bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis-Related Mortality Rates and Trends Based on Site of Infection
Authors: Prest Jonathan , Nguyen Thai , Rajah Tiffany , Prest Alayna B. , Sathananthan Matheni , Jeganathan Niranjan 
Published: October 2022

OBJECTIVES:
Sepsis is defined as life-threatening organ dysfunction triggered by an underlying infection. A recent study noted that the overall sepsis-related mortality rate in the United States is stable. In this study, we evaluated the sepsis-related mortality rates and trends associated with the three most common sites of infection.

DESIGN:
Retrospective population-based study.

SETTING:
Multiple Cause of Death (MCOD) database available through the Centers for Disease Control and Prevention website.

PATIENTS:
Decedents with sepsis-related deaths and the source of sepsis were identified using previously validated International Classification of Diseases codes.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
From 2004 to 2018, using the MCOD, the age-adjusted mortality rate per 1,000,000 population from pulmonary sepsis was 111.8, from abdominal sepsis was 46.7, and from genitourinary sepsis was 52. Mortality rates from all three sites increased. Males had a higher mortality rate from pulmonary sepsis and abdominal sepsis and lower mortality rate from genitourinary sepsis. Black and Native American decedents had the highest mortality rates from all three sepsis sites. Compared with White decedents, Hispanic decedents had a higher mortality rate from pulmonary sepsis but lower rate from genitourinary sepsis. Asian decedents had the lowest mortality rates from abdominal and genitourinary sepsis but similar mortality rates from pulmonary sepsis as White decedents. The mortality rate increased in White and Native American decedents for all three sepsis sites, whereas in Hispanic decedents only abdominal and genitourinary sites increased, and in Black and Asian decedents only abdominal sepsis rates increased.

CONCLUSIONS:
Despite the overall stable sepsis-related mortality rates, the rates secondary to pulmonary, abdominal, and genitourinary sepsis are increasing in both sexes and all age groups. This is likely due to improved identification/documentation of a site of infection in patients with sepsis. We noted significant racial variation in mortality rates/trends, which should be considered in future studies.
Impact of antagonist peptides and chelators on the diagnostic performance of PET/CT using gallium-68–labeled somatostatin receptor antagonists
Authors: Xing Haiqun , Zhu Wenjia , Cheng Yuejuan , Yang Qiao , Jia Ru , Zhao Hong , Bai Chunmei , Huo Li , Wu Wenming 
Published: October 2022

Objective:
Different SSTR2 antagonists have been developed. This study aims to evaluate the impact of different peptides and chelators on the diagnostic performance of SSTR2 antagonists in well-differentiated NETs.

Methods:
In this prospective study, participants were equally randomized into 2 arms: arm A, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-DOTA-LM3 PET/CT scan on the second day; arm B, participants would undergo a whole-body 68Ga-NODAGA-LM3 PET/CT scan on the first day and 68Ga-NODAGA-JR11 PET/CT scan on the second day. Biodistribution in normal organs, lesion detection ability, and tumor uptakes were compared within each arm.

Results:
A total of 40 participants (age, 49.5 ± 13.4, 21 men), 20 in each arm, were recruited in the study. In arm A, 68Ga-DOTA-LM3 showed lower background. However, the lesion detection ability (overall lesion detected, 445 vs 548; P = .005) and the lesion uptake (overall lesions SUVmax, 19.8 ± 17.2 vs 35.3 ± 28.8; P < .001) was significantly lower than those of 68Ga-NODAGA-LM3. In arm B, both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 showed similar biodistribution and lesion uptake (SUVmax, 28.5 ± 23.8 vs 25.0 ± 20.0; P < .001) despite minor differences. The lesion detection ability was the same between these 2 tracers (overall lesion detected, 503 vs 503).

Conclusions:
The diagnostic performance of SSTR2 antagonists was sensitive to chelators. Both 68Ga-NODAGA-LM3 and 68Ga-NODAGA-JR11 outperformed 68Ga-DOTA-LM3 with higher lesion uptake and detection ability, of which 68Ga-NODAGA-LM3 had marginally but significantly higher lesion uptake.
Incidence and Management of Facial Paralysis After Skull Base Trauma, an Administrative Database Study
Authors: Wamkpah Nneoma S. , Kallogjeri Dorina , Snyder-Warwick Alison K. , Buss Joanna L. , Durakovic Nedim 
Published: October 2022

Objective
Report the incidence of and treatment patterns for facial nerve palsy after skull base fracture.

Study Design
Retrospective cohort study.

Setting
IBM MarketScan Commercial Database (2006–2019).

Patients
Human subjects with skull base fracture, per International Classification of Diseases—9th and 10th Revisions—Clinical Modification diagnosis codes.

Main Outcome Measures
The primary outcomes were the incidence and median time to facial nerve palsy diagnosis within 30 days of skull base fracture. Secondary outcomes were treatments (corticosteroids, antivirals, facial nerve decompression, botulinum toxin, and facial reanimation), demographics, and rates of hearing loss, vertigo, tympanic membrane rupture, cerebrospinal fluid leak, comorbidities, and loss of consciousness.

Results
The 30-day incidence of facial nerve palsy after skull base trauma was 1.0% (738 of 72,273 patients). The median (95% confidence interval [CI]) time to diagnosis was 6 (6–7) days, and only 22.9% were diagnosed within 1 day. There were significantly higher rates (risk difference, 95% CI) of hearing loss (26%, 22–29%), tympanic membrane rupture (6.3%, 4.5–8.1%), cerebrospinal fluid leak (6.4%, 4.5–8.3%), comorbidity (14%, 10.4–17.6%), and loss of consciousness (24.3%, 20.7–27.9%). Loss of consciousness was associated with longer median (95% CI) time to facial nerve palsy diagnosis: 10 (9–10) days. Corticosteroids were the most common treatment but only reported for less than one-third of patients. Only eight patients underwent facial nerve decompression.

Conclusions
Facial nerve palsy after skull base fracture is associated with higher comorbidity, and the diagnosis is often delayed. Few patients were treated with surgery, and there are inconsistencies in the types and timing of treatments.
Clinical efficacy of acupuncture in patients with adhesive intestinal obstruction: A meta-analysis
Authors: Xie Yujia , Zheng Chengwen , Tan Xiyue , Li Zongyu , Zhang Yiyi , Liu Yuan 
Published: October 2022

Background:
Adhesive intestinal obstruction (AIO) is a common surgical emergency. Surgical exploration has a considerable risk of intestinal injury, and surgical treatment may greatly reduce the quality of life after surgery and cause AIO after re-operation. The nonsurgical treatment is effective for approximately 70% to 90% of patients with adhesive small bowel obstruction (ASBO). However, the high recurrence (30%) and mortality (2%) rates of ASBO are concerning. Moreover, the ideal management method of ASBO remains debatable. Studies have shown that acupuncture can also promote postoperative gastrointestinal function recovery and prevent postoperative complications such as nausea, vomiting, and visceral pain.

Aim:
We aimed to evaluate the effectiveness of acupuncture in the treatment of AIO.

Methods:
Randomized controlled trials investigating the effectiveness of acupuncture for adhesive bowel obstruction published until November 2021 were identified by searching 8 comprehensive databases. Data analysis was performed using RevMan v. 5.4 and Stata software v. 16.0. The random-effects model and the fixed-effects model were used to perform the meta-analysis on the experimental group and control group.

Results:
Twelve studies with a total of 892 participants were included. The results showed that the experimental group had a significantly higher effective rate (relative risk: 1.20; 95% confidence interval (CI): 1.11–1.28; P < .00001) and a markedly shorter time of the first defecation (mean difference: −11.49, 95% CI: −19.31 to −3.66; P = .004) than the control group. The experimental group also showed a reduction in the duration of abdominal pain, and the reduced length of hospital stay. However, no statistical differences were observed between the 2 groups in terms of the surgery conversion rate.

Conclusion:
Acupuncture is effective in the treatment of AIO. It can remarkably alleviate some clinical symptoms in patients with AIO.
A fetus with Bosch-Boonstra-Schaaf optic atrophy syndrome characterized by bilateral ventricle widening: A case report and related literature review
Authors: Sun Yu , Guo Lili , Sha Jing , Tao Huimin , Wang Xuezhen , Liu Ying , Zhai Jingfang , Wu Jiebin , Zhao Yongxiu 
Published: October 2022

Rationale:
Bosch–Boonstra–Schaaf optic atrophy syndrome (BBSOAS) is a rare neurodevelopmental disorder caused by loss-of-function variants in the Nuclear Receptor Subfamily 2 Group F Member 1 (NR2F1). Here, we report a case of fetal BBSOAS. The fetus is typically featured by bilateral ventricle widening in the late second trimester, meanwhile, a 7.94-Mb deletion fragment on 5q14.3q15 involving the whole NR2F1 gene was confirmed by copy number variation sequencing (CNV-Seq) combined with karyotyping analysis. Our aim is to provide comprehensive prenatal clinical management strategy for fetal BBSOAS.

Patient concerns:
A 29-year-old primipara and her husband were referred to our prenatal diagnosis center due to the widening of bilateral ventricles at 29 + 1 weeks of gestation age.

Diagnoses:
Ultrasound revealed the fetal widening posterior horns of bilateral ventricles at the GA of 27 + 3 weeks, 11 mm on the left and 10 mm on the right. At the following 29 + 1 weeks, ultrasound showed the posterior horn of the left lateral ventricle: 12 mm while the width of the right decreased to 9 mm, and intracranial arachnoid cyst. Furthermore, MRI confirmed that intracranial cyst might originate from an enlarged cisterna venae magnae cerebri, with mild dilation of 13.5 mm on the left ventricle. The fetal karyotyping analysis and CNV-Seq detection confirmed a 7.94-Mb deleted fragment on 5q14.3q15 (89340000_97280000) through the amniocentesis at 29 + 4 weeks of GA.

Interventions:
The fetus was closely monitored and underwent the following assessment by the multidisciplinary team.

Outcomes:
The pregnancy was terminated in the end.

Lessons:
It is vital to use molecular and cytogenetical detections combined with a dynamic development history to make a definite diagnosis and evaluate the genetic status for the fetuses with BBSOAS.
New smokeless moxibustion for knee osteoarthritis: A study protocol for a multicenter, single-blind, randomized controlled trial
Authors: Chen Lusheng , Ren Xiumei , Li Fengxing , Deng Haiping , Ding Guanghong , Yao Wei , Zhao Ling , Shen Xueyong 
Published: October 2022

Introduction:
Knee osteoarthritis (KOA) is a chronic inflammatory disease with high morbidity and disability. As the aging and obese population increase, so will the medical services for this disease. The purpose of this study is to compare the clinical efficacy of herbal activated carbon smokeless moxibustion and traditional moxibustion in the treatment of KOA and to determine the clinical efficacy of herbal activated carbon smokeless moxibustion in the treatment of KOA.

Methods/design:
This is a multicenter, two parallel-group, single-blind, randomized controlled trial. Eighty-eight subjects with KOA (Kellgren Lawrence grade II or III) will be recruited and randomly treated with smokeless moxibustion or traditional moxibustion in the ratio of 1:1. The smokeless moxibustion group will use plant herbal activated carbon smokeless moxa cone. The traditional moxibustion group will be treated with pure moxa cone. Subjects in both groups will receive treatment at the affected knee(s) at the acupuncture point ST35, EX-LE2, and EX-LE4. Subjects in both groups will receive 3 sessions per week of moxibustion for 4 weeks. The primary outcome are changes in the Western Ontario and McMaster Universities Osteoarthritis Index pain scores from baseline to week 24. Secondary outcomes include visual analog scale, 50 yards fast walking time, short-form heath survey 36, overall clinical efficacy evaluation, self-assessment of safety, treatment credibility and expectancy, and cytokines related to osteoarthritis in serum.

Discussion:
This randomized single-blind controlled trial takes traditional moxibustion as the control group to provide strict evidence for the clinical efficacy and safety of herbal activated carbon smokeless moxibustion in the treatment of KOA.
The role of PTP1B (PTPN1) in the prognosis of solid tumors: A meta-analysis
Authors: Zhou Jiupeng , Guo Hui , Zhang Yongfeng , Liu Heng , Dou Quanli 
Published: October 2022

Background:
Protein tyrosine phosphatase 1B (PTP1B) played different role in different solid tumors, and was associated with the prognosis of solid tumors. However, the roles existed controversy. This meta-analysis was performed to determine whether PTP1B was relevant to the prognosis of solid tumors.

Materials and methods:
A literature search in Web of Science, Embase and PubMed databases were performed up to November 1, 2021. A meta-analysis dealed with PTP1B assessment in solid tumors, providing clinical stages and survival comparisons according to the PTP1B status.

Results:
High PTP1B expression was significantly associated with later clinical stage of solid tumors (Odds ratio [OR] 2.25, 95% confidence interval [CI]: 1.71–2.98, P < .001). For solid tumors, the hazard ratio (HR) for disease free survival (DFS) detrimental with high PTP1B expression compared with low PTP1B expression was 1.07 (95%CI: 0.67–1.73, P = .77) with the obvious heterogeneity (P = .03, I
2 = 66%). The HR of overall survival (OS) for solid tumors with high PTP1B expression versus low PTP1B expression was 1.26 (95%CI: 1.03–1.55, P = .03) with significant publication bias (t = 3.28, P = .005). Subgroup analysis indicated that the high expression of PTP1B was remarkably correlated with poor OS in colorectal carcinoma, only (HR = 1.43; 95%CI: 1.18–1.74; P = .003).

Conclusions:
High PTP1B expression is significantly associated with later clinical stage of solid tumors. The high expression of PTP1B is remarkably correlated with poor OS in colorectal carcinoma, only. There is no definite conclusion that PTP1B was, or not associated with DFS and OS of solid tumors because of heterogeneity and publication bias. Whether PTP1B can be used as a biomarker for predicting the prognosis of solid tumors needs further study.
Hypercalcemia worsened after vitamin D supplementation in a sarcoidosis patient: A case report
Authors: Mio Kimito , Haruhara Kotaro , Shimizu Akihiro , Oshiro Kentaro , Kawai Rena , Ikeda Masato , Yokoo Takashi 
Published: October 2022

Rationale:
There are many causes of hypercalcemia, with hyperparathyroidism and malignancy accounting for 90% of cases. Sarcoidosis and the intake of vitamin D supplements may also cause hypercalcemia, although the occurrence rate is low if only one is involved. We herein report a sarcoidosis patient who developed hypercalcemia after taking cholecalciferol (vitamin D supplement) for a year.

Patient concern:
A 62-year-old Japanese man presented with hypercalcemia and acute kidney injury along with symptoms of fatigue and appetite loss while being followed up for sarcoidosis.

Diagnoses:
We determined that a combination of cholecalciferol supplementation and sarcoidosis had led to hypercalcemia for several reasons. First, hypercalcemia had not been noted when this patient had first been admitted due to sarcoidosis-related respiratory failure several years earlier, which we presumed that was the highest sarcoidosis disease activity. Second, low serum 25-OH Vit.D3 and high 1,25-(OH)2 Vit.D3 levels were noted despite cholecalciferol supplementation for a year, suggesting that 1-α-hydroxylase overexpression caused by sarcoidosis accelerated the conversion from 25-OH Vit.D3 to 1,25-(OH)2 Vit.D3.

Interventions:
Although initially resistant to preservative management, the hypercalcemia promptly improved after starting corticosteroid treatment.

Outcomes:
Hypercalcemia and acute kidney injury were normalized after corticosteroid treatment.

Lessons:
We should be aware of patients’ medications, especially in patients with granulomatosis disease. The concomitant measurement of 25-OH Vit.D3 and 1,25-(OH)2 Vit.D3 levels is useful for determining the cause of hypercalcemia.
Clinical effect of Anwei Qingyou recipe on peptic ulcer and its effect on the levels of EGF and PGE2: A retrospective study
Authors: Bai Guoxin , Yi Junyu , Yu Yuanyuan , Du Hongxing 
Published: October 2022

Background:
To investigate the effect of Anwei Qingyou formula on the clinical treatment of patients with peptic ulcer (PU) and its effect on the levels of epidermal growth factor (EGF) and prostaglandin E2 (PGE2).

Methodology:
Medical records of 83 patients with PU, treated in our hospital from January 2020 to January 2021, were retrospectively analyzed. Among them, 40 patients received conventional triple therapy (scheme I), that is, oral omeprazole, clarithromycin and amoxicillin, twice a day, and 43 patients received conventional triple therapy + Anwei Qingyou formula, taken orally twice a day (scheme II). The improvement of clinical symptoms, the quality of ulcer healing, clinical effectiveness and recurrence rate were analyzed after 4 weeks of treatment. Patients were followed up for six months.

Results:
After treatment with corresponding regimen, the total clinical effective rate of scheme II was 97.57% (42/43), which was significantly higher than 82.50% (33/40) of scheme I. Six-month follow-up results showed that the recurrence rate in scheme II patients was 4.65% (2/43), which was significantly lower than 20.00% (8/40) in the scheme I group (χ 2 = 5.479, 4.607, all P < .05). After one course of treatment, the levels of serum EGF and PGE2 in scheme II group were higher than those in scheme I group (P < .05).

Conclusion:
In combination with the conventional western medicine treatment, Anwei Qingyou formula administration in PU patients effectively improves the overall control of the disease and therapeutic effectiveness.
Sensitivity and specificity analyses of COVID-19 screening protocol for emergency medical services: A STARD-compliant population-based retrospective study
Authors: Fukushima Hidetada , Nishioka Yuichi , Kasahara Kei , Asai Hideki , Sonobe Shota , Imamura Tomoaki , Muro Shigeo , Nishio Kenji 
Published: October 2022

During the novel coronavirus disease (COVID-19) pandemic, emergency medical services (EMS) has borne a huge burden in transporting emergency patients. However, the protocol’s effect on identifying emergency patients who are likely to have COVID-19 is unknown. We aimed to evaluate the diagnostic accuracy of a prehospital COVID-19 screening protocol for EMS.
We conducted this population-based retrospective study in Nara Prefecture, Japan. The Nara Prefectural Government implemented a screening protocol for COVID-19 comprising the following symptom criteria (fever, cough, sore throat, headache, malaise, dysgeusia, or anosmia) and epidemiological criteria (contact history with confirmed COVID-19 cases or people with upper respiratory symptoms, or travel to areas with high infection rate). A patient meeting at least one criterion of each class was considered positive. We evaluated all 51,351 patients from the regional EMS database of the Nara Prefecture (emergency Medical Alliance for Total Coordination of Healthcare) who were registered from June 15, 2020 to May 31, 2021 and had results of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests. We assessed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this protocol. We also assessed how these outcomes changed by adding vital signs and conducted a 10-fold and 100-fold prevalence simulation.
The screening protocol was used for 246/51351 patients (0.5%). Among them, 31 tested positive after EMS transportation. This protocol’s sensitivity, specificity, PPV, and NPV were 40.8%, 99.6%, 12.6%, and 99.9%, respectively. With the addition of ≥2 vital signs (body temperature ≥37.5 °C, respiratory rate ≥20 breaths/minute, and oxygen saturation <90%), sensitivity and PPV changed to 61.8% and 1.0%, respectively, while NPV remained 99.9%. With a 10-fold and 100-fold increase in disease, the protocol PPV would be 59.0% and 94.3%, and NPV would be 99.1% and 90.7%, respectively, and with additional vital signs, PPV would be 8.9% and 53.1%, and NPV would be 99.4% and 93.2%, respectively.
This COVID-19 screening protocol helped enable EMS transport for patients with COVID-19 with a PPV of 12.6%. Adding other vital sign variables may improve its diagnostic value if the prevalence rate increases.
Abnormal uterine position during pregnancy secondary to abdominal surgery: Two case reports
Authors: Li Huanxi , Wu Quanfeng , Wei Wei , Lin Xueyan , Zhang Xueqin 
Published: October 2022

Rationale:
The umbilical cord is the way to exchange gas, supply nutrients, excrete metabolized. Thrombosis of the umbilical cord leads to fetal hypoxia, which jeopardizes fetal health and can cause fetal death. Umbilical vessel thrombosis, which is rarely reported, is difficult to detect prenatally.

Patient concerns:
Both individuals included in this study had a history of abdominal operation before pregnancy. The abnormal uterine position demonstrated in the first patient developed secondary to adhesions between the anterior bladder wall and lower segment of the uterus. As the uterus increased in size in proportion with the gestational age, the uterine body continued to enlarge even as the lower uterine segment remained fixed by the adhesions, which resulted in cervical displacement. In comparison, the abnormal uterine position in the second patient was due to a rare case of uterine incarceration developed.

Diagnosis:
Both cases were diagnosed as abnormal uterine position during pregnancy secondary to abdominal surgery.

Interventions:
The first patient underwent a cesarean section at 33 weeks and 5 days age of gestation for pregnancy complications. The second patient performed a cesarean section at 37 weeks age of gestation.

Outcomes:
Due to reasonable treatment, the 2 cases achieved good maternal-infant outcomes.

Conclusion:
Abnormal uterine position during pregnancy should be considered seriously, because it can affect the prognosis of the mother and child. When appropriate, a cesarean section is an effective method for terminating such pregnancies. During cesarean section, a longitudinal skin incision may be more beneficial in avoiding secondary injuries. However, the choice of uterine incision should be adjusted for each patient. Care should be given to prevent postpartum hemorrhage.