bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patatin-like phospholipase domain-containing 3 gene (PNPLA3) polymorphic (rs738409) single nucleotide polymorphisms and susceptibility to nonalcoholic fatty liver disease: A meta-analysis of twenty studies
Authors: Zhao Yan , Zhao Wenli , Ma Jingchao , Toshiyoshi Maeda , Zhao Ye 
Published: March 2023

Background:
To investigate the correlation between rs738409 polymorphism of patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene (encoding I148m) and genetic susceptibility to nonalcoholic fatty liver disease (NAFLD).

Methods:
Web of Science, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform databases were subjected to study retrieving, from the earliest records to November 2022. International databases were searched using the key words (PNPLA3 gene or PNPLA3 polymorphism or patatin-like phospholipase domain-containing pro-tein3) and (nonalcoholic fatty liver disease or NAFLD or nonalcoholic steatohepatitis) and their possible combination. There was no limitation to language. Ethnicity and country restrictions were not applied. Hardy–Weinberg equilibrium about the genotype frequencies of rs738,409 polymorphism in group of controls was assessed using a chi-square goodness-of-fit test (P > .05). A chi-square-based Q test was applied to assess heterogeneity among studies. The random-effect model (DerSimonian–Laird method) was used when a probability value of P < .10, I
2 > 50%. If not, the fixed-effect model (Mantel–Haenszel method) was adopted. The current meta-analysis was done by using STATA 16.0.

Results:
Twenty studies are selected for this meta-analysis, which includes totally 3240 patients in the treatment group and 5210 patients in the control group. These studies demonstrated a significant increased association between rs738,409 and NAFLD under 5 models: allelic contrast (odds ratio [OR] = 1.98, 95% confidence interval [CI] = 1.65–2.37, P
heterogeneity = 0.000, Z = 7.346, P = .000), homozygote comparison (OR = 3.59, 95% CI = 2.56–5.04, P
heterogeneity = 0.000, Z = 7.416, P = .000), heterozygote comparison (OR = 1.93, 95% CI = 1.63–2.30, P

heterogeneity
= 0.002, Z = 7.507, P = .000), the dominant allele model (OR = 2.33, 95% CI = 1.89–2.88, P
heterogeneity = 0.000, Z = 7.856, P = .000), and the recessive allele model (OR = 2.56, 95% CI = 1.96–3.35, P
heterogeneity = 0.000, Z = 6.850, P = .000). Subgroup analysis shows that the rs738,409 polymorphism of PNPLA3 gene in Caucasians and those with a sample size of < 300 is significantly associated with the susceptibility to nonalcoholic fatty liver. Sensitivity analysis shows that the results of meta-analysis are stable.

Conclusion:
PNPLA3 rs738,409 may play a significant role in increasing risk of NAFLD.
Application of a novel M-NED in ENBD patients: A case series report
Authors: Liu Zhaohui , Lin Runhua , Wu Ruinuan , Deng Jiwen , Sun Dayong 
Published: March 2023

Rationale:
The traditional methods for exchanging the endoscopic nasobiliary drainage (ENBD) tube from the mouth to the nose, such as the guidewire method, sponge holding forceps method, and finger method, have significant drawbacks including pharyngeal stimulation symptoms, high incidence of epistaxis, low success rate, and potential bite injuries to the operator.

Patient concerns:
A case series of 9 patients who underwent ENBD at Shenzhen Second People’s Hospital from January 2021 to December 2021 was collected.

Diagnoses:
The study included 9 patients diagnosed with choledocholithiasis, with 3 males and 6 females, with an average age of (55 ± 9.798) years (range 43–71).

Interventions:
The M-NED was used to exchange the ENBD tube, and the success rate, operation time, and complications were recorded.

Outcomes:
All patients successfully completed the operation in one go with an average mouth-nose exchange time of (44.67 ± 13.388) seconds (range 28–65). Two patients had mild adverse events, one of which was controllable bleeding caused by nasal mucosal injury with an estimated blood loss of 1 mL. The other patient had nausea during the operation, which improved after completion.

Lessons:
The novel M-NED is an effective and safe method for exchanging the ENBD tube from the mouth to the nose with a high success rate and low incidence of complications. It is a device with potential clinical application value.
Effect of low-dose propofol combined with dexamethasone on the prevention of postoperative nausea and vomiting in gynaecological day surgery under remimazolam-based general anesthesia
Authors: Xiao Hongyi , Liu Mingming , Man Yan , Wei Yaxin , Ji Fanceng 
Published: March 2023

Background:
To observe the effect of low-dose propofol combined with dexamethasone on the prevention of postoperative nausea and vomiting (PONV) in gynaecological day surgery under remimazolam-based general anesthesia.

Methods:
A total of 120 patients, aged from 18 to 65 years old, American Society of Anesthesiologists grade I or II, were scheduled to undergo hysteroscopy under total intravenous anesthesia. The patients were divided into 3 groups (n = 40 each): dexamethasone plus saline group (DC group), dexamethasone plus droperidol group (DD group) and dexamethasone plus propofol group (DP group). Dexamethasone 5 mg and flurbiprofen axetil 50 mg were given intravenously before induction of general anesthesia. Anesthesia induction: remimazolam 6 mg/kg/hours was continuously pumped until sleep and slow intravenous injection of alfentanil 20 ug/kg and mivacurium chloride 0.2 mg/kg was given. Anesthesia maintenance: remimazolam 1 mg/kg/hour and alfentanil 40 ug/kg/hours were continuously pumped. After the start of surgery, DC group was given 2 mL saline, DD group was given droperidol 1 mg, and DP group was given propofol 20 mg. Primary outcome: incidence of PONV in the postanesthesia care unit (PACU). Secondary outcome: incidence of PONV in patients within 24 hours after surgery, as well as general patient data, duration of anesthesia, the recovery time of patients, dose of remimazolam and alfentanil, etc.

Results:
In PACU, patients of group DD and DP showed less PONV than those in group DC (P < .05). Within 24 hours after operation, there was no significant difference in the incidence of PONV among the 3 groups (P > .05), but the incidence of vomiting in DD group and DP group was significantly lower than that in DC group (P < .05). There was no significant difference in general data, anesthesia time, the recovery time of patients and dosage of remimazolam and alfentanil among the 3 groups (P > .05).

Conclusion:
The effect of low-dose propofol combined with dexamethasone to prevent PONV under remimazolam-based general anesthesia was similar to that of droperidol combined with dexamethasone, both of which significantly reduced the incidence of PONV in the PACU compared to dexamethasone alone. However, low-dose propofol combined with dexamethasone had little effect on the incidence of PONV within 24 hours compared to dexamethasone alone and only reduced the incidence of postoperative vomiting in patients.
Polo-like kinase 1 Decrease During Induction Therapy Could Indicate Good Treatment Response, Favorable Risk Stratification, and Prolonged Survival in Pediatric Acute Lymphoblastic Leukemia: [RETRACTED]
Authors: Zhao Yiran , Li Chunmei , Cai Chunquan , Fu Hongtao , Zhao Zinian , Han Jing , Zhang Fang , Wang Jing 
Published: March 2023

Objective:
Polo-like kinase 1 (PLK1) modulates leukemia cell apoptosis, proliferation, and cell cycle arrest in the progression of acute lymphoblastic leukemia (ALL). This study intended to investigate the dysregulation of PLK1 and its association with induction therapy response and prognosis in pediatric ALL patients.

Materials and Methods:
Bone marrow mononuclear cell samples were collected from 90 pediatric ALL patients at baseline and on the 15th day of induction therapy (D15), as well as from 20 controls after enrollment, for the detection of PLK1 by reverse transcription-quantitative polymerase chain reaction.

Results:
PLK1 was increased in pediatric ALL patients compared with controls (P<0.001). In pediatric ALL patients, PLK1 decreased from baseline to D15 (P<0.001). Lower PLK1 at baseline was associated with a good prednisone response (P=0.002), while decreased PLK1 at D15 was related to good prednisone response (P=0.001), better bone marrow response (P=0.025), and favorable risk stratification (P=0.014). In addition, reduced PLK1 at baseline was linked with better event-free survival (EFS) (P=0.046), and decreased PLK1 at D15 was related to prolonged EFS (P=0.027) and overall survival (OS) (P=0.047). Moreover, PLK1 decline ≥25% was linked to favorable EFS (P=0.015) and OS (P=0.008). Further multivariate Cox proportional regression analysis revealed that PLK1 decline ≥25% was independently linked with prolonged EFS (hazard ratio (HR)=0.324, P=0.024) and OS (HR=0.211, P=0.019).

Conclusion:
The reduction of PLK1 after induction therapy reflects a good treatment response and correlates with a favorable survival profile in pediatric ALL patients.
Hopping as an Indicator of Chemotoxicity: Gait Analysis in Patients With Leukemia and Lymphoma
Authors: Parker Kellee , Durben Nancy , Oleson David , Yu Yun , Lim Jeong Y. , Recht Michael , Lindemulder Susan 
Published: March 2023

Background:
Survivors of acute lymphoblastic leukemia (ALL) can experience chemotherapy-related changes in neuromuscular function, which can persist and impact the quality of life. Clinically, neuromuscular changes are assessed by observing gait. The primary aims of this study were to compare observational gait/functional movement analysis to matched electronic gait analysis in children with ALL and lymphoblastic lymphoma at specific time points during and after treatment.

Patients and Methods:
Participants 2 to 27 years old diagnosed with ALL/lymphoblastic lymphoma who were on or off therapy within 10 years were eligible. Participants underwent electronic gait assessment using GAITRite, observational gait, and functional movement analysis and completed quality of life questionnaires. Parents also completed quality-of-life assessments.

Results:
Electronic gait parameters were not different in this cohort compared with controls. Mean overall scores on observational gait and functional movement analysis improved over time. Hopping was the most frequent and walking was the least frequent noted deficit. Participants had a lower patient and parent-reported QoL scores compared with the general population

Conclusion:
Observational gait and functional movement analysis identified more deficits than the electronic gait assessment. Future studies are warranted to determine whether hopping deficits are an early clinical indicator of toxicity and signal for intervention.
Determinants of Frame Running capacity in athletes with cerebral palsy to improve training routines and classification strategies: A cross-sectional observational study
Authors: Hjalmarsson Emma , Lidbeck Cecilia , Barrero Santiago Laura , Pingel Jessica , Norrbom Jessica , Sanz Gema , Palmcrantz Alexandra , Pontén Eva , von Walden Ferdinand , Fernandez-Gonzalo Rodrigo 
Published: March 2023

Abstract

Objective
Investigate 1) what physical and physiological parameters are most important for Frame Running (FR) capacity, a parasport for individuals with ambulatory difficulties, and 2) determine if FR capacity can be predicted in athletes with cerebral palsy (CP).

Design
Athletes with CP (n = 62, GMFCS I-V; 2/26/11/21/2) completed a 6-minute FR test (6-MFRT). Before the 6-MFRT, muscle thickness, passive range of motion (hip, knee, ankle), selective motor control, and spasticity (hip, knee, ankle) were measured in both legs. In total, 54 variables per individual were included. Data were analyzed using correlations, Principal Component Analysis (PCA), Orthogonal Partial Least Square (OPLS) regression, and Variable Importance in Projection (VIP) analysis.

Results
Mean 6-MFRT distance was 789 ± 335 m and decreased with motor function severity. The OPLS analysis revealed a modest degree of covariance in the variables analyzed, and that the variance in the 6-MFRT distance could be predicted with 75% accuracy based on all the variables measured. VIP analysis indicated hip and knee extensor spasticity (negative effect), and muscle thickness (positive effect) arose as the most important factors contributing to FR capacity.

Conclusions
These results are an important resource to enable optimization of training regimes to improve FR capacity and contribute to evidence-based and fair classification for this parasport.
Medial gastrocnemius muscle properties of children with cerebral palsy after different tone treatments – a pilot study
Authors: Raymond-Pope Christiana J. , Hoffman Daniel B. , Bloxsom Rachael M. , Greising Sarah M. , Novacheck Tom F. , Boyer Elizabeth R. 
Published: March 2023

Abstract

Objective
Spasticity in children with cerebral palsy (CP) can be managed by a spectrum of approaches, from conservative therapy to temporary botulinum toxin A (BoNT-A) injections, to permanent transection of sensory nerves with a selective dorsal rhizotomy (SDR). This pilot study investigated whether these three tone management approaches are associated with histological and biochemical properties of the medial gastrocnemius.

Design
A convenience sample of children with CP undergoing gastrocnemius lengthening surgery were enrolled. Intraoperative biopsies were obtained from three individuals (1 each: minimal tone treatment; frequent gastrocnemius BoNT-A injections; prior SDR). All individuals had plantarflexor contractures, weakness, and impaired motor control prior to the biopsy.

Results
Differences between participants were observed for muscle fiber cross-sectional area, fiber type, lipid content, satellite cell density, and centrally located nuclei. The most pronounced difference was the abundance of centrally located nuclei in the BoNT-A participant (52%) compared to the others (3-5%). Capillary density, collagen area and content, and muscle protein content were similar across participants.

Conclusions
Several muscle properties appeared to deviate from reported norms, though age- and muscle-specific references are sparse. Prospective studies are necessary to distinguish cause and effect and to refine the risks and benefits of these treatment options.
Odds of Influenza in Patients Receiving Intra-Articular Corticosteroid Injections: A Cohort Study
Authors: Sytsma Terin T. , McCoy Rozalina G. , Fischer Karen M. , Dean Kelly R. , Greenlund Laura S. 
Published: March 2023

ABSTRACT

Objective
Although intra-articular corticosteroid (IACS) is injected locally, some systemic absorption occurs, potentially causing immunosuppression in recipients. This study examined odds of influenza in patients who received IACS compared to matched controls.

Design
Adults in our health system who received IACS from May 2012 through April 2018 were 1:1 matched to adults without IACS. The primary outcome was overall odds of influenza. Secondary analyses examined influenza odds by timing of IACS, joint size, and vaccination status.

Results
23,368 adults (mean age 63.5 years, 62.5% female) received IACS and were matched to a control. While there was no difference in influenza odds by IACS status overall (OR 1.13,[95%CI,0.97-1.32]), patients receiving IACS during influenza season had higher odds of influenza than matched controls (OR 1.34,[95%CI,1.03-1.74]). Furthermore, unvaccinated patients who received IACS during influenza season had higher influenza odds compared to matched controls (OR 1.41,[95%CI,1.04-1.91]), while there was no difference among vaccinated patients.

Conclusion
Patients receiving IACS injections during influenza season had higher odds of influenza. However, vaccination appeared to mitigate this risk. Patients receiving IACS injections should be counseled on infection risk and importance of vaccinations. Further research is needed to examine IACS effects on other viral illnesses.
MR Elastography in Cancer
Authors: Guo Jing , Savic Lynn Jeanette , Hillebrandt Karl Herbert , Sack Ingolf 
Published: March 2023

Abstract
The mechanical traits of cancer include abnormally high solid stress as well as drastic and spatially heterogeneous changes in intrinsic mechanical tissue properties. Whereas solid stress elicits mechanosensory signals promoting tumor progression, mechanical heterogeneity is conducive to cell unjamming and metastatic spread. This reductionist view of tumorigenesis and malignant transformation provides a generalized framework for understanding the physical principles of tumor aggressiveness and harnessing them as novel in vivo imaging markers. Magnetic resonance elastography is an emerging imaging technology for depicting the viscoelastic properties of biological soft tissues and clinically characterizing tumors in terms of their biomechanical properties. This review article presents recent technical developments, basic results, and clinical applications of magnetic resonance elastography in patients with malignant tumors.
Impact of Spousal Donation on Postoperative Outcomes of Living-donor Lobar Lung Transplantation
Authors: Kayawake Hidenao , Tanaka Satona , Yutaka Yojiro , Yamada Yoshito , Ohsumi Akihiro , Hamaji Masatsugu , Nakajima Daisuke , Yurugi Kimiko , Hishida Rie , Date Hiroshi 
Published: March 2023

Background.
The effect of human leukocyte antigen mismatches between donors and recipients on postoperative outcomes of lung transplantation remains controversial. We retrospectively reviewed adult recipients receiving living-donor lobar lung transplantation (LDLLT) to examine the difference in de novo donor-specific antibody (dnDSA) development and clinically diagnosed unilateral chronic lung allograft dysfunction per graft (unilateral CLAD) between lung grafts donated by spouses (nonblood relatives) and nonspouses (relatives within the third degree). We also investigated the difference in prognoses between recipients undergoing LDLLTs including spouse donors (spousal LDLLTs) and not including spouse donors (nonspousal LDLLTs).

Methods.
In this study, 63 adult recipients undergoing LDLLTs (61 bilateral and 2 unilateral LDLLTs from 124 living donors) between 2008 and 2020 were enrolled. The cumulative incidence of dnDSAs per lung graft was calculated, and prognoses were compared between recipients undergoing spousal and nonspousal LDLLTs.

Results.
The cumulative incidence of both dnDSAs and unilateral CLAD in grafts donated by spouses was significantly higher than that in grafts donated by nonspouses (5-y incidence of dnDSAs: 18.7% versus 6.4%, P = 0.038; 5-y incidence of unilateral CLAD: 45.6% versus 19.4%, P = 0.011). However, there were no significant differences in the overall survival or chronic lung allograft dysfunction-free survival between recipients undergoing spousal and nonspousal LDLLTs (P > 0.99 and P = 0.434, respectively).

Conclusions.
Although there were no significant differences in prognoses between spousal and nonspousal LDLLTs, more attention should be paid to spousal LDLLTs because of the higher development rate of dnDSAs and unilateral CLAD.
Using an Artificial Intelligence Application Expedited ENRICH Trial Patient Screening: A Single Center Experience
Authors: C. Field Nicholas , Rogers Aubrey , Custozzo Amanda J. , Boulos Alan S. , Dalfino John , Paul Alexandra R. 
Published: March 2023

ObjectiveThe ENRICH Trial was the first to demonstrate superiority of surgical intervention over medical management when performed within 24 hours of symptom onset for supratentorial lobar hemorrhages. We aimed to determine whether the implementation of an intracranial hemorrhage detection algorithm that provides immediate active notification to provider cell phones would expediate the screening of hemorrhagic stroke patients for the trial at our institution.MethodsA retrospective review of our prospectively collected ENRICH Trial patient screening log was performed at our Comprehensive Stroke Center. The log encompassed patients screened for the ENRICH Trial who presented between January 2018 and March 2022. Trial screening data was compared pre- and post-implementation of the VizAI (Viz.ai, San Francisco, California, USA) smartphone application.Results188 adult patients were identified during the study period. Time between CT Head and notification of the neurosurgical team for trial screening was reduced by 50 minutes after the implementation of VizAI (p<0.002). The number increases to 57 minutes when hemorrhages not identified by the ICH algorithm were excluded.ConclusionsActive notification of the neurosurgical team by an artificial intelligence application significantly reduces the time from hemorrhage identification to trial screening. Further studies are needed to evaluate whether this results in a clinical benefit.
Clinical hypoxemia score for outpatient child pneumonia care lacking pulse oximetry in Africa and South Asia
Authors: Schuh Holly B. , Hooli Shubhada , Ahmed Salahuddin , King Carina , Roy Arunangshu D. , Lufesi Norman , Islam ASMD Ashraful , Mvalo Tisungane , Chowdhury Nabidul H. , Ginsburg Amy Sarah , Colbourn Tim , Checkley William , Baqui Abdullah H. , McCollum Eric D. 
Published: March 2023

ABSTRACTBackgroundPulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.MethodsThis was a retrospective pooled analysis of two outpatient datasets of 3-35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi. We constructed, internally validated, and compared fit & discrimination of four models predicting SpO2<93% and <90%: (1) Integrated Management of Childhood Illness guidelines, (2) WHO-composite guidelines, (3) Independent variable least absolute shrinkage and selection operator (LASSO); (4) Composite variable LASSO. Results: 12,712 observations were included. The independent and composite LASSO models discriminated moderately (both C-statistic 0.77) between children with a SpO2<93% and ≥94%; model predictive capacities remained moderate after adjusting for potential overfitting (C-statistic 0.74 and 0.75). The IMCI and WHO-composite models had poorer discrimination (C-statistic 0.56 and 0.68) and identified 20.6% and 56.8% of SpO2<93% cases. The highest score stratum of the independent and composite LASSO models identified 46.7% and 49.0% of SpO2<93% cases. Both LASSO models had similar performance for a SpO2<90%.ConclusionsIn the absence of pulse oximeters, both LASSO models better identified outpatient hypoxemic pneumonia cases than the WHO guidelines. Score external validation and implementation are needed.
Does ChatGPT Provide Appropriate and Equitable Medical Advice?: A Vignette-Based, Clinical Evaluation Across Care Contexts
Authors: Nastasi Anthony J. , Courtright Katherine R. , Halpern Scott D. , Weissman Gary E. 
Published: March 2023

ABSTRACTChatGPT is a large language model trained on text corpora and reinforced with human supervision. Because ChatGPT can provide human-like responses to complex questions, it could become an easily accessible source of medical advice for patients. However, its ability to answer medical questions appropriately and equitably remains unknown. We presented ChatGPT with 96 advice-seeking vignettes that varied across clinical contexts, medical histories, and social characteristics. We analyzed responses for clinical appropriateness by concordance with guidelines, recommendation type, and consideration of social factors. Ninety-three (97%) responses were appropriate and did not explicitly violate clinical guidelines. Recommendations in response to advice-seeking questions were completely absent (N=34, 35%), general (N=18, 18%), or specific (N=44, 46%). Fifty-three (55%) explicitly considered social factors like race or insurance status, which in some cases changed clinical recommendations. ChatGPT consistently provided background information in response to medical questions but did not reliably offer appropriate and personalized medical advice.