bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct and indirect health effects of the nuclear power plant disasters: a review for health care professionals
Authors: Okano Ichiro , Rosenberg Ashley , Dworkin Myles , Murthy Vijayashree , Jayaraman Sudha , Takabe Kazuaki 
Published: August 2022

Background:
Nuclear power plants are deeply integrated into our society. They possess substantial risk for major disasters. Two of the worst-categorized nuclear power plant disasters were Chernobyl and Fukushima, emitting large amounts of radioactive materials and required mass evacuations in neighboring areas.

Methods:
This is a rapid review of the literature. We searched PUBMED and Medline for original studies of all large nuclear power plant disaster information documented in literature.

Results:
Eighty-three publications were identified in the review. The results are summarized in categories based on direct health effects such as immediate health effects, indirect health effects related to evacuation, cancer, behavioral effects and environmental effects like proliferation of wildlife and other infectious diseases.

Conclusion:
Nuclear power plant disasters have a great impact on human health including increased rates of cancer, behavioral and psychosocial problems, and evacuation related problems. These disasters can lead to major environmental impact, specifically on wildlife, resulting in unanticipated health consequences for local populations. In this review, we describe these consequences of nuclear power plant disasters as they apply to local health care workers.
Trends in pelvic pain symptoms over 2 years of follow-up among adolescents and young adults with and without endometriosis
Authors: Sasamoto Naoko , Shafrir Amy L. , Wallace Britani M. , Vitonis Allison F. , Fraer Cameron J. , Sadler Gallagher Jenny , DePari Mary , Ghiasi Marzieh , Laufer Marc R. , Sieberg Christine B. , DiVasta Amy D. , Schrepf Andrew , As-Sanie Sawsan , Terry Kathryn L. , Missmer Stacey A. 
Published: August 2022

Abstract
We described trends in pelvic pain characteristics over 2 years of follow-up among adolescents and adults with and without endometriosis participating in the longitudinal observational cohort of the Women's Health Study: From Adolescence to Adulthood, using data reported at baseline and at years 1 and 2 of follow-up. Participants completed a questionnaire at baseline (between November 2012 and May 2019) and annually thereafter that included validated measures of severity, frequency, and life interference of dysmenorrhea, acyclic pelvic pain, and dyspareunia. Our study population included 620 participants with surgically confirmed endometriosis (rASRM stage I/II = 95%) and 671 community-based and hospital-based controls, with median age = 19 and 24 years, respectively. The proportion reporting hormone use varied across the 3 years ranging from 88% to 92% for cases and 56% to 58% for controls. At baseline, endometriosis cases were more likely to report severe, frequent, and life-interfering dysmenorrhea, acyclic pelvic pain, and dyspareunia compared with controls. Among cases, frequency and severity of dysmenorrhea and dyspareunia were relatively static across 2 years. However, acyclic pelvic pain improved. Severe acyclic pain decreased from 69% at baseline to 46% at year 2. Daily pain decreased from 28% to 14%, and life interference from 68% to 38%. Trends among controls remained fairly stable across 2 years. Among endometriosis cases who completed the questionnaire at all 3 time points, 18% reported persistent, severe acyclic pelvic pain at all 3 time points. Over time, different trends were observed by pelvic pain type among endometriosis cases and controls, supporting the importance of assessing multidimensional features of pelvic pain.
Technological innovation and clinical application of direct percutaneous computed tomography–guided enterostomy versus other enterostomy techniques
Authors: Sun Ming-Yao , Zheng Tian , Chen Jian , Zhan Zhou-Wei , Wang Zeng-Lin , Chen Wei , Yang Chang-Shun , Zheng Xiao-Ling 
Published: August 2022

Background:
To investigate the technological innovation, safety, operational advantages, and clinical application value of direct percutaneous computed tomography (CT)–guided enterostomy.

Methods:
This retrospective study included patients who underwent direct percutaneous CT-guided enterostomy (n = 52), percutaneous endoscopic gastrojejunostomy (PEG-J, n = 39), or laparoscopic jejunostomy (n = 68) at Fujian Provincial Hospital between October 2019 and July 2021. The study indices included stoma surgery success rate, operation time, complication rate, and postoperative pain score. We concurrently analyzed the technological innovation of direct percutaneous CT-guided enterostomy and the changes in body mass index (BMI), serum albumin, pre-albumin, and C-reactive protein (CRP) levels and patient-generated subjective global assessment (PG-SGA) scores after patients received 2 months of nutritional support.

Results:
Direct percutaneous CT-guided enterostomy had a high success rate (100%) and low postoperative complication rate (5.77%). Compared to laparoscopic jejunostomy, direct percutaneous CT-guided enterostomy had a shorter operation time (36.92 ± 10.60) min, lower postoperative pain score (4.06 ± 2.02), lower anesthesia risk, and lower operative cost. The anesthetic risk for direct percutaneous CT-guided enterostomy is lower than that for PEG-J and has wider applications. After 2 months of postoperative nutritional support, patients had increased BMI, serum albumin level, and serum pre-albumin level and decreased PG-SGA scores and CRP level with statistically significant differences compared to the preoperative state (p < 0.05).

Conclusion:
Direct percutaneous CT-guided enterostomy is an important method of establishing an enteral nutrition therapy pathway, especially when endoscopic jejunostomy is not possible. It has a high safety profile and few complications, has unique advantages, and deserves further promotion of its application in clinical practice.
Early cardiac rehabilitation after heart transplantation in a patient with limb-girdle muscular dystrophy: A case report
Authors: Kim Youngmo , Park Min Kyung , Shin Myung-Jun , Shin Yong Beom , Lee Hye Won , Yun Ra Yu , Lee Byeong-Ju 
Published: August 2022

Rationale:
Cardiac rehabilitation (CR) after heart transplantation (HT) decreases the mortality rate and increases exercise capacity of patients. Dilated cardiomyopathy develops in most patients with muscular dystrophy (MD), leading to advanced heart failure, necessitating the use of left ventricular assist devices or HT. As the clinical outcomes of left ventricular assist devices and HT in patients with myopathy differ from those in patients without myopathy, CR adapted to patients with MD should be considered.

Patient concerns:
A 39-year-old man with limb-girdle muscular dystrophy developed dilated cardiomyopathy and underwent HT.

Diagnosis:
The patient was diagnosed as having limb-girdle muscular dystrophy in 1997.

Intervention:
Early CR was performed based on the patient’s physical condition and ability.

Outcomes:
With chest physiology, aerobic, and resistance exercises, the patient was able to walk using a walker 28 days after HT. This is important because his lower-extremity strength and walking ability were, to some extent, maintained after surgery.

Lessons:
Since an increasing number of patients with MD are undergoing HT, specific CR programs for these patients should be discussed.
The association between the neutrophil to lymphocyte ratio and in-hospital mortality among sepsis patients: A prospective study
Authors: Chebl Ralph Bou , Assaf Mohamad , Kattouf Nadim , Haidar Saadeddine , Khamis Mohamed , Abdeldaem Karim , Makki Maha , Tamim Hani , Dagher Gilbert Abou 
Published: August 2022

The Neutrophil to lymphocyte ratio (NLR) was shown to be associated with disease severity, poor prognosis and increased mortality in sepsis. However, the association between NLR and sepsis prognosis remains controversial.
Our study aims to prospectively examine the prognostic ability of NLR in predicting in-hospital mortality among sepsis patients and determine the optimal cutoff of NLR that can most accurately predict in-hospital mortality in sepsis patients. This study was a prospective cohort study that included adult sepsis patients that presented to the emergency department of a tertiary care center between September 2018 and February 2021.
Receiver operating characteristic curve was used to determine the optimal cutoff of the neutrophil to lymphocyte ratio that predicts in-hospital mortality. Patients were divided into 2 groups: above and below the optimal cutoff. Stepwise logistic regression was performed to assess the magnitude of the association between NLR and in-hospital mortality.
A total of 865 patients were included in the study. The optimal cutoff for the neutrophil to lymphocyte ratio that predicts in-hospital mortality was found to be 14.20 with a sensitivity of 44.8% and a specificity of 65.3% (with PPV = 0.27 and NPV = 0.80). The area under the curve for the ratio was 0.552 with a 95% confidence intervals = [0.504–0.599] with a P value = .03. Patients that have a NLR above the cutoff were less likely to survive with time compared to patients below the cutoff based on the Kaplan–Meier curves. In the stepwise logistic regression, the optimal neutrophil to lymphocyte ratio cutoff was not associated with in-hospital mortality (odds ratios = 1.451, 95% confidence intervals = [0.927–2.270], P = .103).
In conclusion the optimal cutoff of the NLR that predicts in-hospital mortality among sepsis patients was 14.20. There was no association between the NLR and in-hospital mortality in sepsis patients after adjusting for confounders. Further studies with a larger sample size should be done to determine the optimal NLR cutoff and its prognostic role in septic patients (in-hospital mortality and other clinically significant outcomes).
Correlation between medical student empathy and a Korean nationwide comprehensive clinical assessment score at a medical school in Korea
Authors: Jung Min Kyu , Yeo Sanghee , Lee Won Kee 
Published: August 2022

Empathy is the ability to understand and communicate a patient’s situation, perspective, and feelings. When demonstrated by healthcare professionals, this can improve patient adherence, satisfaction, and treatment outcomes. Empathic students have stronger affective skills and can acquire, develop, reinforce, and display strong affective behaviors, abilities, and attitudes.
We measured student empathy using the Student Version of the Jefferson Scale of Empathy (JSE-S) and assessed 3-year sequential clinical comprehensive assessment scores conducted by the Korean Medical Education Assessment Corporation to determine the relationship between JSE-S and clinical comprehensive assessment scores.
The study population comprised of 80 males (74%) and 28 females (26%), among which 38 (35%) and 62 (57%) students wanted to become private physicians and attending faculty, respectively. Regarding future majors, 58 students (54%) considered medical fields, whereas 40 students (37%) considered surgical fields. No significant differences in Korean JSE-S were observed according to medical student gender, career aspirations, or future major fields.
The modified Korean version of the JSE-S has 18 items. Item-total score correlations and Cronbach α evaluated the internal consistency reliability of the scale. The reliability of the Korean JSE-S was 0.910 by Cronbach α coefficient.
Female students had better scores than males. Students who wanted to be an attending faculty had better scores than others who wanted to be private physicians; however, these findings were not statistically significant. Significantly higher scores were seen among students aspired to work in the medical field (65.6 ± 8.8) versus in the surgical field (60.4 ± 8.2) in their 5th year (P < .01).
We were unable to show the positive correlations between the empathy scale and comprehensive assessment results. Among female medical students, comprehensive assessment results were inversely correlated with empathy toward the patient, but this was not statistically significant.
The modified Korean JSE-S has acceptable reliability. Every student had a better comprehensive assessment after studying the medical curriculum between the 4th and 6th years. The current nationwide assessment tool does not measure student empathy.
Regional 18F-fluoromisonidazole PET images generated from multiple advanced MR images using neural networks in glioblastoma
Authors: Qin Jianhua , Tang Yu , Wang Bao 
Published: August 2022

Generated 18F-fluoromisonidazole (18F-FMISO) positron emission tomography (PET) images for glioblastoma are highly sought after because 18F-FMISO can be radioactive, and the imaging procedure is not easy. This study aimed to explore the feasibility of using advanced magnetic resonance (MR) images to generate regional 18F-FMISO PET images and its predictive value for survival.
Twelve kinds of advanced MR images of 28 patients from The Cancer Imaging Archive were processed. Voxel-by-voxel correlation analysis between 18F-FMISO images and advanced MR images was performed to select the MR images for generating regional 18F-FMISO images. Neural network algorithms provided by the MATLAB toolbox were used to generate regional 18F-FMISO images. The mean square error (MSE) was used to evaluate the regression effect. The prognostic value of generated 18F-FMISO images was evaluated by the Mantel-Cox test.
A total of 299 831 voxels were extracted from the segmented regions of all patients. Eleven kinds of advanced MR images were selected to generate 18F-FMISO images. The best neural network algorithm was Bayesian regularization. The MSEs of the training, validation, and testing groups were 2.92E-2, 2.9E-2, and 2.92E-2, respectively. Both the maximum Tissue/Blood ratio (P = .017) and hypoxic volume (P = .023) of the generated images were predictive factors of overall survival, but only hypoxic volume (P = .029) was a predictive factor of progression-free survival.
Multiple advanced MR images are feasible to generate qualified regional 18F-FMISO PET images using neural networks. The generated images also have predictive value in the prognostic evaluation of glioblastoma.
The prognosis of refractory hypotension and severe intraventricular hemorrhage in very low birth weight infants
Authors: Hwang-Bo Seok , Seo Yu-Mi , Oh Moon-Yeon , Im Soo-Ah , Youn Young-Ah 
Published: August 2022

Background:
The increased survival rate among very low birth weight infants has resulted in a higher risk for developing neuro-complications such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and adverse neurodevelopmental outcomes.

Purpose:
We examined refractory hypotension experienced within a week of life in association with severe IVH (grades 3–4) among very low birth weight infants (VLBWIs).

Method:
Between Jan 2014 and Dec 2017, the clinical data of 191 VLBWIs were retrospectively chart reviewed. Of a total of 191 VLBWIs, 71.2% (136/191) had IVH, and 28.7% (55/191) had severe IVH.

Results:
The VLBWI with severe IVH group (grade 3–4) presented with a significantly lower gestational age along with higher use of postnatal hydrocortisone for refractory hypotension within a week of life. Resuscitation at delivery, pulmonary hemorrhage, neonatal seizure, and PVL were significantly more frequent in the severe IVH group (P < .05). Higher mortality occurred in the VLBWI with severe IVH group (P < .001). The multivariable logistic regression analysis consistently showed that refractory hypotension within a week of life and neonatal seizures were significantly associated with severe IVH. Those in the severe IVH and refractory hypotension groups had significantly lower composite cognitive, language, motor scores in Bayley Scales of Infant and Toddler Development III scores at corrected 18–24 months.

Conclusion:
Refractory hypotension within a week of life and seizures were consistently associated with severe IVH and developmental delay at corrected 18–24 months. VLBWI who experienced refractory hypotension within a week of life may indicate a more vulnerable clinical setting with a higher risk for developmental delay.
Intravenous plus intraventricular tigecycline-amikacin therapy for the treatment of carbapenem-resistant Klebsiella pneumoniae ventriculitis: A case report
Authors: Li Jiyao , Liu Yiguo , Wu Guangtao , Wang Hongyan , Xu Xiaoyan 
Published: August 2022

Rationale:
Central nervous system infections (CNSIs) are one of the most serious complications after neurosurgery, especially carbapenem-resistant bacterial meningitis. Owing to the poor blood-brain barrier permeability of most antibiotics, the treatment of CNSIs by intraventricular (IVT) administration is becoming a hot topic in clinical research. Currently, the treatment of CNSIs caused by carbapenem-resistant Klebsiella pneumoniae is mainly based on intraventricular injection of an antibiotic combined with one or more other systemic intravenous (IV) antibiotics, whereas there are few case reports of intraventricular injection of 2 antibiotics.

Patient concerns:
A 57-year-old man with an open craniocerebral injury presented with dyspnea, high fever, and seizures associated with surgery.

Diagnosis:
Intracranial infection caused by carbapenem-resistant K. pneumoniae was diagnosed.

Interventions:
On the advice of a clinical pharmacist, the patient was given tigecycline (100 mg IV + 3 mg IVT q12h) combined with amikacin (0.8 g IV + 30 mg IVT qd) antiinfective therapy. Ultimately, the pathogens in the cerebrospinal fluid were eradicated after 7 days, and the CNSIs were completely cured after 14 days.

Outcomes:
The patient recovered and was discharged from the hospital without adverse reactions.

Lessons:
A series of in vitro and in vivo synergy tests of carbapenem-resistant K. pneumoniae showed that tigecycline combined with aminoglycosides had good synergistic effects and effectively suppressed bacterial resistance selection. Intravenous plus intraventricular tigecycline-amikacin seems to be a safe and effective treatment option for carbapenem-resistant K. pneumoniae CNSIs.
Cardioprotective effect of Chinese herbal medicine for anthracycline-induced cardiotoxicity in cancer patients: A meta-analysis of prospective studies
Authors: Hao Wei , Shi You-Yang , Qin Yue-Nong , Sun Chen-Ping , Chen Li-Ying , Wu Chun-Yu , Bao Yi-Jia , Liu Sheng 
Published: August 2022

Background:
To assess the benefits and harmful effects of Chinese herbal medicine (CHM) formulations in preventing anthracyclines (ANT)-induced cardiotoxicity.

Method:
The Cochrane Library, Pubmed and EMBASE databases were electronically searched for relevant randomized controlled trials (RCTs) published till December 2021 in English or Chinese-language, in addition to manual searches through the reference lists of the selected papers, and the Chinese Conference Papers Database. Data was extracted by 2 investigators independently.

Result:
Seventeen RCTs reporting 11 different CHMs were included in this meta-analysis. The use of CHM reduced the occurrence of clinical heart failure (RR 0.48, 95% CI 0.39 to 0.60, P < .01) compared to the control group. Data on subclinical heart failure in terms of LVEF values showed that CHM reduced the occurrence of subclinical heart failure (RR 0.47, 95% CI 0.35 to 0.62, P < .01) as well.

Conclusion:
CHM is an effective and safe cardioprotective intervention that can potentially prevent ANT-induced cardiotoxicity. However, due to the insufficient quality of the included trials, our results should be interpreted with cautious.
An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis
Authors: Huang Taobi , Xu Jinlan , Wang Maoying , Pu Ke , Li Longquan , Zhang Huiyun , Liang Yuan , Sun Weiming , Wang Yuping 
Published: August 2022

Background:
Fecal microbiota transplantation (FMT) as a promising therapy for ulcerative colitis (UC) remains controversial. We conducted a systematic review and meta-analysis to assess the efficiency and safety of FMT as a treatment for UC.

Methods:
The target studies were identified by searching PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials and by manual supplementary retrieval. We conducted a general review and quantitative synthesis of included studies. We used the RevMan and Stata programs in the meta-analysis. The outcomes were total remission, clinical remission, steroid-free remission, and serious adverse events. We also performed subgroup analyses based on different populations.

Results:
A total of 34 articles were included in the general review. Only 16 articles, including 4 randomized controlled trials, 2 controlled clinical trials, and 10 cohort studies, were selected for the meta-analysis. We found that donor FMT might be more effective than placebo for attaining total remission (risk ratio [RR]: 2.77, 95% confidence interval [CI]: 1.54–4.98; P = .0007), clinical remission (RR: 0.33, 95% CI: 0.24–0.41; P < .05), and steroid-free remission (RR: 3.63, 95% CI: 1.57–8.42; P = .003), but found no statistically significant difference in the incidence of serious adverse events (RR: 0.88, 95% CI: 0.34–2.31, P = .8). The subgroup analyses revealed significant differences between the pooled clinical remission rates for different regions, degrees of severity of the disease, and patients with steroid- or nonsteroid-dependent UC.

Conclusions:
FMT can achieve clinical remission and clinical response in patients with UC.
Successful limb salvage in progressive proximal tibia osteosarcoma following denosumab chemotherapy: A case report
Authors: Chen Qian , Wu Junjie , Zheng Kai , Xu Ming , Hou Ziwei , Yu Xiuchun 
Published: August 2022

Rationale:
Osteosarcoma (OS) is a primary malignant bone tumor that originates in the mesenchymal tissue. It is the most common type of pleomorphic tumor occurring in children and adolescents. Currently, there is no established systematic treatment for OS that progresses during standard preoperative chemotherapy.

Patient concerns and diagnoses:
We describe a 14-year-old male patient with a 4-month history of pain in the upper right leg. Based on the results of percutaneous biopsy, a diagnosis of OS was made. After admission, the patient was treated with first-line chemotherapy agents. After a single course of treatment, the tumor progressed locally and no limb salvage was feasible.

Interventions and outcomes:
Intervention with denosumab combined with chemotherapy led to a significant reduction in tumor volume and ossification of soft tissue, which successfully resulted in limb salvage rather than amputation. The patient showed no evidence of recurrent or distant metastasis at 6-month follow-up.

Lessons:
Treatment with receptor activator of nuclear factor-ĸB ligand inhibitor denosumab combined with standard chemotherapy is effective for advanced OS progressing after chemotherapy. We recommend denosumab therapy for successful limb salvage in patients with high-grade OS associated with osteolytic bone destruction and refractory to preoperative neoadjuvant chemotherapy.