance qualities: exposure, execution, adverse event, and end-product. The overall G-coefficient was 0.883. Inter-rater and interitem reliability were 0.883 and 0.986. To enter COLOR III, 2 unedited TaTME and 1 laparoscopic TME videos were submitted and assessed by 2 independent assessors using CAT.

Conclusion:
We described an iterative approach to develop an objective SQA within multicenter RCT. This approach provided standardization, the development of reliable and valid CAT, and the criteria for trial entry and monitoring surgical performance during the trial.
A Survey of Current Procurement Travel Practices, Accident Frequency, and Perceptions of Safety
Authors: Schenk Austin D. , Washburn William K. , Adams Andrew B. , Lynch Raymond J. 
Published: October 2019

Background.
In 2018, 81% of the 36, 529 solid organs transplanted in the United States came from deceased donors. These organs were recovered through widespread use of aeromedical and emergency ground transportation systems. Urgently scheduled travel to remote hospitals at night and in varied weather conditions carries risk for the transplant professionals involved. A landmark survey conducted in 2007 demonstrated that 80% of respondents had experienced a “near-miss” event while on a procurement trip, and 15% had been involved in at least 1 accident. One decade later, we sought to revisit the issue of procurement related travel safety.

Methods.
A 32 question survey designed to interrogate travel practice, accident frequency, and perceptions of safety was sent to the American Society of Transplant Surgeons membership.

Results.
Our survey response rate was 20.6%. At least 1 travel accident with bodily injury was reported by 23% of respondents and yet only 7% of respondents reported feeling “unsafe” or “very unsafe” during procurement travel. Sixteen percent of respondents participated in a procurement at a dedicated organ procurement facility, and only 53% of procurement surgeons completed at least 1 deceased donor procurement at their own hospital facility within the preceding 12 months.

Conclusions.
In a field where increasingly aggressive organ utilization is the norm, the efficiency and safety of procurement travel merits ongoing consideration. Addressing these concerns takes on new significance as organ allocation policies change geographic distribution to expand the extent of travel required for surgical teams.
Fastidious anaerobe agar (FAA) as a suitable medium for antimicrobial susceptibility testing (AST) of anaerobes by agar dilution
Authors: Copsey-Mawer Sarah , Scotford Selina , Copsey-Mawer Bethan , Davis Carol , Perry Michael , Morris Trefor , Hughes Harriet 
Published: October 2019

Background
Agar dilution is the reference method for antimicrobial susceptibility testing (AST) of anaerobes, but currently the only verified and published method utilises supplemented brucella agar, which is not readily available in the UK.
As FAA is often the medium of choice for primary culture of anaerobes in clinical laboratories, the aim of this study was to investigate the suitability of this medium as an alternative to brucella agar for the reference method.

Methods
One hundred isolates submitted to the UKARU, all with pre-determined MICs to: clindamycin; meropenem; metronidazole; penicillin and doxycycline, were tested.
MICs were obtained by agar dilution using both in-house produced FAA, supplemented with 5% defibrinated horse blood, and supplemented brucella blood agar (BRU).
End points were selected according to CLSI guidance and interpreted using EUCAST clinical breakpoints for anaerobes (FDA guidance for doxycycline).

Results
For the majority of isolates the correlation between FAA and BRU MICs was good.
Errors were found for each antimicrobial, with the highest numbers recorded for metronidazole and doxycycline. The majority of errors were within 1-2 dilutions, but spanned the clinical breakpoints. Others were single replicate errors, which were anomalous against a minimum of three additional results.
Several species such as P. distasonis and C. ramosum demonstrated raised numbers of errors/ variable results and will require further investigation.

Conclusions
Overall the reproducibility of agar dilution testing on FAA compared to BRU was good, suggesting that FAA is a suitable media for AST of anaerobes. Further assessment of several species is required.
Diversity of the class Coriobacteriia within different ecosystems
Authors: Hoyles Lesley 
Published: October 2019

Members of the class Coriobacteriia are little studied, important fastidious anaerobes within the human gut microbiota. Collinsella aerofaciens is a core member of the gut microbiota that can present several different fermentation profiles within individuals, while Eggerthella lenta is implicated in xenobiotic metabolism. Recent ‘culturomics’ studies have greatly increased the number of Coriobacteriia recovered from human-associated samples, with the names of nine novel genera comprising 12 species published to date. However, the ecological range and genomic diversity of the class Coriobacteriia are poorly understood. Taxonomic assignments within the class Coriobacteriia are unclear, limiting the ways in which data from 16S rRNA gene-based diversity studies in humans and rodent models are interpreted.
Whole-genome and 16S rRNA gene sequences of members of the class Coriobacteriia were analysed and assigned to the families Atopobiaceae, Coriobacteriaceae and Eggerthellaceae. Inconsistencies between 16S rRNA gene sequence and whole genome sequence data deposited in public databases were identified. Newly annotated data searched against 85,000 16S rRNA gene sequence datasets included in the IMNGS (Integrated Microbial Next Generation Sequencing) database demonstrates humans and rodents harbour distinct Coriobacteriia populations. Members of the family Coriobacteriaceae predominate in the human gut, while Eggerthellaceae are more representative of the rodent gut. Metabolic capabilities of the three families of Coriobacteriia vary greatly, with Eggerthellaceae asaccharolytic compared with Coriobacteriaceae and Atopobiaceae. Correct annotation of Coriobacteriia in 16S rRNA gene (and by extension shotgun metagenomic) datasets is required to determine the contributions of these increasingly important bacteria to different ecosystems.
Using PCR in place of GDH as the first line assay in a two-step CDI testing algorithm – evidence of help not hindrance from samples processed at clinical microbiology laboratories in Wales
Authors: Perry Michael , Anderson Bethan , Perry Selina , Graham Lee , Gilbert Lauren , Birchley Alec , Copsey Sarah , Morris Trefor 
Published: October 2019

Background
Guidance recommends the use of a two-stage algorithm for diagnosis of Clostridioides difficile infection (CDI) utilising either PCR or a glutamate dehydrogenase (GDH) assay as the first line screen. There is ongoing debate as to whether PCR is a hindrance due to fear of over-diagnosis.

Methods
Between December 2017 and March 2019 over 65,000 tests for CDI were undertaken in Wales. PCR (Serosep EntericBio C. difficile assay) was employed as the first line test for 36% of samples with the remainder tested using a GDH assay (Techlab C. diff ChekTM -60). Positive samples were tested using a toxin EIA (Techlab Tox A/B Quik Chekò). Culture (alcohol shock & CCEY; Oxoid) and capillary electrophoresis PCR ribotyping were undertaken at the UK Anaerobe Reference Unit (UKARU).

Results
The proportion of samples testing positive using PCR and GDH was 5.2% and 8.3% with a toxin EIA positive percentage of 30% and 25% respectively. Of these samples 73% (n=2543) of GDH and 80% (n=974) of PCR positive samples were referred for culture and ribotyping.
No C. difficile was isolated from 15% of GDH and 10.5% of PCR positive specimens. Non-toxigenic strains were isolated from 6.6% of GDH and 0.2% of PCR positive samples and approximately equal proportions of both GDH and PCR positive samples were ribotyped (60% vs. 63% of 2125 samples).

Conclusions
There was no evidence of increased ascertainment of CDI using PCR. In fact, culture and ribotyping demonstrated an improved specificity for PCR that is helpful for accurate CDI diagnosis.