bluuebunny/crossref_metadata_2025_split huggingface dataset:
Omadacycline for the treatment of severe pneumonia caused by Chlamydia psittaci complicated with acute respiratory distress syndrome during the COVID-19 pandemic
Authors: Wang Dao-Xin , Xiao Ling-Xi , Deng Xin-Yu , Deng Wang 
Published: January 2024

IntroductionChlamydia psittaci infection in humans is a rare cause that mainly present as community-acquired pneumonia. Severe Chlamydia psittaci pneumonia can lead to acute respiratory distress syndrome (ARDS), septic shock, or multiple organ dysfunction with a mortality rate of 15%–20% before accurate diagnosis and targeted treatment. Metagenomic next-generation sequencing (mNGS) has an advantage in achieving early diagnosis. In the study, omadacycline implementation was described to provide a better understanding of effectiveness in severe psittacosis pneumonia with ARDS.MethodsSixteen patients with severe psittacosis pneumonia with ARDS were selected between September 2021 and October 2022. They were diagnosed using mNGS and treated with omadacycline. Retrospective analysis of clinical manifestations, laboratory data, disease progression, diagnostic tool, treatment, and prognosis was summarized.ResultsCommon symptoms included fever, dyspnea, and cough. All patients developed ARDS, accompanied by septic shock (43.7%) and pulmonary embolism (43.7%). Laboratory data showed normal leucocytes, increased creatine kinase isoenzyme, and decreased albumin with liver dysfunction in most patients. All patients had increased neutrophils, C-reactive protein, procalcitonin, and D-dimer with decreased lymphocytes. Airspace consolidation, ground glass opacity, and pleural effusion were found on chest CT. mNGS results were obtained in 24–48 h to identify the diagnosis of Chlamydia psittacosis. All patients received mechanical ventilation with omadacycline treatment. Fourteen patients experienced complete recovery, while the other two patients died from multidrug-resistant bacterial infection and renal failure.ConclusionmNGS has a significant value in the diagnosis of Chlamydia psittaci infection. Timely treatment of omadacycline can improve prognosis and provide a promising new option for the treatment of severe Chlamydia psittaci pneumonia with ARDS.
Knowledge and awareness of nicotine, nicotine replacement therapy, and electronic cigarettes among general practitioners with a special interest in respiratory medicine in China
Authors: Zhong Qian , An Kang , Wu Zengxiang , Zhang Haijun , Li Shengxi , Zhang Lin , Li Caizheng , Li Heting , Zhuo Ga Qi Mei , Yang Zong De Ji , An Zhenmei 
Published: January 2024

ObjectivesThis study aimed to assess the knowledge and awareness of nicotine, nicotine replacement therapy (NRT), and electronic cigarettes (e-cigarettes) among general practitioners with a special interest (GPwSIs) in respiratory medicine.MethodsA cross-sectional study was conducted from October 2021 to February 2022. Knowledge and awareness were compared among smokers and non-smokers, as well as different age and gender groups.ResultsThe study consisted of 102 GPwSIs from 21 cities in Sichuan Province, China. Most respondents would recommend NRT for long-term use. Only a few believed that e-cigarettes are an effective means of smoking cessation and 71.6% would not recommend e-cigarettes as a substitute for cigarettes to their patients. Additionally, the majority did not regularly provide extensive help to assist patients in quitting smoking and needed smoking cessation counseling training.ConclusionGPwSIs in respiratory medicine in China could have a relatively low level of knowledge and awareness regarding nicotine, NRT, and e-cigarettes. The study highlights the need for smoking cessation training among GPwSIs to improve their knowledge and provide better assistance to patients who want to quit smoking.
Blood–brain barrier breakdown, central nervous system cell damage, and infiltrated T cells as major adverse effects in CAR-T-related deaths: a literature review
Authors: Del Duca Fabio , Napoletano Gabriele , Volonnino Gianpietro , Maiese Aniello , La Russa Raffaele , Di Paolo Marco , De Matteis Serena , Frati Paola , Bonafè Massimiliano , Fineschi Vittorio 
Published: January 2024

BackgroundCAR-T-related deaths observed worldwide are rare. The underlying pathogenetic mechanisms are the subject of study, as are the findings that enable diagnosis. A systematic literature search of the PubMed database and a critical review of the collected studies were conducted from the inception of this database until January 2023. The aim of the study is to determine when death is related to CAR-T cell therapy and to develop a shareable diagnostic algorithm.MethodsThe database was searched by combining and meshing the terms (“CAR-t” OR “CART”) AND (“Pathology” OR “Histology” OR “Histological” OR “Autopsy”) AND (“Heart” OR “Cardiac” OR “Nervous System” OR “Kidney” OR “Liver”) with 34 results and also the terms: [(Lethal effect) OR (Death)] AND (CAR-T therapy) with 52 results in titles, abstracts, and keywords [all fields]. One hundred scientific articles were examined, 14 of which were additional records identified through other sources. Fifteen records were included in the review.ResultsNeuronal death, neuronal edema, perivascular edema, perivascular and intraparenchymal hemorrhagic extravasation, as well as perivascular plasmatodendrosis, have been observed in cases with fatal cerebral edema. A cross-reactivity of CAR-T cells in cases of fatal encephalopathy can be hypothesized when, in addition to the increased vascular permeability, there is also a perivascular lymphocyte infiltrate, which appears to be a common factor among most authors.ConclusionMost CAR-T-related deaths are associated with blood–brain barrier breakdown, central nervous system cell damage, and infiltrated T cells. Further autopsies and microscopic investigations would shed more light on the lethal toxicity related to CAR-T cells. A differential diagnosis of CAR-T-related death is crucial to identifying adverse events. In this article, we propose an algorithm that could facilitate the comparison of findings through a systematic approach. Despite toxicity cases, CAR-T therapy continues to stand out as the most innovative treatment within the field of oncology, and emerging strategies hold the promise of delivering safer therapies in future.
Artificial intelligence for skin cancer detection and classification for clinical environment: a systematic review
Authors: Furriel Brunna C. R. S. , Oliveira Bruno D. , Prôa Renata , Paiva Joselisa Q. , Loureiro Rafael M. , Calixto Wesley P. , Reis Márcio R. C. , Giavina-Bianchi Mara 
Published: January 2024

BackgroundSkin cancer is one of the most common forms worldwide, with a significant increase in incidence over the last few decades. Early and accurate detection of this type of cancer can result in better prognoses and less invasive treatments for patients. With advances in Artificial Intelligence (AI), tools have emerged that can facilitate diagnosis and classify dermatological images, complementing traditional clinical assessments and being applicable where there is a shortage of specialists. Its adoption requires analysis of efficacy, safety, and ethical considerations, as well as considering the genetic and ethnic diversity of patients.ObjectiveThe systematic review aims to examine research on the detection, classification, and assessment of skin cancer images in clinical settings.MethodsWe conducted a systematic literature search on PubMed, Scopus, Embase, and Web of Science, encompassing studies published until April 4th, 2023. Study selection, data extraction, and critical appraisal were carried out by two independent reviewers. Results were subsequently presented through a narrative synthesis.ResultsThrough the search, 760 studies were identified in four databases, from which only 18 studies were selected, focusing on developing, implementing, and validating systems to detect, diagnose, and classify skin cancer in clinical settings. This review covers descriptive analysis, data scenarios, data processing and techniques, study results and perspectives, and physician diversity, accessibility, and participation.ConclusionThe application of artificial intelligence in dermatology has the potential to revolutionize early detection of skin cancer. However, it is imperative to validate and collaborate with healthcare professionals to ensure its clinical effectiveness and safety.
Enhancing undergraduate research talents: the role of tutors in dental basic research education
Authors: Miao Xiaoyu , Chen Xuanyu , Li Jiayi , Wu Zhe , Guo Lvhua , Luo Siqi , Luo Tao , Yang Xuesong 
Published: January 2024

PurposeThis study endeavors to investigate ways to optimize the role of teachers in undergraduate dental basic research education (UDBRE) with the aim of nurturing the research potential of undergraduate students.MethodsWe conducted a cross-sectional study among medical undergraduates enrolled at the School of Stomatology, Guangzhou Medical University. Descriptive statistics were employed to comprehensively analyze UDBRE’s fundamental aspects. Kendall rank correlation analysis was performed to evaluate the relationship between the quality of feedback provided by tutors to undergraduates and the students’ scientific research abilities. Additionally, multivariate logistic regression analysis was employed to uncover the factors influencing the effectiveness of UDBRE.ResultsA total of 168 medical students were surveyed with a valid response rate of 93.85%. The effectiveness of UDBRE was demonstrated by undergraduates’ self-rated research abilities, active participation in scientific research projects, and a certain amount of academic outputs. Significant and positive correlations (𝓣b&gt; 0.5, p &lt; 0.001) were identified between the tutor-undergraduate feedback quality and students’ self-rated scores for scientific research abilities. These abilities included developing scientific questions, designing research projects, retrieving and reading literature, academic writing, experiment operation, and analyzing and evaluating experimental results. Positive effects on students’ academic performance (p &lt; 0.05) were observed when higher-quality feedback, an authoritative tutoring style and tutors with middle-career experience were present.ConclusionThis study underscores the pivotal role of UDBRE in fostering the scientific research aptitude of medical undergraduates. It emphasizes the constructive influence of tutor-undergraduate feedback, authoritative teaching styles, providing valuable insights for establishing an effective mentorship framework.
Relationship between serum sodium level and sepsis-induced coagulopathy
Authors: Han Yanyu , Duan Jianfeng , Chen Ming , Huang Shijie , Zhang Beiyuan , Wang Yan , Liu Jiali , Li Xiaoyao , Yu Wenkui 
Published: January 2024

PurposeA discussion about the correlation between the level of serum sodium and sepsis-induced coagulopathy (SIC).Materials and methodsA retrospective analysis was conducted on sepsis patients who were admitted to the Intensive Care Unit (ICU) of Nanjing Drum Tower Hospital from January 2021 to December 2022. Based on the presence of coagulation disorders, the patients were divided into two groups: sepsis-induced coagulopathy (SIC) and non-sepsis-induced coagulopathy (non-SIC) groups. We recorded demographic characteristics and laboratory indicators at the time of ICU admission, and analyzed relationship between serum sodium level and SIC.ResultsOne hundred and twenty-five patients with sepsis were enrolled, among which, the SIC and the non-SIC groups included 62 and 63 patients, respectively. Compared to patients in the non-SIC group, the level of serum sodium of those in the SIC was significantly higher (p &lt; 0.001). Multi-factor logistic regression showed serum sodium level was independently associated with SIC (or = 1.127, p = 0.001). Pearson’s correlation analysis indicated that the higher the serum sodium level, the significantly higher the SIC score was (r = 0.373, p &lt; 0.001). Additionally, the mortality rate of patients with sepsis in the ICU were significantly correlated with increased serum sodium levels (p = 0.014).ConclusionAn increase in serum sodium level was independently associated with an increased occurrence of SIC and also associated with the poor prognosis for patients with sepsis.
Randomized controlled trial on healthy volunteers of pharmacokinetic and antimicrobial activity of a novel hydrogel-containing chlorhexidine dressing to prevent catheter-related bloodstream infection
Authors: Masferrer Emili , Riera-Rodríguez Laura , Farré-Alins Víctor , Vilà de Muga Sandra , Arroyo-Muñoz Francisco-Javier , González-Caro María-Dolores 
Published: January 2024

IntroductionCatheter-related blood stream infection (CRBSI) is one of the most relevant complications associated to the use of intravascular catheters. In this context, chlorhexidine gluconate (CHG) releasing dressings have been developed to reduce the catheter colonization rate and the risk of infection. The aim of this study is to analyze the release rate of CHG and the antimicrobial activity of a novel CHG-releasing dressing, Oper film® protect CHG, and to compare these parameters to those of the dressing Tegaderm™ CHG in healthy volunteers.MethodsThe study was performed in a cohort of 25 healthy volunteers. Two commercially available chlorhexidine-containing dressings were evaluated and compared in this study, Oper film® protect CHG and Tegaderm™ CHG. The release of CHG and the antimicrobial capacity was determined for one week.ResultsHPLC analysis revealed that both dressings have an equivalent CHG release to the skin 2 days (Oper film® protect CHG, 321 μg/cm2; Tegaderm™ CHG, 279 μg/cm2) and 7 days (Oper film® protect CHG, 456 μg/cm2; Tegaderm™ CHG, 381 μg/cm2) after the placement of the products in the non-disinfected back of the subjects. On the other hand, Oper film® protect CHG and Tegaderm™ CHG similarly reduced colony forming units (CFU) in cultures obtained from the skin under the CHG-containing hydrogel compared to control cultures at both 2 days (control, 3.34 log10 cfu/cm2; Oper film® protect CHG, 0.64 log10 cfu/cm2; Tegaderm™ CHG, 0.7 log10 cfu/cm2) and 7 days (control, 3.95 log10 cfu/cm2; Oper film® protect CHG, 0.11 log10 cfu/cm2; Tegaderm™ CHG, 1 log10 cfu/cm2).DiscussionData confirm that the recent commercially available dressing Oper film® protect CHG maintains the release of CHG and the antimicrobial activity during at least 7 days, and possesses equivalent drug release and antimicrobial action to Tegaderm™ CHG.
Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study
Authors: Liu Yishan , Jiang Jinlong , Yuan Hao , Wang Luhao , Song Wenliang , Pei Fei , Si Xiang , Miao Shumin , Chen Minying , Gu Bin , Guan Xiangdong , Wu Jianfeng 
Published: January 2024

BackgroundMyoglobin is an important biomarker for monitoring critically ill patients. However, the relationship between its dynamic changes and prognosis remains unclear.MethodsWe retrospectively enrolled 11,218 critically ill patients from a general and surgical intensive care unit (ICU) of a tertiary hospital between June 2016 and May 2020. Patients with acute cardiovascular events, cardiac and major vascular surgeries, and rhabdomyolysis were excluded. To investigate the early myoglobin distribution, the critically ill patients were stratified according to the highest myoglobin level within 48 h after ICU admission. Based on this, the critically ill patients with more than three measurements within 1 week after ICU admission were included, and latent class trajectory modeling was used to classify the patients. The characteristics and outcomes were compared among groups. Sensitivity analysis was performed to exclude patients who had died within 72 h after ICU admission. Restricted mean survival time regression model based on pseudo values was used to determine the 28-day relative changes in survival time among latent classes. The primary outcome was evaluated with comparison of in-hospital mortality among each Trajectory group, and the secondary outcome was 28-day mortality.ResultsOf 6,872 critically ill patients, 3,886 (56.5%) had an elevated myoglobin level (≥150 ng/mL) at admission to ICU, and the in-hospital mortality significantly increased when myoglobin level exceeded 1,000 μg/mL. In LCTM, 2,448 patients were unsupervisedly divided into four groups, including the steady group (n = 1,606, 65.6%), the gradually decreasing group (n = 523, 21.4%), the slowly rising group (n = 272, 11.1%), and the rapidly rising group (n = 47, 1.9%). The rapidly rising group had the largest proportion of sepsis (59.6%), the highest median Sequential Organ Failure Assessment (SOFA) score (10), and the highest in-hospital mortality (74.5%). Sensitivity analysis confirmed that 98.2% of the patients were classified into the same group as in the original model. Compared with the steady group, the rapidly rising group and the slowly rising group were significantly related to the reduction in 28-day survival time (β = −12.08; 95% CI −15.30 to −8.86; β = −4.25, 95% CI −5.54 to −2.97, respectively).ConclusionElevated myoglobin level is common in critically ill patients admitted to the ICU. Dynamic monitoring of myoglobin levels offers benefit for the prognosis assessment of critically ill patients.
Development and validation of a novel detection method for Rickettsia rickettsii using a loop-mediated isothermal amplification assay
Authors: Carvajal-Gamez Bertha I. , Olguín-Barrera Aída , Tinoco-Gracia Luis , Gordillo-Perez Guadalupe , Dzul-Rosado Karla , Aguilar-Tipacamú Gabriela , Hidalgo-Ruiz Mario , Mosqueda Juan 
Published: January 2024

IntroductionRickettsia rickettsii is an obligate, intracellular pathogen and the causative agent of Rocky Mountain spotted fever (RMSF). RMSF is an important zoonotic disease due to its high fatal outcome in humans. The difficulty of clinical diagnosis due to the low sensitivity and specificity of current diagnostic methods are a principal setback. We reported the development of a new method for the detection of R. rickettsii in human and tick DNA samples using loop-mediated isothermal amplification (LAMP), as well as the validation of the LAMP test for R. rickettsii in field samples of infected ticks and humans, determining the diagnostic sensitivity and specificity, as well as the reproducibility of the test.MethodsThis technique uses hydroxy naphthol blue (HNB) as an indicator of the formation of magnesium pyrophosphate, a marker for the presence of DNA. Here, we used a putative R. rickettsii gene as a target for three pairs of primers that specifically amplify R. rickettsii DNA by hairpin-based isothermal amplification technique (LAMP).Results and discussionThe sensitivity of the assay was ~1.6–3 pg, which is 10 times more sensitive than PCR. To determine the diagnostics specificity and sensitivity, 103 human DNA samples and 30 tick DNA samples were evaluated. For the human samples, a sensitivity for HNB of 93%, a specificity of 70% and a k of 0.53 were obtained. For electrophoresis the sensitivity was 97% with a specificity of 58% and a k of 0.42. For tick samples, a sensitivity of 80% was obtained, a specificity of 93% for HNB and for electrophoresis the sensitivity and specificity were 87%. The k for both was 0.73. The degree of concordance between HNB and electrophoresis was 0.82 for humans and for ticks, it was 0.87. The result is obtained in shorter time, compared to a PCR protocol, and is visually interpreted by the color change. Therefore, this method could be a reliable tool for the early diagnosis of rickettsiosis.
Diversity of Trichoderma species associated with green mold contaminating substrates of Lentinula edodes and their interaction
Authors: Cao Zi-Jian , Zhao Juan , Liu Yu , Wang Shou-Xian , Zheng Su-Yue , Qin Wen-Tao 
Published: January 2024

IntroductionThe contamination of Trichoderma species causing green mold in substrates poses a significant obstacle to the global production of Lentinula edodes, adversely impacting both yield and quality of fruiting bodies. However, the diversity of Trichoderma species in the contaminated substrates of L. edodes (CSL) in China is not clear. The purpose of this study was to assess the biodiversity of Trichoderma species in CSL, and their interactions with L. edodes.MethodsA comprehensive two-year investigation of the biodiversity of Trichoderma species in CSL was conducted with 150 samples collected from four provinces of China. Trichoderma strains were isolated and identified based on integrated studies of phenotypic and molecular data. Resistance of L. edodes to the dominant Trichoderma species was evaluated in dual culture in vitro.ResultsA total of 90 isolates were obtained and identified as 14 different Trichoderma species, including six new species named as Trichoderma caespitosus, T. macrochlamydospora, T. notatum, T. pingquanense, T. subvermifimicola, and T. tongzhouense, among which, T. atroviride, T. macrochlamydospora and T. subvermifimicola were identified as dominant species in the CSL. Meanwhile, three known species, namely, T. auriculariae, T. paraviridescens and T. subviride were isolated from CSL for the first time in the world, and T. paratroviride was firstly reported to be associated with L. edodes in China. Notebly, the in vitro evaluation of L. edodes resistance to dominant Trichoderma species showed strains of L. edodes generally possess poor resistance to Trichoderma contamination with L. edodes strain SX8 relatively higher resistant.DiscussionThis study systematically investigated the diversity of Trichoderma species in the contaminated substrate of L. edodes, and a total of 31 species so far have been reported, indicating that green mold contaminated substrates of edible fungi were undoubtedly a biodiversity hotspot of Trichoderma species. Results in this study will provide deeper insight into the genus Trichoderma and lay a strong foundation for scientific management of the Trichoderma contamination in L. edodes cultivation.
Biofilm formation is a risk factor for late and delayed complications of filler injection
Authors: Zhang You-liang , Sun Zhong-sheng , Hong Wei-jin , Chen Yin , Zhou Yang-fan , Luo Sheng-kang 
Published: January 2024

IntroductionBiofilm formation is a major cause of delayed-graft complications. Similarly to implants, dermal fillers carry the risk of biofilm formation, which can lead to the development of nodules, chronic inflammatory reactions, abscesses and other complications. In this study, we investigated the late or delayed complications associated with biofilm formation on dermal fillers.MethodsIn this retrospective analysis, we analyzed all cases of complications caused by filler injections at a single center between January 2017 and December 2022, the majority of which comprised nodule formation and chronic persistent inflammatory reactions. The risk of biofilm formation with fillers was summarized and analyzed based on the results of bacterial culture and pathological examination.ResultsSixty-one patients were enrolled, including 42 cases of nodule formation, 15 of chronic inflammatory reactions, and 4 of active infection. Bacterial culture of the tissue samples obtained from seven patients after surgical treatment were positive, and comprised four cases of Staphylococcus aureus, one case of Staphylococcus epidermidis, one case of Staphylococcus saprophyticus and one case of Mycobacterium abscessus. The corresponding histopathological results indicated extensive mononuclear lymphocyte infiltration, with a giant cell reaction in the fibrous connective tissue.ConclusionThe results of this study suggest that biofilm formation is a significant risk factor for late and delayed complications following filler injection, and is caused by the contamination of resident bacteria and recessive infection at the injection site.