bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk of colorectal polyps among the Korean population under 50 years
Authors: Jeong Su Jin , Lee Jinho , Kim Eunju , Hwang Jun Seong , Lee Jin , Choi Joon Hyuk , Heo Nae-Yun , Park Jongha , Park Seung Ha , Kim Tae Oh , Park Yong Eun 
Published: July 2022

Colorectal cancer is a common cancer; generally, adults aged ≥ 50 years are screened using stool occult blood tests and colonoscopy. However, colorectal adenoma and cancer have been found in patients under the aged of 50, and studies on characteristics and risk factors in young patients are lacking. We evaluated the prevalence and risk factors of colorectal adenoma and cancer in young adults aged under 50 years.
We retrospectively analyzed 570 individuals aged under 50 years who underwent colonoscopy at the Haeundae Paik Hospital, Korea, from January to June 2018. Logistic regression model was used to identify the risk factors for colorectal adenoma and colorectal cancer.
The prevalence of colorectal adenoma in group of 19–29 years was 3.2% (1 of 31), 30–39 years was 13.8% (30 of 217) and in the group of 40–49 years was 21.1% (68 of 322) (P = .009). In multivariable analysis, age over 45 years (adjusted odds ratio [OR], 1.941; 95% confidence interval [CI], 1.187–3.172; P = .008) and male sex (adjusted OR, 1.711; 95% CI, 1.044–2.806; P = .033) were independent risk factors for colorectal neoplasia including cancer.
The prevalence of colorectal adenoma increases as the age increased in young adults under 50 years of age, especially after the age of 45 years, the risk of colorectal neoplasia increases; hence, early screening should be considered before the age of 50 years.
Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
Authors: Kim Yeo Jin , Kim Dae Hoon , Choi Hanlim , Ryu Dong Hee , Yun Hyo Yung 
Published: July 2022

Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy.
A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site.
Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula.
The patient was discharged 55 days after his third surgery.
This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided.
Accelerated-strategy renal replacement therapy for critically ill patients: A systematic review and meta-analysis
Authors: Lan Shao-Huan , Lai Chih-Cheng , Chang Shen-Peng , Lu Li-Chin , Hung Shun-Hsing , Lin Wei-Ting 
Published: July 2022

Background:
The aim of this study was to investigate the clinical effect and safety of accelerated-strategy initiation of renal replacement therapy (RRT) in critically ill patients.

Methods:
PubMed, Embase, OVID, EBSCO, and the Cochrane Library databases were searched for relevant articles from inception to December 30, 2020. Only RCTs that compared the clinical efficacy and safety between accelerated-strategy RRT and standard-strategy RRT among critically ill adult patients with acute kidney injury (AKI) were included. The primary outcome was 28-day mortality.

Results:
A total of 5279 patients in 12 RCTs were included in this meta-analysis. The 28-day mortality rates of patients treated with accelerated and standard RRT were 37.3% (969/2596) and 37.9% (976/2573), respectively. No significant difference was observed between the groups (OR, 0.92; 95% CI, 0.70–1.12; I
2 = 60%). The recovery rates of renal function were 54.5% and 52.5% in the accelerated- and standard-RRT groups, respectively, with no significant difference (OR, 1.03; 95% CI, 0.89–1.19; I
2 = 56%). The rate of RRT dependency was similar in the accelerated- and standard-RRT strategies (6.7% vs 5.0%; OR, 1.11; 95% CI, 0.71–1.72; I
2 = 20%). The accelerated-RRT group displayed higher risks of hypotension, catheter-related infection, and hypophosphatemia than the standard-RRT group (hypotension: OR, 1.26; 95% CI, 1.10–1.45; I
2 = 36%; catheter-related infection: OR, 1.90; 95% CI, 1.17–3.09; I
2 = 0%; hypophosphatemia: OR, 2.11; 95% CI, 1.43–3.15; I
2 = 67%).

Conclusions:
Accelerated RRT does not reduce the risk of death and does not improve the recovery of kidney function among critically ill patients with AKI. In contrast, an increased risk of adverse events was observed in patients receiving accelerated RRT. However, these findings were based on low quality of evidence. Further large-scale RCTs is warranted.
Is brace necessary after cervical surgery: A meta-analysis of randomized controlled trials
Authors: Mao Yang , Jindong Zhao , Zhaohui Fang 
Published: July 2022

Background:
Currently, there are increasing surgical treatments for neck pain. However, whether to use cervical brace after operation remains poorly defined. We aim to clear the clinical efficacy of the use of cervical brace after cervical surgery.

Methods:
We searched for relevant studies in 8 electronic databases up to March 2021. The mean difference and 95% confidence intervals were used for continuous data. Cochrane Collaboration’s tool was used to assess the risk of bias. The data were collected and input into the Review Manager 5.3 software (The Cochrane Collaboration, Copenhagen, Denmark).

Results:
Four randomized controlled trials were finally included in our study. For pain, the pooled analysis showed that postoperative neck brace compared with no brace can relieve neck pain at all follow-up periods except 6 months. For neck disability index, the result showed that postoperative neck brace compared with no brace can improve neck disability index during the 3 to 12 month follow-up period. However, no significant difference was identified between 2 groups within the follow-up of 6 weeks after surgery. In addition, the result tends to get the opposite at follow-up of 24 months. For 36-Short form health survey Physical Component Summary, there was no significant difference between 2 groups in the early 3 weeks after surgery, but the results were changed after 3 weeks. For 36-short form health survey Mental Component Summary, there appears to be no significant change between 2 groups at all time intervals.

Conclusion:
Wearing a cervical brace after cervical surgery is conducive to improving symptoms after cervical surgery at different stages. However, there is no relevant evidence indicating it can improve the mental health of postoperative patients. Higher quality, large prospective randomized studies are needed to verify the current conclusions.
Our experience with 80 cases of SARS-CoV-2-Clostridioides difficile co-infection: An observational study
Authors: Birlutiu Victoria , Dobritoiu Elena Simona , Lupu Claudia Daniela , Herteliu Claudiu , Birlutiu Rares Mircea , Dragomirescu Dan , Vorovenci Andreea 
Published: July 2022

Beside the changes in the gut microbiota in context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the increased use of high-risk broad-spectrum antibiotics during the actual pandemic raises concerns about a possible increase of Clostridioides difficile infections (CDIs).
We retrospectively analyzed 80 consecutive patients, with SARS-CoV-2 pneumonia and CDI.
The mean length of hospitalization was 19.63 days. The mean time of the onset of the digestive symptoms related to CDI was 5.16 days. Patients with an onset of the digestive symptoms from hospital admission have a significantly lower median length in hospital stay. The recovered patients present a statistically significant decreased median age. coronavirus disease 2019 (COVID-19) cured patients present CDI symptoms much earlier than the deceased patients, when comparing the median days before the occurrence of any digestive symptoms regarding CDI. Among the patients that prior to their hospitalization for COVID-19 were exposed to antibiotics, 54.7% presented CDI digestive symptoms during their hospitalization and 65.6% had a severe or critical COVID-19 form.
Although the incidence of CDI in the pandemic is lower compared to the period before the pandemic, the severity of cases and the death rate increased. In the actual setting clinicians need to be aware of possible CDI and SARS-CoV-2 co-infection.
Clinical presentations and prognosis of metformin-associated lactic acidosis patients in the intensive care unit: A 20-year survey
Authors: Yang Chun-Chieh , Weng Shih-Feng , Tseng Kuei-Ling , Ho Chung-Han 
Published: July 2022

Metformin-associated lactic acidosis (MALA) is a rare but serious adverse event. It is associated with a high mortality rate and is diagnosed by the peak lactate level (PLL). This study examines the relationship between the clinical presentations and PLL in patients under metformin therapy admitted to the intensive care unit (ICU) to better diagnose MALA and prevent a worsening prognosis. The mortality distribution of clinical characteristics among patients with MALA was also examined.

Methods:
We retrospectively analyzed 82 adult patients with MALA admitted to the ICU over 20 years. The association between the clinical parameters and mortality post-MALA was estimated using logistic regression analysis.

Results:
Patients with MALA admitted to the ICU presented with clinical symptoms mainly associated with the head (40.24%), chest (41.46%), and abdomen (35.37%). Additionally, the PLL distribution significantly varied with age, APACHE II = Acute Physiology and Chronic Health Evaluation II (APACHE II) score, various laboratory parameters like nadir arterial bicarbonate level, multiple treatment modalities such as renal replacement therapy, and mortality. The overall mortality rate was 17.07%. After adjustment of age and gender, the significant predictors of mortality were APACHE II score, PLL, vasoactive support, ventilator support, and cardiopulmonary resuscitation.

Conclusions:
Despite MALA being a rare event, it is necessary to evaluate its clinical characteristics, especially the associated PLL and mortality. In the current study, higher levels of APACHE II score and PLL show a greater likelihood of mortality in MALA patients.
Unintentional Pediatric Lithium Exposure
Authors: Seltzer Justin A. , Friedman Nathan A. , Winkler Garret A. , Lasoff Daniel , Cantrell F. Lee 
Published: July 2022

Objectives
Lithium is an uncommon pediatric exposure, and the effects of accidental or exploratory ingestions are not well characterized. This study examined the clinical effects and outcomes of unintentional lithium ingestions treated in a health care facility for patients up to 16 years old.

Methods
The database from a single-state Poison Control System was queried for all pediatric lithium exposures managed in a health care facility between January 2006 and December 2021. Inclusion criteria were 16 years or younger and acute lithium exposure treated in a health care facility. Those older than 16 years, nonoral exposures, intentional, chronic, or nonlithium exposures, and out-of-state patients were excluded.

Results
One hundred eighteen cases were included, and 619 were excluded. The median age was 2 years (range, 0.5–15 years). One hundred fifteen (97%) were 7 years or younger. Sixty-eight (57.6%) were boys. One hundred thirteen (96%) were exploratory ingestions. Lithium carbonate was the most common formulation, with a median reported dose of 525 mg (range, 100–13,500 mg). Sixty-seven (57%) had serum lithium concentrations available: 19 (28%) were detectable (>0.1 mEq/L) and 4 were supratherapeutic (>1.2 mEq/L).
One hundred (85%) patients were coded as having no effects. Four (3%) patients had coded effects—1 mild, 2 moderate, and 1 major; all were polydrug ingestions and recovered fully with basic supportive care. The loss to follow-up rate was 12%.
A small minority received treatment with intravenous fluids and/or whole bowel irrigation. Thirteen (11%) were admitted, 3 to the ICU. No morbidity or mortality was reported.

Conclusions
The majority of unintentional pediatric lithium ingestions examined were exploratory and resulted in no significant symptoms. Only a small minority had detectable serum lithium concentrations. All isolated lithium exposures were asymptomatic. Unintentional exposures appear to be benign, even with detectable lithium levels. Further study is needed to better risk stratify for home care versus health care facility evaluation.
Mechanism of the Salvia miltiorrhiza-Codonopsis pilosula drug pair in the treatment of premature ovarian failure based on network pharmacology-molecular docking
Authors: Ni Rui-Jun , Dong Li , Huang Hong-Li , Xia Yanq-Qiu 
Published: July 2022

Abstract

Objective:
Premature ovarian failure (POF) is a disease characterized by irregular menstruation and results in infertility which markedly affects the reproductive health of women. The Salvia miltiorrhiza-Codonopsis pilosula drug pair is effective at treating POF; however, knowledge of the mechanisms of S. miltiorrhiza-C. pilosula in the treatment of POF is lacking. Thus, we carried out network pharmacology and molecular docking to clarify the mechanisms of this drug pair.

Methods:
The core components and targets of S. miltiorrhiza-C. pilosula were obtained using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database and UniProt database, and the disease targets related to POF were searched using different tools to obtain the overlapping target genes of S. miltiorrhiza and C. pilosula. A protein interaction network of the intersection target was constructed using STRING database, and the network of “traditional Chinese medicine-active ingredient-intersection target-disease” and “pathways-targets” was constructed using Cytoscape 3.8.0. The DAVID online tool was also used to determine the gene ontology functions and Kyoto Encyclopedia of Genes and Genomes pathways associated with the intersection target genes. Finally, the binding ability of the drug to the active components and potential targets were predicted using molecular docking.

Results:

S. miltiorrhizae-C. pilosula had 72 active components, 128 targets, 3,775 POF targets, and 106 common targets. The potential targets were mainly related to the biological processes of DNA-binding transcription factor binding, RNA polymerase II-specific DNA-binding transcription factor binding, transcription factor activity, steroid receptor activity, and hypoxia response. Further, the Kyoto Encyclopedia of Genes and Genomes enrichment pathways included PI3K-Akt signaling pathway, apoptosis, interleukin (IL)-17 signaling pathway, relaxin signaling pathway, and other biological pathways.

Conclusion(s):

S. miltiorrhiza-C. pilosula can inhibit ovarian granulosa cell apoptosis and improve ovarian hemodynamics through multiple targets and multiple pathways and help treat POF.
Role of fatty acids and calcium in male reproduction
Authors: Naz Taniya , Chakraborty Srinjoy , Saha Sudipta 
Published: July 2022

Abstract
Both fatty acids (FAs) and calcium ions play important roles in contraceptive cycles via several systems. Polyunsaturated FAs (PUFAs) act as precursors for prostaglandin production and can alter the expression of numerous crucial catalysts that are involved in prostaglandin and steroid digestion. Lipids are essential components of cell membranes. A diet rich in PUFAs enhances sperm motility and viability. It also improves testis development and spermatogenesis in several domesticated animal species. Increased PUFA content in spermatozoa increases plasma membrane fluidity, which is important for fertilization. However, the major drawback of high dietary PUFA intake is that it increases the levels of reactive oxygen species in the body. An increase in reactive oxygen species levels markedly affects fertility. Calcium is an important component that acts as an intra-cellular secondary messenger and plays an important role in some of the physiological processes that occur in male gametes. Some of these processes include spermatogenesis, sperm motility, capacitation, acrosome response, and fusion of gametes. These processes are associated with calcium influx through ion protein channels. Dietary fat intake is associated with increased intestinal calcium absorption. In this review, we discuss the impact of lipids, particularly PUFAs and monounsaturated FAs, and calcium ions on male reproduction, along with their effects on each other.
Effect of vitrification on clinical outcomes of cleavage-stage embryos with poor quality in human embryo cryopreservation
Authors: Liu Tao , Lian Ying , Liu Ping , Li Rong , Yan Jie , Qiao Jie 
Published: July 2022

Abstract

Objective:
To evaluate the effect of morphologic factors on survival rate (SR), pregnancy rate (PR), and implantation rate (IR) of human embryo vitrification following frozen embryo transfer (FET) on day 3 post-ovulation.

Methods:
Women undergoing FET (n = 921) with embryos cryopreserved by vitrification between 2012 and 2013 were enrolled in this retrospective cohort study.

Results:
Embryos with >9 blastomeres yielded the highest SR of 100%. Lower SR was observed in embryos with 5 to 6 (57.5%) and 4 blastomeres (41.4%). In terms of blastomere symmetry, the SR of embryos with equally sized blastomeres was significantly higher than that of embryos with unequally sized cells (82.5% vs. 64.6%, P < 0.05). As fragmentation increased, SR decreased from 92.1% to 20.6% (P < 0.05). Significant differences were observed among groups when analyzing PR and IR according to the 3 embryonic parameters before vitrification. Embryos with 13 to 16 blastomeres yielded the highest PR (39.5%) and IR (24.1%). The PR and IR of embryos with blastomeres of equal size were significantly higher than those with unequally sized blastomeres (36.5% vs. 21.7%, 23.7% vs. 12.4%, P < 0.05). After warming, embryos with 13 to 16 blastomeres yielded the highest PR and IR (40.9% and 24.2%, respectively). The PR and IR were observed to grow with an increase in the percentage of intact blastomeres (23.2%-38.2%, 14.2%-23.2%).

Conclusions:
These results show that vitrification methods do not effectively improve survival outcomes for embryos of poor quality and it is needed to develop a comprehensive vitrification protocol that considers all the practical aspects, including the current limitation regarding cleavage-stage embryos of poor quality.
Source of human oocytes for infertility treatment and fertility preservation
Authors: Chian Ri-Cheng 
Published: July 2022

Abstract
The source of human oocytes is directly associated with the success of infertility treatment and fertility preservation. The number of oocytes obtained is possibly correlated with the success rate in terms of live birth rates. However, oocyte quality must be refined such that the number of oocytes is not positively correlated with the quality of oocytes. Different ovarian stimulation protocols can be used to obtain numerous oocytes. However, oocyte quality should be considered the most important factor affecting infertility treatment and fertility preservation. Infertile women are generally willing to take health-related risks to achieve a live birth, and ovarian stimulation using high-dose hormonal treatments may be harmful for both women and infants. Therefore, successful infertility treatment and fertility preservation should be defined as the birth of a healthy baby at term without compromising the health and safety of the mother and infant. Therefore, the source of high-quality oocytes must be carefully considered prior to infertility treatment and fertility preservation.
How fertility preservation guidelines have progressed worldwide: Potential implications and inspiration
Authors: Chen Min-Xin , Zhang Ying , Cai Qing-Qing , Zhang Shuo , Xu Ran , Chen Hua , Kang Yu , Wu Yue , Chian Ri-Cheng , Xu Cong-Jian 
Published: July 2022

Abstract
To summarize fertility preservation (FP) guidelines and consensus provided by medical facilities worldwide. Five reference databases (PubMed/Embase, China BioMedical Literature Database, ClinicalKey, Wanfang Data, and China Knowledge Resource Integrated) and 7 guideline databases (Guideline International Network, National Collaborating Centre for Women's and Children's Health, National Guideline Clearinghouse, The National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guideline Group, and Canadian Medical Association infobase) were searched. Official websites of societies were searched to find relevant guidelines and consensus, and guidelines and published systematic reviews and consensus were reviewed from inception through May 2021. A literature search was performed regarding guidance offered in professional facilities, and 304 records (including 4 in Chinese) of existing guidelines for full-text review were found. Moreover, 55 guidelines were identified after a manual search. The literature review demonstrated that FP guidance and options were unevenly distributed worldwide for women who wanted to post-pone pregnancy or had impaired fertility after gonadal toxicity. With promising cancer survival rates and diversified family decisions, more attention should be paid to the improvement and update of accessible guidelines and regulatory infrastructure to inform patients about the available options and empower them to make informed choices. Restrictions to such services can be gradually eased due to the efficacy and safety of certain FP techniques for the right candidates to initiate pregnancy conception.
Non-invasive chromosome screening for embryo preimplantation using cell-free DNA
Authors: He Fang , Yao Ya-Xin , Wang Jing , Zhao Dun-Mei , Wan An-Qi , Ren Jun , Lei Xi 
Published: July 2022

Abstract
Preimplantation genetic testing (PGT) is a widely adopted screening method that can be performed to identify and select embryos with normal ploidy; however, PGT relies on embryo biopsy, that is, polar body, embryo cells, or trophectoderm biopsy, to obtain embryonic DNA, increase its technical limitations. Studies have indicated that biopsy may have an influence on the quality and development of embryos, and increase the chance of abnormal epigenetic modifications. Therefore, non-invasive PGT (niPGT) detection of cell-free DNA (cfDNA) has gradually become a hot research topic in the field of assisted reproduction. Studies showed cfDNA could be detected in blastocyst fluid and spent culture medium (SCM) in vitro cultured embryos. The cfDNA collection requires less skill and makes lower risk to embryos. Some studies have been conducted to evaluate the feasibility of SCM-based niPGT approaches. When comparing the ploidy consistency of cfDNA in SCM, its consistency to the conventional PGT for aneuploidies results fluctuated widely, it is critical to recognize the factors influencing accuracy. These contradictory results may be related to factors such as the difference in SCM sampling methods and sampling time, and the definition of consistency. In this review, we aimed to comprehensively summarize how researchers use embryonic cfDNA to conduct niPGT detection. It also systematically reviews the factors affecting the accuracy of the test and its underlying issues, as well as prospective applications. We hope to provide a basis for future niPGT research and a useful reference for the standardized operation of niPGT that can be widely applied in clinical practice.