bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-N-methyl-D-aspartate receptor encephalitis after coronavirus disease 2019: A case report and literature review
Authors: Lee Hyesun , Jeon Jong Hyun , Choi Hojin , Koh Seong-Ho , Lee Kyu-Yong , Lee Young Joo , Kwon Hyuk Sung 
Published: September 2022

Rationale:
Coronavirus disease 2019 (COVID-19) has become a global pandemic and COVID-19-associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may occur through an immune-mediated pathomechanism.

Patient concerns:
A 21-year-old woman with a history of COVID-19 presented to our hospital with memory decline and psychiatric symptoms.

Diagnosis:
The patient was diagnosed with anti-NMDAR encephalitis.

Intervention:
Intravenous methylprednisolone (1 g/day over 5 days) followed by immunoglobulin (0.4 g/kg/day over 5 days) were administered. The patient underwent laparoscopic salpingo-oophorectomy to remove an ovarian teratoma.

Outcomes:
The patient was discharged with sequelae of short-term memory impairment, without other neuropsychiatric symptoms.

Lessons:
Cases of previously reported anti-NMDAR encephalitis with COVID-19 were reviewed and compared with the present case. Clinicians should be aware of the occurrence of anti-NMDAR encephalitis in patients who present with neuropsychiatric complaints during or after exposure to COVID-19. Further studies are required to determine the causal relationship between the 2 diseases and predict the prognosis of anti-NMDAR encephalitis after COVID-19 exposure.
Evaluation of the efficacy and safety of artemether emulsion on localized senile pruritus: A randomized pilot study
Authors: He Hui-Qiong , Shen Wen-Tong , Pei Qin , Fei Jian-Biao , Yu Yue , Qin Hai-Hong , Wang Guo-Jiang 
Published: September 2022

Background:
Localized senile pruritus is a continued health problem for the elderly. This study aimed to evaluate the efficacy and safety of artemether emulsion on localized senile pruritus.

Methods:
Sixty patients diagnosed with senile pruritus were randomized into the artemether emulsion (1%) group or emulsion base group in a 1:1 ratio (the artemether group vs the control group). The patients used artemether emulsion or emulsion base for pruritus twice daily for 2 weeks. The pruritus visual analog scale (VAS) and the rate of adverse events were evaluated in week 0 and week 2.

Results:
The VAS scores in week 2 after treatment decreased significantly compared with those before treatment in both groups (P < .05). After treatment, patients receiving the artemether emulsion had significantly lower mean VAS scores compared to those who received the emulsion base (1.21 ± 1.64 vs 3.67 ± 2.97, P < .05). When the VAS scores were compared between the 2 groups before treatment, the effective rate of the artemether group was significantly higher than that of the control group (χ
2 = 55, P < .05) in week 2 after treatment. Besides, no adverse events occurred in both groups.

Conclusions:
Both artemether emulsion and emulsion base were effective in treating localized senile pruritus, and artemether emulsion was superior to emulsion base.
Prophylactic effect of intravenous lidocaine against cognitive deficit after cardiac surgery: A PRISMA-compliant meta-analysis and trial sequential analysis
Authors: Hung Kuo-Chuan , Ho Chun-Ning , Liu Wei-Cheng , Yew Ming , Chang Ying-Jen , Lin Yao-Tsung , Hung I-Yin , Chen Jen-Yin , Huang Ping-Wen , Sun Cheuk-Kwan 
Published: September 2022

Background:
This study aimed at providing an updated evidence of the association between intraoperative lidocaine and risk of postcardiac surgery cognitive deficit.

Methods:
Randomized clinical trials (RCTs) investigating effects of intravenous lidocaine against cognitive deficit in adults undergoing cardiac surgeries were retrieved from the EMBASE, MEDLINE, Google scholar, and Cochrane controlled trials register databases from inception till May 2021. Risk of cognitive deficit was the primary endpoint, while secondary endpoints were length of stay (LOS) in intensive care unit/hospital. Impact of individual studies and cumulative evidence reliability were evaluated with sensitivity analyses and trial sequential analysis, respectively.

Results:
Six RCTs involving 963 patients published from 1999 to 2019 were included. In early postoperative period (i.e., 2 weeks), the use of intravenous lidocaine (overall incidence = 14.8%) was associated with a lower risk of cognitive deficit compared to that with placebo (overall incidence = 33.1%) (relative risk = 0.49, 95% confidence interval: 0.32–0.75). However, sensitivity analysis and trial sequential analysis signified insufficient evidence to arrive at a firm conclusion. In the late postoperative period (i.e., 6–10 weeks), perioperative intravenous lidocaine (overall incidence = 37.9%) did not reduce the risk of cognitive deficit (relative risk = 0.99, 95% confidence interval: 0.84) compared to the placebo (overall incidence = 38.6%). Intravenous lidocaine was associated with a shortened LOS in intensive care unit/hospital with weak evidence.

Conclusion:
Our results indicated a prophylactic effect of intravenous lidocaine against cognitive deficit only at the early postoperative period despite insufficient evidence. Further large-scale studies are warranted to assess its use for the prevention of cognitive deficit and enhancement of recovery (e.g., LOS).
Liver abscess in advanced hepatocellular carcinoma after atezolizumab plus bevacizumab treatment: A case report
Authors: Uchida Keisuke , Ozono Yoshinori , Uchiyama Naomi , Hatada Hiroshi , Nakamura Kenichi , Komaki Yuri , Iwakiri Hisayoshi , Hasuike Satoru , Nagata Kenji , Sato Yuichiro , Kawakami Hiroshi 
Published: September 2022

Rationale:
Hepatocellular carcinoma (HCC) is the sixth most common type of cancer globally. Since 2020, combination treatment with atezolizumab and bevacizumab were approved in patients with unresectable HCC in Japan, and atezolizumab plus bevacizumab is the first-line treatment for unresectable HCC.

Patient concerns:
A 73-year-old Japanese man diagnosed with a large HCC was treated with atezolizumab plus bevacizumab. After 2 cycles, he had fever and fatigue and was admitted to the hospital.

Diagnosis:
Abdominal contrast-enhanced computed tomography revealed tumor necrosis in HCC with gas formation in the necrotic area. Laboratory examination revealed a white blood cell (WBC) count of 16,340/μL and C-reactive protein (CRP) level of 33.0 mg/dL. Based on the above findings, he was diagnosed with a liver abscess.

Interventions:
Percutaneous transhepatic liver abscess drainage and broad-spectrum antibiotics treatment were performed.

Outcomes:
Despite liver abscess drainage, persistent fever and no improvement in the WBC count or CRP level was observed. The patient’s respiratory condition and renal function gradually worsened; The patient’s general condition did not improve despite the ventilator support and continuous hemodiafiltration, and he died on day 37.

Lessons:
We report the first case of liver abscess after atezolizumab plus bevacizumab treatment for unresectable HCC.
Security research of blockchain technology in electronic medical records
Authors: Qu Jia 
Published: September 2022

Background:
A blockchain-based Electronic Health Record(EHR) data-sharing scheme was proposed to solve the problems of data sharing difficulties and privacy disclosure.

Methods:
This paper designs a blockchain-based electronic health record model based on the characteristics of blockchain antitampering, decentralization, and distributed storage. Utilize blockchain network and distributed database to store encryption-related access control policies to prevent EHR data from being tampered with and leaked. Data security sharing protocol combines Distributed Key Generation (DKG) and reencryption.

Results:
The protocol used the Delegated Proof of Stake(DPOS) algorithm to select the proxy node, which reencrypted the EHR to share data between a pair of users. Simulation experiments and comparative analysis showed that DPOS efficiency was higher than Proof of Work (POW) and slightly lower than the Practical Byzantine Fault Tolerance(PBFT).

Conclusions:
The scheme proposed in this paper is more decentralized and less computationally intensive.
Analgesic efficacy of the superficial versus deep serratus plane blocks for mastectomy with axillary clearance: A randomized controlled trial
Authors: Tan Kok Wang , Sayed Masri Syarifah Noor Nazihah , Musthafa Qurratu Aini , Mohd Azidin Azrin , Nik Mohamed Kamil Amiruddin , Izaham Azarinah , Md Nor Nadia 
Published: September 2022

Background:
The serratus plane block is an effective technique for providing analgesia to patients undergoing breast surgery.

Methods:
This prospective, double-blind, randomized study enrolled 60 female patients scheduled for unilateral mastectomy and axillary clearance. The patients received either a superficial serratus plane block or deep serratus plane block. Dermatomal spread was recorded 30 minutes after block administration. Postoperatively, pain visual analog scale (VAS) scores were documented at recovery (time 0), at 30 minutes; and in the ward hourly for 4 hours, and 4-hourly until 24 hours postoperatively. The time to first analgesic rescue and cumulative morphine consumption using patient-controlled analgesia morphine (PCAM) were recorded.

Results:
The results showed lower VAS scores at rest (at 1, 2, 3, and 4 hours postoperatively), and during movement (at 1, 2, 3, 4, 8, and 24 hours postoperatively) in the superficial serratus plane block group, P < .005. Similarly, cumulative morphine usage was lower in the superficial serratus plane group, P < .005. The time to the first rescue analgesic was also significantly longer in the superficial group, P < .001. More patients in the superficial serratus plane group achieved greater dermatomal spread at T2 and T7 than those in the deep group.

Conclusions:
Superficial serratus plane block provides better analgesic efficacy than deep serratus plane block in mastectomy and axillary clearance.
Transferrin saturation as a surrogate marker for assessment of labile nontransferrin bound iron in chronic liver disease
Authors: Oliveira Patricia Marinho Costa de , Espósito Breno Pannia , Carvente Claudia , Silva Genimari Arruda , Dellavance Alessandra , Baldo Danielle Cristiane , Ferraz Maria Lucia Gomes 
Published: September 2022

Background
Increased transferrin saturation (TS) and ferritin are common in hereditary hemochromatosis (HH) but also in chronic liver diseases (CLD). Nontransferrin bound iron (NTBI) is believed to be associated with iron-induced cell damage. We aimed to evaluate NTBI in CLD and their relationship with liver damage.

Methods
Two groups of patients were studied. Group 1 (G1): 94 CLD patients from an Outpatient Hepatology Unit. Group 2 (G2): 36 healthy individuals form a Medical Checkup Clinic. Transferrin iron-binding capacity, TS, ferritin, AST, ALT, and red cell count were performed using standard tests. NTBI was assessed as enhanced labile plasma iron (eLPi). Levels of eLPi less than 0.4 µmol/l were considered within the normal range.

Results
Prevalence of increased iron tests (elevated TS and ferritin) was 14% in G1 and 5.5% in G2 (P = 0.19). Positive NTBI was found in 12 patients (11 in G1 and 1 in G2). Positivity to NTBI was associated with increased iron tests (P = 0.03), cirrhosis (P = 0.03) and AST index (ASTI) (P = 0.03). NTBI was associated with TS of more than 70% (P = 0.002) but not to elevated ferritin (P = 0.74). Variables strongly associated with a positive NTBI in univariate analysis (TS > 70%, cirrhosis and ASTI) were submitted to binary regression analysis. TS of more than 70% was the only independent predictive factor (P = 0.049; odds ratio, 6.8).

Conclusion
NTBI was associated with TS in CLD, but not with ferritin. NTBI testing could be useful for CLD patients with increased iron tests. Alternatively, a TS of more than 70% can be used as a surrogate marker.
Identification of ceRNA regulatory network in acute pancreatitis and acute recurrent pancreatitis
Authors: Liu Hang , Huang Wei , Feng Yuxi , Li Yu , Li Jinzhi , Mai Gang 
Published: September 2022

Objective
The aim of this study was to find differentially expressed long noncoding RNAs (lncRNAs), microRNAs (miRNAs) and mRNAs and related signaling pathways, contributing to understanding the molecular mechanism of acute recurrent pancreatitis (ARP).

Methods
First, peripheral whole blood samples from five acute pancreatitis (AP) patients, five ARP patients and five healthy individuals (N) were collected for RNA sequencing. Second, differentially/specifically expressed lncRNAs, miRNAs and mRNAs were identified in AP vs. N, ARP vs. N and ARP. Third, the ceRNA (lncRNA-miRNA-mRNA) networks of common/specifical lncRNAs, miRNAs and mRNAs were constructed in AP vs. N, ARP vs. N and ARP. Finally, functional analysis of common mRNAs in AP vs. N and ARP vs. N was performed.

Results
A total of 315 common lncRNAs, 12 common miRNAs and 909 common mRNAs were identified between AP and ARP. Ninety-four specifically expressed lncRNAs, one specifically expressed miRNAs and 286 specifically expressed mRNAs were found in ARP. Some interaction pairs were identified in AP and ARP, such as LUCAT1/NEAT1-hsa-miR-16-2-3p-HK2, CHRM3-AS2-hsa-miR-122-5p/hsa-miR-145-3p-DBH/CACNA1C, CHRM3-AS2-hsa-miR-200a-3p-PDGFD, RBM26-AS1-hsa-miR-200b-3p-FHIT and LINC00891/KTN1-AS1-hsa-miR-143-3p-tyrosine kinase (TXK). ASAP1-IT2/DGCR9-hsa-miR-342-5p-ABCC5/MAP2K6 was the only one specific interaction pair identified in ARP. Four significantly enriched signaling pathways were identified in AP vs. N and ARP vs. N, including amino sugar and nucleotide sugar metabolism (involved NPL and HK2), MAPK signaling pathway (involved CACNA1C and PDGFD), metabolic pathways (involved DBH and FHIT) and leukocyte transendothelial migration (involved TXK).

Conclusion
The identified altered lncRNAs, miRNAs, mRNAs and related signaling pathways may be involved in the AP development and recurrence.
Relationship of Functional Constipation and Growth Status: A Systematic Review and Meta-Analysis
Authors: Lazarus Glen , Junaidi Michelle Clarissa , Oswari Hanifah 
Published: September 2022

Objectives:
Functional constipation (FC) and malnutrition are 2 of the most common diseases affecting children worldwide with long-term consequences. We hereby performed a systematic review and meta-analysis to analyze the relationship between these 2 entities.

Methods:
We searched PubMed, American Academics of Pediatrics (AAP), Cochrane, ClinicalTrials.gov (from inception to December 11, 2021) using “constipation,” “growth,” and “children” as the keywords. Newcastle-Ottawa Scale was used as the risk of bias assessment tool. Meta-analysis using the random-effects model was done.

Results:
Eighteen studies involving 33,410 children were chosen in this study. Meta-analysis of all the studies showed statistically significant relationship between FC with both overweight/obesity [odds ratio (OR) = 1.75; 95% confidence interval (CI) = 1.11-2.76; P = 0.02], in Asian countries subgroup, and undernutrition (OR = 2.38; 95% CI = 1.43-3.97; P < 0.001) in Asian countries using ROME criteria’s subgroup. Normal weight patients were also more prevalent in non-FC patients in Asia (OR = 0.54; 95% CI = 0.38-0.76; P < 0.001). The relationship between FC and short stature is still inconclusive.

Conclusions:
FC is correlated with the prevalence of both overweight/obesity and undernutrition. Future studies should evaluate the causal relationship and whether FC treatment could help.
Derivation and Validation of Vasoactive Inotrope Score Trajectory Groups in Critically Ill Children With Shock
Authors: Perizes Elitsa N. , Chong Grace , Sanchez-Pinto L. Nelson 
Published: September 2022

OBJECTIVES:
To determine whether there are clinically relevant and reproducible Vasoactive Inotrope Score (VIS) trajectories in children with shock during the acute phase of critical illness.

DESIGN:
Retrospective, observational cohort study.

SETTING:
Two tertiary, academic PICUs.

PATIENTS:
Children (< 18 yr old) who required vasoactive infusions within 24 hours of admission to the PICU. Those admitted post cardiac surgery were excluded.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
An hourly VIS was calculated for the first 72 hours after initiation of vasoactives. Group-based trajectory modeling (GBTM) was applied to a derivation set (75% of encounters) and compared with the trajectories in a validation set (25% of encounters) using the same variables. The primary outcome was in-hospital mortality, and the secondary outcome was multiple organ dysfunction syndrome (MODS) on day 7. A total of 1,828 patients met inclusion criteria, and 309 (16.9%) died. GBTM identified four subgroups that were reproducible in the validation set: “Mild, fast resolving shock” (n = 853 [47%]; mortality 9%), “Moderate, slow resolving shock” (n = 422 [23%]; mortality 15%), “Moderate, prolonged shock” (n = 312 [17%]; mortality 21%), and “Severe, prolonged shock” (n = 241 [13%]; mortality 40%). There was a significant difference in mortality, MODS on day 7, and suspected infection (p < 0.001) across groups. The “Mild, fast resolving shock” and “Severe, prolonged shock” groups were identifiable within the first 24 hours. The “Moderate, slow resolving” and “Moderate, prolonged shock” groups were indistinguishable in the first 24 hours after initiation of vasoactives but differed in in-hospital mortality and MODS on day 7. Hydrocortisone administration was independently associated with poor outcomes in the “Mild, fast resolving shock” group.

CONCLUSIONS:
We uncovered four distinct and reproducible VIS trajectory groups that were associated with different risk factors, response to therapy, and outcomes in children with shock. Characterizing VIS trajectory groups in the acute phase of critical illness may enable better prognostication and more targeted management.
Trends in Rates of Surgery and Postoperative Mortality Among Patients Receiving Chronic Kidney Replacement Therapy
Authors: Palamuthusingam Dharmenaan , Hawley Carmel M. , Pascoe Elaine M. , Johnson David W. , Sivalingam Palvannan , McDonald Stephen , Boudville Neil , Jose Matthew D. , Talaulikar Girish , Fahim Magid 
Published: September 2022

Objective:
To estimate the incidence and postoperative mortality rates of surgery, and variations by age, diabetes, kidney replacement therapy (KRT) modality, and time over a 15-year period.

Background:
Patients with kidney failure receiving chronic KRT (dialysis or kidney transplantation) have increased risks of postoperative mortality and morbidity. Contemporary data on the incidence and types of surgery these patients undergo are lacking.

Methods:
This binational population cohort study evaluated all incident and prevalent patients receiving chronic KRT using linked data between Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and jurisdictional hospital admission datasets between 2000 and 2015. Patients were categorized by their KRT modality (hemodialysis, peritoneal dialysis, home hemodialysis, and kidney transplant) for each calendar year. Incidence rates for overall surgery and subtypes were estimated using Poisson models. Logistic regression was used to estimate 30-day/in-hospital mortality risk.

Results:
Overall, 46,497 patients over a median (interquartile range) follow-up of 6.3 years (3.5–10.2 years) underwent 81,332 surgeries. The median incidence rate of surgery remained stable over this period with a median of 14.9 surgeries per 100 patient-years. Annual incidence rate was higher in older people and those with diabetes mellitus. Patients receiving hemodialysis had a higher incidence rate of surgery compared with kidney transplant recipients (15.8 vs 10.0 surgeries per 100 patient-years, respectively). Overall adjusted postoperative mortality rates decreased by >70% over the study period, and were lowest in kidney transplant recipients (1.7%, 95% confidence interval, 1.4–2.0). Postoperative mortality following emergency surgery was >3-fold higher than elective surgery (8.4% vs 2.3%, respectively).

Conclusions:
Patients receiving chronic KRT have high rates of surgery and morbidity. Further research into strategies to mitigate perioperative risk remain a priority.
Juvenile Mucopolysaccharidosis plus disease caused by a missense mutation inVPS33A
Authors: Pavlova Elena V. , Lev Dorit , Michelson Marina , Yosovich Keren , Michaeli Hila Gur , Bright Nicholas A. , Manna Paul T. , Dickson Veronica Kane , Tylee Karen L. , Church Heather J. , Luzio J. Paul , Cox Timothy M. 
Published: September 2022

ABSTRACTBackgroundA rare and fatal disease resembling mucopolysaccharidosis in infants, is caused by impaired intracellular endocytic trafficking due to deficiency of core components of the intracellular membrane-tethering protein complexes, HOPS and CORVET.MethodsWhole Exome Sequencing identified a novel VPS33A mutation in a patient suffering from a variant form of mucopolysaccharidosis. Electron and confocal microscopy, immunoblotting, and glycosphingolipid trafficking experiments were undertaken to investigate the effects of the mutant VPS33A in patient-derived skin fibroblasts.ResultsWe describe an attenuated juvenile form of VPS33A-related syndrome - mucopolysaccharidosis plus in a man who is homozygous for a hitherto unknown missense mutation (NM_022916.4: c.599 G>C; R200P) in a conserved region of the VPS33A gene. Urinary glycosaminoglycan analysis revealed increased heparan, dermatan sulphates and hyaluronic acid. We showed decreased abundance of VPS33A in patient derived fibroblasts and provided evidence that the R200P mutation leads to destabilisation of the protein and proteasomal degradation. As in the infantile form of mucopolysaccharidosis plus, the endocytic compartment in the fibroblasts also expanded – a phenomenon accompanied by increased endolysosomal acidification and impaired intracellular glycosphingolipid trafficking. Experimental treatment of the patient’s cultured fibroblasts with the proteasome inhibitor, bortezomib, or exposure to an inhibitor of glucosylceramide synthesis, eliglustat, improved glycosphingolipid trafficking.ConclusionTo our knowledge this is the first report of an attenuated juvenile form of VPS33A insufficiency characterised by appreciable residual endosomal-lysosomal trafficking and a milder mucopolysaccharidosis plus than the disease in infants. Our findings expand the proof of concept of redeploying clinically approved drugs for therapeutic exploitation in patients with juvenile as well as infantile forms of mucopolysaccharidosis plus disease.
GHSI COVID-19 puzzle: did highly developed countries indeed fare worse?
Authors: Markovic Sofija , Salom Igor , Rodic Andjela , Djordjevic Marko 
Published: September 2022

AbstractGlobal Health Security Index (GHSI) categories are formulated to assess the capacity of world countries to deal with infectious disease risks. Thus, higher values of these indices were expected to translate to lower COVID-19 severity. However, it turned out to be the opposite, surprisingly suggesting that higher estimated country preparedness to epidemics may lead to higher disease mortality. To address this puzzle, we:i) use a model-derived measure of COVID-19 severity;ii) employ a range of statistical learning approaches, including non-parametric machine learning methods;iii) consider the overall excess mortality, in addition to official COVID-19 fatality counts. Our results suggest that the puzzle is, to a large extent, an artifact of oversimplified data analysis and a consequence of misclassified COVID-19 deaths, combined with the higher median age of the population and earlier epidemics onset in countries with high GHSI scores.