bluuebunny/crossref_metadata_2025_split huggingface dataset:
Albumin to Total Cholesterol Ratio and Mortality in Peritoneal Dialysis
Authors: Wu Xianfeng , Meng Jiao , Zhou Lei , Zhan Xiaojiang , Wen Yueqiang , Wang Xiaoyang , Feng Xiaoran , Wang Niansong , Peng Fenfen , Wu Junnan 
Published: June 2022

BackgroundSerum albumin and total cholesterol are associated with mortality. In clinical practice, evaluating the association of combining album and total cholesterol with mortality may be more reasonable. Thus, we examined the association between serum albumin to total cholesterol ratio and mortality in peritoneal dialysis (PD) patients.MethodsWe conducted a retrospective cohort study of 3447 incident continuous ambulatory peritoneal dialysis (CAPD) patients from five PD centers in China from 1 January 2005 and 31 May 2020. The association between albumin to total cholesterol ratio and mortality was evaluated.ResultsWith a median follow-up of 39.3 months, 762 (22.1%) all-cause deaths occurred, including 382 (11.1%) cardiovascular deaths. As compared with a serum albumin to total cholesterol ratio of 0.77–0.82 (reference range), a higher ratio (&gt;0.82) was associated with increased risks of all-cause mortality[hazards ratio (HR), 1.54; 95% confidence interval (CI), 1.16–2.05, E-value = 2.45] and cardiovascular mortality (HR, 2.10; 95% CI, 1.35–3.29, E-value = 3.62). A lower ratio (&lt;0.77) was also associated with increased risks of all-cause mortality (HR, 1.46; 95% CI, 1.10–1.94, E-value = 2.28) and cardiovascular mortality (HR, 1.78; 95% CI, 1.14–2.78, E-value = 2.96) compared with the reference. No interaction was observed in subgroup analyses of age, sex, diabetes mellitus, hypertension, prior cardiovascular disease, and hyperlipidemia, and malnutrition (serum albumin &lt;3.6 g/dL).ConclusionAn albumin to total cholesterol ratio before the start of PD between 0.77 and 0.82 was associated with a lower risk of death than a higher or lower ratio, resulting in a U-curve association. Therefore, serum albumin to total cholesterol ratio, as an inexpensive and readily available biochemical biomarker, may further improve the stratification risk of mortality in PD patients.
Clinical Prediction of Inadequate Vault in Eyes With Thick Lens After Implantable Collamer Lens Implantation Using Iris Morphology
Authors: Yang Zhikun , Meng Lihui , Zhao Xinyu , Chen Youxin , Luo Yan 
Published: June 2022

BackgroundObtaining an ideal vault is crucial in the implantable collamer lens (ICL) surgery. Prediction of the vault value is difficult since it requires the integration of multiple factors. The purpose of this study was to investigate the association between the iris shape and vault value in eyes with thick lens.MethodsThe study was conducted in Peking Union Medical College Hospital. Patients who received ICL V4c between 2017 and 2021 were screened. Eyes with thick lens (&gt;4.0 mm) and abnormal iris shape (concave or convex) were included. The preoperative biometric parameters and postoperative vault value were compared between eyes with concave shape group and convex shape group. The relationship between various factors and vault was assessed by spearman rank analysis and multiple linear regression analysis. Representative cases our strategies to deal with the abnormal vault were demonstrated.ResultsTwenty eight eyes of 14 patients with thick lens and concave or convex shape iris were eventually included, with 14 eyes of 7 patients in group 1 (concave shape iris) and the other 14 eyes of 7 patients in group 2 (convex shape iris). The mean vault of group 1 was (0.16 ± 0.07) mm, which was significantly lower than (0.88 ± 0.13) mm in group 2. Multiple linear regression analysis showed iris shape (P &lt; 0.001) was only the explanatory variables associated with the postoperative vault. In group1, 4 eyes showed extremely large ACA, requiring a secondary surgical intervention. So all of them underwent ICL exchange for a larger ICL. In group2, the ICL was implanted in a vertical or oblique position to avoid or rescue an extremely large vault.ConclusionConcave shape iris had a higher risk of low vault and convex shape iris were more likely to demonstrate high vault in eyes with thick lens. Exchanging ICL for the larger size and adjusting ICL to the vertical or oblique orientation are good option to rescue the low or high vault, respectively.
Gut Microbiota Characteristics Are Associated With Severity of Acute Radiation-Induced Esophagitis
Authors: Lin Ming-qiang , Wu Ya-hua , Yang Jun , Lin Han-cui , Liu Ling-yun , Yu Yi-lin , Yao Qi-wei , Li Jian-cheng 
Published: June 2022

BackgroundAcute radiation-induced esophagitis (ARIE) is one of the most debilitating complications in patients who receive thoracic radiotherapy, especially those with esophageal cancer (EC). There is little known about the impact of the characteristics of gut microbiota on the initiation and severity of ARIE.Materials and MethodsGut microbiota samples of EC patients undergoing radiotherapy (n = 7) or concurrent chemoradiotherapy (n = 42) were collected at the start, middle, and end of the radiotherapy regimen. Assessment of patient-reported ARIE was also performed. Based on 16S rRNA gene sequencing, changes of the gut microbial community during the treatment regimen and correlations of the gut microbiota characteristics with the severity of ARIE were investigated.ResultsThere were significant associations of several properties of the gut microbiota with the severity of ARIE. The relative abundance of several genera in the phylum Proteobacteria increased significantly as mucositis severity increased. The predominant genera had characteristic changes during the treatment regimen, such as an increase of opportunistic pathogenic bacteria including Streptococcus. Patients with severe ARIE had significantly lower alpha diversity and a higher abundance of Fusobacterium before radiotherapy, but patients with mild ARIE were enriched in Klebsiella, Roseburia, Veillonella, Prevotella_9, Megasphaera, and Ruminococcus_2. A model combining these genera had the best performance in prediction of severe ARIE (area under the curve: 0.907).ConclusionThe characteristics of gut microbiota before radiotherapy were associated with subsequent ARIE severity. Microbiota-based strategies have potential use for the early prediction of subsequent ARIE and for the selection of interventions that may prevent severe ARIE.
Case Report: Diagnosis of Petrous Apex IgG4-Related Disease by Middle Cranial Fossa Craniotomy and Temporal Bone Biopsy
Authors: Hofmeyr Louis , Herbst Gerrida , Pretorius Elias , Sarembock Brian , Taylor Kathryn , Roytowski David 
Published: June 2022

IntroductionPrimary IgG4-related disease (IgG4-RD) of the temporal bone is a rare condition. Unlike typical petrous apicitis or Gradenigo syndrome, our patient presented exclusively with unilateral cranial nerve VI palsy and symptoms of diplopia. Skull base imaging demonstrated a destructive bony lesion in the petrous apex. Imaging and systemic investigations were insufficient to support a diagnosis. The diagnosis was achieved histologically after acquiring the specimen by middle cranial fossa craniotomy and temporal bone biopsy. This case report is thought to be the first published description of a diagnosis of IgG4-RD proven with the middle cranial fossa approach.Case ReportWe describe a 29-year-old female with primary IgG4-RD of the petrous apex of the temporal bone. This patient presented with a few-month history of left-sided headache and recent-onset diplopia due to paralysis of cranial nerve VI. Imaging demonstrated a petrous apex lesion, and comprehensive systemic investigations could not reach a diagnosis. A middle cranial fossa craniotomy and a biopsy of the temporal bone lesion were undertaken to establish the diagnosis. Histological confirmation of IgG4-RD was proven. Following treatment with corticosteroids, the patient experienced complete recovery and resolution of her symptoms.ConclusionThis study describes a case of primary IgG4-RD of the petrous apex of the temporal bone that presented with diplopia and was diagnosed by middle fossa craniotomy and temporal bone biopsy. To the best of our knowledge, this is the first case description where primary diagnosis was made based on middle cranial fossa craniotomy and temporal bone biopsy.
HPN Standard of Care and Long-Term Outcomes of CIF Pediatric Patients: Twenty-Eight Years' Experience in a Reference Center
Authors: Lezo Antonella , D'Eusebio Chiara , Riboldi Lorenzo , Baldini Letizia , Spada Marco 
Published: June 2022

Background and AimsChronic intestinal failure (CIF) therapy changed significantly in recent decades, and both survival and complication rates improved over time. International guidelines claim that early referral of long-term home parenteral nutrition (HPN) patients to an expert center with specific standards of care may positively affect long-term outcomes. Herein, we retrospectively analyse the long-term outcomes of a cohort of pediatric patients with CIF followed-up since our Pediatric Intestinal Failure Unit foundation, in 1989.MethodsData of the 120 children followed up at Pediatric Intestinal Failure Unit during the last 28 years were retrospectively collected. Patients' and HPN characteristics, as well as dependence, survival, and complication rates, were described.ResultsIncidence and prevalence of CIF increased during the study period particularly due to the increase of HPN for non-digestive disease (NDD) CIF (47.5% of the study sample). Catheter-related bloodstream infection (CRBSI) rate decreased over the study period: 0.33 episodes/1,000 catheters days before 2011 and 0.19 episodes/1,000 catheters days afterwards. Only 1 patient out of 12 died because of HPN complications. The survival rate of patients with PDD was 98.4% at 1 year from the beginning of HPN, 96.5% at 2 years, and 93.8% from the fifth year onwards. Concerning the dependence rate, 70.6% of patients were still on HPN 1 year after the start of HPN, 63.7% at 2 years, 52.4% at 5 years, and 40.8% from the 9th year onwards, with no significant difference according to the underlying intestinal pathology. The survival rate of NDD patients was 91.2% at 1 year from the beginning of HPN, 87.4% at 2 years, and 81.9% from the third year onwards. For what concerns the enteral autonomy, it was regained by 56.7% 1 year after the start of HPN, 74.5% at 2 years, and 95.0% in the 5th year.ConclusionsOur data confirmed the importance of appropriate standards of care and suggest that applying a specific set of standards and protocols may further improve patients' outcomes and survival. Indeed, both primary and non-digestive diseases HPN showed good outcomes.
Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review
Authors: Carroll Kaitlin L. , Frugé Andrew D. , Heslin Martin J. , Lipke Elizabeth A. , Greene Michael W. 
Published: June 2022

BackgroundColorectal cancer in adults 50 years old and younger is increasing in incidence worldwide. Diet may be a modifiable risk factor. The objective of this study was to examine evidence regarding the association between diet and the risk of developing early-onset colorectal cancer (EOCRC) and early-onset colorectal adenomas in young adults.MethodsPUBMED, Web of Science, and Embase were systematically searched for studies examining dietary intake as a risk factor for EOCRC and early-onset colorectal adenomas. Results were synthesized narratively due to the heterogeneity of the studies.ResultsOf the 415 studies identified, ten met the inclusion criteria. Of these ten studies, four provided data on dietary risk factors for early-onset colorectal adenomas and six provided data on dietary risk factors for EOCRC. The four studies that measured colorectal adenoma occurrence reported an increased incidence with high sugar sweetened beverage intake, a higher pro-inflammatory diet, a higher Western diet score and higher sulfur microbial diet score. A protective effect against early-onset colorectal adenomas was observed in those who had a higher Prudent diet score or higher adherence to other health dietary approaches (Dietary Approaches to Stop Hypertension, Alternative Healthy Eating Index-2010, or the alternative Mediterranean diet). Those who consumed large amounts of deep-fried foods, refined foods, followed a high fat diet, consumed large amounts of sugary drinks and desserts, and had low folate and fiber consumption had a significantly higher occurrence of EOCRC. A protective effect against EOCRC was observed for those who consumed more fruits and vegetables, high amounts of micronutrients and those who adhered to a vegetarian diet.ConclusionsThe results of this study reveal various dietary habits may be risk factors or protective against early-onset colorectal cancer and adenomas. Future research should focus on large prospective cohort studies with long-term follow-up to confirm published results and further examine whether differences in diet quality are associated with EOCRC risk.
Case Report: Arterial Wall Inflammation in Atherosclerotic Cardiovascular Disease is Reduced by Olamkicept (sgp130Fc)
Authors: Schulte Dominik M. , Waetzig Georg H. , Schuett Harald , Marx Marlies , Schulte Berenice , Garbers Christoph , Lokau Juliane , Vlacil Ann-Kathrin , Schulz Juliane , Seoudy Anna K. , Schieffer Bernhard , Rosenstiel Philip , Seeger Marcus , Laudes Matthias , Rose-John Stefan , Lützen Ulf , Grote Karsten , Schreiber Stefan 
Published: June 2022

Inflammation is a strong driver of atherosclerotic cardiovascular disease (ASCVD). There is a large unmet need for therapies that prevent or reduce excessive inflammation while avoiding systemic immunosuppression. We showed previously that selective inhibition of pro-inflammatory interleukin-6 (IL-6) trans-signalling by the fusion protein olamkicept (sgp130Fc) prevented and reduced experimental murine atherosclerosis in low-density lipoprotein receptor-deficient (Ldlr−/−) mice on a high-fat, high-cholesterol diet independently of low-density lipoprotein (LDL) cholesterol metabolism. Therefore, we allowed compassionate use of olamkicept (600 mg intravenously biweekly for 10 weeks) in a patient with very-high-risk ASCVD. Despite optimal LDL cholesterol under maximum tolerated lipid-lowering treatment, the patient had a remaining very high risk for future cardiovascular events related to significant arterial wall inflammation with lipoprotein (a) [Lp(a)]-cholesterol as the main contributor. 18Fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT) measurements were performed before and after the treatment period. Olamkicept reduced arterial wall inflammation in this patient without interfering with lipoprotein metabolism. No clinical or laboratory side effects were observed during or after treatment with olamkicept. Our findings in this patient matched the results from our mechanistic study in Ldlr−/− mice, which were extended by additional analyses on vascular inflammation. Olamkicept may be a promising option for treating ASCVD independently of LDL cholesterol metabolism. A Phase II trial of olamkicept in ASCVD is currently being prepared.
Identification of a Subtype-Selective Allosteric Inhibitor of GluN1/GluN3 NMDA Receptors
Authors: Zeng Yue , Zheng Yueming , Zhang Tongtong , Ye Fei , Zhan Li , Kou Zengwei , Zhu Shujia , Gao Zhaobing 
Published: June 2022

N-methyl-D-aspartate receptors (NMDARs) are Ca2+-permeable ionotropic glutamate receptors (iGluRs) in the central nervous system and play important roles in neuronal development and synaptic plasticity. Conventional NMDARs, which typically comprise GluN1 and GluN2 subunits, have different biophysical properties than GluN3-containing NMDARs: GluN3-containing NMDARs have smaller unitary conductance, less Ca2+-permeability and lower Mg2+-sensitivity than those of conventional NMDARs. However, there are very few specific modulators for GluN3-containing NMDARs. Here, we developed a cell-based high-throughput calcium assay and identified 3-fluoro-1,2-phenylene bis (3-hydroxybenzoate) (WZB117) as a relatively selective inhibitor of GluN1/GluN3 receptors. The IC50 value of WZB117 on GluN1/GluN3A receptors expressed in HEK-293 cells was 1.15 ± 0.34 μM. Consistently, WZB117 exhibited strong inhibitory activity against glycine-induced currents in the presence of CGP-78608 but only slightly affected the NMDA-, KA- and AMPA-induced currents in the acutely isolated rat hippocampal neurons. Among the four types of endogenous currents, only the first one is primarily mediated by GluN1/GluN3 receptors. Mechanistic studies showed that WZB117 inhibited the GluN1/GluN3A receptors in a glycine-, voltage- and pH-independent manner, suggesting it is an allosteric modulator. Site-directed mutagenesis and chimera construction further revealed that WZB117 may act on the GluN3A pre-M1 region with key determinants different from those of previously identified modulators. Together, our study developed an efficient method to discover modulators of GluN3-containing NMDARs and characterized WZB117 as a novel allosteric inhibitor of GluN1/GluN3 receptors.
A Qualitative Study of Stakeholders’ Views on Pharmacovigilance System, Policy, and Coordination in Pakistan
Authors: Khan Muhammad Akhtar Abbas , Hamid Saima , Khan Shahzad Ali , Sarfraz Mariyam , Babar Zaheer-Ud-Din 
Published: June 2022

Objectives:Due to the absence of necessary rules, poor coordination, and various challenges, the pharmacovigilance system of Pakistan is not optimally functional at all levels of the health system. The objective of the study was to assess the stakeholders’ perceptions of the current ADR reporting system and to identify the pharmacovigilance policy issues and problems of effective coordination.Methodology:Stakeholders from a broad range of disciplines, academia, regulatory authorities, the pharmaceutical industry, international health organizations, as well as pharmacovigilance experts, and healthcare professionals were included in the study. A total of 25 stakeholders throughout Pakistan were interviewed during exploratory semi-structured interviews. The interviews were recorded digitally, transcribed, coded, compared, and grouped according to their similarity of themes. Participants provided insights into gaps, limitations, and challenges of Pakistan’s current ADR reporting system, issues with proposed pharmacovigilance rules, and coordination difficulties.Results:The majority of the participants considered the ADR reporting system in Pakistan to be improving but in a nascent phase. The identified gaps, challenges, limitations of the system, and barriers to reporting were labeled as reasons for limited functioning. Almost all stakeholders were aware of the existence of draft pharmacovigilance rules; however, participants in the industry were familiar with the contents and context of draft pharmacovigilance rules. Bureaucratic red tape and lack of political will appeared to be the top reasons for delaying the approval of the pharmacovigilance rules. Wider consultation, advocacy, and awareness sessions of policymakers and HCPs were suggested for early approval of rules. Participants unanimously agreed that the approval of rules shall improve the quality of life and reduce the economic burden along with morbidity and mortality rates. The need for greater and collaborative coordination among the stakeholders in promoting medicines’ safety was highlighted. All participants suggested the use of media and celebrities to disseminate the safety information.Conclusion:Participants showed partial satisfaction with the way pharmacovigilance in Pakistan is moving forward. However, stakeholders believed that engagement of multi-stakeholders, approval of pharmacovigilance rules, and the establishment of pharmacovigilance centers in provinces, hospitals, and public health programs (PHPs) shall support in achieving the desired results.
Recommendations on Off-Label Drug Use in Pediatric Guidelines
Authors: Meng Min , Zhou Qi , Lei Wenjuan , Tian Min , Wang Ping , Liu Yunlan , Sun Yajia , Chen Yaolong , Li Qiu 
Published: June 2022

Objective: To systematically analyze the supporting evidence, drug information, and the type of off-label drug use in recommendations on off-label drug use in pediatric guidelines.Methods: A cross-sectional study was performed by systematic search through MEDLINE (via PubMed) and Embase databases to identify literature published from 1 January 2018, to 31 December 2020. Only pediatric clinical practice guidelines that included recommendations on off-label use of drugs were included. We present descriptive information on the sources of the included guidelines, country, publication year, evidence grading system used, details on the types of off-label drug use, and the types of studies used as references to support the recommendations.Results: A total of 66 pediatric guidelines with 605 recommendations were included. Eighty-seven (14.4%) recommendations did not cite any references; and the remaining 518 recommendations were supported by 2,240 references (mean 4.3 references/recommendation). The most common types of studies cited were pediatric RCTs (n = 314, 14.0%), pediatric case series studies (n = 260, 11.6%), and reviews (n = 255, 11.4%). Twenty-one percent (n = 470) of the references were studies on adults. One hundred and forty (23.1%) recommendations were graded using the Grading of Recommendations, Assessments, Development, and Evaluations (GRADE) system, of which 37 (26.4%) were graded as strong but supported with only C or D level of evidence. The most commonly reported type of information in the recommendations was indication (n = 499, 82.5%). The most commonly addressed type of off-label drug use in the 523 positive recommendations was unapproved population (n = 255, 48.8%). Sixty-nine (11.4%) recommendations explicitly reported the drug use as off-label.Conclusion: Children may be exposed to medical risks due to gaps in reporting and evidence of off-label drug use recommendations in pediatric guidelines.
Stray-Light Suppression of the Internally Occulted Reflecting Solar Corona Imager
Authors: Zhang Guang , Wang Yunqi , He Lingping , Wang Xiaodong , Ren Shuai , Xuan Yubo , Liu Fei , Chen Bo 
Published: June 2022

In order to achieve a clear observation of the ultra-low brightness solar corona and provide a physical basis for forecasting space weather that seriously affects the human living environment, the stray-light suppression level becomes the key factor affecting the development of the coronagraph. In this study, a stray-light suppression method is adopted for Solar Corona Imager (SCI) which is a dual-waveband internally occulted reflecting coronagraph simultaneously and independently observing the inner corona in the HI Lyman-alpha (121.6 ± 10 nm) line and white-light (700.0 ± 40 nm) wavebands with a field-of-view (FOV) from 1.1 to 2.5 R⊙ (R⊙ stands for the mean solar radius). The scattered stray-light from the primary mirror, including the surface errors, cosmetic defects, and particulate contamination, is analyzed and suppressed, and the corresponding scattering models are established for simulation based on the laboratory testing. The stray-light measurement results for SCI in the laboratory show that the stray-light level can be suppressed to the order of 10−8 B⊙ at 2.5 R⊙ (B⊙ is the mean brightness of the solar disk) in the white-light (WL) band, which is consistent with the stray-light level obtained by simulation and verifies the modeling and simulation.