bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on Three-level Enrichment Method Based on 222Rn
Authors: Wang Yutao , Shan Jian , Yang Xiyu , Zhang Hao , Li Haoxuan 
Published: December 2022

Abstract
Various low-concentration inert gases, including 222Rn, 133Xe, and 85Kr, pollute the atmosphere near nuclear facilities (e.g., nuclear power plants or reprocessing plants). Owing to the detection limits of instruments, it has become urgent to determine the concentration of these gases efficiently and perform their online monitoring. However, current technologies are limited by low enrichment efficiencies. In this study, a high-pressure, low-flow, large-volume, and high-efficiency adsorption method has been proposed along with a high-temperature, low-pressure, high-flow, and small-volume rapid desorption and collection method, which are based on the gas enrichment principle of activated carbon. The results demonstrated that when dynamic adsorption was implemented using a two-level enrichment method, the final desorbed gas concentration was proportional to the volume ratio of both the large and small activated carbon beds. At a volume ratio of 15:1, 222Rn concentration increased from 110 to 21,016 Bq m−3 after the two-level enrichment; meanwhile, 222Rn concentration increased from 110 to 42,012 Bq m−3 after three-level enrichment. The three-level enrichment technology provides technical support for the enrichment of low-concentration inert gases in the environment, while offering an important technical foundation for improving the monitoring of low-concentration inert gases in specific environments as well as the atmospheric environment.
Efficacy and safety clinical trial with efavirenz in patients diagnosed with adult Niemann-pick type C with cognitive impairment
Authors: Gascón-Bayarri Jordi , Simon Petru Cristian , Llop Roser , Carnaval Thiago , Ledesma María Dolores , Rico Imma , Sánchez-Castañeda Cristina , Campdelacreu-Fumadó Jaume , Calvo-Malvar Nahum , Cos Mònica , de Lama Eugenia , Cortés-Romera Montserrat , Rodríguez-Bel Laura , Pérez-Sousa Celia , Cerdán Sánchez María , Muelas Nuria , Sevillano María Dolores , Mir Pablo , López de Munain Adolfo , Ferrer Anna , Videla Sebastián 
Published: December 2022

Background:
Niemann-Pick disease Type C (NPC) is a genetic, incurable, neurodegenerative disorder. This orphan disease is most frequently caused by mutations in the NPC1 protein, resulting in intralysossomal cholesterol accumulation. NPC1 is found in neuronal cell bodies, axon terminals and synaptosomes, suggesting it plays a role in lysosomal degradation pathway and in synaptic transmission. Neuronal function is especially vulnerable to NPC1 deficiency and synaptic changes seem a key element in disease development. Currently, Miglustat (Zavesca®) is the only approved treatment for NPC. However, preclinical evidence showed that low-dose Efavirenz reverted synaptic defects through pharmacological activation of the enzyme CYP46.

Methods:
This is a single-center, phase II clinical trial to evaluate the efficacy and safety of Efavirenz in addition to standard of care in patients diagnosed with adult or late juvenile-onset NPC with cognitive impairment. All enrolled patients will be treated orally with 25 mg/d of Efavirenz for 52 weeks (1 year). Secondary objectives include evaluating clinical (neurological and neuropsychological questionnaires) and biological (imaging and biochemical biomarkers) parameters.

Discussion:
NPC is still an unmet medical need. Although different therapeutic approaches are under study, this is the first clinical trial (to the best of our knowledge) studying the effects of Efavirenz in adult- and late-juvenile-onset NPC. Despite the small sample size and the single-arm design, we expect the results to show Efavirenz’s capacity of activating the CYP46 enzyme to compensate for NPC1 deficiency and correct synaptic changes, therefore compensating cognitive and psychiatric changes in these patients. This study may provide direct benefit to enrolled patients in terms of slowing down the disease progression.
Reliability of electroencephalogram indicator and event related potential in subacute stroke
Authors: Yun Dong Hyuk , Sohn Min Kyun , Choi Jae Eun , Jee Sungju 
Published: December 2022

Cognitive impairment is observed in 12% to 56% of stroke patients, and screening for cognitive impairment is often complex and time-consuming, with results dependent on patient compliance. Therefore, there is a need for an objective method to assess cognitive impairment regardless of patient compliance. Objective evaluation methods include electroencephalogram (EEG) and event-related potential (ERP). This study was conducted to assess intra-tester reliability of resting EEG-based spectral features and auditory/visual P300 latency/amplitude in patients with subacute ischemic stroke.
Twenty patients with subacute ischemic stroke were included in the study. The resting EEG and P300 wave using an auditory and visual oddball paradigm were measured at baseline and once again in 24 hours. The following electrode positions (10–20 system) were constantly recorded: F3 (Frontal), Fz, F4, C3 (Central), Cz, C4, P3 (Parietal), Pz, P4. DAR (delta/alpha ratio) and BSI (brain symmetry index) were determined using EEG data. F3 and F4, C3 and C4 and P3 and P4 were switched according to the stroke side and classified as affected hemisphere (AH) and unaffected hemisphere (UH) after the evaluation. In ERP, the amplitude and latency of P300 were obtained.
In reliability analysis of EEG-based spectral characteristics, significant reliability was observed for DAR (ICC = 0.447), BSldir (ICC = 0.713) and BSIdirtheta (ICC = 0.724) (Table 4). DAR was showed a poor ICC level, and BSIdir and BSIdirtheta had a moderate ICC level. Visual P300 latency showed excellent intraclass correlation coefficient (ICC) in several montages (PUH = 0.972, Pz = 0.945). In 6 montages, auditory P300 latency was reliable, while in 9 montages, visual P300 latency was reliable. In 4 montages, auditory P300 amplitude was reliable, while visual P300 amplitude was reliable in 7.
The visual P300 was more reliable than the auditory P300. The ICC values for P300 latency were greater than those for amplitude. Therefore, when ERP is performed on subacute stroke patients, visual has higher reliability than auditory.
Diagnostic value of EBV-DNA in CSF for PCNSL in AIDS patients with focal brain lesions: A meta-analysis of diagnostic test
Authors: Ding Xinghuan , Liang Tingyu , Liang Bo , Gao Haili , Wang Jianbo , Liu Hongxing , Wang Fang , Zheng Xinmei , Li Peiliang , Chen Shichao , Feng Enshan 
Published: December 2022

Background:
Epstein-Barr virus (EBV) infection plays a crucial role in the progression of acquired immunodeficiency syndrome related primary central nervous system lymphoma (AR-PCNSL). This study aimed at evaluating the diagnostic value of cerebrospinal spinal fluid (CSF) EBV-deoxyribonucleic acid (DNA) for PCNSL in patients with infection of human immunodeficiency (HIV) virus through a meta-analysis of diagnostic test.

Methods:
A systematic search in PubMed, Embase, Web of Science, Wanfang, Chinese Biomedical Database and Chinese National Knowledge Infrastructure was conducted before May 10, 2022. Heterogeneity among the studies was assessed using Q test and I2 statistics. Publication bias was assessed using the Deek’s funnel plot asymmetry test. Statistical analyses were performed using Stata 16.0 software. The pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratios (DOR) and 95% confidence intervals (CI) were caculated to evaluate the diagnostic value. A symmetric receiver operating characteristic (SROC) curve and the area under the SROC curve (AUC) were constructed to evaluate the test-performance.

Results:
Twelve studies were included in the final analyses, with a total of 141 patients with AR-PCNSL and 590 controls. The pooled diagnostic values were sensitivity of 0.83 (95% CI: 0.73–0.90), specificity of 0.95 (95%CI: 0.89–0.98), PLR of 17.8 (95%CI: 6.8–46.1), NLR of 0.17 (95%CI: 0.10–0.30), DOR of 102 (95%CI: 28–379), and AUC of 0.94 (95%CI: 0.91–0.96).

Conclusion:
In summary the overall diagnostic value of CSF EBV-DNA is very high and it can be a reliable diagnostic biomarker for AR-PCNSL.
A single-center randomized controlled study of intraperitoneal hyperthermic chemoperfusion in combination of recombinant human tumor necrosis factor (TNF) in treatment of malignant ascites caused by advanced abdominal cancers
Authors: Wu Lexia , Zhu Wanshan , Meng Jincheng , Wu Jiaming , Li Luzhen , Fang Cantu , Zhang Huatang 
Published: December 2022

Introduction:
Malignant peritoneal effusion is a common complication of advanced malignancies, which has a poor prognosis for patients. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been widely used in the treatment of advanced gynecological tumors, especially ovarian cancer (OC). Relative studies have indicated that HIPEC allows for direct exposure of tumor cells to high peritoneal concentrations of cytotoxic drugs without increasing systemic toxicity compared with intravenous treatment. Recombinant human tumor necrosis factor for injection (rmhTNF-NC) is a safely tolerated immunotherapeutic drug that has becoming a mainstay of treatment for malignant effusions. Currently, a prospective study is required to determining the efficacy of rmhTNF-NC plus cisplatin for the treatment of malignant peritoneal effusion for OC.

Methods:
Design and setting: This is a single-center, open trial will be performed in Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine.

Participants:
Eligible patients will be those with advanced gynecologic cancers and who would be suitable for HIPEC.

Intervention and Control:
HIPEC with cisplatin and intraperitoneal perfusion with rmhTNF-NC.

Co-interventions:
Further chemotherapy will be offered to patients as per current practice.
Outcomes
Pilot study: Patients and clinicians’ acceptability of the trial to assist in optimization of recruitment.
Primary outcome: One-year overall survival (OS).
Secondary outcomes: Progression-free survival (PFS), adverse events.
Follow-up: One-year follow-up for OS.
Sample size: Twenty patients to demonstrate therapeutic effect of peritoneal effusion caused by OC.

Discussion:
This trial will determine the effectiveness of HIPEC with cisplatin and intraperitoneal perfusion with rmhTNF-NC for advanced gynecologic cancers, and guide the optimal treatment for these patients.
A case report of Wernicke Korsakoff syndrome in a patient with cholangiocellular carcinoma: An underestimated cause of encephalopathy in cancer patients
Authors: Koca Oguzhan , Demir Bilal , Derin Sumeyra , Turna Zeynep Hande 
Published: December 2022

Introduction:
Wernicke’s encephalopathy, a disorder caused by thiamin deficiency, is characterized by a classical triad of encephalopathy, ataxia, and ophthalmoplegia. Although alcoholism is the most common predisposing factor, it can also be associated with nonalcoholic states (hyperemesis gravidarum, intestinal obstruction, bariatric surgery, and others). This work presents a case of nonalcoholic Wernicke-Korsakoff syndrome diagnosed in a cholangiocellular carcinoma patient and literature review.

Case report:
A 65-year-old male patient with a history of cholangiocellular carcinoma (Klatskin tumor) was treated with radiotherapy at the operation site after Roux-en-Y hepaticojejunostomy. During follow-up, the patient developed gastric outlet obstruction and was diagnosed with peritoneal carcinomatosis after a palliative gastrojejunostomy. As the patient could not tolerate oral nutrition during hospitalization, total parenteral nutrition was administered. After 10 days of admission, the patient showed decreased response to verbal stimuli as well as bilateral horizontal nystagmus, lethargy, and disorientation. Furthermore, the patient displayed confabulation. Clinical and imaging findings were consistent with Wernicke’s encephalopathy. Therefore, treatment with intravenous thiamin replacement was initiated. The patient’s encephalopathy regressed on the second day after treatment, and he recovered the place-person-time orientation. In the following month, the abnormal imaging findings were almost entirely resolved.

Conclusion:
In order to prevent irreversible brain damage induced by chronic thiamin deficiency, thiamin replacement therapy with parenteral nutrition solutions should be included as a treatment for hospitalized cancer patients unable to receive enteral nutrition for a long time.
Risk and outcome of second primary malignancy in patients with classical Hodgkin lymphoma
Authors: Wang Fan 
Published: December 2022

Background:
Hodgkin lymphoma survivors demonstrated increased risk of secondary primary malignancies (SPMs), but comprehensive analysis of the risk and outcome of SPMs in classical Hodgkin lymphoma (cHL) patients has not yet been reported.

Methods:
Patients with cHL from 1975 to 2017 were identified from the Surveillance, Epidemiology and End Results (SEER) database. Standardized incidence ratios were calculated for the risk of solid and hematologic SPMs in cHL patients compared to the general population. The outcome of cHL patients developing SPMs were assessed by performing survival, competing risks regression, and cox proportional regression analyses.

Results:
In a follow-up of 26,493 cHL survivors for 365,156 person years, 3866 (14.59%) secondary cancers were identified, with an standardized incidence ratio of 2.09 (95% CI: 2.02–2.15). The increased risk was still notable after follow-up of 10 years or more, and the risk is more pronounced for patients with female gender, younger age, advanced stage, chemotherapy, and radiation therapy. The overall survival is worse for cHL patients with SPMs after 11 years of follow-up (P < .0001). The main cause of death for cHL patients with SPMs is not cHL but other causes including SPMs. Multivariate Cox regression analysis confirmed SPMs as an independently adverse prognostic factor for cHL survivors (hazard ratio, 1.13; 95% CI, 1.05–1.21, P = .001).

Conclusions:
There is a significantly increased risk of developing SPMs for cHL survivors. The overall survival is worse for cHL patients and SPMs is an independent prognostic factor for cHL.
Efficacy and safety of HIFU in combination with TACE in unresectable pediatric HB: A randomized, controlled, single-center clinical trial
Authors: Tang Xinliang , He Xiaobing , Jiang Han 
Published: December 2022

Background:
Hepatoblastoma (HB) is the most common liver tumor in children, and the main treatment for HB is currently surgery. Studies have shown that transcatheter arterial chemoembolization (TACE) combined with high intensity focused ultrasound (HIFU) has significant efficacy, but there are relatively few studies on TACE combined with HIFU in China.

Objective:
To investigate the effect of using HIFU combined with TACE on patients’ liver function impairment and immune function in pediatric HB patients and to analyze the effectiveness and safety.

Materials and methods:
The clinical data of 110 unresectable pediatric HB patients treated in our hospital from December 2019 to December 2021 were selected as the subjects and divided into 2 groups. The comparison group was treated with TACE, and the combination group was treated with HIFU on the basis of the comparison group. The differences in immune function, survival, treatment side effects and clinical efficacy between the 2 groups were observed.

Results:
In the combined group, the 1-year survival rate was 100%, the 3-year survival rate was 84.0%, the 5-year survival rate was 16.0%; while in comparison group, it was 82%, 16%, 0%, respectively. The ratio of CD4+/CD8+ in the combined group were significantly higher than in the comparison group after treatment (P < .05). Granulocytopenia, mucositis, thrombocytopenia, and cardiac and renal toxicity were significantly lower in the combined group than in the comparison group, and the effective rate of the combined group was 98.00% which was significantly higher than that of the control group (76.00%) (P < .05).

Conclusion:
Comparative study of HB in children treated with HIFU combined with TACE is more effective, effectively improving the immune level of patients, significantly increasing the remission rate, which can improve the tumor necrosis and improve the survival quality of patients, and is a better choice for HB in children.
Severe lower gastrointestinal bleeding caused by rectal Dieulafoy’s lesion: Case reports and literature review
Authors: Han Ping , Lei Yu , Hou Wei , Chen Nianjun , Liu Jingmei , Tian Dean , Guo Qiaozhen , Yan Wei 
Published: December 2022

Rationale:
Dieulafoy’s lesion are relatively rare and can cause severe gastrointestinal bleeding. A Dieulafoy’s lesion is defined as an artery that erodes the overlying epithelium without the presence of an ulcer. Bleeding in Dieulafoy’s lesion predominantly involves the proximal stomach and upper gastrointestinal tract and is rarely observed in the lower gastrointestinal tract.

Patient concerns:
Case 1 was a 58-year-old woman complaining of sudden headache and vomiting who was diagnosed with subarachnoid hemorrhage. She underwent transcatheter embolization for intracranial aneurysm treatment but had an acute profuse hematochezia on the 11th day of admission. Case 2 was a 63-year-old man admitted to the respiratory intensive care unit because of fever with altered consciousness level for a week. He was diagnosed with advanced lung cancer that had metastasized to multiple organs one month prior. On the third day of admission, he had an attack of profuse hematochezia, and quickly developed shock and apathy.

Diagnosis:
Both patients were diagnosed with actively bleeding rectal Dieulafoy’s lesion by bedside emergency colonoscopy.

Interventions:
Endoscopic hemostatic clipping was performed in 2 patients.

Outcomes:
Hemostasis was successfully achieved in these 2 patients, and there was no recurrence of symptoms during follow-up.

Conclusions:
We propose that hemostatic clipping is one of the options in the treatment of rectal Dieulafoy’s lesions.
Traditional Chinese acupoint massage, acupuncture, and moxibustion for people with diabetic gastroparesis: A systematic review and meta-analysis
Authors: Li Xiaoming , Yan Zongbao , Xia Jin , Sun Yanan , Gong Peijun , Fan Yuncui , Wang Xiaodong , Cui Xinjie 
Published: December 2022

Background:
Traditional Chinese acupoint therapy has been used for thousands of years on gastrointestinal diseases. In this work, we evaluated the efficiency and safety of traditional Chinese acupoint therapies versus standard therapies, nursing or recovery treatments in the treatment of diabetic gastroparesis.e expect that traditional Chinese medicine acupoint therapy can be noticed by more people, so as to provide more high-quality clinical evidence.

Methods:
Randomized controlled trials were included in this meta-analysis. The treatment groups received traditional Chinese acupoint therapy, while the control groups received standard therapies, nursing, or recovery treatments. The relative risk and weighted mean difference with 95% confidence interval for the total effective rate, gastrin level, gastric-emptying time, fasting blood glucose level, 2-hour blood glucose level, and glycosylated hemoglobin level were evaluated using RevMan 5.3 software. Bias assessment was performed using the Cochrane risk-of-bias tool.

Results:
A total of 59 articles were included in the analysis. In comparison with the control groups, the acupoint therapy groups showed higher total effective rates (P < .00001), enhanced gastric-emptying rates (P < .00001), and reduced glycosylated hemoglobin levels.

Conclusion:
In comparison with Western medicine or conventional care, traditional Chinese acupoint therapies showed a significant advantage in the treatment of diabetic gastroparesis. However, considering the low quality and high risk of the included studies, more high-quality randomized controlled trials are needed to confirm the results.
Risk factors of cardiovascular and cerebrovascular diseases in young and middle-aged adults: A meta-analysis
Authors: Wu Yinghua , Xiong Yan , Wang Ping , Liu Rui , Jia Xiaoling , Kong Yuyan , Li Fangfang , Chen Chen , Zhang Xia , Zheng Yuzhen 
Published: December 2022

Background:
The risk factors for cardiovascular and cerebrovascular diseases in young and middle-aged people have not yet been determined. We conducted a meta-analysis to find the risk factors for cardiovascular and cerebrovascular diseases, in order to provide guidance for the prevention of diseases in the young and middle-aged population.

Methods:
We searched PubMed, Embase, Cochrane Library from the establishment of the database to Mar 2022. We included case-control or cohort studies reporting risk factors for cardiovascular and cerebrovascular disease in young and middle-aged adults. We excluded repeated publication, research without full text, incomplete information or inability to conduct data extraction and animal experiments, reviews and systematic reviews. STATA 15.1 was used to analyze the data.

Results:
The pooled results indicated that increased systolic blood pressure was significantly associated with increased risk of any stroke, ischemic stroke and hemorrhagic stroke. Body Mass Index (BMI), current smoking, hypertension, and diabetes were significantly associated with increased risk of any stroke and ischemic stroke. Atrial fibrillation was only significantly associated with increased risk of any stroke. Increased total cholesterol was significantly associated with an increased risk of ischemic stroke, whereas increased triglycerides were significantly associated with a decreased risk of ischemic stroke. In addition, increased hypertension was also significantly associated with an increased risk of acute coronary syndrome.

Conclusion:
Our pooled results show that BMI, current smoking, atrial fibrillation, hypertension, systolic blood pressure, and total cholesterol can be used as risk factors for cardiovascular and cerebrovascular diseases in young people, while triglycerides can be used as protective factors for cardiovascular and cerebrovascular diseases in young and middle-aged adults.
New technologies in airway management: A review
Authors: Vasconcelos Pereira Ana , Simões André Vicente , Rego Luísa , Pereira João Gonçalves 
Published: December 2022

The evolution of medical knowledge and technological growth have contributed to the development of different techniques and devices for airway management. These appear to play a role in optimizing the number of attempts and overall success, ultimately reducing the negative consequences of airway manipulation. In this literature review, we highlight the recent evidence regarding new technologies applied to airway management.
Before intubation, every patient should have an individualized structured airway management plan. Technology can help with both airway evaluation and tracheal intubation. Point-of-care cervical ultrasound and artificial intelligence models with automated facial analysis have been used to predict difficult airways. Various devices can be used in airway management. This includes a robotic video endoscope that guides intubation based on real image recognition, a laryngeal mask with a non-inflatable cuff that tries to reduce local complications, video laryngeal masks that are able to confirm the correct position and facilitate intubation, Viescope™, a videolaryngoscope developed for combat medicine with a unique circular blade, a system that uses cervical transillumination for glottis identification in difficult airways and Vivasight SL™ tracheal tube, which has a high-resolution camera at its tip guaranteeing visual assurance of tube position as well as guiding bronchial blocker position.
To conclude, we detailed the challenges in airway management outside the operating room as well as described suction-assisted laryngoscopy and airway decontamination technique for contaminated airways.
Further research in the clinical setting is recommended to better support the use of these technologies