bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visit-to-visit SBP variability and risk of atrial fibrillation in middle-aged and older populations
Authors: Wang Chi , Sun Yizhen , Xin Qian , Han Xu , Cai Zefeng , Zhao Maoxiang , Yun Cuijuan , Zhang Sijin , Hou Ziwei , Chen Shuohua , Wu Shouling , Xue Hao 
Published: October 2022

Objective:
We sought to examine the relationship between visit-to-visit variability of SBP and incident atrial fibrillation in middle-aged and older population.

Methods:
This prospective cohort study included 26 999 participants aged 50 years or older at study entry. Visit-to-visit variability of SBP was defined as the average real variability (ARV) of three values of SBP from the examinations of 2006, 2008, and 2010. We categorized participants into four groups according to the quartiles of ARV. Incident atrial fibrillation cases were identified via ECG during biennial resurveys, and reviewing medical insurance record and discharge registers. We used Cox regression models to evaluate the hazard ratios and 95% confidence intervals (CI) for incident atrial fibrillation.

Results:
After an average follow-up of 9.24 years, a total of 420 atrial fibrillation cases were identified. The incidence of atrial fibrillation from the lowest to the highest quartiles of SBP variability were 1.23, 1.53, 1.81 and 2.19 per 1000 person-years, respectively. After adjusting for potential confounders, including mean blood pressure, we found a graded association between SBP variability and risk of atrial fibrillation. Participants in the third quartile and the highest quartile were associated with 35 and 53% higher risk of developing atrial fibrillation, respectively, compared with participants in the lowest quartile [hazard ratio (95% CI), 1.35 (1.01–1.82) and 1.53 (1.15–2.04)]. The results persisted across sensitivity analyses.

Conclusion:
Increased visit-to-visit variability of SBP is a strong predictor of incident atrial fibrillation in middle-aged and older population. Evaluation of long-term SBP variability could help to identify individuals at higher risk of atrial fibrillation.
Preliminary Application of High-Frequency Ultrasound in the Differentiation of Pemphigus and Bullous Pemphigoid: An Observational Study
Authors: Liu Yang-Ai , Cao Rong , Da Mei-Hong , Dong Zheng-Bang , Wang Fei 
Published: October 2022

Objective:
Ultrasonography is a diagnostic imaging technique used to visualize subcutaneous body structures for identification of possible pathologies. In this study, we aimed to explore the clinical significance of high-frequency ultrasound in differentiating the location of blisters between pemphigus and bullous pemphigoid.

Methods:
Eighteen patients were recruited in Department of Dermatology, Zhongda Hospital from 2020 to 2021 and divided into a pemphigus group (n = 8) and a bullous pemphigoid group (n = 10) according to the diagnostic criteria for each. Ultrasonographic images were collected using a 50-MHz high-frequency ultrasound system. The indexes of ultrasonic evaluation were the layer (epidermis or dermis), size, shape, internal echo, and boundary of the blister. Categorical variables are expressed as n (%), and differences were compared using Fisher’s exact test.

Results:
The ultrasonographic images in the pemphigus group showed an intraepidermal semi-arc or irregular anechoic or hypoechoic areas. The inferior borders were situated above the characteristic thin linear hyperechoic bands of the epidermis. A linear hypoechoic band was present at the dermoepidermal junction in some cases. In the ultrasonographic images of the bullous pemphigoid group, the linear hyperechoic bands of the epidermis were continuous and intact. An oval fluid anechoic area (subepidermal blister) was present immediately below the bands. The location of the blisters in the ultrasonographic images was significantly different between the 2 groups (P < 0.001).

Conclusion:
High-frequency ultrasound can be used as an auxiliary means to differentiate the location of blisters between pemphigus and bullous pemphigoid.
The potential benefit of endothelin receptor antagonists’ therapy in idiopathic pulmonary fibrosis: A meta-analysis of results from randomized controlled trials
Authors: Li Shuang , Pan Yong-li , Xin Wenqiang , Yan Chunhua 
Published: October 2022

Background:
Fibrotic diseases take a very heavy toll in terms of morbidity and mortality equal to or even greater than that caused by metastatic cancer. This meta-analysis aimed to evaluate the effect of endothelin receptor antagonists on idiopathic pulmonary fibrosis.

Method:
A systematic search of the clinical trials from the Medline, Google Scholar, Cochrane Library, and PubMed electronic databases was performed. Stata version 12.0 statistical software (Stata Crop LP, College Station, TX) was adopted as statistical software.

Result:
A total of 5 studies, which included 1500 participants. Our analysis found there is no significant difference between using the endothelin receptor antagonists’ group and placebo groups regarding the lung function via estimating both the change of forced vital capacity from baseline and DLco index. Exercise capacity and serious adverse effects are taken into consideration as well; however, there is still no significant change between the 2 groups.

Conclusion:
This meta-analysis provides insufficient evidence to support that endothelin receptor antagonists’ administration provides a benefit among included participants who encounter idiopathic pulmonary fibrosis.
Efficacy and safety of vedolizumab for inflammatory bowel diseases: A systematic review and meta-analysis of randomized controlled trials
Authors: Qiu Bo , Liang Jia-Xu , Li Cong 
Published: October 2022

Background:
Vedolizumab is a humanized monoclonal antibody that inhibits gut-selective α4β7 integrins on the surface of leukocytes, preventing their trafficking into the gastrointestinal tract, and ultimately achieves the effect of suppressing intestinal inflammation. This study aimed to evaluate the efficacy and safety of vedolizumab in the treatment of inflammatory bowel disease.

Methods:
After a systematic review of relevant studies, the pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated to evaluate the effect. Heterogeneity was explored using sensitivity analysis, univariate meta-regression, and subgroup analysis. Potential publication bias was evaluated using Egger test and trim-and-fill method.

Results:
Nine randomized controlled trials involving 4268 participants were included in the meta-analysis. During induction therapy, vedolizumab was more effective than placebo in treating active ulcerative colitis and Crohn disease in terms of clinical response (RR = 1.55, 95%CI: 1.35–1.78), clinical remission (RR = 1.90, 95%CI: 1.50–2.41), and mucosal healing (RR = 1.53, 95%CI: 1.21–1.95). A superior effect in terms of durable Clinical or Crohn disease Activity Index-100 response (RR = 1.65, 95%CI: 1.20–2.26), clinical remission (RR = 1.92, 95%CI: 1.48–2.50), and glucocorticoid-free remission (RR = 2.22, 95%CI: 1.71–2.90) was found during maintenance treatment. Vedolizumab was not associated with any adverse events and was as safe as placebo in terms of the risk of serious adverse reactions.

Conclusions:
Vedolizumab may be safe and effective as an induction and maintenance therapy for the treatment of inflammatory bowel disease; however, further studies are needed to validate this conclusion.
Nasal protection strategy reduces the incidence of nasal pressure injuries during nasotracheal intubation: Meta-analysis with trial sequential analysis
Authors: Hoshijima Hiroshi , Mihara Takahiro , Nagumo Takumi , Sato (Boku) Aiji , Shiga Toshiya , Mizuta Kentaro 
Published: October 2022

Background:
Nasal pressure injury is a serious problem during nasotracheal intubation. We performed this systematic review and meta-analysis to determine whether use of a nasal protection strategy (a protective dressing or a modified fixation method for the tracheal tube) reduces the incidence of nasal pressure injury during nasotracheal intubation.

Methods:
Literature searches were performed using three electronic databases. Data from each of the eligible trials were combined, and calculations were made using DerSimonian and Laird random effects models. The pooled effect estimates for nasal pressure injury were evaluated using the relative risk and 95% confidence interval, the Cochrane Q statistic, and the I
2 statistic. We also performed trial sequential analysis (TSA) to assess sensitivity to prevent type I error. We separated patients into subgroups to analyze the incidence of nasal pressure injury according to whether a protective dressing or a modified fixation method for the tracheal tube was used.

Results:
The literature search yielded five eligible trials. Meta-analysis of these trials showed that a nasal protection strategy significantly reduced the incidence of nasal pressure injury during nasotracheal intubation (relative risk (RR) 0.34; 95% confidence interval (CI) 0.21–0.56; P < .0001; Cochrane’s Q = 5.86, I
2 = 32%). The TSA boundary for futility could not be calculated because of an insufficient sample size. In subgroup analysis, both methods significantly reduced the incidence of nasal pressure injury during nasotracheal intubation.

Conclusions:
The findings of this meta-analysis suggest that a nasal protection strategy significantly reduces the incidence of nasal pressure injury during nasotracheal intubation. During nasotracheal intubation, the use of a protective dressing or modified fixation method for the tracheal tube can prevent to the incidence of nasal pressure injuries. However, the number of samples in our meta-analysis was too small for TSA and further studies are required.

Trials registration:
PROSPERO (International Prospective Register of Systematic Reviews; registration number 252091).
Efficacy of Phellinus linteus extract on immunity enhancement: A CONSORT-randomized, double-blind, placebo-controlled pilot trial
Authors: Ku Yong Ho , Kang Jae Hui 
Published: October 2022

Background:
Immunity is a major system that defends the human body from the outside. Recently, interest in foods related to immunity has been increasing.

Methods:
The purpose of this clinical trial was to determine the safety and efficacy of Phellinus linteus (PL) extract in improving immune function. A total of 30 participants were randomly assigned to 3 groups: the PL1000 group (n = 10) took 1000 mg of PL extract and 1000 mg of dextrin per day; the PL2000 group (n = 10) took 2000 mg of PL extract per day; and the placebo group (n = 10) took 2000 mg of dextrin per day. All participants took 2 capsules twice a day for 8 weeks. We measured their natural killer cell activity and cytokine levels in blood before and after consuming the clinical trial food. Variables were also investigated to evaluate safety, such as adverse reactions, vital signs, and abnormal findings. Student t test or the Mann–Whitney U test, a paired t test or the Wilcoxon signed-rank test, a chi-square test, analysis of variance, and Kruskal–Wallis test were conducted according to the characteristics of the data to compare the differences between each group before and after participants ate the clinical trial food.

Results:
The natural killer cell activity and interleukin-6 levels of the PL1000 group tended to improve compared to those of the placebo group. Immunoglobulin G1, immunoglobulin G2, and immunoglobulin M levels did not show significant changes, but tended to improve in the PL1000 and PL2000 groups compared to those of the placebo group. Both the Per Protocol and Intention to Treat populations had improved validation parameters. It is safe because no hazards were found in the safety assessment.

Conclusion:
PL extract can help improve immunity. Evidences to conduct the main clinical trial is secured through this pilot study. A future large-scale main trial will be conducted based on this pilot study results.
Robot-assisted rehabilitation for total knee or hip replacement surgery patients: A systematic review and meta-analysis
Authors: Yoo Jun-Il , Oh Min-Kyun , Lee Shi-Uk , Lee Chang Han 
Published: October 2022

Background:
This study was performed to update the current evidence and evaluate the effects of robot-assisted rehabilitation (RAR) in comparison with conventional rehabilitation (CR) in patients following total knee (TKR) or hip replacements (THR).

Methods:
PubMed Central, OVID Medline, Cochrane Collaboration Library, and EMBASE for a comprehensive search for all relevant studies, from database inception to July 2022. The following inclusion criteria were used to determine eligibility for studies: randomized and matched controlled trials recruiting men and women who underwent TKR and THR; and studies examining the effect of RAR on outcome measures of physical function and pain.

Results:
A total of 9 studies (230 patients) were included in this review and 4 were included in the meta-analysis. The meta-analysis of 2 studies showed that Hybrid Assistive Limb (HAL) training for 5 days, significantly improved pain measured on a visual analogue scale, compared to CR in patients following TKR (SMD = 1.05, 95% confidence interval [Cl] 0.39–1.71). Heterogeneity for I2 value was lower than moderate (tau^2 = 0.0121; I
2 = 5%; P = .30). There were 2 studies that assessed self-selected walking speed. The meta-analysis of these studies showed that HAL training was significantly superior to CR in patients following TKR (SMD = 48.70, 95% Cl -50.53 to 147.94) at 2 months. A high heterogeneity was detected (P < .01; I
2 = 97%).

Conclusion:
The result of this systematic review and meta-analysis suggest that RAR may be an effective treatment in TKR and THR patients. However, high-quality studies are needed to verify the long-term effect on their recovery.
Clinical intervention of a tighter-than-tolerated fit of aesthetic hand and finger prosthesis via controlled silicone swelling: A novel, speedier and versatile alternative method
Authors: Leow Michael E.L. , Le Lan Anh T. , Chan Yiong Huak , Chong Alphonsus K.S. 
Published: October 2022

A tighter-than-tolerated fit of aesthetic hand prosthesis is conventionally rectified by stretching the affected segment to plastic deformation. This method is not only time-consuming, but also ineffective in stretching irregular, non-cylindrical prosthesis segments apart from the “wrist and digits”.
This study investigates controlled silicone swelling as an alternative method of expanding aesthetic hand and finger prosthesis to address a tight fit.
The technique of “controlled” swelling that minimizes oil uptake to as little as is necessary to achieve the desired magnitude of elastomer expansion was demonstrated using experimental test samples. Brush-coats of a cosmetics-grade oil, KF-96A-10CS, 2 a time, were applied on CosmesilTM samples to obtain elastomer expansion. The same technique of staggered oil delivery was used on tight-fitting segments of patients’ prosthesis, with test-fitting of each incremental expansion till satisfactory outcomes were achieved. Percentage circumference increases in swelled test samples and in all rectified/ patients’ prostheses were then compared to validate the effectiveness of the method.
Circumference increases in the test samples after each 2 coats were significantly different (P <.001). Representative (unreinforced) Samples 1, 2, and 3 recorded circumferential increases of 4.0% to 11.4% within 30 minute after swelling by 2.6% to 9.7% from 2 to 6 oil coats. This largely correlated with patient data, where circumferential increases of 3.6% to 9.5% from 2 to 6 oil coats were collectively recorded in all fit-rectified finger prostheses. Swelling in the expanded proximal segment of all 24 finger prostheses was estimated to be within 9.7%. Of these, 22 (92%) required 2 to 4 oil coats, inferring a lower still swelling of 6.5%. The rapid and consistent elastomer expansion enabled prosthetic fit rectification to be achieved in a much shortened time. Clinical outcomes indicated that low swelling magnitudes involving small amounts of 2 to 6 brush-coats of oil have no adverse effects on the prostheses. None of the participating patients had reported any incidence of discernible change in all of the important properties of their prostheses.
Outcomes based on the CosmesilTM-KF-96A-10CS elastomer-oil combination demonstrated that controlled silicone swelling involving minimal use of oil is an effective method of intervention for a tighter-than-tolerated prosthetic fit of silicone hand and fingers.
The controversial expression of SOX2 in gastric cancer and its correlation with Helicobacter pylori infection: A meta-analysis
Authors: Li Ning , Pang Yu , Sang Jing , Sun Yong , Hou Weiwei 
Published: October 2022

Background:
The expression of sex-determining region Y (SRY)-like high-mobility group (HMG) box 2 (SOX2) in gastric cancer and the prognosis of patients are controversial. This study analyzed the relationship between SOX2 expression and baseline data, clinicopathological parameters, prognosis, and Helicobacter pylori infection in patients with gastric cancer, and provided new supplements for the diagnosis and treatment of gastric cancer.

Methods:
The articles which reported SOX2 expression in gastric cancer from medical database was collected. The literature search was conducted in PubMed, Google Scholar, Cochrane library, SpringerLink, China National Knowledge Infrastructure, Web of Science, and Wanfang databases, which were written in English and Chinese.

Results:
A total of 32 articles, including 4641 gastric cancer patients. The results showed that SOX2 expression in gastric cancer group was lower than that in the para-cancerous control group (P < .001). Statistical difference was found between the SOX2 expression and differentiation (Well/Moderate vs Poor), TNM stage (I/II vs III/IV), lymphatic invasion (N0 vs N+), edge infiltration (R0 vs R1), and H pylori infection in the pathological parameters. The prognosis analysis showed that the level of SOX2 expression was unrelated to the overall survival of patients (P = .329). No statistical difference was observed between the SOX2 expression and the baseline data of the patients (all P > .05).

Conclusions:
Although downregulation expression of SOX2 are related to clinicopathological parameters in gastric cancer, which is not correlated with prognosis. This controversy over the expression of SOX2 will provide a new idea for the study of gastric cancer.
Prognostic nomogram for female patients suffering from non-metastatic Her2 positive breast cancer: A SEER-based study
Authors: Wu Jiangwen , Xie Zhaomin , Xiao Yu , Wang Bingbing , Zhang Pengcheng 
Published: October 2022

This paper aimed at constructing and validating a novel prognostic nomogram, so that physicians forecast the overall survival (OS) rates of female patients suffering from non-metastatic human epidermal growth element receptor-2 (HER2) positive breast.
Information of primary female her2 positive breast cancer patients without metastasis was obtained from the Surveillance, Epidemiology, and End Results (SEER) database with given inclusion and exclusion standards. Independent variables were obtained greatly by performing univariable and multivariate analyses. Based on those independent predictors, a novel prognostic nomogram was constructed for predicting the survival of those with 3- and 5-year OS. Then, concordance index (C-index), receiver operating characteristic curve (ROC), and calibration plot were adopted for the assessment of the predictive power of the nomogram.
A total of 36,083 eligible patients were classified into a training cohort (n = 25,259) and a verification cohort (n = 10,824) randomly. According to the identification of multivariate analysis, survival was predicted by age at diagnosis, marital status, race, site, T stage, N stage, progesterone receptor (PR) status, estrogen receptor (ER) status, surgery, radiation, and chemotherapy independently. A nomogram was established by applying the training cohort. The nomogram displayed excellent discrimination and performance as indicated by the C-index (0.764, 95% confidence interval: 0.756–0.772), and the 3- and 5-year area under the curve of ROC (AUC) values (0.760 and 0.692 respectively). The calibration plots for forecasting the 3- and 5-year OS were in great agreement.
The OS for female her2 positive breast cancer patients without metastasis was predicted by constructing a nomogram on basis of the SEER database. A precise survival prediction could be offered for each patient.
Successful treatment of Talaromyces marneffei pneumonia in a HIV-negative renal transplantation recipient: A case report
Authors: Cai De-Han , Wang Jun , Fang Xiao-Lin 
Published: October 2022

Rationale:

Talaromyces marneffei causes life-threatening opportunistic fungal infections in immunocompromised patients. It often has a poorer prognosis in non-human immunodeficiency virus (HIV)-infected than in HIV-infected individuals because of delayed diagnosis and improper treatment.

Patient concerns:
A 51-year-old man presented with complaints of pyrexia, cough, and expectoration that had lasted for 15 day. This patient has been taking anti-rejection medication since kidney transplant in 2011.

Diagnosis:

T marneffei pneumonia; post renal transplantation; renal insufficiency; hypertension.

Interventions:
Intravenous moxifloxacin was administered on admission. After the etiology was established, moxifloxacin was discontinued and replaced with voriconazole. The tacrolimus dose was adjusted based on the blood concentration of tacrolimus and voriconazole.

Outcomes:
The patient was successfully treated and followed-up without recurrence for 1 year.

Lessons:
A high degree of caution should be maintained for the possibility of T marneffei infection in immunodeficient non-HIV patients who live in or have traveled to T marneffei endemic areas. Early diagnosis and appropriate treatment can prevent progression of T marneffei infection and achieve a cure. Metagenomic next-generation sequencing (mNGS) can aid the physician in reaching an early pathogenic diagnosis. Close monitoring of tacrolimus and voriconazole blood levels during treatment remains a practical approach at this time.
The difficult removal of tracheal tube after general anesthesia: A case report
Authors: Li Man , Yan YaLan , Li PeiYu , Zhang Lan 
Published: October 2022

Background:
Laryngeal injury is common after endotracheal intubation, presenting with varying degrees of edema, ulceration, granulation, and limited vocal cord movement, usually resulting in lumen narrowing. In these cases, laryngeal edema is a common complication after intubation, usually caused by direct pressure and inflammatory reaction caused by endotracheal intubation on the contact surface.

Case presentation:
A 71-year-old female was scheduled to undergo open reduction and internal fixation of femoral neck. On admission, she was diagnosed with femoral neck fracture. Tracheal intubation induced by general anesthesia was successful, but the tracheal catheter was difficult to remove after the operation. After 2 days of detumescence in ICU, the extubation was successful under the condition of complete recovery of spontaneous breathing.

Conclusions:
Patients undergoing general anesthesia may have laryngeal or glottic edema due to operation time, operation and other reasons, resulting in difficulty in extubation after general anesthesia. The extubation action shall be gentle. In case of obvious resistance, it shall not be forcibly extubated to prevent serious dyspnea after extubation.