bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of GMI, a fungal immunomodulatory protein, for head and neck cancer patients with chemotherapy-related oral mucositis
Authors: Lu Hsueh-Ju , Li Che-Hsing , Kang Yu-Ting , Wu Chi-Mei , Wu Chih-Hsien , Ko Jiunn-Liang , Wu Ming-Fang 
Published: April 2022

Abstract

Background:
Cancer patients usually suffer from intensive chemotherapy-related oral mucositis (OM), yet limited effective treatment can rapidly alleviate OM severity.

Methods:
This prospective study examined the efficacy of Reishimmune-S containing one fungal immunomodulatory protein, GMI on OM in patients with head and neck cancer. Patients with head and neck cancer and the diagnosis of chemotherapy-related OM were enrolled randomizedly to receive standard supportive care with/without Reishimmune-S 500 mg/day orally for consecutive 14 days. Due to intolerance to standard supportive care alone in the control arm, only the experimental arm with Reishimmune-S supplementation was analyzed in our trial. OM grading was evaluated as the primary outcome on day 1, 8, and 15. Secondary outcomes were absolute neutrophil counts and quality of life assessed by the EORTC-QLQ-H&N 35 questionnaire on day 1, 8, and 15.

Results:
Reishimmune-S supplement significantly reduced OM grading both at day 8 and 15. Trouble with social contact and weight loss conditions were also improved by Reishimmune-S. Reishimmune-S did not significantly affect absolute neutrophil counts during the 15-day follow-up.

Conclusion:
Reishimmune-S supplement potentially alleviates the severity of chemotherapy-mediated OM.
A prenatal case of Simpson-Golabi-Behmel syndrome type 1 with a 0.26-Mb deletion fragment at Xq26.2 inherited from mother
Authors: Sha Jing , Tan Fangfang , Liu Ying , Xu Zaochun , Wang Xuezhen , Zhai Jingfang 
Published: April 2022

Abstract

Rationale:
The purpose of this report was to explore how to manage the fetus of Simpson-Golabi-Behmel syndrome type 1 (SGBS1) and to provide a definite diagnosis to guide the following genetic counseling for the pregnancy.

Patient concerns:
A 24-year-old women, gravida 1, para 0, was 172 cm tall with weight 65 kg. She was referred to our center for counseling due to second-trimester ultrasound screening anomalies at 22 + 5 weeks of gestation age. Meanwhile the ultrasound examination indicated the overgrowth of the fetus. She and her husband were healthy and nonconsanguineous without family history.

Diagnoses:
The karyotype and copy number variations sequencing (CNV-seq) combined with fetal ultrasound manifestation confirmed the diagnosis of SGBS1.

Interventions:
No treatment for the fetus.

Outcomes:
Pregnancy was terminated.

Lessions:
Once fetal overgrowth and other malformation are revealed in prenatal ultrasound, although without polyhydramnios and organomegaly, SGBS1 should be considered and further genetic testing such as CNV-seq and whole exon sequencing should be conducted to help clinicians provide a definite diagnosis to guide the following genetic counseling and the next pregnancy.
Diagnostic value of a liver biopsy in patients with an acute liver failure or acute liver injury
Authors: Hunyady Peter , Herrmann Eva , Bojunga Joerg , Friedrich-Rust Mireen , Pathil Anita , Zeuzem Stefan , Mihm Ulrike 
Published: April 2022

Objectives
The diagnostic value of liver biopsy in patients with acute liver injury or acute liver failure (ALI/ALF) was investigated.

Methods
Data from the initial event and follow-up visits were retrospectively analyzed in all patients with a liver biopsy during ALI/ALF from January 2010 to May 2020 at the University Hospital Frankfurt, Germany.

Results
The cohort comprised 66 patients. Post-biopsy hemorrhage occurred in 2 of 66 but was self-limited. In five patients suspected liver involvement by a systemic extrahepatic disease was confirmed and excluded in eight patients. In 4 of 66 patients, the etiology of ALI/ALF remained unknown. Liver biopsy hinted at the etiology of ALI/ALF in 2 of 6 patients with rare diagnoses (hemophagocytic lymphohistiocytosis: 2 of 66; ischemic liver injury: 1 of 66, ALI/ALF due to a systemic infection: 3 of 66). In 31 of 34 patients with drug-induced liver injury (DILI), histopathology suggested DILI; in further 2 patients, DILI was among the differential diagnoses. However, DILI was also the histopathologically preferred diagnosis in 12 of 15 patients with autoimmune hepatitis (AIH). Only in 3 of 15 patients, histopathology was considered compatible with AIH. Serum immunoglobulin G (IgG) and autoantibodies during ALI/ALF were higher in patients with AIH than with DILI. Patients with AIH did not show a more pronounced biochemical response to corticosteroids in the first 10 days of treatment than patients with DILI.

Conclusions
Liver biopsy is indispensable when liver involvement by an extrahepatic disease is suspected. To distinguish AIH from DILI in ALI/ALF, serum IgG, and autoantibodies seem more helpful than liver biopsy; long-term follow-up is needed in these patients.
Transesophageal endoscopic ultrasound in the diagnosis of the lung masses: a multicenter experience with fine-needle aspiration and fine-needle biopsy needles
Authors: Mangiavillano Benedetto , Spatola Federica , Facciorusso Antonio , De Nucci Germana , Ligresti Dario , Henry Eusebi Leonardo , Lisotti Andrea , Auriemma Francesco , Lamonaca Laura , Paduano Danilo , Crinò Stefano , Scarlata Simone , Troncone Edoardo , Del Vecchio Blanco Giovanna , Manes Giampiero , Traina Mario , Bertani Alessandro , Ofosu Andrew , Binda Cecilia , Fabbri Carlo , Muscatiello Nicola , Fusaroli Pietro , Repici Alessandro , Carrara Silvia 
Published: April 2022

Background and aim
Intraparenchymal lung masses inaccessible through bronchoscopy or endobronchial ultrasound guidance pose a diagnostic challenge. Furthermore, some fragile or hypoxic patients may be poor candidates for transbronchial approaches. Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) offers a potential diagnostic approach to lung cancers adjacent to the esophagus. We aimed to evaluate the feasibility, accuracy, and safety of trans-esophageal EUS-FNA/FNB for tissue sampling of pulmonary nodules.

Methods
We retrospectively analyzed data from patients with pulmonary lesions who underwent EUS-FNA/FNB between March 2015 and August 2021 at eight Italian endoscopic referral centers.

Results
A total of 47 patients (36 male; mean age 64.47 ± 9.05 years) were included (22 EUS-FNAs and 25 EUS-FNBs). Overall diagnostic accuracy rate was 88.9% (76.3–96.2%). The sensitivity and diagnostic accuracy were superior for EUS FNB sampling versus EUS-FNA (100% vs. 78.73%); P = 0.05, and (100% vs. 78.57%); P = 0.05, respectively. Additionally, sample adequacy was superior for EUS-FNB sampling versus EUS-FNA (100% vs. 78.5%); P = 0.05. Multivariate logistic regression analysis for diagnostic accuracy showed nodule size at the cutoff of 15 mm (OR 2.29, 1.04–5.5, P = 0.05) and use of FNB needle (OR 4.33, 1.05–6.31, P = 0.05) as significant predictors of higher diagnostic accuracy. There were no procedure-related adverse events.

Conclusion
This study highlights the efficacy and safety of EUS-FNA/FNB as a minimally invasive procedure for diagnosing and staging peri-esophageal parenchymal lung lesions. The diagnostic yield of EUS-FNB was superior to EUS-FNA.
The association between patients' illness perceptions and longitudinal clinical outcome in patients with low back pain
Authors: Fors Maria , Öberg Birgitta , Enthoven Paul , Schröder Karin , Abbott Allan 
Published: April 2022

Abstract

Introduction:
Illness perception is suggested to influence outcome in patients with low back pain (LBP). It is unknown if specific illness perceptions are of more importance for longitudinal outcomes, including development of self-management strategies.

Objectives:
This study explores whether patients' initial illness perceptions were associated with disability, pain, health-related quality of life, and self-care enablement outcomes in patients with LBP after 3 and 12 months.

Methods:
Four hundred sixty-seven consecutive patients seeking physiotherapeutic primary care for LBP were eligible to participate in this prospective cohort study, providing data at baseline and after 3 and 12 months (mean age 45 years, 56% women). Multiple linear regression analysis was used to explore whether patients' illness perceptions at baseline were associated with outcome in the Oswestry Disability Index (ODI), Numeric Rating Scale–LBP (NRS-LBP), EuroQol Five Dimensions, and Patient Enablement Instrument (PEI).

Results:
Stronger beliefs that the back problem will last a long time at baseline were associated with worse outcome in ODI, NRS-LBP, and PEI at 3 and 12 months and in EuroQol Five Dimensions at 12 months. Negative beliefs regarding treatment's ability to improve LBP were associated with worse outcome in NRS-LBP and PEI at 3 and 12 months and in ODI at 12 months.

Conclusions:
Illness perceptions regarding prognosis and treatment's ability to improve symptoms were the most prominent perceptions explaining several longitudinal clinical outcomes. These expectations should be addressed in an early stage in the delivery of interventions for LBP. These expectations were also important for patients' development of coping and self-management strategies.
Postoperative pain treatment after spinal fusion surgery: a systematic review with meta-analyses and trial sequential analyses
Authors: Geisler Anja , Zachodnik Josephine , Køppen Kasper , Chakari Rehan , Bech-Azeddine Rachid 
Published: April 2022

Abstract
Patients undergoing spinal surgery are at high risk of acute and persistent postoperative pain. Therefore, adequate pain relief is crucial. This systematic review aimed to provide answers about best-proven postoperative analgesic treatment for patients undergoing lumbar 1- or 2-level fusions for degenerative spine diseases. We performed a search in PubMed, Embase, and The Cochrane Library for randomized controlled trials. The primary outcome was opioid consumption after 24 hours postoperatively. We performed meta-analyses, trial sequential analyses, and Grading of Recommendations assessment to accommodate systematic errors. Forty-four randomized controlled trials were included with 2983 participants. Five subgroups emerged: nonsteroidal anti-inflammatory drugs (NSAIDs), epidural, ketamine, local infiltration analgesia, and intrathecal morphine. The results showed a significant reduction in opioid consumption for treatment with NSAID (P < 0.0008) and epidural (P < 0.0006) (predefined minimal clinical relevance of 10 mg). Concerning secondary outcomes, significant reductions in pain scores were detected after 6 hours at rest (NSAID [P < 0.0001] and intrathecal morphine [P < 0.0001]), 6 hours during mobilization (intrathecal morphine [P = 0.003]), 24 hours at rest (epidural [P < 0.00001] and ketamine [P < 0.00001]), and 24 hours during mobilization (intrathecal morphine [P = 0.03]). The effect of wound infiltration was nonsignificant. The quality of evidence was low to very low for most trials. The results from this systematic review showed that some analgesic interventions have the capability to reduce opioid consumption compared with control groups. However, because of the high risk of bias and low evidence, it was impossible to recommend a “gold standard” for the analgesic treatment after 1- or 2-level spinal fusion surgery.
Diagnostic Feasibility of Magnetic Resonance Elastography Radiomics Analysis for the Assessment of Hepatic Fibrosis in Patients With Nonalcoholic Fatty Liver Disease
Authors: Sim Ki Choon , Kim Min Ju , Cho Yongwon , Kim Hyun Jin , Park Beom Jin , Sung Deuk Jae , Han Yeo Eun , Han Na Yeon , Kim Tae Hyung , Lee Yoo Jin 
Published: April 2022

Objective
The aim of the study was to investigate the diagnostic feasibility of radiomics analysis using magnetic resonance elastography (MRE) to assess hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).

Methods
One hundred patients with suspected NAFLD were retrospectively enrolled. All patients underwent a liver parenchymal biopsy. Magnetic resonance elastography was performed using a 3.0-T scanner. After multislice segmentation of MRE images, 834 radiomic features were analyzed using a commercial program. Radiologic features, such as median and mean values of the regions of interest and variable clinical features, were analyzed. A random forest regressor was used to extract important radiomic, radiological, and clinical features. A random forest classifier model was trained to use these features to classify the fibrosis stage. The area under the receiver operating characteristic curve was evaluated using a classifier for fibrosis stage diagnosis.

Results
The pathological hepatic fibrosis stage was classified as low-grade fibrosis (stages F0–F1, n = 82) or clinically significant fibrosis (stages F2–F4, n = 18). Eight important features were extracted from radiomics analysis, with the 2 most important being wavelet-high high low gray level dependence matrix dependence nonuniformity-normalized and wavelet-high high low gray level dependence matrix dependence entropy. The median value of the multiple small regions of interest was identified as the most important radiologic feature. Platelet count has been identified as an important clinical feature. The area under the receiver operating characteristic curve of the classifier using radiomics was comparable with that of radiologic measures (0.97 ± 0.07 and 0.96 ± 0.06, respectively).

Conclusions
Magnetic resonance elastography radiomics analysis provides diagnostic performance comparable with conventional MRE analysis for the assessment of clinically significant hepatic fibrosis in patients with NAFLD.
Kinematic Tibiofibular Syndesmotic Measurements as Indicators of Tibiotalar Osteoarthritis: Exploratory Analysis Using 4-Dimensional Computed Tomography
Authors: Haj-Mirzaian Arya , Shakoor Delaram , Hafezi-Nejad Nima , de Cesar Netto Cesar , Dalili Danoob , Mousavian Alireza , Schon Lew C. , Demehri Shadpour 
Published: April 2022

Objective
The aim of this study was to evaluate the association between 4-dimensional computed tomography (4DCT)–derived measurements of tibiofibular syndesmosis during active dorsiflexion-plantarflexion motion and the presence of tibiotalar osteoarthritis (OA).

Methods
Sixteen ankle joints underwent 4DCT imaging during active dorsiflexion-plantarflexion. Syndesmotic anterior distance (SAD) and syndesmotic translation (ST) were obtained by a foot-and-ankle surgeon. We used Kellgren-Lawrence (KL) grading to determine tibiotalar OA.

Results
Of 16 scanned ankles, 12 ankles had KL ≥2 at the tibiotalar joint. In these ankles, SAD (−0.4, P = 0.02) and ST (−0.9, P = 0.006) measurements significantly changed during the dorsiflexion-plantarflexion motion. Changes in SAD measurements were significantly correlated with the KL grades (correlation coefficient: −0.688, P = 0.003); however, the changes in ST measurements were not significantly correlated with the KL grade.

Conclusions
Our exploratory cross-sectional analysis shows that SAD measurement changes during motion using 4DCT are correlated with the tibiotalar OA grading. This measurement may be used but requires confirmation in larger studies including patients with actual syndesmotic injuries.
Fluid-Filled Dehiscences in the Anterior Cranial Fossa Floor: A Magnetic Resonance Imaging Study
Authors: Tsutsumi Satoshi , Ono Hideo , Ishii Hisato 
Published: April 2022

Objective
To date, only limited information regarding the anterior cranial fossa floor (AFF) and the appearance of sites of dehiscence and potential channels has been available. We aimed to evaluate this region with thin section magnetic resonance imaging (MRI).

Patients and Methods
A total of 65 patients underwent thin-sliced coronal T2-weighted MRI. The AFF was divided into 3 parts for analysis: the anterior, middle, and posterior.

Results
Dehiscences were identified in 84.6% of 65 patients with apparently transmitting channels. In 49.2% of the patients, the dehiscences were located in the anterior part, whereas they were located in the middle and posterior parts in 52.3% and 12.3%, respectively. The morphology and number of these dehiscences were highly variable. In 12.3%, channels in the dehiscences were distributed extradural. Statistically, dehiscences were more frequently identified on the left side in any part of the AFF.

Conclusions
With thin-sliced, coronal T2-weighted MRI, dehiscences were frequently identified in the anterior two-thirds of the AFF. Further study is warranted to determine the role of AFF channels and dehiscences, including possibly for cerebrospinal fluid drainage.
Retinal Input to the Primate Lateral Geniculate Nucleus Revealed by Injection of a Different Label Into Each Eye
Authors: Spahr Zachary R. , Economides John R. , Horton Jonathan C. 
Published: April 2022

Abstract:
The primate lateral geniculate nucleus has long been a favorite structure among anatomists because of its striking lamination. It has been shown that each lamina receives input from a different eye using various single label techniques but never by double labeling. Here, we illustrate the organization of retinal inputs to the lateral geniculate nucleus by injection of cholera toxin-B conjugated to Alexa Fluor-488 into the right eye and cholera toxin-B conjugated to Alexa Fluor-594 into the left eye.
The Impact of Leber Hereditary Optic Neuropathy on the Quality of Life of Patients and Their Relatives: A Qualitative Study
Authors: Chen Benson S. , Holzinger Erik , Taiel Magali , Yu-Wai-Man Patrick 
Published: April 2022

Background:
Leber hereditary optic neuropathy (LHON) is an inherited mitochondrial disease characterized by severe bilateral vision loss and chronic visual impairment. The objective of this study was to comprehensively explore the impact of LHON on the lives of patients and their relatives at the time of diagnosis and now.

Methods:
Qualitative study design with 8 focus group interviews conducted in France, Germany, the United Kingdom, and the United States, involving 17 individuals with m.11778G>A mutation and their relatives. Separate focus groups for patients and their relatives were facilitated by a moderator in French, German, or English. Qualitative analysis of interviews using a pre-defined analytical framework.

Results:
Participants reported feeling devastated by the diagnosis of LHON after a lengthy and worrisome diagnostic journey. Patients were frustrated by the loss of autonomy, which also affected their relatives. Participants described challenges across several domains: physical capabilities, emotional well-being, interpersonal relationships, work and studies, finances, and recreational activities. Access to disability allowances, vision aids, and funded or subsided idebenone varied by country, resulting in unequal financial impact. Patients are hopeful for therapy that would restore autonomy and improve their ability to enjoy a fulfilling life, while alleviating the demands placed on their relatives.

Conclusions:
The impact of LHON extends beyond vision-related activity limitations. Addressing the psychosocial impact of LHON and helping patients and their relatives adapt and cope with vision loss are vital. As part of this, an accurate and timely diagnosis is important to enable early intervention. Further investigation of specific unmet needs is required.
Muscle pathology of antisynthetase syndrome according to antibody subtypes
Authors: Tanboon Jantima , Inoue Michio , Hirakawa Shinya , Tachimori Hisateru , Hayashi Shinichiro , Noguchi Satoru , Okiyama Naoko , Fujimoto Manabu , Suzuki Shigeaki , Nishino Ichizo 
Published: April 2022

AbstractAntisynthetase syndrome is recently recognized as one of the major entities of autoimmune myositis. The prototype of antisynthetase syndrome is anti-Jo-1 antibody associated syndrome while the syndromes associated with non-Jo-1 antisynthetase antibodies are clinically and pathologically less recognized. Identifying a non-Jo-1 antisynthetase syndrome patient could be challenging because the full panel serology test may not be available at the time of diagnosis in addition to technical difficulty especially for anti-OJ antibody detection. This study aimed to characterize the muscle pathology and explore the utility of myofiber HLA-DR expression for the diagnosis of antisynthetase syndrome.We retrospectively compared 212 muscle biopsies from antisynthetase syndrome patients regarding four pathology domains and histology of interests usingttest and Fisher’s exact test as appropriate. We further compared the myofiber HLA-DR expression pattern in antisynthetase syndrome with 602 muscle biopsies with other autoimmune myositis and 140 muscle biopsies with other myopathies potentially containing myositis-like pathology and calculated sensitivity, specificity, positive predictive value, and negative predictive value to identify the most diagnostic pattern for antisynthetase syndrome.The most common myopathological pattern in antisynthetase syndrome was necrotizing myopathy (46.2%). Perifascular necrosis was present in 28.3% of antisynthetase syndrome. Anti-OJ and anti-EJ antisynthetase syndrome were associated with high muscle fiber scores. Anti-OJ also showed high inflammatory domain score. If muscle biopsies suspicious for dermatomyositis by sarcoplasmic myxovirus resistance protein A immunohistochemical expression and those with inclusion body myositis clinicopathology were excluded, myofiber HLA-DR expression was the most diagnostic of antisynthetase syndrome with 95.4% specificity, 61.2% sensitivity, 85.9% positive predictive value, and 84.2% negative predictive value. HLA-DR expression in perifascicular fibers was highly specific to anti-Jo-1 antisynthetase syndrome.Anti-OJ antisynthetase syndrome has more prominent myopathology than the other antisynthetase syndrome subtypes. Presence of myofiber HLA-DR expression in a clinicopathologically approved non-dermatomyositis and non-inclusion body myositis muscle biopsy is highly indicative of antisynthetase syndrome. Presence of HLA-DR expression suggests the involvement of type II interferon in the pathogenesis in antisynthetase syndrome subpopulation although the detailed mechanism and the reason for preferential perifascicular localization are yet to be identified.