bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speech in Noise With Bilateral Active Bone Conduction Implant for Conductive and Mixed Hearing Loss
Authors: Canale Andrea , Ndrev Drita , Sapino Silvia , Bianchi Carlotta , Bordino Valerio , Albera Andrea 
Published: August 2022

Objective
To evaluate speech in noise results and subjective benefit in bilateral active bone conduction implant (ABCI) for bilateral mixed hearing loss.

Study Design
Prospective, comparative.

Setting
Ear, Nose and Throat Unit, Department of Surgical Sciences, University of Turin.

Patients
Seven patients with conductive/mixed hearing loss.

Intervention(s)
Patients underwent simultaneous or sequential bilateral surgery for ABCI.

Main Outcome Measure(s)
The speech intelligibility in noise was assessed with the Ita Matrix test in summation, squelch and head shadow settings. First, the tests were performed with one device activated in the ear with lower speech recognition score, then with both devices. Patients filled in an Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire to investigate the hearing aid benefit.

Results
When bilateral devices were activated, an improvement of signal-to-noise ratio was observed in all settings. The difference between bilateral and unilateral stimulation is 4.66 dB (p = 0.016) in the summation, 2.24 dB (p = 0.047) in the squelch, 7.50 dB (p = 0.016) in the head shadow setting.
Looking at the APHAB global score (GS), patients report lower mean scores, hence less difficulties, when using two devices (GS, 21.9%; standard deviation (SD), 8.28) rather than one (GS, 33.0%; SD, 10.24) (p = 0.018).

Conclusion
In symmetric mixed bilateral hearing loss, rehabilitation with an ABCI fitted bilaterally shows audiologic advantages in speech perception in noise, not only thanks to the summation effect and by reducing head shadow but also by improving the binaural unmasking based on the squelch effect. Audiometric outcomes are confirmed by the GSs obtained in the APHAB questionnaire.
Successful treatment of cardiac sarcoidosis based on clinical suspicion and advanced cardiac imaging: A case report
Authors: Aguilar-Gallardo Jose S. , Arreaza Javier , Omar Alaa , Lasam Glenmore , Contreras Johanna P. 
Published: August 2022

Introduction:
Confirming the diagnosis of cardiac sarcoidosis (CS) is a challenging task as we often do not count with histopathologic evidence. However, prompt initiation of treatment is sometimes necessary, and advanced cardiac imaging along with key clinical findings can play a crucial role in the diagnostic workup.

Patient concerns:
A 77-year-old male with a history of heart failure presented with chest pain and shortness of breath. He was found to have an acute drop in left ventricular ejection fraction associated with frequent premature ventricular contractions and nonsustained ventricular tachycardia. Coronary angiogram was negative for acute coronary syndrome. Advanced cardiac imaging with cardiac magnetic resonance raised suspicion of CS, and steroids were started empirically. Endomyocardial biopsy was attempted but was not successful.

Diagnosis:
The patient’s presentation was highly suggestive of cardiac sarcoidosis.

Interventions:
Corticosteroids, diuresis, guideline-directed medical therapy for heart failure.

Outcomes:
The patient’s symptoms and ventricular arrhythmias improved on steroids. Subsequent FDG-PET revealed increased uptake in a pattern consistent with CS.

Conclusion:
This clinical scenario highlights the importance of advanced cardiac imaging and clinical findings for the diagnosis of CS and exposes the practical need for a standardized, noninvasive strategy to the diagnosis of CS.
The efficacy of Yiqi Huoxue therapy for chronic heart failure: A meta-analysis in accordance with PRISMA guideline
Authors: Zhang Miao , Sun Ming-Yue , Yin Hui-Jun , Wu Zheng-Zhi , Jin Yu , Min Ma , Xu Feng-Qin 
Published: August 2022

Background:
Chronic heart failure (CHF) is the final destination of most cardiovascular diseases and the most important cause of death. The main clinical manifestations were pulmonary congestion and decreased cardiac output. The purpose of this systematic review is to evaluate the effectiveness of Yiqi Huoxue therapy on CHF.

Methods:
Seven electronic databases were searched to identify randomized controlled trials of Yiqi Huoxue (YQHX) method for CHF until April 30, 2020. The quality assessment of the included trials was performed by employing the Cochrane Risk of Bias tool and Jadad scale.

Results:
Nineteen randomized controlled trials were included in our review. Most of the included trials were considered as low quality. The aggregated results suggested that experimental group with YQHX therapy got better effect in increasing overall response rate (risk ratio, RR = 1.21, 95% confidence interval, CI 1.15–1.27), traditional Chinese medicine (TCM) syndrome response rate (RR = 1.26, 95% CI 1.17–1.36), 6-minute walk test (RR = 2.14, 95% CI 1.05–3.22), left ventricular ejection fraction (RR = 0.97, 95% CI 0.60–1.34), and stroke volume (standardized mean difference, SMD = 0.94, 95% CI 0.23–1.56), and in lowering down the TCM syndrome scores (SMD = –0.78, 95% CI –0.91 to –0.64), Minnesota Living with Heart Failure questionnaire (SMD = –1.01, 95% CI –1.56 to –0.45), 6-month readmission rate (RR = 0.50, 95% CI 0.28–0.89), B-type natriuretic peptide (SMD = –0.89, 95% CI –1.52 to –0.25), NT-proBNP (SMD = –2.07, 95% CI –3.34 to –0.08), and C-reactive protein (SMD = –2.04, 95% CI –4.12 to –0.67) as compared to using conventional Western medicine alone. There were no significant differences found in left ventricular end diastolic diameter and E/E′ between experimental groups and control groups. Moreover, the included sample capacity is small and the trails are all in Chinese. Quality of the evidence for outcomes were “low” and “very low” according to the GRADE assessment.

Conclusion:
YQHX is a valid complementary and alternative therapy in the management of CHF, especially in improving overall response rate, TCM syndrome response rate, 6-minute walk test, left ventricular ejection fraction, and stroke volume and in decreasing TCM syndrome scores, Minnesota Living with Heart Failure questionnaire, 6-month readmission rate, B-type natriuretic peptide, NT-proBNP, and C-reactive protein levels. Hence, YQHX is a relatively effective and safe therapy for CHF patients, which can be popularized and applied in the clinic. More long-term follow-up studies are still needed to substantiate and confirm the current findings.
Safety analysis of natural orifice specimen extraction surgery for colorectal cancer
Authors: Zheng Shuai , Zhao Zimin , Zheng Honghong , Li Jianjun , Yang Ji , Zhao Enhong 
Published: August 2022

Summary
This study investigated the safety, feasibility, and clinical outcomes of natural orifice specimen extraction surgery (NOSES) by collecting clinical from patients who underwent complete laparoscopic radical resection for colorectal cancer versus those who underwent conventional laparoscopic radical resection for colorectal cancer. Patients with colorectal cancer were selected as the study sample and grouped according to the different surgical methods. A total of 182 patients were eligible for enrollment in the study, including 92 patients who underwent NOSES (NOSES group) and 90 patients who underwent conventional laparoscopic radical colorectal cancer surgery. In the NOSES group, a total of 14 cases were observed to have a postoperative abdominal infection, and the remaining 78 cases did not have an abdominal infection, which we refer to as the infected and uninfected groups in this paper for further analysis. There was no difference in surgical outcome between NOSES surgery and conventional laparoscopic surgery. Diabetes mellitus, prolonged drain retention, and prolonged operative time were risk factors for the development of abdominal infection in NOSES. In contrast, intraoperative use of specimen retrieval bags, use of transanal endoscopic operations, and intraoperative flushing of the abdominal cavity with dilute iodophenol were protective factors for the development of postoperative abdominal infections. NOSES for colorectal cancer is worth promoting because of its small trauma and quick postoperative recovery.
Adductor canal block versus femoral nerve block for pain control after total knee arthroplasty: A systematic review and Meta-analysis
Authors: Hasabo Elfatih A. , Assar Ahmed , Mahmoud Maysa Madny , Abdalrahman Hamid Ali , Ibrahim EzzElDien A. , Hasanin Menna Allah , Emam Amr Khaled , AbdelQadir Yossef Hassan , AbdelAzim Ahmed Alaa , Ali Ahmed Said 
Published: August 2022

Background:
Femoral nerve block is a widely accepted nerve block method with evident reduction in consumption of opioid painkiller and minimization of the duration of hospital stay but may cause weakness of quadriceps muscle strength. Adductor canal block is another nerve block technique that attracts the attention of scientific community nowadays because of its possible superiority over Femoral nerve block regarding mobility and muscle strength.

Methods:
This is a systematic review and meta-analysis of 33 studies, aiming to compare femoral nerve block with adductor canal block following total knee arthroplasty regarding pain control and mobilization.

Results:
Adductor canal block showed better preservation of quadriceps muscle strength (MD = 0.28, 95% CI [0.11, 0.46], P = .002), and better mobilization up to 2 days postoperatively. However, no significant difference was found between the 2 interventions regarding pain control (MD = 0.06, 95% CI [−0.06, 0.17], P = .33) or opioid consumption (SMD = 0.08, 95% CI [−0.06, 0.22], P = .28) up to 2 days postoperatively. The better mobilization results of adductor canal block did not translate into a significant difference in the risk of falls or patients’ satisfaction; however, adductor canal block patients had less mean length of hospital stay than the patients with femoral nerve block.

Conclusion:
Both femoral nerve block and adductor canal block provide similar results regarding pain control and opioid consumption, however adductor canal block provides better preservation of quadriceps strength and mobilization, giving it more advantage over femoral nerve block.
Clinicopathological significances of PLOD2, epithelial–mesenchymal transition markers, and cancer stem cells in patients with esophageal squamous cell carcinoma
Authors: Gong Xiaomeng , Wang Ailian , Song Wenqing 
Published: August 2022

Background:
To examine the expression level of procollagen-lysine2-oxoglutarate 5-dioxygenase 2 (PLOD2) in esophageal squamous cell carcinoma (ESCC) and analyze its correlation with clinicopathological parameters, in order to explore the mechanism of PLOD2 in regulating invasion and metastasis of ESCC.

Methods:
Immunohistochemistry was used to detect the expression level of PLOD2 in tumor tissues and paired adjacent tissues of 172 patients with ESCC, and the relationship between PLOD2 expression and clinicopathological parameters was analyzed. The deposition of collagen fibers in tumor was detected by Sirius red staining. The correlation between tumor stem cells and epithelial–mesenchymal transition (EMT) markers ZEB1 was analyzed by multivariate logistic regression.

Results:
The expression level of PLOD2 in tumor tissues of patients with ESCC (70.35%, 121/172) was significantly higher than that in paired adjacent tissues (29.65%, 51/172; P < .01). The positive expression rate of PLOD2 in ESCC was related to T classification, lymph node metastasis, and pathological tumor node metastasis of a tumor. The expression rates of ZEB1, CD44, and CD133 in ESCC were correlated with T classification, lymph node metastasis and pathological tumor node metastasis. Scarlet red staining showed that collagen fiber deposition in ESCC tissues with high expression of PLOD2 was significantly higher than that in tissues with low expression of PLOD2 (P < .01). A positive correlation was observed between the expression of PLOD2 and CD133, PLOD2 and CD44, and PLOD2 and N-cadherin (P < .01). Moreover, a negative correlation was noted between the expression of PLOD2 and E-cadherin (P < .01). The combined expression of PLOD2 and ZEB1 were independent prognostic factors for the total survival time of patients with ESCC.

Conclusion:
PLOD2 is highly expressed in ESCC and is closely related to tumor invasion and metastasis. The mechanism of PLOD2 for promoting invasion and metastasis of ESCC may be related to activation of the EMT signaling pathway to promote EMT and tumor stem cell transformation.
Prediction of lower extremity strength by nerve conduction study in cauda equina syndrome
Authors: Han Jun-Hyeong , Lee Ji-Young , Yun Dong Hyuk , Moon Chang-Won , Cho Kang Hee 
Published: August 2022

An electrodiagnostic test is more useful than the lower extremity isometric strength test for objectively determining the degree of nerve damage and prognosis in cauda equina syndromes (CES). This study evaluated the correlation between nerve conduction study (NCS) parameters and the lower extremity isometric strength and manual muscle test (MMT) grades.
The isometric strengths of knee extension (KE), ankle dorsiflexion (ADF), and ankle plantarflexion (APF) were measured. NCS parameters, MMT, and isometric strength of femoral, peroneal, and tibial nerves were evaluated, including their correlations with each other. A regression equation between the isometric strength and compound muscle action potential (CMAP) amplitudes was derived and cutoff values were used to confirm boundary values of strength and amplitude between the MMT grades.
KE isometric strength and femoral nerve CMAP amplitude were significantly correlated (r = 0.738, P < .001). ADF isometric strength and peroneal nerve CMAP amplitude were significantly correlated (tibialis anterior, r = 0.707, P < .001). KE (r = 0.713, P < .001), ADF (r = 0.744, P < .001), and APF (r = 0.698, P < .001) isometric strengths were correlated with the MMT grades. For the regression curve, the second-order curve was more reasonable than the first-order curve. Cutoff femoral nerve CMAP amplitude and isometric strength cutoff values were ≥2.05 mV and 17.3, respectively, for MMT grades 2 to 3 and 2.78 ± 1.08 and 20.8 ± 9.33, respectively, for grade 3.
The isometric strengths of the KE, ADF, and APF and the CMAP amplitude of the electrophysiologic parameters were correlated in CES patients and a significant correlation with MMT grade was also identified. Accordingly, it is possible to identify the precise neurological condition, objectively evaluate the degree of paralysis and disability, and determine the quantitative muscle strength from MMT in order to establish an appropriate rehabilitation treatment plan.
Clinical outcomes of palliative self-expandable metal stent placement in right- and left-sided malignant colon obstruction: A Honam Association for the Study of Intestinal Disease (HASID) multicenter study
Authors: Oh Hyung-Hoon , Cho Sung-Bum , Hong Ji-Yun , Kim Dong-Hyun , Yang Hee-Chan , Kim Sang-Wook , Lee Jun , Kim Seong-Jung , Han Yeom-Dong , Seo Geom-Seok , Hong Gun-Young , Kim Ho-Dong , Myung Dae-Seong , Kim Hyun-Soo , Joo Young-Eun 
Published: August 2022

Self-expandable metal stent (SEMS) placement is commonly used for palliation of left-sided malignant colorectal obstruction (MCO). However, right-sided MCO is usually treated surgically. Recent studies that compared palliative SEMS insertion and emergency surgery in right-sided MCOs have reported conflicting results. This study aimed to compare the effectiveness of palliative SEMS placement in left-sided MCOs and right-sided MCOs and to investigate the predictive factors for clinical success and risk factors for complications.
Data from 469 patients who underwent palliative SEMS placement for MCO at 6 hospitals in the Honam province of South Korea between 2009 and 2018 were reviewed. Among them, 69 patients with right-sided MCO and 400 patients with left-sided MCO who underwent SEMS placement for palliative purposes were enrolled. Clinical success, overall survival, complications, and predictive factors for clinical success and risk factors for complications were included as the main outcome measures.
The clinical success rates were 97.1% (65/67) in right-sided MCO patients and 88.2% (353/400) in left-sided MCO patients. Complications including stent migration, tumor ingrowth, outgrowth, perforation, bacteremia/fever, and bleeding occurred in 10.1% (7/69) of right-sided MCO patients and 19.9% (79/400) of left-sided MCO patients. The mean overall survival of right-sided MCO was 28.02 months and 18.23 months for left-sided MCO. In multivariate logistic regression analysis, T3 stage tumors and the use of uncovered stents were significant factors for the clinical success of SEMS. The use of covered stents and performance status score of 0 to 2 were independent significant risk factors for complications.
Palliative SEMS placement in right-sided MCO showed better clinical success rates than left-sided MCO. The use of uncovered stents is recommended for higher clinical success rates and lower complication rates.
Chronic constipation that resulted in fecal impaction and colon perforation: A case report
Authors: Alburakan Ahmed , Alshunaifi Aljoharah , AlRabah Razan , Alshammari Sulaiman , Alnasser Saleh , Nouh Thamer 
Published: August 2022

Rationale:
Gastrointestinal (GI) motility disorders represent a set of variable presentations caused by an abnormal functioning enteric neuromusculature. Any part of the GI tract can be affected, and depending on the organ involved, the patient presentation will differ.

Patient concerns:
A 26-years old female who had a history of laparoscopic Heller myotomy 15 years ago for progressive dysphagia. She presented with peritonitis and sigmoid colon perforation secondary to severe chronic constipation. Later after undergoing Hartman procedure, she continued to have significant constipation. In addition, she reported progressive dysphagia and regurgitation to both solids and liquids.

Diagnosis:
An esophageal manometry revealed Achalasia type 3, and stomach motility nuclear study showed mild delay in gastric emptying.

Interventions:
Initially, Hartmann procedure was performed. Afterward, we performed a reversal of Hartman, robotic redo of Heller myotomy, and Dor fundoplication was performed.

Outcomes:
The patient had an uneventful postoperative course and was discharged in good condition.

Lessons:
Our case highlights an unusual presentation of GI motility disorder resulting in peritonitis from sigmoid colon perforation. Early recognition and prompt treatment of GI motility disorders are essential to avoid severe complications.
Curative effect of different drainage methods on laparoscopic inguinal hernia repair: A meta-analysis
Authors: Zhong Yang , Liu Zhi , He Miao , Lv Xiao Jiang , Liu Mao , Wen Ai Ping , Chen Jian Yu , Qin Long , Li Jian Shui 
Published: August 2022

Background:
Laparoscopic inguinal hernia repair has developed rapidly as an important surgical method for inguinal hernia repair; however, postoperative complications, especially postoperative seroma, are becoming an important factor hindering its development. Many studies have shown that placing a negative-pressure drainage tube in the preperitoneal space can effectively reduce postoperative seromas. Accordingly, this study aimed to compare differences in postoperative seroma between surgical procedures with drainage tubes (DRG) and those without drainage tubes (nonDRG).

Methods:
PubMed/Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched from the establishment of the database to May 1, 2021. Odds ratio (OR), mean difference (MD), standardized mean difference (SMD), and 95% confidence interval (CI) were selected as the effect scale indices for the evaluation of the difference in seroma, operation time, hospital stay time, blood loss, and recovery time. All of these were compared using RevMan 5.3 Software.

Results:
Sixteen studies involving 4369 patients, 2856 in the DRG group and 1513 in the nonDRG group, were included. The incidence of seroma in the DRG group was lower than that in the nonDRG group (OR = 0.16, 95% CI: 0.07–0.35, P < .001). Additionally, the operation time (min) in the DRG group was longer than that in the nonDRG group (MD = 3.67, 95% CI: 2.18–5.17, P < .001). Nevertheless, no significant differences were found in hospital stay (days) (SMD = 0.22, 95% CI: −0.10–0.54, P = .17), blood loss (mL) (MD = 0.28, 95% CI: −0.14–0.69, P = .19), and recovery time (h) (SMD = 0.54, 95% CI: −0.60–1.69, P = .35) between the 2 groups.

Conclusion:
Despite the slightly prolonged operation time, negative pressure drainage in the preperitoneal space during laparoscopic inguinal hernia repair can significantly reduce the occurrence of postoperative seroma without increasing blood loss, recovery, and hospital stay.
Excellent response of lung adenocarcinoma harboring a rare SLC8A1 downstream intergenic region ALK fusion to ceritinib treatment: A case report
Authors: Fang Lei , Ding Guozheng , Wang Muzi , Ye Yuanzi , Yan Xuebo , Ding Peishan , Wang Jiong , Zhang Yanbei 
Published: August 2022

Rationale:
Anaplastic lymphoma kinase (ALK) gene fusion, an important driver gene alteration leading to the development of lung cancer, occurs in 5% of nonsmall cell lung cancer (NSCLC) cases in China. In addition to echinoderm microtubule-associated protein-like 4 (EML4)-ALK, which is the most common type of ALK fusion, various fusion partner genes have been identified in recent years. However, ALK intergenic breakpoint fusions confound fusion detection and targeted treatment.

Patient concerns:
A 40-year-old woman presented to our hospital with a 2-month history of a cough.

Diagnosis:
Based on the right hilar lymph node biopsy and positron emission tomography computed tomography (PET-CT) examination, the patient was diagnosed with “stage IV lung adenocarcinoma” showing metastases in the mediastina, right hilar lymph nodes, and C7 vertebral body. A rare solute carrier family 8 member A1 (SLC8A1) downstream intergenic region ALK fusion was identified in biopsy specimens using next-generation sequencing (NGS).

Interventions:
The patient received first-line molecular-targeted therapy (ceritinib).

Outcomes:
After nearly 9 months, the best evaluation of partial remission (PR) was obtained.

Lessons:
This is the first clinical evidence of advanced NSCLC due to a rare SLC8A1 downstream intergenic region ALK fusion that has been effectively treated with ceritinib. Whether this finding represents an inherent property of this fusion protein or its unique clinicopathological characteristics in patients carrying this fusion protein remains to be investigated. Moreover, the patient’s durable response to ceritinib and future resistance mechanisms require further follow-up.