bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in abdominal lymphadenopathy of unknown etiology
Authors: Wang Wenli , Han Chaoqun , Ling Xin , Guo Xianwen , Liu Jun , Lin Rong , Ding Zhen 
Published: August 2023

BackgroundEndoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an established method for the evaluation of abdominal organ lesions. However, there are few studies on EUS-FNA for abdominal lymph node (LN) lesions. The purpose of this study was to evaluate the diagnostic role of EUS-FNA in isolated abdominal lymphadenopathy (LAP).MethodsA retrospective analysis was performed on patients with isolated abdominal LAP who underwent a EUS-FNA examination. The diagnosis was made based on cytology, histology, and immunohistochemical (IHC) studies. The area under curve (AUC) value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated.ResultsA total of 99 patients were included in this study. The final diagnoses were metastatic tumor (n = 32), lymphoma (n = 32), tuberculosis (n = 17), sarcoidosis (n = 5), castleman’s disease (n = 1), and reactive LAP (n = 12). The AUC value, sensitivity, specificity, PPV, NPV, and accuracy of EUS-FNA in the diagnosis of malignant LAP were 0.9531, 90.6, 100, 100, 85.4, and 93.9%, respectively. For the diagnosis of lymphoma, the accuracy of EUS-FNA combined with IHC staining was 94.9%. Retroperitoneal LN enlargement is more commonly associated with lymphoma, while hepatic hilar LN enlargement predominantly suggests benign conditions or metastatic tumors. Malignant lymph nodes are more likely to be regular border, circular/quasi-circular, and fusion. Lymphomas are more likely to present with fusion and heterogeneous echogenicity than metastatic tumors.ConclusionEUS-FNA is a safe and effective method to diagnose isolated abdominal LAP.
Evaluation of the effectiveness of a joint general practitioner-pharmacist intervention on the implementation of benzodiazepine deprescribing in older adults (BESTOPH-MG trial): protocol for a cluster-randomized controlled trial
Authors: Huon Jean-François , Nizet Pierre , Caillet Pascal , Lecompte Hélène , Victorri-Vigneau Caroline , Fournier Jean-Pascal ,   the BESTOPH-MG consortium
Published: August 2023

BackgroundDeprescribing benzodiazepines and related drugs (BZDR) is a challenge due to a lack of time on physicians’ part, a lack of involvement of other health professionals, and the need for adapted tools. This study is based on primary care collaboration, by evaluating the effectiveness of a joint intervention between general practitioners and community pharmacists on the implementation of BZDR deprescribing in older adults.MethodsThis is a cluster randomized controlled trial in which each cluster will be formed by a physician-pharmacist pair. Within a cluster allocated to the intervention, the pharmacist will be trained in motivational interviewing (MI), and will offer the patient 3 interviews after inclusion by the physician. They will base their intervention on validated deprescribing guidelines. The pharmacist will receive methodological support during the first interviews. Interprofessional collaboration will be encouraged by writing reports for the physician after each interview. The following implementation outcomes will be evaluated: acceptability/adoption, appropriateness, cost, and fidelity. They will be measured by means of sociological interviews, observations, logbooks, and cost-utility analysis. Focus groups with physicians and pharmacists will be carried out to identify levers and barriers experienced in this collaboration. Observations will be conducted with pharmacists to assess their approach of the MIs. Effectiveness outcomes will be based on medication (discontinuation or reduction of BZDR) and clinical outcomes (such as quality of life, insomnia or anxiety), assessed by health insurance databases and validated questionnaires.DiscussionThis study will determine whether collaboration in primary care between physicians and pharmacists, as well as training and coaching of pharmacists in motivational interviewing, allows the implementation of BZDR deprescribing in the older adults.This study will provide an understanding of the processes used to implement deprescribing guidelines, and the contribution of collaborative practice in implementing BZDR discontinuation. The cluster methodology will allow to assess the experience of the relationship between the different primary care actors, and the related obstacles and levers.The results obtained will make it possible to produce guidelines on the involvement of community pharmacists in the management of substance abuse in older adults, or even to legislate new missions or care pathways.Clinical trial registrationClinicalTrials.gov, identifier, NCT05765656.
The effect of vitamin C in adults with sepsis: a meta-analysis of randomized controlled trials
Authors: Luo Xing , Zhu Youfeng , Zhang Rui , Zhu JianQiu , Kuang Huanming , Shao Yuebin , Guo Xinmin , Ning Bo 
Published: August 2023

BackgroundThe effect of intravenous (IV) vitamin C in the treatment of sepsis remains controversial. We aimed to explore the clinical efficacy of vitamin C in the treatment of sepsis.MethodsElectronic databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from inception through November 15th, 2022, for randomized controlled trials evaluating the effect of IV vitamin C treatment in patients with sepsis. The primary outcome was short-term mortality, secondary outcomes included duration of vasopressor use, length of intensive care unit (ICU) stay, and Sequential Organ Failure Assessment (SOFA) score after vitamin C treatment. Subgroup analyses were performed based on the dose and duration of IV vitamin C and region to determine whether vitamin C benefited patients with sepsis.ResultsA total of 10 studies including 1,426 patients fulfilled the predefined criteria and were analyzed. Overall, there were no significant differences between the vitamin C group and the control group regarding short-term mortality [odds ratio (OR), 0.61; 95% confidence interval (CI) 0.37–1.01; p = 0.05], ICU length of stay [mean difference (MD), −1.24; 95% CI -3.54 to 1.05, p = 0.29] and SOFA score (MD, −0.85, 95% CI -2.38 to 0.67, p = 0.27). However, vitamin C significantly reduced the duration of vasopressor use (MD, −14.36, 95% CI −26.11 to −2.61, p = 0.02). Furthermore, subgroup analysis found that in developing countries, vitamin C was associated with a significant reduction in short-term mortality (OR, 0.33; 95% CI 0.12–0.90; p = 0.03), duration of vasopressor use (MD, −24.37, 95% CI -33.72 to −15.02, p &lt; 0.001) and SOFA score (MD, −2.55, 95% CI -4.81 to −0.28, p = 0.03).ConclusionIn our study, vitamin C administration for sepsis patients was not associated with a significant reduction in short-term mortality, length of ICU stay or SOFA score. However, we observed that vitamin C could reduce the duration of vasopressor use. Furthermore, sepsis patients in developing countries may benefit more from vitamin C administration than those in developed countries.Systematic review registration: Identifier CRD42022380958, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=380958.
A method for temporal-spatial multivariate genomic analysis of acute wound healing via tissue stratification: a porcine negative pressure therapy pilot study
Authors: Hodge Jacob G. , Gunewardena Sumedha , Korentager Richard A. , Zamierowski David S. , Robinson Jennifer L. , Mellott Adam J. 
Published: August 2023

Introduction: Wound therapies are capable of modulating the complex molecular signaling profile of tissue regeneration. However traditional, bulk tissue analysis results in nonspecific expressional profiles and diluted signaling that lacks temporal-spatial information.Methods: An acute incisional porcine wound model was developed in the context of negative pressure wound therapy (NPWT). Dressing materials were inserted into wounds with or without NPWT exposure and evaluated over 8-hours. Upon wound explantation, tissue was stratified and dissected into the epidermis, dermis, or subcutaneous layer, or left undissected as a bulk sample and all groups processed for RNAseq. RNAseq of stratified layers provided spatial localization of expressional changes within defined tissue regions, including angiogenesis, inflammation, and matrix remodeling.Results: Different expressional profiles were observed between individual tissue layers relative to each other within a single wound group and between each individual layer relative to bulk analysis. Tissue stratification identified unique differentially expressed genes within specific layers of tissue that were hidden during bulk analysis, as well as amplification of weak signals and/or inversion of signaling between two layers of the same wound, suggesting that two layers of skin can cancel out signaling within bulk analytical approaches.Discussion: The unique wound stratification and spatial RNAseq approach in this study provides a new methodology to observe expressional patterns more precisely within tissue that may have otherwise not been detectable. Together these experimental data offer novel insight into early expressional patterns and genomic profiles, within and between tissue layers, in wound healing pathways that could potentially help guide clinical decisions and improve wound outcomes.
Clinical features of progressive supranuclear palsy
Authors: Wen Yafei , Yang Qijie , Jiao Bin , Zhang Weiwei , Lin Jingyi , Zhu Yuan , Xu Qian , Zhou Hui , Weng Ling , Liao Xinxin , Zhou Yafang , Wang Junling , Guo Jifeng , Yan Xinxiang , Jiang Hong , Tang Beisha , Shen Lu 
Published: August 2023

BackgroundProgressive supranuclear palsy (PSP) is a clinically heterogenous atypical parkinsonian syndrome. Therefore, early recognition and correct diagnosis of PSP is challenging but essential. This study aims to characterize the clinical manifestations, magnetic resonance imaging (MRI), and longitudinal MRI changes of PSP in China.MethodClinical and MRI presentations were compared among 150 cases with PSP. Then the longitudinal MRI changes among 20 patients with PSP were further explored. Additionally, a series of midbrain-based MRI parameters was compared between PSP-P and PD.ResultsThroughout the course of the disease, there were differences in the symptoms of the fall and hand tremor between the PSP-RS and PSP-P. There were significant differences in the six midbrain-based MRI parameters between the PSP-RS and the PSP-P, including hummingbird sign, midbrain diameter, midbrain to pons ratio (MTPR), midbrain area, midbrain area to pons area ratio (Ma/Pa), and midbrain tegmental length (MBTegm). Longitudinal MRI studies revealed that the annual rel.ΔMTPR and rel.Δ (Ma/Pa) for PSP were 5.55 and 6.52%, respectively; additionally, PSP-RS presented a higher decline rate than PSP-P. Moreover, MTPR ≤0.56, midbrain diameter ≤ 0.92, midbrain area ≤ 1.00, and third ventricle width ≤ 0.75 could identify PSP-P from PD.ConclusionPSP-P differs from PSP-RS regarding clinical manifestations, MRI, and longitudinal MRI changes. MRI parameters could be potential imaging markers to identify PSP-P from PD.
Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
Authors: de Pont Lisa M. H. , Houben Maartje T. P. M. , Verhagen Thijs O. , Verbist Berit M. , Buchem Mark A. van , Bommeljé Claire C. , Blom Henk M. , Hammer Sebastiaan 
Published: August 2023

BackgroundMénière's disease (MD) is a chronic inner ear disorder with a multifactorial etiology. Decreased visualization of the endolymphatic duct (ED) and sac (ES) is thought to be associated with MD, although controversy exists about whether this finding is specific to MD. Recent literature has revealed that two distinct ES pathologies, developmental hypoplasia and epithelial degeneration, can be distinguished in MD using the angular trajectory of the vestibular aqueduct (ATVA) or ED-ES system as a radiographic surrogate marker. It has been suggested that these two subtypes are associated with distinct phenotypical features. However, the clinical differences between the ATVA subtypes require further validation.Research objectiveThe objective of this study is to investigate whether (1) non-visualization of the ED-ES system is a discriminative radiological feature for MD in a cohort of vertigo-associated pathologies (VAPs) and whether (2) different angular trajectories of the ED-ES system in MD are associated with distinguishable clinical features.SettingThe study was conducted in the Vertigo Referral Center (Haga Teaching Hospital, The Hague, the Netherlands).MethodsWe retrospectively assessed 301 patients (187 definite MD and 114 other VAPs) that underwent 4h-delayed 3D FLAIR MRI. We evaluated (1) the visibility of the ED-ES system between MD and other VAP patients and (2) measured the angular trajectory of the ED-ES system. MD patients were stratified based on the angular measurements into αexit ≤ 120° (MD-120), αexit 120°-140° (MD-intermediate), or αexit ≥ 140° (MD-140). Correlations between ATVA subgroups and clinical parameters were evaluated.ResultsNon-visualization of the ED-ES system was more common in definite MD patients compared with other VAPs (P &lt; 0.001). Among definite MD patients, the MD-140 subtype demonstrated a longer history of vertigo (P = 0.006), a higher prevalence of bilateral clinical disease (P = 0.005), and a trend toward a male preponderance (p = 0.053). No significant differences were found between ATVA subgroups regarding the presence or severity of auditory symptoms, or the frequency of vertigo attacks.ConclusionNon-visualization of the ED-ES system is significantly associated with MD. Among MD patients with a visible ED-ES system, we demonstrated that the MD-140 subtype is associated with a longer disease duration, a higher prevalence of bilateral MD, and a trend toward a male preponderance.
On the reliability of motor evoked potentials in hand muscles of healthy adults: a systematic review
Authors: Osnabruegge Mirja , Kanig Carolina , Schwitzgebel Florian , Litschel Karsten , Seiberl Wolfgang , Mack Wolfgang , Schecklmann Martin , Schoisswohl Stefan 
Published: August 2023

AimsMotor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex are used as a neurophysiological marker of cortical excitability in clinical and scientific practice. Though, the reliability of this outcome parameter has not been clarified. Using a systematic approach, this work reviews and critically appraises studies on the reliability of MEP outcome parameters derived from hand muscles of healthy subjects and gives a proposal for most reliable TMS practice.MethodsA systematic literature research was performed in PubMed, according to the PRISMA guidelines. Articles published up to March 2023 that were written in English, conducted repeated measurements from hand muscles of healthy subjects and reliability analysis were included. The risk of publication bias was determined. Two authors conducted the literature search and rated the articles in terms of eligibility and methodological criteria with standardized instruments. Frequencies of the checklist criteria were calculated and inter-rater reliability of the rating procedure was determined. Reliability and stimulation parameters were extracted and summarized in a structured way to conclude best-practice recommendation for reliable measurements.ResultsA total of 28 articles were included in the systematic review. Critical appraisal of the studies revealed methodological heterogeneity and partly contradictory results regarding the reliability of outcome parameters. Inter-rater reliability of the rating procedure was almost perfect nor was there indication of publication bias. Identified studies were grouped based on the parameter investigated: number of applied stimuli, stimulation intensity, reliability of input-output curve parameters, target muscle or hemisphere, inter-trial interval, coil type or navigation and waveform.ConclusionThe methodology of studies on TMS is still subject to heterogeneity, which could contribute to the partly contradictory results. According to the current knowledge, reliability of the outcome parameters can be increased by adjusting the experimental setup. Reliability of single pulse MEP measurement could be optimized by using (1) at least five stimuli per session, (2) a minimum of 110% resting motor threshold as stimulation intensity, (3) a minimum of 4 s inter-trial interval and increasing the interval up to 20 s, (4) a figure-of-eight coil and (5) a monophasic waveform. MEPs can be reliably operationalized.
Free and bioavailable 25-hydroxyvitamin D thresholds for bone metabolism and their associations with metabolic syndrome in Chinese women of childbearing age
Authors: Shan Xiaoyun , Cao Yang , Zhang Huidi , Zhao Xiayu , Li Siran , Hu Yichun , Yang Lichen 
Published: August 2023

ObjectiveThe free hormone hypothesis suggests that free and bioavailable 25-hydroxyvitamin D [25(OH)D] may better reflect vitamin D bioactivity. This study aimed to determine the free and bioavailable 25(OH)D characteristics, estimate their thresholds based on parathyroid hormone (PTH) and bone turnover markers (BTMs), assess their associations with the risk of metabolic syndrome (MetS), and evaluate their potential advantages.MethodsA cross-sectional study was conducted using a nationally representative database (n = 1,505, female, 18–45 years). Serum total 25(OH)D, vitamin D-binding protein, albumin, PTH, and BTMs [osteocalcin, β-CrossLaps of type 1 collagen containing cross-linked C-telopeptide (β-CTX), and procollagen type 1 N-terminal propeptide (P1NP)] were measured. Free 25(OH)D and bioavailable 25(OH)D were calculated. The threshold associations of 25(OH)D with PTH and BTMs were analyzed. The relationship between 25(OH)D and MetS risk was examined. An intervention study was then performed in 39 women (18–47 years) to assess the associations of increasing 25(OH)D with PTH and BTMs after vitamin D supplementation.ResultsIn the cross-sectional study, the three forms of 25(OH)D were found to have similar distribution characteristics. Free and bioavailable 25(OH)D correlated well with total 25(OH)D. Significant total 25(OH)D cutoffs were observed for PTH (14.19 ng/mL and 18.03 ng/mL), osteocalcin (15.14 ng/mL), β-CTX (14.79 ng/mL), and P1NP (15.08 ng/mL). Free and bioavailable 25(OH)D cutoffs were only found for P1NP (3.47 pg/mL and 1.66 ng/mL, respectively). A total 25(OH)D of &lt;15.14 ng/mL was marginally associated with a higher risk of reduced high-density lipoprotein cholesterol (HDL-C) [odd ratios (OR) = 1.371 (0.991–1.899)]. The ORs of higher versus lower free and bioavailable 25(OH)D levels for reduced HDL-C were 0.770 (0.621–0.956) and 0.772 (0.622–0.958), respectively. The results of the intervention study indicated that PTH and BTMs responded more sensitively to total 25(OH)D than to free or bioavailable 25(OH)D.ConclusionFree and bioavailable 25(OH)D only had a threshold effect on P1NP. The active 25(OH)D thresholds could be used for risk assessment of reduced HDL-C. However, no superiority of free or bioavailable 25(OH)D was found based on the response of PTH and BTMs to changes in 25(OH)D in Chinese women of childbearing age following vitamin D supplementation.Clinical trial registrationhttp://www.chictr.org.cn, ChiCTR2200058290.
The associations between dietary fibers intake and systemic immune and inflammatory biomarkers, a multi-cycle study of NHANES 2015–2020
Authors: Qi Xiangjun , Li Yanlong , Fang Caishan , Jia Yingying , Chen Meicong , Chen Xueqing , Jia Jie 
Published: August 2023

BackgroundIn recent years, there has been considerable growth in abnormal inflammatory reactions and immune system dysfunction, which are implicated in chronic inflammatory illnesses and a variety of other conditions. Dietary fibers have emerged as potential regulators of the human immune and inflammatory response. Therefore, this study aims to investigate the associations between dietary fibers intake and systemic immune and inflammatory biomarkers.MethodsThis cross-sectional study used data from the National Health and Nutrition Examination Survey (2015–2020). Dietary fibers intake was defined as the mean of two 24-h dietary recall interviews. The systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red blood cell distribution width-to-albumin ratio (RA), ferritin, high-sensitivity C-reactive protein (hs-CRP), and white blood cell (WBC) count were measured to evaluate systemic immune and inflammatory states of the body. The statistical software packages R and EmpowerStats were used to examine the associations between dietary fibers intake and systemic immune and inflammatory biomarkers.ResultsOverall, 14,392 participants were included in this study. After adjusting for age, gender, race, family monthly poverty level index, alcohol consumption, smoking status, vigorous recreational activity, body mass index, hyperlipidemia, hypertension, diabetes, and dietary inflammatory index, dietary fibers intake was inversely associated with SII (β = −2.19885, 95% CI: −3.21476 to −1.18294, p = 0.000248), SIRI (β = −0.00642, 95% CI: −0.01021 to −0.00263, p = 0.001738), NLR (β = −0.00803, 95% CI: −0.01179 to −0.00427, p = 0.000284), RA (β = −0.00266, 95% CI: −0.00401 to −0.00131, p = 0.000644), ferritin (β = −0.73086, 95% CI: −1.31385 to −0.14787, p = 0.020716), hs-CRP (β = −0.04629, 95% CI: −0.0743 to −0.01829, p = 0.002119), WBC (β = −0.01624, 95% CI: −0.02685 to −0.00563, p = 0.004066), neutrophils (β = −0.01346, 95% CI: −0.01929 to −0.00764, p = 0.000064). An inverse association between dietary fibers and PLR was observed in the middle (β = −3.11979, 95% CI: −5.74119 to −0.4984, p = 0.028014) and the highest tertile (β = −4.48801, 95% CI: −7.92369 to −1.05234, p = 0.016881) and the trend test (βtrend = −2.2626, 95% CI: −3.9648 to −0.5604, Ptrend = 0.0150). The observed associations between dietary fibers intake and SII, SIRI, NLR, RA, ferritin, hs-CRP, WBC, and neutrophils remained robust and consistent in the sensitivity analysis. No significant interaction by race was found.ConclusionDietary fibers intake is associated with the improvement of the parameters of the immune response and inflammatory biomarkers, supporting recommendations to increase dietary fibers intake for enhanced immune health.