bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myasthenia-like paraneoplastic syndrome with multiple cranial nerve tumor infiltration: A case report and literature review
Authors: Wen Chunbei , Yang Jie , Xu Changyou , Wei Dongsheng , Luo Lijun 
Published: May 2023

Rationale:
Approximately 0.001% of patients with cancer have paraneoplastic nerve system syndrome, which can affect the central nervous system, neuromuscular junction, or peripheral nervous system. Although myasthenia gravis (MG) may exist as a thymic paraneoplastic syndrome (PNPS), its association with primary lung cancer remains unknown.

Patient concerns:
A 55-year-old female presented with slurred speech, weakness in chewing, sporadic difficulty in swallowing, and weakness in both lower limbs for half a year.

Diagnoses:
Based on cerebrospinal fluid and electromyography findings, we present the case of a female patient diagnosed with overlapping multicranial nerve tumor infiltration and MG-like neurological PNPS secondary to lung adenocarcinoma.

Interventions:
The patient received intrathecal injections of pemetrexed and neurotrophic (vitamin B) therapy before ceasing chemoradiotherapy and chose cabozantinib on her own.

Outcomes:
Weakness of the proximal limbs, choking cough, and chewing problems did not improve significantly.

Lessons:
Although it is unclear why MG coexists with lung cancer, it is probable that MG is a paraneoplastic condition. Cerebrospinal fluid testing should be carried out along with electrophysiological, serological, and pharmacological procedures pertinent to the diagnosis of MG to thoroughly examine if people simultaneously experience MG-like PNPS and tumor growth. Starting immunotherapy and anticancer medication at the same time that tumor development and MG-like syndrome are discovered is crucial.
Laparoscopic fundoplication in treating refractory gastroesophageal reflux-related chronic cough: A meta-analysis
Authors: Liu Jiannan , Deng Changrong , Zhang Meiguang , Zhang Yu , Hu Zhiwei , Sun Minjie , Wu Jimin 
Published: May 2023

Background:
Gastroesophageal reflux-related chronic cough (GERC), is one common type of chronic cough. Drug treatment is effective for some GERC patients. But, there is refractory GERC (rGERC). For rGERC, fundoplication may be the only effective method. However, there were very few studies about laparoscopic fundoplication in treating rGERC, and the cure rate of fundoplication in treating rGERC was unknown. So there is a question, what is the cure rate of fundoplication in treating rGERC? To solve this question, we performed this meta-analysis.

Methods:
The PRISMA strategy and Cochrane collaboration method were used for this study. Our study was registered with PROSPERO (ID: CRD42021251072). We searched PubMed, Medline, Web of Science, and the Cochrane databases from 1990 to December 2022. The meta-analysis was performed with Review Manager 5.4 and Stata 14.

Results:
After selection and exclusion, 8 articles out of 672 were included. The meta-analysis showed the cure rate of laparoscopic fundoplication in treating rGERC was 62% (95% confidence interval: 53–71%), with no deaths in 503 patients. There was no significant heterogeneity or bias in the meta-analysis.

Conclusions:
In terms of safety, laparoscopic fundoplication is quite reliable offered by skilled surgeons. In terms of cure rate, laparoscopic fundoplication could completely heal two-thirds of rGERC patients; however, there are still some patients who can not be completely cured by fundoplication.
Clinical efficacy of selenium supplementation in patients with Hashimoto thyroiditis: A systematic review and meta-analysis
Authors: Kong Xiang-Qi , Qiu Gui-Ying , Yang Zhong-Bin , Tan Zhi-Xiong , Quan Xiao-Qing 
Published: May 2023

Background:
Evidence suggests that selenium supplementation could be useful in the treatment of Hashimoto thyroiditis (HT), but the available trials are heterogeneous. This study investigates clinically relevant effects of selenium supplementation in patients with HT.

Methods:
A systematic search was performed in PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Library. The latest update was performed on December 3, 2022. We investigated the changes in thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) after selenium supplementation. The effect sizes were expressed as weighted mean difference (WMD) with 95% confidence intervals (CIs).

Results:
After screening and full-text assessment, 7 controlled trials comprising 342 patients were included in the systematic review. The results showed that there was no significant change in TPOAb levels (WMD = −124.28 [95% CI: −631.08 to 382.52], P = .631, I
2 = 94.5%) after 3 months of treatment. But there was a significant decrease in TPOAb levels (WMD = −284.00 [95% CI: −553.41 to −14.60], P < .05, I
2 = 93.9%) and TgAb levels (WMD = −159.86 [95% CI: −293.48 to −26.24], P < .05, I
2 = 85.3%) after 6 months of treatment.

Conclusions:
Selenium supplementation reduces serum TPOAb and TgAb levels after 6 months of treatment in patients with HT, but future studies are warranted to evaluate health-related quality or disease progression.
A case report: Hemophagocytic lymphohistiocytosis and thrombotic thrombocytopenic purpura in an otherwise healthy woman
Authors: Li Yuanyuan , Li Wenqiang , Li Zhen , Ma Fubing , Xu Baocai 
Published: May 2023

Rationale:
Thrombotic thrombocytopenic purpura (TTP) with hemophagocytic lymphohistiocytosis (HLH) is very rare, and both of these rare blood diseases have high mortality. There have been few reports of 2 diseases being combined at the same time. We provide a rare case with a clear diagnosis, prolonging the patient's survival through aggressive treatment, providing clinicians with our experience in early diagnosis and early treatment of this disease.

Patient concerns:
A 56-year-old woman presented with a 1-month history of fever.

Diagnoses:
She was diagnosed with HLH due to elevated levels of ferritin and lactase dehydrogenase, which were confirmed by the presence of hemophagocytosis in the bone marrow. TTP was diagnosed based on the presence of symptoms characteristic of TTP and significantly low levels of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13).

Interventions:
Systemic corticosteroids and plasma exchange using 2 L of virus-inactivated frozen plasma per day were initiated as specific treatment.

Outcomes:
The patient’s consciousness improved posttreatment and platelets also increase gradually. In a follow-up after 1 month, the patient was generally well and without specific discomfort.

Lessons:
HLH patients themselves can have a significant reduction in platelet, as with TTP, it is very easy to misdiagnose or delay the diagnosis. How to diagnose early, actively find the primary disease, and treat it is crucial to improve the prognosis of HLH.
Surgical treatment of gastric stump carcinoma after Whipple procedure: A case report
Authors: Xie Wenjie , Liu Kuan , Lai Jianxiong , Li Jian 
Published: May 2023

Rationale:
Gastric stump carcinoma (GSC) is very exceptional and little known after Whipple procedure, and its diagnosis and treatment are extremely difficult to handle.

Patient concerns:
The patient, a 68-year-old man, visited our hospital’s General surgery outpatient clinic complaining of upper abdominal pain that had been bothering him for half a month. The endoscopy revealed lesions in the stomach residual, and the pathological results suggested adenocarcinoma. The patient underwent Whipple procedure for periampullary adenocarcinoma in the 4th year ago.

Diagnoses:
The final diagnosis was gastric adenocarcinoma and its pathological stage was Ⅱ A (T3N0M0).

Interventions:
The patient underwent stump gastrectomy and end-to-side esophagojejunostomy (Roux-en-Y reconstruction).

Outcomes:
The operation went smoothly and the patient recovered well with only mild bloating and nausea, and the symptoms completely disappeared during the hospital stay.

Lessons:
The development of GSC several years after Whipple procedure is uncommon. This is the first case from China that has received international attention. Early diagnosis is crucial. Surgery is considered to be the most effective treatment for GSC after Whipple procedure if long-term survival is possible and surgical risks are controllable.
Stomach ulcer caused by mistakenly oral medication of 14,400 mg ibuprofen: A case report
Authors: Meijuan Zhang , Yu Penglong , Yuan Jie , Yu Tao , SUN Dan 
Published: May 2023

Rationale:
Gastric mucosal ulcer caused by drug overdose is very rare in clinical practice, and here is a case of gastric antral ulcer caused by drug overdose.

Patient concerns:
A 35-year-old housewife from a mountainous region in China took 48 Ibuprofen Sustained-Release capsules (300 mg/capsule) orally at 1 time. Because of severe tingling in the upper abdomen accompanied by a sharp increase in blood pressure, she came to the doctor 48 hours later.

Diagnoses:
Gastric antral ulcer (multiple stage A1), duodenococcitis, chronic nonatrophic gastritis, Helicobacter pylori infection, moderate depression, and cognitive impairment.

Interventions:
Acid suppression, antihypertensive and a series of symptomatic treatments.

Outcomes:
All somatic symptoms disappeared after a follow-up visit 2 months later.

Lessons:
This case provides valuable information to the clinic, through the compilation of literature and case analysis, the author found that paying attention to mental health, to women in poor areas and to women from families of low education level are indispensable in medical diagnosis and treatment.
Using Rasch KIDMAP to identify whether China dominates the research area of computer science (CS) based on the specialization index of article citations: Bibliometric analysis
Authors: Yen Po-Tsung , Chien Tsair-Wei , Chou Willy , Kan Wei-Chih 
Published: May 2023

Background:
Scientific comparative advantage is measured by using a specialization index (SI) of article citations. The profile data have been published in the literature. However, no such research has been conducted to determine which countries dominate the field of computer science (CS) (subject category [SC]) using the SI. A KIDMAP in the Rasch model has been applied to the display of individual student performance in school. Based on the SI of article citations, we used KIDMAP to determine whether China dominates the field of CS.

Methods:
The data were derived from published research in the Web of Science, which included 199 countries and 254 subject categories (SC, between 2010 and 2019). A total of 96 SC related to biomedicine were extracted. We examined 7 factors associated with CS using exploratory factor analysis. Based on the SI in CS under the Rasch model, 1-dimensional SCs on CS were displayed on Wright Maps and KIDMAPs. An analysis of the dominance of CS in China was presented on the basis of a scatter plot.

Results:
Our findings indicate that (1) CS domains are divided into 2 groups (traditional and advanced domains); (2) no evidence has been found that China dominates CS; based on SI indicators, China was ranked third with -−2.62 and 0.79 logits after Taiwan and Slovenia (-(−2.62 and 9.24 logits in Factors 1 and 2) in the period from 2010 to 2019.

Conclusions:
There is insufficient evidence to demonstrate that China has a dominant role over other countries/regions despite ranking third in CS. In future studies, it is recommended to include a KIDMAP visual to assess dominant roles in other areas of research, rather than to confine ourselves to CS as we did in this study.
First experience of lymphaticovenular anastomosis using BHC RobotiScope: A case report
Authors: Chung Jae-Ho , Kim Dong-Jin , Yoon Eul-Sik , Park Seung-Ha 
Published: May 2023

Rationale:
The RoboticScope (BHS Technologies GmbH, Innsbruck, Austria) is a robotic exoscope, which consists of a robotic arm that holds a 3-dimensional camera. It has an advantage that a surgeon can perform an operation comfortably with a favorable ergonomic position. Also, it allows the delivery of clear and high-quality visualization for surgeons. In this study, we would like to share our initial experience with this newly developed microscope technology in lymphaticovenular anastomosis (LVA). To the best of our knowledge, it is the first experience of LVA using this microscope in Asia.

Patient concerns:
A 65-year-old woman presented with bilateral lower extremity lymphedema after a hysterectomy that was performed 25 years back. Despite complex decongestive physiotherapy, an edematous symptom in both legs worsened.

Diagnoses:
In lymphoscintigraphy, a decreased visualization of main lymphatic flow in both the lower extremities was evident which was further suggestive of lymphatic obstruction.

Intervention:
Although both sides showed edematous symptoms, we decided to proceed with the surgery on the left side first, because of the worsened condition. Four LVAs were performed at the dorsum of the foot (×2), ankle, and the superior edge of the knee using RoboticScope

Outcomes:
At 6-months follow-up after operation, the postoperative circumference diameters were improved than preoperative in 10 cm above the knee (45 cm vs 49 cm), 10cm below the knee (37 cm vs 41 cm) and lateral malleolus (25 cm vs 28 cm). The lower extremity lymphedema index was also improved from 346.7 to 287.4 postoperatively. The RoboticScope provided a high-resolution image and a favorable ergonomic position during an operation.

Lessons:
The results represent the possibility of the application of a robotic microscope in the field of microsurgery, and further studies are necessitated to confirm the efficacy of this system.
Home monitoring vs hospitalization for mild acute pancreatitis. A pilot randomized controlled clinical trials
Authors: Sorribas Maria , Carnaval Thiago , Peláez Núria , Secanella Luis , Salord Silvia , Sarret Sònia , Videla Sebastián , Busquets Juli ,   On Behalf of the RHINO Study Group
Published: May 2023

Introduction:
Acute pancreatitis is a high-incidence benign disease. In 2009, it was the second highest cause of total hospital stays, the largest contributor to aggregate costs (approximately US$ 7000.00 per hospitalization), and the fifth leading cause of in-hospital deaths in the United States. Although almost 80% of acute pancreatitis cases are mild (usually requiring short-term hospitalization and without further complications), severe cases can be quite challenging.
Classifications, scores, and radiological criteria have been developed to predict disease severity and outcome accurately; however, in-hospital care remains of widespread use, regardless of disease severity. A recent Turkish study reported that mild acute pancreatitis can be effectively and safely managed with home monitoring. Although the optimal timing for oral refeeding remains controversial and could cast some doubt on the feasibility of home monitoring, some guidelines already advocate for starting it within 24 hours.
The present clinical trial aims to assess whether home monitoring is effective, safe and non-inferior to hospitalization for managing mild acute pancreatitis.

Methods:
This will be a multicenter open-label randomized (1:1) controlled clinical trial to assess the efficacy and safety of home monitoring compared to in-hospital care for mild acute pancreatitis. All patients coming to the emergency department with suspected acute pancreatitis will be screened for enrollment. The main variable will be treatment failure (Yes/No) within the first 7 days after randomization.

Discussion:
Acute pancreatitis implies a high economic burden in healthcare systems worldwide. Recent evidence suggests that mild disease can be safely and effectively treated with home monitoring. This approach may produce considerable cost savings and positively impact patients’ quality of life. We expect the results to show that home monitoring is effective and not inferior to hospitalization for managing mild acute pancreatitis and that the economic costs are lower, kickstarting similar trials throughout the world, optimizing the use of limited healthcare budgets, and improving patients’ quality of life.
Radiological findings of contrast-induced encephalopathy following cerebral angiography: A case report
Authors: Wu Bin , Zeng Ling , Peng Kaifa , Shao Xi , Liu Li , Man Rongyong , Tang Xianbi , Zhong Yushi 
Published: May 2023

Introduction:
Contrast-induced encephalopathy (CIE) is a rare complication associated with the use of contrast media. New contrast agents make contrast complications increasingly rare. The diagnosis of CIE is challenging, particularly in patients with acute ischemic stroke. Neuroimaging results for patients with CIE can also be highly variable.

Patient concerns:
A 63-year-old man with severe internal carotid artery stenosis who experienced several symptoms, including dizziness, nausea, vomiting, fever, and blurred vision after being administered the contrast agent iodixanol.

Diagnoses:
Multiple CT and MRI brain scans were performed. After excluding other differential diagnoses such as electrolytes imbalance, hypo/hyperglycemia and other neurological emergencies such as cerebral hemorrhage, cerebral infarction, the final diagnosis of CIE was made.

Intervention:
Treatment consisted of adequate hydration, intravenous dexamethasone, mannitol, and anticonvulsants.

Outcome:
The patient demonstrated progressive neurological improvement, and recovered from all symptoms on the fifth day. Follow-up at 3 months shows a good prognosis for patients.

Conclusion:
Patients with CIE may have a high signal on diffusion-weighted imaging and a low signal on apparent diffusion coefficient brain MRI. This is similar to the MRI findings in acute stroke. This needs to be distinguished from acute cerebral infarction and suggests that we should closely monitor patients’ neurological symptoms at the time of cerebral angiography and after the investigations.
“Financial Literacy in Plastic Surgery Training: Importance and Current Status”
Authors: Krasniak Peter J. , Kraft Casey T. , O’Brien Andrew L. , Huayllani Maria T. , Kaptsan Irina , Pearson Gregory D. , Moore Amy M. 
Published: May 2023

Background:
Medical training is known to impose financial burden on trainees, which has been shown to contribute to burnout, even possibly compromising patient care. Financial literacy allows for management of financial situations affecting professional and personal life. We aimed to evaluate the financial status and knowledge amongst Plastic Surgery residents.

Methods:
A survey regarding finances and financial literacy of plastic surgery residents was sent to all the current accredited US residency programs. The same survey was distributed internally. A descriptive analysis was performed, and multiple Fisher’s Exact tests and a Student’s T-test evaluated comparisons.

Results:
Eighty-six residents were included. Most trainees had a student loan (59.3%), with 22.1% having more than $300k. A majority had at least one personal loan debt other than educational (51.1%). Residents with more debt were significantly less likely to pay off their balances monthly. A total of 17.4% of trainees had no plan for how to invest their retirement savings, whereas 55.8% reported not knowing how much they need to save to retire. One in five trainees did not feel prepared to manage personal finances/retirement planning after graduation, a majority had no formal personal finance education in their curriculum, and 89.5% agreed that financial literacy education would be beneficial. Our institutional data largely mirrored national data.

Conclusion:
Many residents are lacking in financial knowledge, despite most having significant debt. Additional financial literacy education is needed in Plastic Surgery training. Curricula development at an institutional or national society level are possible paths towards a coordinated response towards this need.
Psychological Factors Predict Higher Odds and Impairment of Post-COVID Symptoms: A Prospective Study
Authors: Milde Christopher , Glombiewski Julia A. , Wilhelm Marcel , Schemer Lea 
Published: May 2023

ABSTRACT

Objective
The causes of the long-term persistence of symptoms after a severe acute respiratory syndrome coronavirus 2 infection (i.e., post-COVID syndrome) remain elusive. Although previous research identified demographic and medical risk factors for the development of post-COVID, the present prospective study is the first to investigate the role of psychological factors.

Methods
The interview and survey data of polymerase chain reaction–positive participants (n = 137; 70.8% female) were assessed in the acute, subacute (3 months after symptom onset), and chronic phases (6 months after symptom onset) of COVID.

Results
After controlling for medical (body mass index, disease score) and demographic factors (sex, age), psychosomatic symptom burden (measured by the Somatic Symptom Disorder—B Criteria Scale) predicted higher odds and magnitude of COVID-related symptom impairment in the post-COVID phases. Fear of COVID-related health consequences (measured by the Fear of COVID Scale) also predicted higher odds of reporting any COVID symptoms in the subacute and chronic phases, whereas it only predicted a higher magnitude of COVID-related symptom impairment in the subacute phase. In subsequent exploratory analyses, we found that other psychological factors were associated with an overall increase (i.e., chronic stress and depression) or decrease (i.e., trait positive affect) in the odds and magnitude of COVID-related symptom impairment.

Conclusions
We conclude that psychological factors can fuel or temper the experience in post-COVID syndrome, opening new possibilities for psychological interventions.

Trial Registration
The study protocol was preregistered in the Open Science Framework (https://osf.io/k9j7t).
Psychological Resilience to Trauma and Risk of COVID-19 Infection and Somatic Symptoms Across 2 Years
Authors: Nishimi Kristen , Tan Jeri , Scoglio Arielle , Choi Karmel W. , Kelley Dennis Parker , Neylan Thomas C. , O’Donovan Aoife 
Published: May 2023

ABSTRACT

Objective
Exposure to trauma increases the risk of somatic symptoms, as well as acute and chronic physical diseases. However, many individuals display psychological resilience, showing positive psychological adaptation despite trauma exposure. Resilience to prior trauma may be a protective factor for physical health during subsequent stressors, including the COVID-19 pandemic.

Methods
Using data from 528 US adults in a longitudinal cohort study, we examined psychological resilience to lifetime potentially traumatic events early in the pandemic and the risk of COVID-19 infection and somatic symptoms across 2 years of follow-up. Resilience was defined as level of psychological functioning relative to lifetime trauma burden, assessed in August 2020. Outcomes included COVID-19 infection and symptom severity, long COVID, and somatic symptoms assessed every 6 months for 24 months. Using regression models, we examined associations between resilience and each outcome adjusting for covariates.

Results
Higher psychological resilience to trauma was associated with a lower likelihood of COVID-19 infection over time, with one standard deviation higher resilience score associated with a 31% lower likelihood of COVID-19 infection, adjusting for sociodemographics and vaccination status. Furthermore, higher resilience was associated with lower levels of somatic symptoms during the pandemic, adjusting for COVID-19 infection and long COVID status. In contrast, resilience was not associated with COVID-19 disease severity or long COVID.

Conclusions
Psychological resilience to prior trauma is associated with lower risk of COVID-19 infection and lower somatic symptoms during the pandemic. Promoting psychological resilience to trauma may benefit not only mental but also physical health.