bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new marker of short-term mortality and poor outcome in patients with acute ischemic stroke: Mean platelet volume-to-lymphocyte ratio
Authors: Wu Fan , Wang Qian , Qiao Yingli , Yu Qing , Wang Fuyuan 
Published: October 2022

Background:
The mean platelet volume-to-lymphocyte ratio (MPVLR), as a novel marker of thrombosis and inflammation, has been demonstrated to be closely linked to poor cardiovascular disease prognosis. However, the correlation between MPVLR and acute ischemic stroke (AIS) remains unclear. This study, therefore, aimed to clarify the relationship between MPVLR and the short-term prognosis of AIS.

Methods:
A total of 315 patients with first-time AIS diagnoses were recruited and divided into 3 groups based on the tri-sectional quantiles for MPVLR on admission: group 1 (N = 105) with a MPVLR ≤ 4.93, group 2 (N = 105) with a MPVLR of 4.94 to 7.21, and group 3 (N = 105) with a MPVLR ≥ 7.22. All patients were followed-up for 3 months, and death within 3 months was defined as the endpoint. Baseline characteristics, stroke severity, and functional outcomes were evaluated.

Results:
The Spearman’s correlation coefficient test showed that MPVLR was significantly positively correlated with the National Institutes of Health Stroke Scale score (R = 0.517, P < .001). Multivariate analysis revealed that MPVLR was an independent predictor of both short-term mortality (adjusted odds ratio [OR] 1.435, P < .001) and poor outcome (adjusted OR 1.589, P < .001). The receiver operating characteristic (ROC) curve analysis showed that the best cutoff value of MPVLR for short-term mortality and poor outcome were 6.69 (sensitivity: 86.4%, specificity: 68.6%) and 6.38 (sensitivity: 78.8%, specificity: 72.3%), respectively.

Conclusions:
MPVLR on admission was positively associated with stroke severity. An elevated MPVLR is an independent predictor of short-term mortality and poor outcome after AIS.
Lung adenocarcinoma harboring complex EML4-ALK fusion and BRAF V600E co-mutation responded to alectinib
Authors: Guo Weihong , Liang Jianping , Zhang Dandan , Huang Xikun , Lv Yanhua 
Published: October 2022

Rationale:
The echinoderm microtubule-associated protein-like 4 gene and anaplastic lymphoma kinase gene (EML4-ALK) is the most frequent fusion variant of ALK rearrangements in non-small cell lung cancer (NSCLC). With the widespread application of next-generation sequencing (NGS), more fusions and co-mutations of EML4-ALK have been discovered. Complex co-mutation of EML4-ALK fusions together with BRAF V600E, though rarely occurred, also deserves attention to determine the standard of caring these patients. Herein, we report a case of lung adenocarcinoma harboring a complex ALK fusion that coexisted with a BRAF mutation, as tested by DNA-NGS prior to treatment.

Patient concerns:
A 51-year-old non-smoking man, without any symptoms, was admitted to hospital due to small pulmonary nodules and enlarged supraclavicu larlymph nodes found in health checkup.

Diagnosis:
He was diagnosed with stage IVB (T4N3M1c) lung adenocarcinoma. BRAF V600E (abundance 3.75%) mutation and a novel thus little-understood EML4-ALK (E13, A5; abundance 2.16%) fusion were identified by DNA-NGS analysis of lymph node biopsy tissue in December 2019.

Interventions:
Darafenib plus trametinib targeted therapy and chemotherapy were given firstly, but tumor progression was not inhibited. The ALK inhibitor alectinib was prescribed then.

Outcomes:
The patient exhibited a rapid disease response to ALK tyrosine kinase inhibitors alectinib with a complete remission of widespread metastatic disease and progression-free survival of more than 26 months, but not to darafenib plus trametinib targeted BRAF V600E therapy. Re-analyzed the patient’s DNA-NGS original data, showed it is a rare and complex EML4-ALK (E13, A5, A20) fusion in fact. Additional RNA-NGS analysis showed it verified to be a canonical EML4-ALK (E13, A20) fusion transcript and coexisting with a BRAF V600E mutation.

Lessons:
This case suggests that for patients with rare or complex EML4-ALK fusions at DNA level, additional RNA-NGS is necessary to verify its functionality as early as possible. Targeting EML4-ALK firstly may be more preferable despite the coexisting of BRAF V600E.
The likelihood approach for potential role of “GABRG2 (C588T, C315T) gene polymorphisms” on the poor response to carbamazepine therapy in Pakhtun population of Pakistan
Authors: Ullah Shakir , Ali Niaz , Ahmad Sajjad , Sha Syed Wadood Ali , Ali Saad , Almarshad Feras 
Published: October 2022

Background:
Gamma-aminobutyric acid A receptor, gamma 2 gene (GABRG2) encode the GABAA receptor which is responsible for fast neuronal inhibition. Polymorphisms in GABGR2 gene affect the clinical response of anti-epileptic drugs (AEDs). Therefore, we carried out an updated study to find the association GABRG2 gene polymorphisms with carbamazepine (CBZ) non-responsive therapy in the Pakhtun population.

Methods:
A clinical prospective cohort study was conducted in 79 CBZ treated patients upon consent after the approval of Khyber Medical University Advanced Study and Research Board. Blood sample were taken at optimal dose of CBZ at base line, third and sixth months of the treatment. Blood level of CBZ was measure through reverse phase high performance liquid chromatography (HPLC). Restriction fragment length polymorphisms techniques were used to genotype GABRG2 gene in these patients. CBZ responses were evaluated on three and six months of study by measuring the decrease in frequency of seizure per week.

Results:
The average maximum dose of CBZ was 455 ± 133 mg/day at baseline, 479 ± 142 mg/day at third month and 495 ± 133 mg/day at sixth month of the treatment. CBZ level was found within therapeutic range (4‐12 mg/L) without any significant (P > .5) variations among the CC, CT and TT genotypes of GABRG2 (C588T and C315T) gene. But the poor clinical response during CBZ treatment was linked (P < .05) with CT and TT genotypes of GABRG2 (C588T and C315T) gene in Pakhtun Population.

Conclusion:
A poor response to CBZ was found in variant genotypes (CT and TT) of GABRG2 (C588T and C315T) gene in Pakhtun Population.
COVID-19 in a patient with new adult-onset Still disease: A case report
Authors: Alharbi Samar O. 
Published: October 2022

Rationale:
Adult-onset Still disease (AOSD) is a systemic autoinflammatory illness of unknown cause. Its manifestations comprise fever; arthritis or arthralgia; and skin rash with high inflammatory markers and ferritin levels. Coronavirus disease 2019 (COVID-19) shares several clinical features and laboratory markers of AOSD: making it challenging to differentiate between the 2 conditions.

Patient concerns:
A 29-year-old woman presented with fever, skin rash, and polyarthritis 4 weeks before admission. Two weeks after illness onset, she had an infection with symptoms similar to those of COVID-19. She observed that her symptoms worsened, and new symptoms appeared including headache; vomiting; diarrhea; and loss of taste and smell. The patient tested positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction.

Diagnosis:
The patient was diagnosed with AOSD complicated with COVID-19 after exclusion of other possible causes of her illness, such as infections, malignancy, or underlying rheumatological disease.

Interventions:
The patient was administered corticosteroids and methotrexate. The patient responded quickly, particularly to corticosteroids.

Outcomes:
This is the second reported case of COVID-19 in a patient with AOSD. She experienced COVID-19 shortly after having AOSD, indicating that those with AOSD might have a higher risk of COVID-19 infection. Furthermore, she developed the most prevalent COVID-19 symptoms. However, distinguishing most of these symptoms from AOSD manifestations was difficult.

Lessons:
Early diagnosis and differentiation between AOSD and COVID-19 and prompt initiation of treatment are required.
The effect of dynamic quadripolar radiofrequency on genitourinary atrophy and sexual satisfaction: A systematic review and meta-analysis
Authors: Elbiss Hassan Mohamed , Rafaqat Wardah , Khan Khalid Saeed 
Published: October 2022

Background:
Physiologic processes such as childbirth and menopause can alter vulvovaginal aesthetic appearance, reduce sexual satisfaction, and cause symptoms of vulvovaginal atrophy which affects a woman’s quality of life. There is debate about whether dynamic quadripolar radiofrequency (DQRF) can be used to improve such conditions. We conducted a meta-analysis of studies among patients undergoing treatment with DQRF.

Methods:
We conducted a literature search without language or article type restriction in PubMed, Cochrane library and Web of Science from inception to June 1, 2022. We included studies that reported outcomes of DQRF treatment. Article selection and data extraction in a predesigned data extraction form were conducted in duplicate. Individual studies reported outcomes in terms of the pre- and post-intervention repeated measures. Meta-analysis combined results across studies to produce effect sizes using random effects model with 95% confidence intervals (CI) taking into account sampling variance to adjust the estimated precision. PROSPERO: CRD42021227752.

Results:
The search yielded 781 articles, from which 4 case series (127 participants) were included. Two studies reported a significant improvement in patient and medical evaluation assessments of vulvovaginal aesthetic appearance. Significant improvements were reported by three studies for patient assessed sexual satisfaction/discomfort, vaginal laxity and symptoms of genitourinary syndrome of menopause. Meta-analysis showed a trend towards improvement in aesthetic appearance (4 studies; 0.89; 95% CI –0.15 to 1.93; I
2 75.0%) and sexual satisfaction (2 studies; 0.62; 95% CI –0.03 to 1.27; I
2 0.0%).

Conclusion:
Dynamic quaripolar radiofrequency is a potentially promising intervention to improve vaginal laxity, appearance and sexual satisfaction, as observed in four monocentric case series. Further studies with a control group, well-defined methods of patient selection and longer follow-up periods are necessary to reach a definitive conclusion.
Control effect of virtual reality technology on procedural pain in children’s wound: A meta-analysis
Authors: Li Tuan , Fu Yingping , Yang Yanzheng , Zhou Yu-E 
Published: October 2022

Background:
Children who undergo wound manipulation usually experience pain. Virtual reality technology is a novel and effective non pharmaceutical therapy for reducing pain in children scheduled to undergo wound manipulation. However, the effectiveness of Virtual reality technology in controlling procedural pain in children’s wounds has not been evaluated in a systematic review.

Methods:
It employed a meta-analysis design. We included studies with randomized controlled trials, reporting children’s wound manipulation pain, and published them in English. Two reviewers independently evaluated the methodological quality of the included studies.

Results:
Of the 108 studies identified, 39 were eligible for the meta-analysis, with a total sample of 273 patients. The use of virtual reality technology has significantly reduced pain intensity during wound manipulation in children. There was a significant difference between the experimental group (virtual reality) and the control group (no virtual reality) in reducing the pain of the children’s wound manipulation (P < .05).

Conclusion:
As a distraction method of non drug assisted analgesia intervention, virtual reality technology can reduce children’s procedural pain and discomfort symptoms.
Curcumin protects PC12 cells from a high glucose-induced inflammatory response by regulating the miR-218-5p/TLR4 axis
Authors: Cui Yuan , Song Hong-Tao , Zhang Pei , Yin Xiao , Wang Ying , Wei Xuan , Jia Xin-Ju 
Published: October 2022

Background:
Curcumin exerts a protective effect on diabetic encephalopathy (DN), It is known for its potent neuroprotective, anti-inflammatory, antioxidant, and anticancer properties. However, the underlying mechanisms of curcumin’s neuroprotective effects resulting from high glucose (HG)-induced injuries remain unknown. The purpose of this study is to identify the protective mechanism of Curcumin in the DN.

Methods:
In this study, pheochromocytoma cells (PC12 cells) were pretreated with different concentrations of Curcumin and then co-treated with Curcumin and glucose for 48 hours, and the cell viability was evaluated by CCK-8, the expression of the inflammatory mediators were detected by ELISA, the miR-218-5p and toll-like receptors (TLR4) level were examined by both quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting, the potential target genes of miR-218-5p were identified using luciferase reporter assay.

Results:
The viability of PC12 cells treated with HG was significantly reduced in a dose- and time-dependent manner. Cotreatment of curcumin with HG significantly increased cell viability. Curcumin inhibited the expression of the inflammatory mediators, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6), and induced the expression of the anti-inflammatory mediator interleukin-10 (IL-10). Curcumin upregulated the levels of miR-218-5p and downregulated the expression of TLR4 in HG-treated PC12 cells. The curcumin-induced anti-inflammatory effect was abrogated by a miR-218-5p inhibitor and overexpression of TLR4. The results suggest that curcumin ameliorates the inflammatory response by upregulating miR-218-5p levels in PC12 cells.

Conclusions:
Our results indicate a protective role for curcumin in PC12 cells and suggest that it should be considered for the prophylactic treatment of DN in the future.
The ‘-ics’ of male reproduction: genomics, epigenetics, proteomics, metabolomics, and microbiomics
Authors: Kang Caroline , Bertolla Ricardo , Pagani Rodrigo 
Published: October 2022

Purpose of review
To review the most current findings, from the past 2 years, in various ‘-ics’ fields in male infertility, with a specific focus on nonobstructive azoospermia, the most severe form, and varicocele, the most common correctable cause of male infertility.

Recent findings
Recent studies confirm previously identified causes and identify previously unknown genetic mutations as causes for nonobstructive azoospermia and varicocele.

Summary
Infertility is a common problem for couples with approximately half of cases attributable to male factor infertility. Although advances in assisted reproductive technology have permitted many more men with infertility to father biological children, the majority of infertile men continue to have unknown causes. The recent explosion of the ‘-ics’ fields, including genomics, epigenetics, proteomics, metabolomics, and microbiomics, has shed light on previously unknown causes for various diseases. New information in these fields will not only shed light on the pathogenesis of these conditions but also may shift the paradigm in clinical testing that may allow clinicians to provide more precise counseling and prognostic information for men with infertility.
Management of Malignant Bowel Obstruction
Authors: Jivraj Nazlin , Lee Yeh Chen , Tinker Lisa , Bowering Valerie , Ferguson Sarah E. , Croke Jennifer , Karakasis Katherine , Chawla Tanya , Lau Jenny , Ng Pamela , Dhar Preeti , Shlomovitz Eran , Buchanan Sarah , Dhani Neesha , Oza Amit M. , Stuart-McEwan Terri , Lheureux Stephanie 
Published: October 2022

Background:
Malignant bowel obstruction (MBO) in patients with advanced gynecologic cancer (GyCa) can negatively impact clinical outcomes and quality of life. Oncology nurses can support these patients with adequate tools/processes.

Problem:
Patients with GyCa with/at risk of MBO endure frequent emergency or hospital admissions, impacting patient care.

Approach:
Optimizing oncology nurses' role to improve care for patients with GyCa with/at risk of MBO, the gynecology oncology interprofessional team collaborated to develop a proactive outpatient nurse-led MBO model of care (MOC).

Outcomes:
The MBO MOC involves a risk-based algorithm engaging interdisciplinary care, utilizing standardized tools, risk-based assessment, management, and education for patients and nurses. The MOC has improved patient-reported confidence level of bowel self-management and decreased hospitalization. Following education, nurses demonstrated increased knowledge in MBO management.

Conclusions:
An outpatient nurse-led MBO MOC can improve patient care and may be extended to other cancer centers, fostering collaboration and best practice.
Examining QI Knowledge Among Frontline Nurses and Nurse Leaders
Authors: Prochnow Laura , DiClemente Linda , Riley Penny , Tschannen Dana 
Published: October 2022

Background:
Frontline nurses deliver direct patient care and by participating in quality improvement (QI) can have an impact on health care quality and safety. Unfortunately, nurses are not participating in QI, which may be due to a lack of QI knowledge.

Purpose:
The purpose of this study was to evaluate nurses QI knowledge utilizing the revised Quality Improvement Knowledge Application Tool (QIKAT-R), with newly created nursing scenarios, among frontline nurses and nurse leaders.

Methods:
Using a cross-sectional design, this study evaluated nurses QI knowledge utilizing the QIKAT-R.

Results:
Overall, QI knowledge among nurses was low. The frontline nurses (n = 44) scored higher than nurse leaders (n = 11) on overall QI knowledge scores, although not significant. Frontline nurses scored higher in QI knowledge related to aim and measure, whereas nurse leaders scored higher in change.

Conclusions:
Understanding frontline nurses QI knowledge, such as with the QIKAT-R with newly created nursing scenarios, can assist with creating targeted strategies for improving overall engagement in QI.
Relief of chronic pain associated with increase in midline frontal theta power
Authors: Rustamov Nabi , Wilson Elizabeth A. , Fogarty Alexandra E. , Crock Lara W. , Leuthardt Eric C. , Haroutounian Simon 
Published: October 2022

Abstract

Introduction:
There is a need to identify objective cortical electrophysiological correlates for pain relief that could potentially contribute to a better pain management. However, the field of developing brain biomarkers for pain relief is still largely underexplored.

Objectives:
The objective of this study was to investigate cortical electrophysiological correlates associated with relief from chronic pain. Those features of pain relief could serve as potential targets for novel therapeutic interventions to treat pain.

Methods:
In 12 patients with chronic pain in the upper or lower extremity undergoing a clinically indicated nerve block procedure, brain activity was recorded by means of electroencephalogram before and 30 minutes after the nerve block procedure. To determine the specific cortical electrophysiological correlates of relief from chronic pain, 12 healthy participants undergoing cold-pressor test to induce experimental acute pain were used as a control group. The data were analyzed to characterize power spectral density patterns of pain relief and identify their source generators at cortical level.

Results:
Chronic pain relief was associated with significant delta, theta, and alpha power increase at the frontal area. However, only midfrontal theta power increase showed significant positive correlation with magnitude of reduction in pain intensity. The sources of theta power rebound were located in the left dorsolateral prefrontal cortex (DLPFC) and midline frontal cortex. Furthermore, theta power increase in the midline frontal cortex was significantly higher with chronic vs acute pain relief.

Conclusion:
These findings may provide basis for targeting chronic pain relief via modulation of the midline frontal theta oscillations.
Pharmacokinetics, Tolerability, and Safety of Doravirine and Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate Fixed-Dose Combination Tablets in Adolescents Living With HIV: Week 24 Results From IMPAACT 2014
Authors: Melvin Ann J. , Yee Ka Lai , Gray Kathryn P. , Yedla Mounika , Wan Hong , Tobin Nicole H. , Teppler Hedy , Campbell Havilland , McCarthy Katie , Scheckter Rachel , Aurpibul Linda , Ounchanum Pradthana , Rungmaitree Supattra , Cassim Hassena , McFarland Elizabeth , Flynn Patricia , Cooper Ellen , Krotje Chelsea , Townley Ellen , Moye Jack , Best Brookie M. ,   for the IMPAACT 2014 study team
Published: October 2022

Background:
We studied the pharmacokinetics (PK) and safety of 100-mg doravirine and doravirine/lamivudine/tenofovir disoproxil fumarate fixed-dose combination (100/300/300 mg DOR FDC) treatment in adolescents with HIV-1.

Methods:
Adolescents ages 12 to younger than 18 years were enrolled in 2 sequential cohorts. Cohort 1 evaluated intensive PK and short-term safety of 100-mg single-dose doravirine in adolescents ≥35 kg. Cohort 2 participants either initiated treatment with DOR FDC (antiretroviral (ARV)-naïve) or switched to DOR FDC from a previous ARV regimen (virologically suppressed). The first 10 Cohort 2 participants had intensive PK evaluations, and safety, sparse PK, and HIV RNA were assessed through week 24.

Results:
Fifty-five adolescents, median age 15.0 years and baseline weight 51.5 kg, were enrolled. Nine participants completed Cohort 1 PK assessments (8 of the 9 participants weighed ≥45 kg) and 45 initiated study drug in Cohort 2. The doravirine geometric mean (GM) AUC0–∞ was 34.8 μM∙hour, and the GM C24 was 514 nM after a single dose, with a predicted steady-state GM C24,ss,pred of 690 nM. Cohort 2 enrolled adolescents weighing ≥45 kg. Plasma concentrations of doravirine, tenofovir, and lamivudine achieved by Cohort 2 participants were similar to those reported in adults. No drug-related serious or grade 3 or 4 adverse events occurred. Forty-two of 45 participants (93.3%; 95% CI: [81.7, 98.6]) achieved or maintained HIV-1 RNA <40 copies/mL.

Conclusions:
Doravirine and DOR FDC achieved target PK in adolescents with HIV-1. DOR FDC was well-tolerated and maintained excellent virologic efficacy through 24 weeks, offering a favorable option for adolescents.
Using Mirror Therapy to Optimize the Efficacy of Balance Programs for Older Adults With Poststroke Balance Impairment
Authors: Armat Mohammad Reza , Mortazavi Hamed , Akbari Hadi , Emami Zeydi Amir , Sarani Arezoo 
Published: October 2022

Abstract

Purpose
Poststroke rehabilitation is an inevitable element of the treatment for stroke survivors. This study aimed to investigate the effect of balance training with mirror therapy in older adults with poststroke balance impairment.

Design/Methods
The study adopted a two-arm randomized clinical trial and included 38 older adults with poststroke balance impairment. The intervention group received balance exercises with mirror therapy, whereas the control group received the same balance exercises without mirror therapy (a nonreflective plate was used instead). The patient outcome, the balance score, was measured using the Berg Balance Scale. Analysis of covariance was used for statistical analysis.

Results
Results showed that balance exercises combined with mirror therapy were significantly more effective than balance exercises without mirror therapy in improving balance in the stroke survivors (p < .001).

Conclusion
Mirror therapy combined with regular balance exercises is an effective and practical method for enhancing balance in older adults suffering from balance impairment.

Clinical Relevance
Balance training combined with mirror therapy may be included in the rehabilitation programs of older adults with poststroke balance impairment.