bluuebunny/crossref_metadata_2025_split huggingface dataset:
Black hairy tongue treated with traditional Chinese medicine: A case report
Authors: Kuo Po-Yuan , Chen Ping-Ho , Wu Shan-Hong 
Published: February 2024

Rationale:
Black hairy tongue (BHT) is a rare condition that is conventionally managed by discontinuing associated medications or habits and practicing good oral hygiene, including tongue brushing. Previous studies have indicated that black tongue coating is often associated with gastrointestinal discomfort, which traditional Chinese medicine (TCM) could be a potentially effective option for treating this condition with minimal side effects. We present a case of BHT diagnosed and treated within 2 weeks by using TCM methods.

Patient concerns:
A 73-year-old woman presented with a chief concern of a black tongue that had persisted for 2 weeks and was accompanied by thirst and diarrhea. These symptoms were initially observed during her hospitalization for the treatment of staghorn calculi, xanthogranulomatous pyelonephritis, and urosepsis. Using the “four diagnostic methods” of TCM, we observed that her tongue had a thick black coating surrounded by a thick white coating; her tongue was of medium size with tooth marks, and its body color was light red.

Diagnoses, interventions, and outcomes:
On the basis of TCM theory, we made a clinical diagnosis of BHT and “spleen Qi deficiency with turbid dampness,” which may have been caused by the antibiotic treatment during hospitalization. Subsequently, we administered a Chinese herbal medicine (CHM) formula comprising a combination of Wu-Ling-San (五苓散) and a modification of Da-Yuan-Yin (達原飲). After 2 weeks of CHM treatment, the patient’s BHT was nearly eliminated, and the thick white coating and the corresponding symptoms were ameliorated. After 4 weeks of CHM treatment, the BHT was completely resolved.

Lesson and conclusion:
We present a case of BHT, a benign condition that may be caused by antibiotics. The literature does not contain reports on TCM-based diagnosis and treatment strategies for BHT. Using the 4 diagnostic methods of TCM, we observed that BHT was associated with gastrointestinal symptoms, which is consistent with the TCM theory. Moreover, CHM treatment rapidly relieved BHT and related symptoms without adverse events.
The first Vietnamese patient who presented late onset of pantothenate kinase-associated neurodegeneration diagnosed by whole exome sequencing: A case report
Authors: Tran Van Khanh , Vu Chi Dung , Tran Hai Anh , Lien Nguyen Thi Kim , Tung Nguyen Van , Lan Nguyen Ngoc , Tran Huy Thinh , Hoang Nguyen Huy 
Published: February 2024

Rationale:
Pantothenate kinase-associated neurodegeneration (PKAN), also called Hallervorden-Spatz syndrome, is a rare autosomal recessive disease associated with brain iron accumulation and characterized by progressive dystonia, dementia, and dysarthria symptoms. PKAN, caused by a defective pantothenate kinase 2 (PANK2) gene, is the most common neurodegeneration with a brain iron accumulation (NBIA) group. The “eye of the tiger” sign in the magnetic resonance imaging demonstrated a bilateral hyperintense signal in the basal ganglia region on T2-weighted images, which is a characteristic feature of the diagnosis. PKAN is classified into 2 main types. The early-onset type (classic type) with rapid progression is characterized by symptoms of gait impairment and dystonia leading to loss of ambulation in early childhood. In the later-onset type (atypical type), slow progression usually takes place in the second decade of life with symptoms of neurodegeneration, dystonia, dysarthria, rigidity, choreoathetosis, and motor impairment. Until now, PKAN patients have only been reported in a few countries in Asia such as China, Korea, India, Iran, Taiwan, and Thailand.

Patient concerns:
Here we report the first case of PKAN in Vietnam. The patient had a late onset but the disease progresses rapidly with symptoms of dyskinesia, dysphagia, and difficulty speaking.

Diagnoses:
Pantothenate kinase-associated neurodegeneration.

Interventions:
Whole exome sequencing was performed to identify heterozygous mutations in the PANK2 gene (NM_153638.4) (c.856C>T, p.Arg286Cys and c.1351C>T, p.Arg451Ter) that has been confirmed as the cause of the disease.

Outcomes:
In this study, the first Vietnamese patient with late-onset PKAN was diagnosed by the whole exome sequencing method.

Lessons:
The patient’s case marks an important milestone for the first case in Vietnam. The results of the study will provide a scientific basis for clinicians in the diagnosis and genetic counseling of patients.
Visualizing research trends and identifying hotspots of herbal components for treating cardiovascular diseases: A bibliometric analysis from 2000 to 2023
Authors: Chen Ying , Li Wen-Wen , Bi Si-Ling , Zhang He-Meng , Sun Zhenhai , Zuo Yao-Yao , Xu Liang , Chen Shou-Qiang 
Published: February 2024

Objective:
The objective of this study was to investigate the global research trends in herbal medicine for the treatment of cardiovascular disease (CVD) from 2000 to 2023. A bibliometric approach was employed to analyze international collaborations, knowledge structures, emerging trends, and research frontiers.

Method:
The Web of Science (WOS) core collection was utilized as the database, employing the search formula (((TS = (traditional Chinese medicine)) OR TS = (Chinese herbal medicinal ingredient)) OR TS = (Chinese herbal medicinal constituent)) AND TS = (cardiovascular disease) to conduct the search. The search period spanned from January 1, 2000, to February 14, 2023, and the literature type included articles and reviews.

Results:
A total of 1478 papers were included in the analysis after searching the WOS database and excluding conference proceedings, news articles, retractions, editorials, and letters. China demonstrated the highest number of publications, followed by the United States and Taiwan (China). The institution with the highest publications was the Chinese Academy of Medical Sciences. China, the United States, and India were the main countries involved in research in this field, and there was significant collaboration among them. The hotspots related to herbal components for treating cardiovascular diseases from 2000 to 2023 included systematic reviews, ischemic reperfusion injury, global burden, type 2 diabetes, and protection.

Conclusion:
This paper provides a reference for the future development of herbal research in cardiovascular aspects by revealing the current status, hotspots, and trends of global herbal research in cardiovascular factors over more than 20 years. Identification of potential collaborators and institutions can assist researchers in exploring new directions for future research and discovering new perspectives for potential collaborations in this field.
Application of surgical pleth index in the opioid-free anesthesia: A randomized controlled trial
Authors: Dai Jingwei , Wu Duozhi , Cui Xiaoguang , Li Shanliang , Xu Fengmei 
Published: February 2024

Background:
Currently, there is no gold standard for monitoring noxious stimulation during surgery, and the surgical pleth index (SPI) is only one of many monitoring methods. It is commonly used in the monitoring of conventional opiate anesthesia, but its effectiveness in opioid-free anesthesia (OFA) has not been evaluated. Therefore, the aim of this study was to observe the guidance value of the surgical pleth index in opioid-free anesthesia for patients undergoing lower abdominal or pelvic surgery.

Methods:
A total of 122 patients who underwent lower abdominal or pelvic surgery in our hospital between March 2021 and July 2022 were selected and equally divided into OFA (F) and control (C) groups according to the random number table method. Both groups underwent ultrasound-guided unilateral/bilateral quadratus lumborum block in the supine position according to the surgical field. In group F, 0.50% lidocaine and 0.20% ropivacaine (in 20 mL of 0.9% normal saline) were injected on each side. In group C, 20 mL 0.9% normal saline was injected on each side. Group F received general anesthesia without opioids and group C received general anesthesia with opioids. BP, pulse oxygen saturation, PETCO2, reactionentropy, stateentropy, and SPI values; Steward score; dosage of propofol, dexmedetomidine, rocuronium, and diltiazem; extubation time; and awake time were monitored in both groups.

Results:
There were no significant differences in the general data between the 2 groups (P > .05). There were no significant differences in SPI values at T0, T1, T2, T3, T4, and T5 or the number of cases requiring additional remifentanil, propofol, and diltiazem between the 2 groups (P > .05). The stateentropy, reactionentropy, and Steward scores were higher in group F than in group C at T4 and T5, while the extubation and awake times were lower in group F than in group C (P < .05). The heart rate and SPI of group F were lower than that of group C at T3 (P < .05).

Conclusion:
The guiding value of SPI in OFA was similar to its use in opiated anesthesia. Its clinical efficacy is exact, vital signs are stable, enabling rapid, and complete regaining of consciousness.
Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report
Authors: Kudoh Maika , Kakiuchi Toshihiko , Yoshiura Masato , Esaki Motohiro , Matsuo Muneaki 
Published: February 2024

Rationale:
Juvenile polyps (JPs) are the most common polyp type and can be observed in 1% of all preschoolers. The peak incidence is observed at ages 3 to 5 years, constituting 90% of all polyps in children. Elevated levels of fecal calprotectin (FC) are often seen in children with JPs.

Patient concerns:
A 15-month-old girl was referred to our hospital for blood on the stool surface persisting for 3 months. She was healthy, with no abdominal pain, diarrhea, anorexia, or weight loss and no complaints other than hematochezia. Her physical examination, vital signs and laboratory date were unremarkable.

Diagnosis:
JPs

Intervention:
Total colonoscopy for her found 2 JPs in the sigmoid colon, which were subsequently resected endoscopically.

Outcomes:
At the age of 5 years, this patient again had bloody stools. Her FC measurement at that time was 1020 mg/kg, which normalized to 42 mg/kg 3 months after her second resection.

Lessons:
Single or multiple solitary JPs require follow-up that fully considers the possibility of recurrence. Establishing a method for early confirmation of JP recurrence based on bloody stools, fecal occult blood testing, and FC measurement is necessary.
Assessment of memory recognition using a smartphone-based test system: A pilot study
Authors: Saito Yukari , Kitamura Kazuki , Yokoyama Akane , Tabata Toshihide 
Published: February 2024

Background:
Elucidation of the detailed nature of age-related memory decline requires analysis of memory performance in large populations of various ages. To promote large-scale studies, we developed a smartphone-based self-test for memory recognition. We examined whether this test could detect age-related memory decline and the effects of aerobic exercise on memory.

Methods:
Seventy-eight younger and 42 older participants were randomly divided into active and passive groups. Both groups took a memory recognition test (consisting of 2 sessions separated by a 48-hour interval) conducted on smartphones. The participants answered the positive and negative affect schedule questionnaire at the beginning and end of each session. In the first session, the participants performed cognitive tasks on 90 photographs displayed on a smartphone screen. Immediately after the cognitive tasks, the active group performed a bout of light aerobic exercise for 10 minutes, while the passive group remained calm for 10 minutes. In the second session, the participants were tested on the recognition of 90 previously observed photographs and 90 distractor photographs.

Results:
Passive older participants had ~40% to ~50% lower recognition scores (RSs) than passive younger participants did. Moreover, the aerobic exercise used in this study improved the RSs of active younger participants by up to ~40% compared with those of passive younger participants, while such an improvement was not observed in older participants. The RS did not depend on the affect levels evaluated using positive and negative affect schedule questionnaire.

Conclusions:
These results demonstrated that the smartphone-based test could detect age-related decline and could promote behavior modification that may lead to memory enhancement, as reported in previous studies using conventional laboratory tests. The results of the smartphone-based test were not influenced by the subjects affect. This indicates the possibility of large-scale memory studies and healthcare for memory performance by using personal mobile devices.
COVID-19 studies involving machine learning methods: A bibliometric study
Authors: Baygül Eden Arzu , Bakir Kayi Alev , Erdem Mustafa Genco , Demirci Mehmet 
Published: February 2024

Background:Machine learning (ML) and artificial intelligence (AI) techniques are gaining popularity as effective tools for coronavirus disease of 2019 (COVID-19) research. These strategies can be used in diagnosis, prognosis, therapy, and public health management. Bibliometric analysis quantifies the quality and impact of scholarly publications. ML in COVID-19 research is the focus of this bibliometric analysis.Methods:A comprehensive literature study found ML-based COVID-19 research. Web of Science (WoS) was used for the study. The searches included “machine learning,” “artificial intelligence,” and COVID-19. To find all relevant studies, 2 reviewers searched independently. The network visualization was analyzed using VOSviewer 1.6.19.Results:In the WoS Core, the average citation count was 13.6 ± 41.3. The main research areas were computer science, engineering, and science and technology. According to document count, Tao Huang wrote 14 studies, Fadi Al-Turjman wrote 11, and Imran Ashraf wrote 11. The US, China, and India produced the most studies and citations. The most prolific research institutions were Harvard Medical School, Huazhong University of Science and Technology, and King Abdulaziz University. In contrast, Nankai University, Oxford, and Imperial College London were the most mentioned organizations, reflecting their significant research contributions. First, “Covid-19” appeared 1983 times, followed by “machine learning” and “deep learning.” The US Department of Health and Human Services funded this topic most heavily. Huang Tao, Feng Kaiyan, and Ashraf Imran pioneered bibliographic coupling.Conclusion:This study provides useful insights for academics and clinicians studying COVID-19 using ML. Through bibliometric data analysis, scholars can learn about highly recognized and productive authors and countries, as well as the publications with the most citations and keywords. New data and methodologies from the pandemic are expected to advance ML and AI modeling. It is crucial to recognize that these studies will pioneer this subject.
Electrocardiographic semi-spiked helmet sign in critically Ill patients: A case series
Authors: Sasmita Bryan Richard , Luo Suxin , Huang Bi 
Published: February 2024

Rationale:
ST-segment elevation on electrocardiogram (ECG) is an alarming sign. Although acute myocardial infarction (AMI) is the most common cause of ST-segment elevation, many non-ischemic conditions may produce pseudo-ST segment elevation. Spiked Helmet (SH) sign is one of the pseudo-ST segment elevations that is associated with critical illness and high risk of death. SH sign was characterized by an upward shift starting before the onset of the QRS complex; however, we found some patients presented with a peculiar characteristic on ECG with an upward convex ST-segment elevation after the QRS wave but without elevation before the QRS wave, therefore called Semi-SH sign. Also, this electrocardiographic feature exists in patients with critical disease and is related to poor prognosis. The purpose of this case series is to describe the electrocardiographic Semi-SH sign and enhance the awareness of such electrocardiographic manifestation for clinicians.

Patients Concerns:
This case series explores the possibility of severe infection induced electrocardiographic changes resembling spiked-helmet sign.

Diagnoses:
Sepsis-induced secondary myocardial injury or coronary vasospasm.

Interventions:
Gastric decompression, antibiotics, diuretics, advanced life support.

Outcomes:
The outcome of this case series is the association of the electrocardiographic Semi-SH sign with the prognosis. All 3 patients died several days post manifestation of electrocardiographic Semi-SH sign.

Lesson:
Like SH sign, electrocardiographic Semi-SH sign is a life-threatening or deadly ECG sign, and therefore early recognition and aggressive treatment are important.
Primary mesenteric abscess caused by Klebsiella pneumoniae: A case report
Authors: Wang Peng , Zhu Fengfeng , Wang Mingming , Niu Bingxu , Ma Bin , Du Jundong 
Published: February 2024

Rationale:
Mesenteric abscess, a rare abdominal infection, is regularly mostly secondary to inflammatory bowel disease, diverticula of the small intestine, or tuberculosis. Primary mesenteric abscesses are extremely rare. If not diagnosed and treated in a timely manner, it may lead to serious consequences; computerized tomography is highly beneficial for the diagnosis of this disease; timely surgical intervention, judicious use of antibiotics, and adequate nutritional support are crucial in the management of this disease.

Patient concerns:
A 59-year-old male patient from China was admitted to hospital for intermittent abdominal pain accompanied by poor appetite for 10 days. One week before admission, the patient had been infected with corona virus disease 2019. Past history includes type 2 diabetes and post-operative gastric cancer.

Diagnosis:
The emergency abdominal computerized tomography examination results of the patient suggested that the mesentery was cloudy with a large amount of effusion and visible bubble. Mesentery abscess was considered, but duodenal perforation could not be excluded.

Interventions:
We adopted exploratory laparotomy to further clarify the diagnosis. Intraoperatically, after fully exposing the duodenum, we found extensive abscess formation in the mesentery, but no duodenal perforation. After operation, the patient developed duodenal leakage and was treated with gastric tube and jejunal nutrition tube.

Outcomes:
Postoperatively, due to poor general condition, the patient was transferred to intensive care unit; after anti-infective treatment, the condition improved on the 5th postoperative day, and duodenal leakage appeared on the 9th postoperative day, and conservative treatment was ineffective, and the patient eventually died.

Lessons:
Primary mesenteric abscess is a local tissue infectious disease. Whereas we should consider the physical basic condition of the patient during therapeutic process. We believe adequate postoperative drainage, rational use of antibiotics based on bacterial culture, early ambulation after surgery, and adequate nutritional support might be key points for successful therapy.
Meningitis and sepsis caused by Streptococcus suis in an elderly woman: A CARE-compliant case report
Authors: Li Kuangyi , Li Shilan , Hong Jiana , Cheng Weiyin , Zhang Yingjian , Liang Zhangrong , Tang Qi , Shen Bisheng 
Published: February 2024

Rationale:

Streptococcus suis (S suis)-associated infections are uncommon but life-threatening diseases. The clinical manifestations vary from general symptoms of bacterial infection to fatal meningitis. The clinical manifestation and routine diagnostic testing is not specific enough to obtain well-time diagnosis.

Patient concerns and diagnosis:
We report a case of meningitis and sepsis caused by S suis infection. A 70-year-old woman presented to our emergency department with generalized pain. After hospital admission, her condition rapidly deteriorated to fever, intracranial hypertension, and disturbance of consciousness. Examination of the blood and cerebrospinal fluid with metagenomic next-generation sequencing and bacterial cultures revealed S suis infection.

Interventions and outcomes:
After anti-infection therapy with meropenem and vancomycin, the patient recovered and was discharged from the hospital with no residual effects.

Lessons:
Human infections with S suis are extremely rare. If clinicians encounter a patient with fever, disturbance of consciousness, and intracranial hypertension, especially those who have been exposed to raw pork, S suis infection should be considered. Metagenomic next-generation sequencing can be a useful adjunct for the rapid diagnosis of S suis infection and aid in the planning of clinical treatment. Meanwhile, public health awareness is necessary to limit the risk of S suis infection.
Predictive value of stromal tumor-infiltrating lymphocytes in patients with breast cancer treated with neoadjuvant chemotherapy: A meta-analysis
Authors: Xia Guangfa , Zhang Ziran , Jiang Qin , Wang Huan , Wang Jie 
Published: February 2024

Background:
The predictive value of tumor-infiltrating lymphocytes (TILs) in response to neoadjuvant chemotherapy (NAC) for breast cancer (BC) has received increasing attention. Here, a meta-analysis was conducted to evaluate the correlation between the expression of stromal TILs and pathological complete response (pCR) after NAC in BC patients.

Methods:
The PubMed, Embase, Cochrane Library, and Web of Science databases were searched online by using a combination of keywords and free words to screen literature on the expression of stromal TILs and pCR after NAC in patients with BC. The data were extracted and evaluated for quality. Relative risk (RR) was used to evaluate the relationship between the expression of stromal TILs before NAC and pCR in BC patients. Meta-analysis was performed with Review Manager 5.3 and STATA 14.0 software.

Results:
Eleven studies involving 6039 BC patients were included in the meta-analysis. The results showed a generally high expression of stromal TILs in BC patients, and the pCR rate after NAC in BC patients with a high expression of stromal TILs was significantly higher than that in BC patients with a low expression of stromal TILs [RR = 1.83, 95% confidence interval (CI): 1.69–1.97]. Subgroup analysis based on the molecular subtypes of BC showed that the pCR rate was significantly higher in patients with a high expression of stromal TILs in hormone receptor (HR)-positive BC [RR = 3.23, 95% CI: 2.43–4.30], human epidermal growth factor receptor 2 (HER-2)-positive BC [RR = 1.41, 95% CI: 1.25–1.60], and triple-negative BC [RR = 1.70, 95% CI: 1.53–1.90] than in those with a low expression of stromal TILs. Subgroup analysis based on expression threshold showed that the pCR rate was higher in patients with a high expression of stromal TILs than in patients with a low expression of stromal TILs at different expression thresholds (10% [RR = 1.99, 95% CI: 1.55–2.55], 20%/30% [RR = 1.57, 95% CI: 1.37–1.81], 50%/60% [RR = 1.91, 95% CI: 1.73–2.11].

Conclusion:
TILs can be used as a predictor of pCR after NAC in patients with BC, and the appropriate high expression threshold of stromal TILs should be selected as the predictive value according to the molecular subtype of BC.