bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults
Authors: Zhang Yanbo , Yu Canqing , Chen Shuohua , Tu Zhouzheng , Zheng Mengyi , Lv Jun , Wang Guodong , Liu Yan , Yu Jiaxin , Guo Yu , Yang Ling , Chen Yiping , Guo Kunquan , Yang Kun , Yang Handong , Zhou Yanfeng , Jiang Yiwen , Zhang Xiaomin , He Meian , Liu Gang , Chen Zhengming , Wu Tangchun , Wu Shouling , Li Liming , Pan An 
Published: February 2023

Abstract

Background:
Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.

Methods:
A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004–2018), Dongfeng-Tongji cohort (2008–2018), and Kailuan study (2006–2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.

Results:
During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10–14 vs. 0–6 were 0.52 (0.41–0.67), 0.44 (0.37–0.53), 0.54 (0.45–0.66), and 0.86 (0.64–1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.

Conclusions:
ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.
Effects of anesthetic depth on postoperative pain and delirium: a meta-analysis of randomized controlled trials with trial sequential analysis
Authors: Long Yuqin , Feng Xiaomei , Liu Hong , Shan Xisheng , Ji Fuhai , Peng Ke 
Published: February 2023

Abstract

Background:
Whether anesthetic depth affects postoperative outcomes remains controversial. This meta-analysis aimed to evaluate the effects of deep vs. light anesthesia on postoperative pain, cognitive function, recovery from anesthesia, complications, and mortality.

Methods:
PubMed, EMBASE, and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients. The co-primary outcomes were postoperative pain and delirium (assessed using the confusion assessment method). We conducted a meta-analysis using a random-effects model. We assessed publication bias using the Begg's rank correlation test and Egger's linear regression. We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.

Results:
A total of 26 trials with 10,743 patients were included. Deep anesthesia compared with light anesthesia (a mean difference in bispectral index of −12 to −11) was associated with lower pain scores at rest at 0 to 1 h postoperatively (weighted mean difference = −0.72, 95% confidence interval [CI] = −1.25 to −0.18, P = 0.009; moderate-quality evidence) and an increased incidence of postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI = 1.28–1.91, P < 0.0001; high-quality evidence). No publication bias was detected. For the exploratory secondary outcomes, deep anesthesia was associated with prolonged postoperative recovery, without affecting neurocognitive outcomes, major complications, or mortality. In the subgroup analyses, the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively, without statistically significant subgroup differences, and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries, without statistically significant subgroup differences.

Conclusions:
Deep anesthesia reduced early postoperative pain but increased postoperative delirium. The current evidence does not support the use of deep anesthesia in clinical practice.
Anatomical morphology of the aortic valve in Chinese aortic stenosis patients and clinical results after downsize strategy of transcatheter aortic valve replacement
Authors: Niu Guannan , Ali Walid Ben , Wang Moyang , Jilaihawi Hasan , Zhang Haitong , Zhang Qian , Ye Yunqing , Liu Xinmin , Yao Jing , Zhao Qinghao , Wang Yubin , Zhou Zheng , Zhang Lizhi , Ren Xinshuang , An Yunqiang , Lu Bin , Modine Thomas , Wu Yongjian , Song Guangyuan 
Published: February 2023

Abstract

Background:
The study aimed to describe the aortic valve morphology in Chinese patients underwent transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis (AS), and the impact of sizing strategies and related procedural outcomes.

Methods:
Patients with severe AS who underwent TAVR were consecutively enrolled from 2012 to 2019. The anatomy and morphology of the aortic root were assessed. “Downsize” strategy was preformed when patients had complex morphology. The clinical outcomes of patients who performed downsize strategy were compared with those received annular sizing strategy. The primary outcome was device success rate, and secondary outcomes included Valve Academic Research Consortium-3 clinical outcomes variables based on 1-year follow-up.

Results:
A total of 293 patients were enrolled. Among them, 95 patients (32.4%) had bicuspid aortic valve. The calcium volume (Hounsfield Unit-850) of aortic root was 449.90 (243.15–782.15) mm3. Calcium is distributed mostly on the leaflet level. Downsize strategy was performed in 204 patients (69.6%). Compared with the patients who performed annular sizing strategy, those received downsize strategy achieved a similar device success rate (82.0% [73] vs. 83.3% [170], P = 0.79). Aortic valve gradients (downsize strategy group vs. annular sizing group, 11.28 mmHg vs. 11.88 mmHg, P = 0.64) and percentages of patients with moderate or severe paravalvular regurgitation 2.0% (4/204) vs. 4.5% (4/89), P = 0.21) were similar in the two groups at 30 days after TAVR. These echocardiographic results were sustainable for one year.

Conclusions:
Chinese TAVR patients have more prevalent bicuspid morphology and large calcium volume of aortic root. Calcium is distributed mostly on the leaflet level. Compare with annular sizing strategy, downsize strategy provided a non-inferior device success rate and transcatheter heart valve hemodynamic performance in self-expanding TAVR procedure.
Malignant Melanoma Arising in a Prolific Nevus Sebaceus With Colonization of Trichoblastoma
Authors: Kimball Kelly M. , Craig Elise , Barrick Carl , Usmani Arif 
Published: February 2023

Abstract:
Nevus sebaceus (NS) is a cutaneous hamartoma typically found on the head and neck, with a prevalence of 0.3% in newborns. Most NS are quiescent; however, benign and malignant lesions have been reported to arise within these nevi. Malignant transformation is not common but mainly includes basal cell carcinoma and squamous cell carcinoma. Malignant melanoma arising in NS is exceedingly rare, with only 2 previously documented cases. In this article, we report the first case of malignant melanoma arising in a NS in a 68-year-old man in the United States.
Solitary Vulvar Syringoma With Deep Extension; Potential for Misdiagnosis as the Microcystic Adnexal Carcinoma (MAC)
Authors: Regmi Aayushma , Zelman Brandon , Mudaliar Kumaran M. , Speiser Jodi J. 
Published: February 2023

Abstract:
A 43-year-old woman presented with a palpable, pruritic, minimally painful right vulvar lesion. Physical examination revealed approximately 2.0-cm tender nodule at 70’ clock in the right labia majora. Histological sections of the excision specimen showed an unremarkable epidermis with large, well-circumscribed dermal proliferation with extension to the reticular dermis. Within this proliferation are small solid and ductal structures relatively evenly distributed in the sclerotic stroma. The epithelial elements consisted of monomorphous cuboidal cells and assumed round, oval, curvilinear, or have other peculiar geometric shapes, including “comma-like” or “tadpole”-like configurations. The tumor cells were positive for CEA, EMA, and estrogen receptor and negative for progesterone receptor. The clinical presentation and the deep extension of the tumor were similar to the microcystic adnexal carcinoma. Although a syringoma generally presents with multiple lesions and usually involves the superficial dermis, a syringoma with deep extension was favored based on the lack of follicular differentiation, atypia, mitoses, and perineural invasion. Microcystic adnexal carcinoma and syringoma have a morphologic overlap and are misdiagnosed in 30% of the cases. Thus, it is exceptionally important for pathologists to be aware of and be able to distinguish these entities. To the best of our knowledge, this is the first case of a solitary, painful vulvar syringoma with deep extension.
Concurrent Presentation of Mycosis Fungoides and Primary Cutaneous Marginal Zone LPD: Clinicopathological Study of 4 Cases and Literature Review
Authors: Prieto-Torres Lucía , Machan Salma , Haro Rosario , Cerroni Lorenzo , Requena Luis , Rodríguez-Pinilla Socorro María 
Published: February 2023

Background:
Mycosis fungoides is rarely associated to B-cell malignancies, and the few reported cases are mainly internal lymphomas involving secondarily the skin (ie, chronic lymphocytic leukemia).

Objectives:
The aim of our study is to describe the clinical and histopathological features of 4 patients presenting with 2 concurrent primary cutaneous lymphomas and review the pertinent literature.

Methods:
We identified 4 cases of concurrent primary cutaneous lymphomas in our institutions. An extracutaneous lymphoma was ruled out on the basis of a complete work out. We performed a PubMed search to identify reported cases of primary cutaneous composite or concurrent lymphomas.

Results:
Eleven cases of primary cutaneous concurrent lymphomas have been described in the literature. Counting all together (our cases and the cases previously described in the literature), mycosis fungoides was the most frequent primary cutaneous T-cell lymphoma (TCL) (13/15), followed by 1 case of peripheral TCL-NOS and 1 case of subcutaneous panniculitis–like TCL. Regarding the associated primary cutaneous B-cell lymphomas, 8/15 cases consisted of low-grade B-cell lymphomas [that is, 5 marginal zone lymphoma (in the most recent classification reclassified as marginal zone lymphoproliferative disorder, MZLD, 2 follicular-center B-cell lymphoma (primary cutaneous follicle-center lymphoma) and 1 low-grade NOS B-cell lymphoma]; 4/15 were associated to Epstein–Barr virus; 1 case consisted of a methotrexate-associated lymphoproliferative disease, and 2 cases consisted of primary cutaneous diffuse large B-cell lymphoma-leg type.

Conclusions:
Primary cutaneous concurrent lymphomas are exceptional. Clinicopathological correlation and a complete workout to reach the correct diagnosis may guide the appropriate treatment in each case.
Aesthetic Concerns of Chin Augmentation With Hyaluronic Acid Soft Tissue Filler in Chinese: A Prospective, Observational Study
Authors: Li Xin-Rui , Hong Wei-Jin , Li Zhen-Hao , Luo Cheng-En , Jiang Xuan-Yu , Luo Sheng-Kang 
Published: February 2023

BACKGROUND
The chin is an important facial structure that directly affects the overall contour of the face. The key to achieving a beautiful, effective, and safe chin injection is to make a good facial assessment and use an appropriate injection technique to achieve the best injection effect.

OBJECTIVE
In this article, the authors will discuss cosmetic concepts for the chin area and verify the effectiveness of chin augmentation techniques.

MATERIALS AND METHODS
Chin volume injections were performed on 23 Asian female subjects and 15 Asian male subjects. Demographic and imaging data were collected, and the facial aesthetic length was calculated. The authors also measured the length of beautiful chins, as evaluated by 2 plastic surgeons, and the ratios of chins from “The 100 Most Beautiful/Handsome Faces in China” published by TCC Asia in 2020.

RESULTS
The mean volume of chin filling was 1.89 ± 0.74 mL in female subjects and 2.68 ± 1.28 mL in male subjects. The ideal length of the chin was equal to that of the nasal dorsum in male subjects, and the ideal chin-to-nasal dorsum ratio was 0.9 in female subjects.

CONCLUSION
In this study, the authors investigate sex differences in chin aesthetics among the Chinese population and introduce an aesthetic and anatomical approach to chin injection.
Analysis of the clinical features and risk factors of death in patients with mushroom poisoning
Authors: Yang Yan , Shao Ruifei , Xue Jinfang , Lou Xiran , Ning Deyuan , Chen Guobing 
Published: February 2023

Abstract

Background
Wild edible mushrooms are rich in nutrition and popular with people; however, few laboratory studies are available about the predictability of outcomes among patients with mushroom poisoning. Therefore, this study aimed to analyze the clinical features and death risk factors of patients with mushroom poisoning.

Methods
Patients with mushroom poisoning admitted to the hospital from 2015 to 2021 were retrospectively evaluated.

Results
A total of 197 patients with mushroom poisoning were enrolled in this study, of which 100 (50.76%) were males, and the mortality was 10.66% (21/197). Patients who died were more likely to have demonstrated a long latency, high alanine aminotransferase, aspartate aminotransferase, direct bilirubin, total bilirubin (TB), activated partial thromboplastin time, prothrombin time, international normalized ratio, creatinine, and blood urea nitrogen. Multiple logistic regression analysis indicated that TB level greater than or equal to 34.2 μmol/L had the greatest lethal risk and could increase the risk of death by 14.588 times (odds ratio: 15.588; 95% confidence interval: 2.088–116.351), which indicated that TB was an independent risk factor of death in patients with acute mushroom poisoning.

Conclusion
Bilirubin concentration was associated with the increased likelihood of mortality. Total bilirubin was the independent risk factor of mushroom poisoning.
Esketamine use for anesthesia induction in an ectopic pregnancy patient with hemorrhagic shock: a case report
Authors: Liu Xiaojie , Hua Zhen , Dong He , Zhuo Yanli , Chu Haichen , Li Tianjun 
Published: February 2023

Abstract

Background
Anesthesia induction is challenging in patients with hemodynamic instability. Esketamine has hypnotic, analgesic, and sympathomimetic effects and is the only anesthetic that can increase sympathetic tension. Therefore, it may be more suitable for patients with hypovolemic shock.

Case summary
A 40-year-old female patient presented to the emergency department with new-onset abdominal pain and vaginal bleeding for 2 hours. Menstruation of the patient was regular, her self-reported urine pregnancy test was positive half a month earlier, and she had been diagnosed at another hospital 12 days earlier based on a positive blood human chorionic gonadotropin test. Gynecological ultrasonography demonstrated no pregnancy sac in utero, confirming ectopic pregnancy. Emergency laparoscopy for ectopic pregnancy should be performed immediately. We administered esketamine for induction.

Conclusion
Esketamine-based total intravenous anesthesia results in mild hypotension in ectopic pregnancies with hemorrhagic shock.
Acute infectious purpura fulminans: case report of a medical emergency
Authors: Li Xueying , Ma Yaqian , Sun Qichao , Hu Ruihan , Liu Zhi , Liu Xiaowei 
Published: February 2023

Abstract

Background
Purpura fulminans (PF), characterized by the sudden onset of large, rapidly spreading hemorrhagic skin infarctions and associated disseminated intravascular coagulation, is an uncommon medical emergency. Early recognition, prompt antibiotic therapy, and intensive supportive care are essential to reduce the mortality rate of this disease.

Case Presentation
We report the case of a 28-year-old Chinese man with acute infectious PF. He initially presented with a fever, which rapidly progressed to septic shock, followed by skin lesions and disseminated intravascular coagulation. Computed tomography imaging revealed superior and inferior mesenteric vein thromboses. Although the etiology of the patient’s infection was unclear, the patient received early fluid resuscitation, empiric antibiotic therapy, and blood product replacement, which resulted in gradual clinical improvement.

Conclusion
Sepsis-associated PF may be reversible with timely empirical therapeutic interventions; however, the severity of PF should not be underestimated, and treatment should be tailored to individual patients.
Treatment of prolonged clonidine-induced autonomic instability with midodrine: a case report about a new approach or a cautionary tale?
Authors: Malouf Saada , Henry Catherine , Pemberton Lara , Rotella Joe-Anthony 
Published: February 2023

Abstract

Background
Clonidine is a centrally acting α2 adrenergic and imidazoline-1 receptor agonist that can cause somnolence, bradycardia, and hypotension within several hours of ingestion. Less well-described but observed by us locally is the observation that patients presenting after large overdoses including clonidine can have prolonged autonomic instability. As a result, they may require many days in hospital before recovery. We have previously used midodrine as an indirect antagonist with good effect; however, there are no previous reports of its use for this indication.

Case presentation
We present the case of a young female patient who developed prolonged autonomic instability following a large overdose of clonidine (coingested with smaller doses of escitalopram + lisdexamfetamine) that was treated with midodrine but complicated by a type 2 non-ST segment elevated myocardial infarction.

Conclusion
Midodrine seems to ameliorate this protracted instability and may provide a means to decrease hospital length of stay in appropriate individuals.
Twenty-four-Year Trends in Incidence and Mortality of Nephrotic Syndrome: A Population-Based Cohort Study
Authors: Vestergaard Søren Viborg , Birn Henrik , Jensen Simon Kok , Sørensen Henrik Toft , Nitsch Dorothea , Christiansen Christian Fynbo 
Published: February 2023

Background:
With the increasing prevalence of risk factors for nephrotic syndrome, updated epidemiologic data on the syndrome are needed. We examined its age- and sex-specific incidence, histopathology, and mortality over 24 years.

Methods:
This nationwide cohort study included all adults with first-time-recorded nephrotic syndrome in Denmark during 1995–2018 using the Danish National Patient Registry. We obtained data on age, sex, hospital-diagnosed comorbidities, and histopathologic findings. We computed overall, and age- and sex-specific, incidence rates of nephrotic syndrome, 1- and 5-year mortality by calendar period, and 1-year hazard ratios (HRs) of death using Cox models.

Results:
We identified 3,970 adults with first-time nephrotic syndrome diagnosis. Incidence was highest in men and increased with age to 11.77 per 100,000 person-years (95% confidence interval [CI]: 10.21–13.32) in men aged 80+ years, and 6.56 per 100,000 person-years (95% CI: 5.71–7.41) in women aged 80+ years. Incidence of nephrotic syndrome increased from 3.35 per 100,000 person-years (95% CI: 3.12–3.58) in 1995–2000 to 4.30 per 100,000 person-years (95% CI: 4.05–4.54) in 2013–2018. Over time, 1-year mortality of nephrotic syndrome was stable at 13%–16%, but HR of death was 0.54 (95% CI: 0.42–0.69), adjusted for age, sex, and comorbidities, in 2013–2018 compared with 1995–2000. Subdistribution of glomerulopathies was stable over time with membranous nephropathy and minimal change disease being the most common.

Conclusion:
During 1995–2018, the incidence of recorded adult nephrotic syndrome increased slightly, and the adjusted mortality of nephrotic syndrome decreased markedly. Whether these findings reflect changes in epidemiology or awareness and coding of nephrotic syndrome, remains to be clarified.
Distribution and Prevalence of Serotypes of Group B Streptococcus Isolated from Pregnant Women in 30 Countries: A Systematic Review
Authors: Maria Silva Marta , Alcântara Silva Érica , Novais Teixeira Oliveira Caline , Cordeiro Santos Maria Luísa , Lima Souza Cláudio , Freire de Melo Fabrício , Vasconcelos Oliveira Márcio 
Published: February 2023

Abstract

Objective
This review aimed to compile scientific data on the distribution and prevalence of group B Streptococcus (GBS) serotypes isolated from pregnant women across 30 countries from 2010 to 2019.

Methods
This was a systematic review that addresses the distribution and prevalence of GBS in pregnant women. The search included studies published between January 2010 and December 2019 in PubMed, Virtual Health Library (BVS), ScienceDirect, SciELO (Scientific Electronic Library Online), and LILACS databases. We also surveyed relevant articles published in English, Spanish, and Portuguese between February and April 2020. Original articles, Communication, Short report, Theses, and Dissertations were included. The prevalence of GBS colonization, method for capsular serotyping, antimicrobial resistance, and distribution and prevalence of serotypes were extracted from each study.

Results
In all, 785 publications were identified. After applying the eligibility criteria, 48 articles were included for the final systematic analysis; most articles were from Asia and were published during the years 2014 to 2017. For the identification of serotypes, most studies used the polymerase chain reaction technique. There were records of all 10 GBS serotypes, namely, Ia, Ib, and II–IX, among the countries analyzed. Antibiotic resistance was mainly associated with strains of serotypes Ia–V.

Conclusion
This review showed that GBS serotypes are distributed differently in the 30 analyzed countries, with serotypes Ia, Ib, and II to V being the most prevalent. Furthermore, our results highlighted the relationship of GBS with maternal colonization, implications for neonates, and antibiotic resistance.
Care Bundles: Enhanced Recovery After Delivery
Authors: Hu Ling-Qun , Lysandrou Plato J. , Minehart Rebecca , Wang Jing-Ping , Xia Yun , Hu Yiling , Worly Brett 
Published: February 2023

Abstract
The care of obstetrics patients has improved dramatically over the past few decades. Unfortunately, rates of cesarean section remain high, and decreasing this rate requires close care and follow-up in the prenatal outpatient setting. Counseling regarding cesarean delivery and vaginal delivery is imperative. Opportunities still exist in helping patients objectively weigh the decision for cesarean delivery versus vaginal delivery. Additional developments have occurred in the intrapartum and the postpartum setting, with an aim to improve patient and neonatal outcomes. Changes have been implemented for patients undergoing cesarean delivery including preoperative and intraoperative treatment of pain, nausea, and vomiting, as well as postoperative care bundles that improve patient outcomes. Innovations have also occurred in the care of postpartum patients after vaginal delivery, again with improvements in patient outcomes. This article summarizes the current evidence, provides care recommendations, and identifies the next steps in improving obstetrics care.