bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of ERCP and PTBD for Biliary Interventions for Readmission Rates and Patient Outcomes
Authors: Wang Daniel Huai-En , Chang Patrick , Tintara Supisara , Chang Frederick , Phan Jennifer 
Published: September 2024

Background:
Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) are interventions used to relieve biliary obstruction. The utility of ERCP compared with PTBD is not fully understood from a utilization outcome standpoint. Our study compares readmission rates and hospitalization outcomes in ERCP and PTBD.

Methods:
Using the National Readmission Database (NRD) 2016 to 2020, we identified all patients with an ERCP or PTBD completed during admission. The study cohort was first analyzed by 3 weighted study arms including those admitted with cholangitis, biliary/pancreatic malignancy, and choledocholithiasis. Second, we analyzed the cohort by a 1:1, unweighted propensity match. The primary outcome was 30 day, 90 day, and 6 month readmission. Secondary outcomes were readmission/overall mortality, cost, and length of stay. Outcomes were analyzed using multivariate analysis.

Results:
A total of 621,735 admissions were identified associated with 589,796 ERCP and 31,939 PTBD. In the propensity matched cohort, PTBD had a higher readmission rate at 30 days (20.38% vs. 13.71% P<0.0001), 90 days (14.63% vs. 13.14%, P<0.0001) but lower rate at 6 months (8.50% vs. 9.67%, P=0.0003). Secondary outcomes included increased PTBD-associated hospital length of stay (9.01 d vs. 6.74 d, P<0.0001), hospitalization cost ($106,947.97 vs. $97,602.25, P<0.0001), and overall mortality (6.86% vs. 4.35%, P<0.0001). No major differences were found for mortality among readmissions at 30 days (7.19% vs. 6.88%, P=0.5382), 90 day (6.82% vs. 6.51%, P=0.5612), and 6 months (5.08% vs. 5.91%, P=0.1744).

Conclusions:
ERCP demonstrated superior results compared with PTBD for readmission rates, length of stay and overall mortality. For failed ERCP cases, emerging data for Endoscopic ultrasound guided-biliary drainage (EUS-BD) offers potential over PTBD and may provide additional options for the future in tertiary referral centers with experience.
Comparative Effectiveness of ERCP and EUS-Guided Techniques for “Primary Biliary Drainage” in Malignant Distal Biliary Obstruction
Authors: Nabi Zaheer , Samanta Jayanta , Dhar Jahnvi , Aggarwal Mona , Basha Jahangeer , Gahra Amrit , Golchha Aman , Crinò Stefano Francesco , Facciorusso Antonio , Lakhtakia Sundeep , Reddy D.Nageshwar 
Published: September 2024

Background and Objectives:
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a viable alternative in cases with failed ERCP transpapillary drainage (ERCP-TPD). This systematic review and meta-analysis aimed to compare the efficacy and safety of EUS-BD and ERCP-TPD for primary biliary drainage in patients with distal malignant biliary obstruction (DMBO).

Methods:
We searched Embase, PubMed, and Medline databases for studies comparing EUS-BD and ERCP-TPD in DMBO, from inception until September 2023. The primary endpoint was clinical success and secondary endpoints included technical success, procedure duration, and adverse events.

Results:
Eight studies (815 patients, 56.1% male) were included in this analysis. Indications for biliary drainage were pancreatic carcinoma (75.1%), followed by cholangiocarcinoma (10.1%). Clinical success was comparable between EUS-BD and ERCP-TPD groups (OR 1.34; 95% CI, 0.75-2.40; P=0.32). Technical success was similar between the 2 groups (OR 2.09; 95% CI, 0.83-5.25; P=0.12). There was a trend toward fewer adverse events in the EUS-BD group (OR 0.65; 95% CI, 0.40-1.07; P=0.09), with significantly lower odds of post-procedure pancreatitis (OR 0.17; 95% CI, 0.06-0.50; P=0.001).

Conclusion:
EUS-BD is comparable to ERCP for primary biliary drainage in DMBO patients with shorter procedural time and a significantly reduced risk of post-procedure pancreatitis.
Effects of different traditional Chinese exercise for knee osteoarthritis patients: A network meta-analysis of randomized controlled trials
Authors: Tao Tao , Shi Ming-Peng , Zhang Xian-Shuai , Tan Bo-Yang , Xiao Ya-Nan , Sun Feng-Ling , Li Shao-Jun , Li Zhen-Hua 
Published: September 2024

Background:
The most popular traditional Chinese exercise (TCE) techniques include Tai Chi, Yijinjing, Baduanjin, Wuqinxi, and Qigong. Exercise is advised as a primary treatment for knee osteoarthritis (KOA) according to clinical standards. According to several studies, TCE may be an effective way to help people with KOA manage their pain, stiffness, and physical function. Which TCE therapy is the most effective and whose particular usefulness is still debatable. The network meta-analysis (NMA) method is used in this study to evaluate and compare the effects of various TCE therapies on KOA patients.

Methods:
We will search PubMed, Embase, Scopus, Cochrane Library, Web of Science, the China National Knowledge Infrastructure, Wanfang, the Chinese Scientific Journal Database (VIP), and the China Biology Medical Literature Database (CBM) for randomized controlled trials reporting TCE therapy for KOA patients published before October 25, 2023. The Stata 16.0 program will compare the effectiveness of various TCE therapies on KOA patients using conventional pairwise and NMA.

Results:
The final 29 studies included 15 articles on Tai Chi, 7 articles on Baduanjin, 4 articles on Wuqinxi, and 3 articles on Yijinjing. Tai Chi was first for the effect sizes of VAS scores, WOMAC pain scores, and WOMAC available scores, while Baduanjin was ranked top for WOMAC stiffness scores. Research should continue to be conducted on the effect of Qigong on KOA intervention.

Conclusions:
This NMA will help determine the best TCE treatment for KOA and offer evidence-based bias for clinical decision-making.
Acupuncture for the treatment of anxiety and depression in patients with spinal cord injury: A study protocol for systematic review and meta analysis
Authors: Liu Ke , Gao Xiaoyong , Ou Liang , Tang Zuyu , Zhao Haoming , Hua Sheng , Xiong Yixiao , Zhang Le , Kuang Jianjun 
Published: September 2024

Background:
Spinal cord injury patients frequently suffer from anxiety and depression, which can seriously affect their quality of life and recovery. Acupuncture, as a traditional Chinese therapy, has been used to treat anxiety and depression for more than 2000 years. The aim is to evaluate the clinical efficacy of acupuncture in the treatment of anxiety and depression in spinal cord injury patients.

Methods:
The literature on acupuncture treating anxiety and depression in patients with spinal cord injury in PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Data, and Wanfang data were searched through computers from the establishment of the database to May 2024. In the study, the Cochrane tool for assessing the risk of bias was used and the meta-analyses were carried out using the software package Review Manager 5.4.

Results:
Ten trials were included in this systematic review, with 361 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that compared with conventional treatment, acupuncture combined with conventional treatment was beneficial in improving the total clinical efficacy (odds ratio = 3.55 [95% confidence interval {CI}: 1.34–9.37], P < .001). We found acupuncture-assisted therapy could be beneficial in improving the Modified Barthel Index (MD = 10.48 [95% CI: 4.78–16.19], P < .001) and reducing anxiety or depression scores (such as the Self-Rating Anxiety Scale [MD = −6.08 {95% CI: −6.85 to −5.30}, P < .001]; reducing the Self-Rating Depression Scale [MD = −6.01 {95% CI: −6.95 to −5.07}, P < .001]). In addition, the study showed that the application of acupuncture treatment could improve 5-hydroxytryptamine compared to control group (MD = 44.99 [95% CI: 40.04–49.95], P < .001) and reduce TNF-α compared to control group (MD = −7.78 [95% CI: −8.73 to −6.83], P < .001).

Conclusion:
Acupuncture could be used as a complementary therapy to reduce anxiety and depression in spinal cord injury patients. Further original and high-quality research is needed to verify the conclusions of this study.
Clinical study on the establishment of radio-cephalic autogenous arteriovenous fistulas in small blood vessels by multi-segment balloon dilation technique
Authors: Kang Qiyu , Hao Yajie , Zhang Huifeng , Yu Weimin , Huang Xiaoguang 
Published: September 2024

Background:
To investigate the effect of dilating small blood vessels using a balloon dilation (BD) technique on the occurrence of radio-cephalic autogenous arteriovenous fistulas in terms of patency, blood flow, and vein diameter (VD).

Methods:
The subjects included in this study were all patients with chronic renal failure and required radio-cephalic arteriovenous fistula surgery for the first time and had not received dialysis before. Patients with VDs <2 mm were included as study subjects. They were either assigned treatment using a BD group or a control group that received hydrostatic dilation. The differences between the 2 groups were analyzed in terms of patency, blood flow, and VD.

Results:
A total of 22 patients were enrolled in the balloon dilatation group and 20 patients in the control group. The diameters of cephalic veins (mm) of the experimental and control group were compared at various time points: immediately postoperation, 2.89 ± 0.42 versus 1.99 ± 0.28 (P < .001); 1 week later, 3.16 ± 0.59 versus 2.66 ± 0.60 (P = .022); 1 month later, 3.76 ± 0.91 versus 3.18 ± 0.83 (P = .087); and 2 months later, 4.08 ± 1.15 versus 3.38 ± 1.13 (P = .169). Brachial artery flows (mL/min) of the 2 groups at various time points were given as follows: immediately postoperation, 413.49 ± 145.09 versus 235.61 ± 87.77 (P < .001); 1 week later, 563.26 ± 206.83 versus 331.30 ± 126.78 (P < .001); 1 month later, 679.34 ± 218.56 versus 376.79 ± 156.25 (P < .001); and 2 months later, 736.31 ± 202.61 versus 394.60 ± 161.96 (P < .001). The primary patency at 1 year for the experimental group was 61.9% compared to 11.1% for the control group (P = .045). Similarly, the secondary patency rates at 1 year were 90.5% for the experimental group and 55.6% for the control group (P = .030). The results showed that the functional primary patency rate within 1 year was 57.1% versus 16.7% (P = .032), and the functional secondary patency rate within 1 year was 85.7% versus 50.0% (P = .038).

Conclusion subsections:
BD has obvious advantages over hydrostatic dilation for chronic renal failure patients with small veins in establishing arteriovenous fistula in terms of patency and blood flow.
Effect of targeted temperature management on systemic inflammatory responses after out-of-hospital cardiac arrest: A prospective cohort study
Authors: Chen Dalong , Lin Yukai , Ko Poyen , Lin Jenjyh , Huang Chihyang , Wang Gueijane , Chang Kuan-Cheng 
Published: September 2024

Background:
Interleukin (IL)-6 is a major inflammatory cytokine that predicts mortality after out-of-hospital cardiac arrest (OHCA). Targeted temperature management (TTM) is associated with improved all-cause mortality in patients with OHCA. However, the effect of TTM on IL-6 production remains unclear. This study investigated whether TTM has additional anti-inflammatory effects after OHCA.

Methods:
This prospective cohort study included a total of 141 hospitalized patients with OHCA who were treated between January 2015 and June 2023. The study was conducted in the intensive care unit of China Medical University Hospital, Taichung. Postcardiac arrest care included TTM or the control approach (no TTM). The primary outcomes included the 90-day mortality rate and neurologic outcomes after OHCA. Differences between the TTM and control groups were examined using Student t test, chi-square test, and Kaplan–Meier survival curve analysis. Multivariate analysis of variance model was used to examine interaction effects.

Results:
Plasma IL-6 and IL-6/soluble IL-6 receptor complex levels were measured at 6 and 24 hours after resuscitation. IL-6 and IL-6/soluble IL-6 receptor complex production was lower in the TTM group than in the control group (−50.0% vs +136.7%, P < .001; +26.3% vs +102.40%, P < .001, respectively). In addition, the 90-day mortality rate and poor neurologic outcomes were lower in the TTM group than in the control group (36.8% vs 63.0%, relative risk 0.39, 95% confidence interval 0.24–0.64, P < .001; 65.5% vs 81.5%, relative risk 0.80, 95% confidence interval 0.66–0.98, P = .04).

Conclusion:
TTM improves both the mortality rate and neurologic outcomes in patients resuscitated from OHCA, possibly by reducing IL-6-induced proinflammatory responses.
A discussion on a suspected case with EGPA after maintenance hemodialysis for 5 years and related literature analysis: A case report
Authors: Zhao Lingshan , Zhang Chenli 
Published: September 2024

Rationale:
Pathological featuring by necrotizing granulomatous inflammation of peripheral blood and tissues with increased eosinophils infiltrating small and medium vessels, eosinophilic granulomatosis with polyangiitis (EGPA), a family of rare antineutrophil cytoplasmic antibody (ANCA) associated with systemic vasculitis. With low morbidity, diverse clinical manifestations, and difficult early diagnosis, the majority of patients are confirmed after multiple organ damages, thus missing the best treatment time and having a poor prognosis. About 25% to 30% of EGPA cases have been reported to suffer from the renal disease, and there are few studies on EGPA complicated with kidney damage, most of them on ANCA-positive patients. Generally, the initial diagnosis of EGPA on maintenance hemodialysis is even rare. We report a case of a patient with maintenance hemodialysis for 5 years and then was diagnosed with EGPA.

Patient concerns:
The female patient, 54-year-old, having maintenance hemodialysis for 5 years consecutively, was hospitalized for the recurring rash in the past 3 years and then exacerbation in the last 2 months. With the previous history of bronchial asthma having attacked frequently recently, it could be observed from peripheral blood that the eosinophils increased, from the cardiac color ultrasound that it was prone to eosinophilic endocarditis, from 5 tests for vasculitis that P-ANCA and MPO-AB were positive.

Diagnoses:
The patient’s onset is renal dysfunction, with maintenance hemodialysis for 5 years, recurrent lung infections, combined with eye lesions, scattered skin rashes, P-ANCA positive, MPO-AB positive, asthma present, eosinophil absolute value 1.60 × 109/L, total score >6 points, diagnosis considering EGPA.

Interventions:
Due to multiple organ damage, the patient received treatment with a combination of steroids and cyclophosphamide.

Outcomes:
After 2 days, the patient’s rash significantly darkened compared to before, wheezing improved, and eosinophils returned to normal levels.

Lessons:
The ANCA test shall be put on the high agenda for patients presenting with kidney failure at first. Meanwhile, the neglected immune monitoring for patients with dialysis tells us that it is of great significance for this kind of patient to have immune monitoring in the early diagnosis of EGPA.
A case report of labyrinthine infarction: a ‘central’ cause of vertigo with ‘peripheral’ presentation
Authors: El Bouhmadi Khadija , Darouich Safa , Youbi Myriam , Anajar Said , Essaadi Mustapha , Snoussi Khalid , Hajjij Amal 
Published: September 2024

Introduction and Importance:
The inner ear is considered an ‘end organ’ since its vascular supply comes from one terminal artery, making the labyrinth especially vulnerable to ischemia, causing loss of auditory and vestibular function with variable clinical patterns according to the different arterial distribution in the inner ear and which vascular branches are concerned by the embolism.

Case Presentation:
We report a misleading case of central vascular vertigo caused by a labyrinthine infarction resulting from an embolic vertebral artery, which manifested in a typical peripheral clinical presentation mimicking a vestibular neuritis.

Clinical Discussion:
Vertigo is the result of asymmetrical responses from the vestibules of both ears resulting from any disruption along the complex vestibular pathways, whether peripheral or central. The recognition of the origin of an acute isolated vertigo is fundamental since the therapeutic strategy and prognosis differ, but it can be challenging in the absence of neurological signs, especially when the clinical pattern involves only the vestibular part of the labyrinth.

Conclusion:
The diagnosis strategy should consider the patient vascular risk factors and the clinical bedside tests with diffusion-weighted magnetic resonance imaging (MRI). Then, the management of these patients requires pluridisciplinary cooperation with early vestibular rehabilitation.
Epigenetics of Dietary Phytochemicals in Cancer Prevention
Authors: Chou PoChung Jordan , Peter Rebecca Mary , Shannar Ahmad , Pan Yuxin , Dave Parv Dushyant , Xu Jiawei , Sarwar Md Shahid , Kong Ah-Ng 
Published: September 2024

Abstract
Cancer development takes 10 to 50 years, and epigenetics plays an important role. Recent evidence suggests that ~80% of human cancers are linked to environmental factors impinging upon genetics/epigenetics. Because advanced metastasized cancers are resistant to radiation/chemotherapeutic drugs, cancer prevention by relatively nontoxic “epigenetic modifiers” will be logical. Many dietary phytochemicals possess powerful antioxidant and anti-inflammatory properties that are hallmarks of cancer prevention. Dietary phytochemicals can regulate gene expression of the cellular genome via epigenetic mechanisms. In this review, we will summarize preclinical studies that demonstrate epigenetic mechanisms of dietary phytochemicals in skin, colorectal, and prostate cancer prevention. Key examples of the importance of epigenetic regulation in carcinogenesis include hypermethylation of the NRF2 promoter region in cancer cells, resulting in inhibition of NRF2-ARE signaling. Many dietary phytochemicals demethylate NRF2 promoter region and restore NRF2 signaling. Phytochemicals can also inhibit inflammatory responses via hypermethylation of inflammation-relevant genes to block gene expression. Altogether, dietary phytochemicals are excellent candidates for cancer prevention due to their low toxicity, potent antioxidant and anti-inflammatory properties, and powerful epigenetic effects in reversing procarcinogenic events.
Advancements in Understanding and Preventing Obesity-Related Colon Cancer
Authors: Shieh Christine , Thompson Henry J. , McLaughlin Eric , Chiang Chien-Wei , Hussan Hisham 
Published: September 2024

Abstract
Obesity and colorectal cancer are global public health issues, with the prevalence of both conditions increasing over the last 4 decades. In the United States alone, the prevalence of obesity is greater than 40%, and this percentage is projected to increase past 50% by 2030. This review focuses on understanding the association between obesity and the risk of colorectal cancer while also highlighting hypotheses about molecular mechanisms underlying the link between these disease processes. We also consider whether those linkages can be disrupted via weight loss therapies, including lifestyle modifications, pharmacotherapy, bariatric surgery, and endobariatrics.
Tree diversity reduces pathogen damage in temperate forests: a systematic review and meta-analysis
Authors: Field Elsa , Hector Andrew , Barsoum Nadia , Koricheva Julia 
Published: September 2024

AbstractDiversifying planted forests to reduce the risks associated with large scale disturbances, such as pathogens, is a major aim of sustainable forest management. Previous meta-analyses have shown that insect pest damage is lower in mixed forest stands compared to monocultures, but the same has not been shown for pathogens. Here, we provide the first systematic review and meta-analysis specifically testing the effects of tree species diversity on pathogen damage. Relevant studies were retrieved using bibliographic databases and internet searches, as well as previously unpublished data sets contributed by stakeholders. We found that more diverse forest stands overall had significantly lower pathogen damage, and that this result was most pronounced in temperate forests for which the most studies were available. Although in some cases tree diversity had a strong effect, this was not universal and was influenced neither by pathogen specialism, nor by the presence of alternative hosts in stands. Instead, we found that tree neighbour identity rather than species richness emerged as a crucial variable impacting pathogen damage in mixed stands. Neighbour identity effects reported in studies were far-ranging, including impacts on the microclimate of stands. Future work should focus on mechanistic explanations that could underpin neighbour identity effects in mixed forests. We suggest the use of the disease triangle as a tool for considering the multiple factors that can influence pathogen damage in mixed forest stands.
Fungus-infectedMeiogyneflowers offer a brood site for beetle pollinators in a tripartite nursery pollination system
Authors: Liu Ming-Fai , Chen Junhao , Xue Bine , Wang Rui-Jiang , Saunders Richard M. K. 
Published: September 2024

AbstractFungi are widely known for their pathological impact on flowers, but some play a beneficial role in pollination. We report a case of tripartite pollination system in the flowering plantMeiogyne hainanensis(Annonaceae) in Hainan, China. The flowers emit a fruity scent composed of a mixture of mostly sesquiterpenes and aliphatic esters, attracting the primary beetle pollinatorsParaphloeostibasp. (Staphylinidae) andMimemodessp. (Monotomidae). The pollinators utilise the floral chamber as a mating ground and oviposit onto the adaxial corrugations of the inner petals. After the end of anthesis, extensive growth of filamentous fungi was observed to be restricted on these corrugated tissues. Upon hatching, theParaphloeostibaandMimemodeslarvae consumed the fungal mycelia. ITS2 metabarcoding analysis reveals that the diet of the larvae consists of similar fungal taxa as those found on the inner petals. Both were primarily composed of ascomycete fungi such asFusarium,PenicilliumandCladosporiumspecies. The flower has an unusually long post-anthetic phase that lasts at least 21 days and up to 2 months, during which the fungus-infested petals remain arboreal, offering suitable microclimate and shelter for the broods. This is the second reported angiosperm genus that exhibits tripartite brood-site pollination in which filamentous fungi are an essential mutualistic partner.