bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of clinical, laboratory and imaging features for diagnosing spondyloarthritis—a systematic literature review and meta-analysis
Authors: Bento da Silva Ana , Lourenço Maria Helena , Ramiro Sofia , Falzon Louise , Cunha-Branco Jaime , van der Heijde Désirée , Landewé Robert , Sepriano Alexandre 
Published: February 2024

Abstract

Objective
The Berlin algorithm was developed to help diagnose axial SpA (axSpA), but new studies suggest some features typical of SpA are less specific than previously assumed. Furthermore, evidence is lacking for other SpA subtypes (e.g. peripheral SpA). We aimed to review the evidence on the performance of SpA features for diagnosing each SpA subtype.

Methods
We conducted a systematic literature review of studies reporting the diagnostic performance of one or more SpA features in patients with suspected SpA. The external reference was the rheumatologist’s diagnosis of SpA. Meta-analysis was performed, separately for each SpA subtype, to estimate pooled sensitivity, specificity and positive and negative likelihood ratios (LR+ and LR−, respectively). Meta-regression assessed the effect of covariates (e.g. feature’s prevalence) on each feature’s performance.

Results
Of 13 844 articles screened, 46 were included. Sacroiliitis on MRI, damage on pelvic radiographs and elevated CRP had the best balance between LR+ and LR− (LR+ 3.9–17.0, LR− 0.5–0.7) for diagnosing axSpA. HLA-B27 had an LR+ lower than anticipated (LR+ 3.1). Inflammatory back pain (IBP) had a low LR+ (LR+ ≈1), but substantially decreased the likelihood of axSpA when absent (LR− 0.3). Conversely, peripheral features and extramusculoskeletal manifestations showed a high LR+ (LR+ 1.6–5.0), but were as common in axSpA as non-axSpA (LR− ≈1). The specificity of most features was reduced in settings when these were highly prevalent. Limited data precluded a detailed analysis on diagnosing other SpA subtypes.

Conclusion
Imaging features and CRP have good diagnostic value for axSpA. However, the specificity of other features, especially HLA-B27 and IBP, is lower than previously known.
Association of disease activity with depression and anxiety in systemic lupus erythematosus: a comparison of SLEDAI-2K and SLE-DAS
Authors: Yang Leilei , Gu Bingjie , Wang Xiaoqin , Ren Qijie , Shen Minning , Su Dinglei 
Published: February 2024

Abstract

Objective
To explore the association of disease activity, as evaluated by both the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and the SLEDAI-2000 (SLEDAI-2K), with depression and anxiety in patients with SLE.

Methods
A cross-sectional study was conducted among 85 Chinese patients with SLE. Disease activity was measured using SLEDAI-2K and SLE-DAS scoring systems. Depression and anxiety were assessed using Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. Multivariate logistic regression analysis was performed to evaluate the association of disease activity scores, as well as specific clinical and laboratory items, with depression and anxiety.

Results
There was a robust correlation between SLEDAI-2K and SLE-DAS scores in overall patient population (Spearman’s r = 0.764, 95% CI 0.655–0.842; P &lt; 0.001) and in those with moderate-to-high disease activity (Spearman’s r = 0.792, 95% CI 0.616–0.892; P &lt; 0.0001). However, the correlation weakened for patients with mild disease activity or remission (Spearman’s r = 0.450, 95%CI 0.188–0.652; P = 0.001). Multivariate logistic regression analysis did not show a significant correlation between SLEDAI-2K and SLE-DAS scores and depression/anxiety. The presence of mucosal ulcer/serositis significantly increased the risk of depression (odds ratio = 4.472, 95% CI 1.035–19.328; P = 0.045) and anxiety (odds ratio = 3.978, 95% CI 1.051–15.049; P = 0.042).

Conclusion
The SLE-DAS scoring system demonstrated a comparable ability to assess disease activity in SLE compared with SLEDAI-2K. Though neither scoring system showed significant associations with depression and anxiety, the presence of mucosal ulcer/serositis markedly heightened the risk of both among SLE patients.
Effects of acrylamide exposure during pregnancy and lactation on the development of myelin sheath of corpus callosum in offspring rats
Authors: Liu Shuping , Yang Dehui , Dong Suqiu , Luo Yuyou , Zhang Tong , Li Siyuan , Bai Yanxian , Li Lixia , Ma Yuxin , Liu Jing 
Published: February 2024

Abstract
Acrylamide is an alkene known to induce neurotoxicity in humans and experimental animals. However, the effects of acrylamide on the development of myelin sheath are unclear. The present study was to explore the effects of acrylamide exposure during pregnancy and lactation on the development of myelin sheath in offspring rats. Four groups of thirty-two pregnant Sprague–Dawley rats were exposed to 0, 4.5, 9 and 18 mg/kg BW acrylamide by gavage from gestational day 15 to postnatal day 13. The corpus callosum of nine offspring rats per group were dissected in postpartum day 14. Structural changes and lipid contents in myelin sheaths were examined by transmission electron microscopy(TEM) and Luxol Fast Blue staining(LFB). The expression of MBP and PLP was evaluated by immunohistochemistry and Western blotting. TEM showed that the myelin sheaths in the 18 mg/kg group were disordered compared with control group. Luxol Fast Blue staining gradually decreased with increasing acrylamide maternal exposure. The immunohistochemistry and Western Blotting results showed that maternal exposure to acrylamide caused a decreasing trend in MBP and PLP in the corpus callosum of rats at postnatal day 14. Furthermore, these reduced protein levels may be neurodevelopmental toxicity’s mechanism in response to maternal exposure to acrylamide.
Validation of ChatGPT 3.5 as a Tool to Optimize Readability of Patient-facing Craniofacial Education Materials
Authors: Vallurupalli Medha , Shah Nikhil D. , Vyas Raj M. 
Published: February 2024

Background:To address patient health literacy, the American Medical Association recommends that readability of patient education materials should not exceed a sixth grade reading level; the National Institutes of Health recommend no greater than an eigth-grade reading level. However, patient-facing materials in plastic surgery often remain at an above-recommended average reading level. The purpose of this study was to evaluate ChatGPT 3.5 as a tool for optimizing patient-facing craniofacial education materials.Methods:Eighteen patient-facing craniofacial education materials were evaluated for readability by a traditional calculator and ChatGPT 3.5. The resulting scores were compared. The original excerpts were then inputted to ChatGPT 3.5 and simplified by the artificial intelligence tool. The simplified excerpts were scored by the calculators.Results:The difference in scores for the original excerpts between the online calculator and ChatGPT 3.5 were not significant (P= 0.441). Additionally, the simplified excerpts’ scores were significantly lower than the originals (P < 0.001), and the mean of the simplified excerpts was 7.78, less than the maximum recommended 8.Conclusions:The use of ChatGPT 3.5 for simplification and readability analysis of patient-facing craniofacial materials is efficient and may help facilitate the conveyance of important health information. ChatGPT 3.5 rendered readability scores comparable to traditional readability calculators, in addition to excerpt-specific feedback. It was also able to simplify materials to the recommended grade levels. With human oversight, we validate this tool for readability analysis and simplification.
Clinical performance after implantation of an EDOF intraocular lens in the dominant eye and a presbyopia-correcting intraocular lens in the nondominant eye
Authors: Soscia William L. , DeRojas Joaquin O. , Mathews Priya M. , Brutsky Amy , Solomon Kerry D. , Potvin Richard , Sandoval Helga P. 
Published: February 2024

Purpose:To evaluate subjective and objective outcomes after combined implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) and a combined technology multifocal lens (CT-IOL).Setting:2 clinical practices (Carolina Eyecare Physicians, Center For Sight) in the United States.Design:Prospective, unmasked, multicenter, nonrandomized bilateral eye study.Methods:Patients interested in reducing their dependence on spectacles were implanted with an EDOF IOL in the dominant eye and a CT-IOL in the nondominant eye. Refractive and visual acuity (VA) data at various distances (4 m, 66 cm, 40 cm, and 33 cm) were collected 3 months postsurgery, along with the distance-corrected binocular defocus curve and responses to questionnaires related to spectacle independence, visual disturbances, and overall visual function.Results:Data from 37 participants were analyzed. The distance-corrected binocular defocus curve showed a mean VA better than 0.1 logMAR (20/25) at all vergences from +1.00 to −2.50 diopters (D). 36 participants (97%) had an uncorrected binocular VA of 0.3 logMAR or better, at all test distances. 70% of participants (26/37) reported never wearing spectacles at any distance, and 84% (31/37) were “completely” or “mostly” satisfied with their overall vision after surgery. Halos were the disturbance reported most frequently and reported as most bothersome, with difficulty driving at night the most common visual function issue. Difficulty reading was the next most reported issue. Overall eyesight was rated as “excellent” or “good” by 92% (34/37) of participants.Conclusions:This combined EDOF/CT-IOL approach was well-tolerated by participants and provided some potential benefits relative to bilateral implantation of either lens.
Limited health insurance coverage of injectable neurotoxins and fillers for gender affirmation: a cross-sectional study of Affordable Care Act silver and Medicaid plans
Authors: Roszell Karin , Shumer Daniel , Orringer Jeffrey , Wang Frank 
Published: February 2024

Background:
Injectable neurotoxins and fillers are potential options for facial gender affirmation for transgender/nonbinary patients. However, the largest barrier to access is cost/insurance coverage.

Objective:
The purpose of this article is to assess the extent to which Affordable Care Act (ACA) silver plans and Medicaid policies cover gender-affirming injectable neurotoxin and filler procedures.

Methods:
A cross-sectional study of all ACA silver plans and Medicaid policies was performed from June 22 to August 15, 2021. Plan-specific certificates of coverage, clinical policies of insurance providers, and Medicaid documents were evaluated.

Results:
A total of 915 plans were reviewed (864 ACA silver plans and all 51 Medicaid policies). None potentially covered neurotoxins. Only 72 (71 ACA and 1 Medicaid) potentially covered fillers, specifically collagen injections and lipofilling. Coverage required demonstration of medical necessity or significant variation of physical appearance from the patient’s experienced gender. However, of the 71 ACA plans, 69 outlined cosmetic exclusions, possibly nullifying this coverage.

Limitations:
Data were sourced from publicly available online information in 2021. Additionally, we were unable to confirm explicit coverage of these procedures with insurance companies.

Conclusion:
The majority of ACA silver and Medicaid plans did not cover gender-affirming neurotoxin or filler procedures, limiting access to this gender-affirming care.
Clinical efficacy of subthreshold micropulse laser combined with anti-VEGF drugs in the treatment of diabetic macular edema: A meta-analysis
Authors: Xu Dahua , Zhu Ting , Huang Lin , Wang Xiaolin , Chen Mei 
Published: February 2024

Background:
To systematically evaluate the efficacy and safety of subthreshold micropulse laser (SML) combined with anti-vascular endothelial growth factor (VEGF) drugs for the treatment of diabetic macular edema (DME).

Methods:
The randomized controlled trials on SML combined with anti-VEGF drugs for DME were retrieved from China National Knowledge Infrastructure, Wan Fang Data, VIP Data, Sino Med (China Biomedical Literature Database), PubMed, Web of Science, The Cochrane Library, and Embase by computer from inception to April 19, 2022. The observation group was treated with SML combined with anti-VEGF drugs, while the control group was treated with anti-VEGF agents alone or SML. And the references of the included literature were manually searched. The Meta-analysis was performed using Revman 5.4 and STATA SE 15.

Results:
This study finally included 15 randomized controlled trials involving 891 eyes for Meta-analysis. The results showed that there was no statistically significant difference between the 2 groups in best-corrected visual acuity at 1, 3, 6, 9, and 12 months after treatment. There was no statistical difference between the 2 groups in central macular thickness (CMT) at 1, 3, and 6 months after treatment (P > .05). CMT in the observation group was lower than that in the control group at 9 and 12 months (P < .05). There was no statistical difference between the 2 groups in total macular volume at 3, 6, 9, and 12 months in CMT (P > .05). The number of anti-VEGF drugs injections in the observation was lower than that in the control group (P < .05). The occurrence of complications between the 2 groups was not statistically significant difference (P > .05).

Conclusion:
SML in combination with anti-VEGF drugs in patients with DME are comparable in reducing the number of anti-VEGF drugs injections and CMT, thereby reducing the financial burden on patients. It does not differ in best-corrected visual acuity and total macular volume.
Association of asthma and lung cancer risk: A pool of cohort studies and Mendelian randomization analysis
Authors: Huang Qinyao , Huang Yunxia , Xu Senkai , Yuan Xiaojun , Liu Xinqi , Chen Zisheng 
Published: February 2024

Background:
Over the past 2 decades, population-based studies have shown an increased association between asthma and the risk of lung cancer. However, the causal links between these 2 conditions remain poorly understood.

Methods:
We conducted a comprehensive search of various databases, including PubMed, Embase, Web of Science, and Cochrane Library, up until May 04, 2023. Only articles published in English were included in our study. We performed a meta-analysis using random-effects models to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI). Subgroup analyses were conducted based on study design, gender, and histologic types. We also conducted a 2-sample Mendelian randomization (MR) using the genome-wide association study pooled data (408,422 people) published by the UK Biobank to explore further the potential causal relationship between asthma and lung cancer.

Results:
Our meta-analysis reviewed 24 population-based cohort studies involving 1072,502 patients, revealing that asthma is significantly associated with an increased risk of lung cancer (OR = 1.29, 95% CI 1.19–1.38) in all individuals. Subgroup analysis showed a significantly higher risk of lung cancer in females with asthma (OR = 1.23, 95% CI 1.01–1.49). We found no significant association between asthma and lung adenocarcinoma (LUAD) (OR = 0.76, 95% CI 0.54–1.05), lung squamous carcinomas (LUSC) (OR = 1.09, 95% CI 0.79–1.50), or small-cell lung cancer (SCLC) (OR = 1.00, 95% CI 0.68–1.49). Interestingly, our MR analysis supported an increasing causality between asthma and lung cancer (OR = 1.11, 95% CI 1.04–1.17, P = .0008), specifically in those who ever smoker (OR = 1.09, 95% CI 1.01–1.16, P = .0173) and LUSC pathological type (OR = 1.15, 95% CI 1.05–1.26, P = .0038).

Conclusion:
Through meta-analysis, our study confirms that patients with asthma have a higher risk of developing lung cancer. Our MR study further support an increasing causal relationship between asthma and the risk of lung cancer, particularly in smokers and LUSC. Future studies examining the link between asthma and the risk of developing lung cancer should consider the bias of controlled and uncontrolled asthma.
A case report: Nonsecretory multiple myeloma presenting with bone pain
Authors: Geng Qianshuang , Li Jie , Li Xi , Zhang Wenjie , Zhang Guoxiang , Ge Li , Liang Li 
Published: February 2024

Rationale:
Nonsecretory multiple myeloma (NSMM) is a rare subtype of multiple myelom, occurring in 1% to 2% of multiple myelom and characterized by the inability of clonal plasma cells to synthesize or secrete immunoglobulins. We describe a 71-year-old male patient who began with bone pain and was referred to hospital several times, but was not properly diagnosed and effectively treated.

Patient concerns:
A 71-year-old male patient visited our hematology department, complaining of lumbago for 1 year and back pain for half a year.

Diagnoses:
Low-dose whole-body bone computed tomography: multiple bone destruction of the sternum, ribs, multiple vertebrae and accessories of the spine, pelvis, bilateral humerus, and proximal femur. Monoclonal plasma cells accounted for 17.5% of nuclear cells in bone marrow puncture smear. Fluorescence in situ hybridization detected amplification of CKS1B (1q21) gene. Immunofixation electrophoresis negative. About 10.72% of monoclonal plasma cells were detected by flow cytometry. Finally, he was diagnosed with NSMM.

Interventions:
The patients received VCD chemotherapy (bortezomib 1.3 mg/m2, d1, d4, d8, d11; cyclophosphamide 300 mg/m2, d1–2, d8–9; dexamethasone sodium phosphate 20 mg, d1–2, d4–5, d8–9, d11–12, once every 21 days).

Outcomes:
After 2 cycles of VCD treatment, the symptoms of bone pain were significantly relieved, and the efficacy was evaluated as partial response. Follow-up chemotherapy will continue to be completed on schedule. We will continue to follow up to further evaluate the overall survival and progression-free survival.

Lessons:
This case shows that NSMM is easily missed or misdiagnosed.
Lung carcinoma with diffuse cysts repeatedly misdiagnosed as pulmonary infections and lymphoid interstitial pneumonia: A case report
Authors: Li Yishi , Lu Junyu , Yuan Jinhe 
Published: February 2024

Introduction:
Diffuse cystic lung diseases comprise a heterogeneous group of pulmonary disorders, with most cases being benign and malignant instances being rare.

Case report:
We present an unusual case of lung adenocarcinoma characterized by the progressive diffusion of cystic lesions. The patient, initially diagnosed with a pulmonary infection and lymphoid interstitial pneumonia, underwent repeated misdiagnoses. Ultimately, the diagnosis was confirmed using radial endobronchial ultrasound-guided–transbronchial cryobiopsy (rEBUS–TBCB). A 44-year-old male was admitted to the hospital with a persistent cough and expectoration of bloody sputum for over 6 months. Thoracic computed tomography revealed widespread cystic lesions and nodules. Despite multiple misdiagnoses, rEBUS–TBCB successfully confirmed the presence of lung adenocarcinoma and identified an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) E13:A20 gene rearrangement. The patient was subsequently transferred to a local hospital for oral targeted drug therapy, which resulted in a favorable response.

Conclusion:
In conclusions, transbronchial lung biopsies often provide inadequate specimens for confirming diffuse cystic lung diseases. In contrast, the utilization of rEBUS-guided TBCB offers superior diagnostic capabilities, as it enables the collection of larger lung biopsies with higher diagnostic yields and fewer complications compared to surgical lung biopsy.
Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review
Authors: Zhang Xiang , Jiang Zhenghao , Jin Xiaoliang , Zhou Qiujun 
Published: February 2024

Background:
The efficacy and safety of traditional Chinese medicine (TCM) combined with Silibinin in the treatment of nonalcoholic fatty liver disease (NAFLD) are still inconclusive. This meta-analysis intends to evaluation to explore the clinical efficacy and quality assessment of traditional Chinese medicine in combination with Silymarin in the treatment of NAFLD, aiming to aims to provide evidence-based data analysis for researchers and clinical practitioners involved in TCM research for NAFLD, with the hope of facilitating wider adoption and application

Methods:
In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP and CBM databases from the establishment of the databases to Oct 2023. The study proposed to include studies that reported combination of TCM with Silibinin and Silibinin alone in the treatment of NAFLD, excluding studies for which full text was not available or for which data extraction was not possible; studies using animal studies; reviews and systematic reviews. All data were processed by STATA15.1 statistical software.

Results:
16 randomized controlled trials (RCTs) were included in this meta-analysis. The sample size ranged from 48 to 120, with a total of 1335 patients, including 669 in the Combined treatment group and 384 in the Silibinin group. The findings indicated that the total effective rate of combined treatment group was significantly higher than that of Silibinin alone. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), and gamma glutamyl transpeptidase (GGT) of combined treatment group were all significantly lower than that of western medicine alone. Additionally, after treating NAFLD with a combination of TCM and Silibinin, the TCM syndrome score were significantly lower than those observed with Silibinin alone.

Conclusion:
Traditional Chinese medicine in conjunction with Silibinin capsules has shown significant efficacy in the treatment of NAFLD, improving clinical symptoms, blood lipid levels, and liver function. Furthermore, it is essential to engage in multi-omics research, investigate iron death, and explore the gut microbiota as potential observational indicators for the diagnosis and inclusion criteria. Conducting more high-quality clinical experiments is necessary to further validate these findings.
Combined transhepatic and transsplenic recanalization of chronic splenic vein occlusion to treat left-sided portal hypertension: A cases report
Authors: Liang Jie , Feng Xu , Peng Min , Duan Jin-Tao , Chen Yao-Yong , Zhu Jun 
Published: February 2024

Rationale:
This report describes a unique case of a combination transhepatic and transsplenic recanalization of chronic splenic vein occlusion to treat left-sided portal hypertension (LSPH).

Patient concerns:
In this case report, we report a 49-year-old male who was admitted due to LSPH causing black stools for 2 days and vomiting blood for 1 hour.

Diagnoses:
The patient has a history of multiple episodes of pancreatitis in the past. After admission, abdominal contrast-enhanced CT scan showed the appearance of pancreatitis, with extensive splenic vein occlusion and accompanied by gastric varicose veins, indicating the formation of LSPH.

Intervention:
The patient received treatment with a combination of splenic and hepatic splenic venoplasty.

Outcomes:
Follow up for 1 year, CT and gastroscopy showed disappearance of gastric varices.

Lessons:
Splenic venoplasty is an effective method for treating LSPH. When it is difficult to pass through the occluded segment of the splenic vein through a single approach, percutaneous double approach splenic venoplasty can be attempted for treatment.