bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conservative treatment of gastric perforation after microwave ablation of a hepatocellular carcinoma
Authors: Roller J. , Zimmer V. , Bücker A. , Glanemann M. , Eisele R.M. 
Published: June 2022

Abstract

Rationale:
Microwave ablation (MWA) has been proven to be an efficient and safe method for local tumor control of liver tumors. Reported complications are rare, but include liver abscess, hematoma, pleural effusion, and occasional thermal injury of the adjacent colon. Intestinal perforation usually requires immediate surgical treatment to prevent generalized peritonitis and sepsis.

Patient concerns and diagnosis:
Herein, we describe a case of gastric perforation following percutaneous MWA for hepatocellular carcinoma as a bridging therapy prior to liver transplantation.

Interventions:
Due to the clinical condition of the patient, conservative treatment was considered sufficient. Nine months after MWA, successful liver transplantation followed. Intraoperative findings revealed a scar in the gastric wall with tight adhesions to the liver, requiring adhesiolysis and subsequent suturing. Postoperative recovery was uneventful.

Outcome:
At present, the patient is doing well. No further gastrointestinal events occurred.

Lesson:
To our knowledge, this is the first report of such a complication occurring after MWA. Moreover, in this case, the gastric perforation could be treated conservatively.
Nonintubated bronchoscopic interventions with high-flow nasal oxygen
Authors: Yie Jr-Chi , Lin Ching-Kai , Shih Chung-Chih , Li Ying-Tzu , Lin Wen-Ying , Cheng Ya-Jung 
Published: June 2022

Abstract
To determine the feasibility on maintaining oxygenation of high-flow nasal oxygenation (HFNO) with bispectral index-guided intravenous anesthesia for nonintubated interventional bronchoscopy (NIIB). If desaturation happens, the factors influencing intraprocedural desaturation were also analyzed.
This is a single-center retrospective study on patients receiving NIIB with HFNO and intravenous anesthesia guided by bispectral index levels to the depth of general anesthesia, which were between 40 and 60. Intraprocedural desaturation (SPO2 < 90%) and complications (bleeding, delayed discharge, unexpected admission) were collected. Factors affecting desaturation and complications were analyzed including patients’ factors (age, American Society of Anesthesiologists classification, body mass index [BMI]), procedural factors (procedural time, with or without use of cryoprobe), and setting (outpatient or hospitalized).
Records of 223 patients receiving NIIB were collected. The NIIB procedures time was 56.1 ± 26.8 minute. Sixty patients (26.9%) presented desaturation events. Higher BMI, but not procedure time or setting, was significantly associated with desaturation. The desaturation were resolved after relieving upper airway obstruction but 1 patient required bag–valve–mask ventilation to restore oxygenation. Accidental massive bleeding and intraprocedural desaturation during tracheal and bronchial recannulation with cryoprobes happened in 2 patients and 1 of them was admitted to intensive care unit.
HFNO is feasible to maintain oxygenation during NIIB only if there is effective upper airway management especially for patients with higher BMI. Longer procedural time and different setting did not affect the desaturation rate. Complications and unexpected admission were associated with the use of cryoprobes.
Randomized phase II study of nintedanib with or without pirfenidone in patients with idiopathic pulmonary fibrosis who experienced disease progression during prior pirfenidone administration
Authors: Ikeda Satoshi , Sekine Akimasa , Baba Tomohisa , Kato Terufumi , Katano Takuma , Tabata Erina , Shintani Ryota , Yamakawa Hideaki , Oda Tsuneyuki , Okuda Ryo , Kitamura Hideya , Iwasawa Tae , Takemura Tamiko , Ogura Takashi 
Published: June 2022

Abstract

Introduction:
A subgroup analysis of the CAPACITY and ASCEND trials showed that pirfenidone use beyond disease progression reduced the risk of subsequent forced vital capacity (FVC) decline and death. Our study aimed to compare the efficacy and safety of nintedanib with or without pirfenidone for patients with idiopathic pulmonary fibrosis (IPF) who experienced disease progression during previous pirfenidone therapy.

Methods:
In this randomized, open-label, selection design phase II trial, patients with IPF and a ≥5% relative decline in FVC within 6 months of the pirfenidone administration period were randomly assigned to nintedanib (switch group) or nintedanib plus pirfenidone (combination group). The primary endpoint was the incidence of a ≥5% relative decline in FVC or death during the first 6 months.

Results:
Only 7 patients were enrolled (4 in the switch group and 3 in the combination group). Although the switch group continued with nintedanib for 1 year or more, 2 patients (66.7%) in the combination group discontinued nintedanib within 6 months due to severe adverse events. Given the slow case registration and safety concerns in the combination group, the trial was terminated without extending the registration. The incidence of a ≥5% relative decline in FVC during the first 6 months was 50.0% in the switch group and 66.7% in the combination group. There were no deaths during the observation period.

Conclusions:
Clinical trials verifying the use of pirfenidone after disease progression in IPF may be difficult to enroll patients. Definitive conclusions on both safety and efficacy cannot be drawn from the results of this study alone.

Trial registration:
UMIN Clinical Trial Registry; registration number, UMIN000019436; date of first registration, 21/10/2015; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000022471.
Prophylactic octreotide for postoperative pancreatic fistula in patients with pancreatoduodenectomy
Authors: Yoon So Jeong , Lee Okjoo , Jung Ji Hye , Shin Sang Hyun , Heo Jin Seok , Han In Woong 
Published: June 2022

Abstract

Background:
Postoperative pancreatic fistula is one of the most critical complications following pancreatic surgery. This study aimed to evaluate the utility of selective prophylactic octreotide for patients at high risk of developing postoperative pancreatic fistula.

Methods:
From June 2019 to July 2020, 263 patients underwent pancreatoduodenectomy with pancreatojejunostomy at Samsung Medical Center. The individual fistula risk scores were calculated using a previously developed nomogram. The clinicopathological data of the patients were retrospectively reviewed.

Results:
There were 81 patients in the low-risk group and 182 patients in the high-risk group. No statistically significant differences were found in the rates of clinically relevant postoperative pancreatic fistula between octreotide group and the control group in all patients (15.0% vs 14.7%, P = .963) and in the high-risk group (16.1% vs 23.6%, P = .206). In risk factor analysis, postoperative octreotide was not an independent risk factor for clinically relevant pancreatic fistula in all patients and the high-risk group. Drain fluid amylase levels on the first postoperative day were significantly associated with clinically relevant postoperative pancreatic fistula, regardless of the individual risk.

Conclusions:
The selective use of octreotide, even in high-risk patients, showed no protective effect against pancreatic fistula. Therefore, the routine use of postoperative octreotide is not recommended.
Surgical management strategy for leiomyosarcoma of Zone I-II inferior vena cava
Authors: Tulahong Aisikeer , Tuxun Tuerhongjiang , Yao Gang , Fulati Xiapukati , Apaer Shadike , Anweier Nuerzhatijiang , Wu Jing , Aierken Amina , Zhao Jin-Ming , Bai Lei , Li Tao 
Published: June 2022

Abstract

Objectives:
Leiomyosarcoma of inferior vena cava (IVC) is a rare clinical entity with severe vascular involvement. Surgical management of leiomyosarcoma is still challenging.

Methods:
This a retrospective study of consecutive patients referred to our hospital from January 2017 to June 2019. Depending on the anatomical site of affected IVC, leiomyosarcomas were categorized into zone I-II. The clinical data including baseline information, surgical parameters, peri-operative management, short- and mid-term outcomes were observed.

Results:
Four patients with leiomyosarcoma of zone I-III underwent radical resection without intraoperative mortality. Prosthetic grafts were interpositioned in all patients to instruct vena cava. Renal vein reconstruction was perfumed in two patients due to involvement to renal veins. Median blood loss was 450 mL (200–600 mL), median operative time was 215 minutes (150–240 minutes). No Clavien-Dindo IIIa or higher complication was observed. No organ dysfunction and recurrence were observed with median follow-up of 25.5 months.

Conclusions:
Curative resection of zone I-II leiomyosarcoma is associated with longer survival in selected cases, en-bloc resection with complex vascular reconstruction could be considered.
Investigator initiated clinical trial to validate usefulness of specific system for endoscopic ultrasound guided hepaticogastrostomy (HG01) in malignant biliary obstruction (HG01)
Authors: Itonaga Masahiro , Kitano Masayuki , Isayama Hiroyuki , Takenaka Mamoru , Ogura Takeshi , Yamashita Yasunobu , Fujisawa Toshio , Minaga Kosuke , Okuda Atsushi , Shimokawa Toshio 
Published: June 2022

Abstract

Introduction:
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a novel drainage option for patients with an inaccessible papilla. Although EUS-HGS has clinical benefits in patients for whom endoscopic retrograde cholangiopancreatography (ERCP) has failed, the rates of adverse events (AEs) associated with EUS-HGS, such as bile peritonitis and stent migration, are higher than for other procedures. The development of a dedicated system for EUS-HGS is therefore desirable to reduce the rate of AEs. We developed a dedicated system for EUS-HGS (HG01 system) which is composed of a 19-gauge needle, 0.025-inch guidewire, a thin delivery system for tract dilation, and an antimigration metal stent. This study is designed to evaluate the efficacy and safety of EUS-HGS using the HG01 system in malignant biliary obstruction.

Methods/design:
This is a single-arm multicenter prospective study involving 40 patients across six tertiary centers in Japan. Patients with an unresectable malignant biliary obstruction in whom biliary drainage with ERCP failed, is not possible, or is very difficult will be registered in the study. The primary endpoint is the clinical success rate. The secondary endpoints are the technical success rate, procedure-related AE rate, procedure time, procedure success rate using only the HG01 system, stent patency rate, re-intervention success rate, re-intervention method, survival rate, and distance of movement of the stent position.

Discussion:
We expect use of the HG01 system to reduce the rate of AEs during EUS-HGS, especially bile leakage and stent migration. If the efficacy and safety of EUS-HGS using the HG01 system is confirmed in the present study, it is likely to be considered the first-choice device for use during EUS-HGS.
Malignant giant cell tumor of toe
Authors: Hashimoto Kazuhiko , Nishimura Shunji , Ito Tomohiko , Akagi Masao 
Published: June 2022

Abstract

Introduction:
A giant cell tumor of soft tissue (GCST) is a benign soft tissue tumor that often occurs subcutaneously in the extremities. Rare cases of malignant GCST have been reported, but its pathogenesis remains unclear.

Patients concerns:
We report a case of a 68-year-old man who noticed a painless mass on his second toe one and a half years ago. He visited the Department of Dermatology at our hospital. Magnetic resonance imaging revealed a soft tissue tumor, surrounding the distal aspect of the second toe.

Diagnosis:
A biopsy of the tumor was performed by a dermatologist, and it revealed a malignant giant cell tumor of the toe.

Interventions:
He was referred to our department and underwent lay amputation for wide-margin resection.

Outcomes:
No recurrence or metastasis was observed 5 years after treatment.

Conclusion
: Malignant GCST should be treated with wide-margin resection immediately after its diagnosis.
The Efficacy of Nurse-Performed Ultrasound Guidance Compared with the Conventional Cannulation Technique in Patients with Difficult Peripheral Intravenous Access: A Systematic Review
Authors: Anderssen Lisa Maria , Wang August Gabriel , Sofía Fjallheim Anna 
Published: June 2022

AbstractObjectiveThe aim of this review is to highlight the efficacy of nurse-performed ultrasound guidance compared with the conventional cannulation technique in patients with difficult peripheral intravenous access.DesignA systematic litterature review.Data sourcesThe CINAHL and PubMed databases were searched for articles from the period 2011-2021.MethodThe following search words were used: peripheral intravenous AND ultrasonography OR ultrasound guided AND catheterization, peripheral/methods. The keyword catheterization, peripheral/methods was found via MeSH Terms (Medical Subject Headings) which PubMed recommended as keyword within the intervention of the conventional cannulation technique.Results2 out of 3 articles prove that success rate on the first attempt (primary outcome) was significantly higher in the nurse-performed ultrasound-guided technique compared with the conventional palpation technique. The results of the secondary outcomes; time consumption, complications, patient satisfaction and nurse satisfaction between the two groups proved to be heterogeneous.ConclusionNurse-performed ultrasound guidance in hospital wards increases the success rate in patients with difficult peripheral intravenous access.
Assessment of benefits of Echo Workflow Solution: Findings from a two-step Delphi study
Authors: Boonyaratavej S. , Riccobene F. , Falahi F. , Franke J. , Solis J. , Lang R. M. 
Published: June 2022

ABSTRACTObjectiveThis study aimed to assess the clinical, operational, and economic benefits of Echo Workflow Solution comprising cardiac ultrasound systems and their advanced echo imaging tools; Ultrasound Workspace tools for advanced visualization and analysis; and the IntelliSpace Cardiovascular platform for image and information management and reporting.MethodA modified Delphi method consisting of two rounds of queries was used to survey a panel of seven experts at geographically dispersed sites (Spain: 2, Thailand: 1, Saudi Arabia: 1, United Kingdom: 2, and USA: 1). Experts were identified via referral and selected based on experience with the solution. Both rounds of the Delphi process were conducted via a verbal or offline questionnaire between December 2021 and April 2022. Participants rated 14 attributes of the solution on a Likert Scale and added qualitative responses.ResultsConsensus was unanimous that the solution can enhance access to complete and longitudinal data needed for patient care decision-making; can lead to increased report consistency, measurement reproducibility and comparability; can help with better collaboration within the user’s organization, can help with saving report turnaround time and with improving time-to-detection and/or diagnosis.The majority of respondents (86%) agreed that use of the Echo Workflow Solution can help increase confidence in diagnosis decision-making; can improve staff experience by providing single screen access to the patient data and lower cognitive load.ConclusionThe study demonstrated that the Echo Workflow Solution can offer clinical and operational benefits. Responses indicated that the solution help with several aspects: reducing time to diagnosis, making it easier to accommodate emergency patients, providing time to perform more advanced studies, and/or increasing time spent with patients. Responses also indicated that the increased consistency and reproducibility of studies can potentially eliminate the need for unnecessary exams, which may result in a better patient experience and economic benefits for healthcare systems. The value of reproducibility, improved time to detection/diagnosis and increased confidence were particularly evident in complex cases and for patients requiring serial studies.
Deep learning system for brain image-aided diagnosis of multiple major mental disorders
Authors: Li Qingfeng , Wang Wengzheng , Guo Qian , Jiang Lijuan , Qiao Kaini , Hu Yang , Zhang Xiaochen , Wang Zhen , Peng Daihui , Fan Qing , Zhao Min , Fang Yiru , Wang Jijun , Qiu Hong , Wang Jinhong , Li Guanjun , Sheng Jianhua , Li Chunbo , Yang Zhi ,   the Psychiatric Imaging Consortium
Published: June 2022

AbstractThe current clinical diagnosis of psychiatric disorders relies heavily on subjective assessment of symptoms. While neuroimaging has made an essential contribution to characterizing the brain of psychiatric disorders, it does not currently serve the clinical diagnosis of major psychiatric disorders. Here, we report a neuroimaging-aided diagnostic system for major psychiatric disorders designed for clinical needs. We developed novel deep learning networks with attentional mechanisms and applied them to a large-scale, single-center neuroimaging dataset containing four major psychiatric disorders and healthy groups (n=2490). Both cross-validation and extensive independent validation using multiple open-source datasets (n = 1972) showed that the system could accurately identify any one of the four diagnostic categories and healthy population from brain structural imaging. For the first time, we have constructed an automatic neuroimaging-aid diagnostic system that considers common issues in practice, such as co-morbid diagnoses and the discrimination between specific suspected diagnoses. Furthermore, real-world applications have validated the system’s effectiveness. These works contribute to the translation of brain research to objective diagnostic aids for psychiatric disorders.
AI-Assisted Chemical Probe Discovery for the Understudied Calcium-Calmodulin Dependent Kinase, PNCK
Authors: Essegian Derek J. , Chavez Valery , Khurshid Rabia , Merchan Jaime R. , Schürer Stephan C. 
Published: June 2022

AbstractPNCK, or CAMK1b, is an understudied kinase of the calcium-calmodulin dependent kinase family which recently has been identified as a marker of cancer progression and survival in several large-scale multi-omics studies. The biology of PNCK and its relation to oncogenesis has also begun to be elucidated, with data suggesting various roles in DNA damage response, cell cycle control, apoptosis and HIF-1-alpha related pathways. To further explore PNCK as a clinical target, potent small-molecule molecular probes must be developed. Currently, there are no targeted small molecule inhibitors in pre-clinical or clinical studies for the CAMK family. Additionally, there exists no experimentally derived crystal structure for PNCK. We herein report a three-pronged chemical probe discovery campaign which utilized homology modeling, machine learning, virtual screening and molecular dynamics to identify small molecules with low-micromolar potency against PNCK activity from commercially available compound libraries. We report the first described inhibitor hit series for PNCK that will serve as the starting point for future medicinal chemistry efforts for hit-to-lead optimization of potent chemical probes.
An ensemble method for designing phage-based therapy against bacterial infections
Authors: Aggarwal Suchet , Dhall Anjali , Patiyal Sumeet , Choudhury Shubham , Arora Akanksha , Raghava Gajendra P.S. 
Published: June 2022

AbstractPhage therapy is a viable alternative to antibiotics for treating microbial infections, particularly managing drug-resistant strains of bacteria. One of the major challenges in designing phage based therapy is to identify the most appropriate phage to treat a bacterial infection. In this study, an attempt has been made to predict phage-host interaction with high accuracy to identify the best virus for treating a bacterial infection. All models have been developed on a training dataset containing 826 phage host-interactions, whereas models have been evaluated on a validation dataset comprising 1201 phage-host interactions. Firstly, alignment based models have been developed using similarity between phage-phage (BLASTPhage), host-host (BLASTHost) and phage-CRISPR (CRISPRPred) where we achieved accuracy between 42.4%-66.2% for BLASTPhage, 55%-78.4% for BLASTHost, and 43.7%-80.2% for CRISPRPred at five taxonomic levels. Secondly, alignment free models have been developed using machine learning techniques. Thirdly, hybrid models have been developed by integrating alignment-free models and similarity-score where we achieved maximum performance of (60.6%-93.5%). Finally, an ensemble model has been developed that combines hybrid and alignment based model. Our ensemble model achieved highest accuracy of 67.9%, 80.6%, 85.5%, 90%, 93.5% at Genus, Family, Order, Class and Phylum levels, which is better than existing methods. In order to serve the scientific community we have developed a webserver named PhageTB and standalone software package (https://webs.iiitd.edu.in/raghava/phagetb/).Key PointsPhage therapy provides an alternative to mange drug resistant strains of bacteriaPrediction bacterial strains that can be treated by a given phageAlignment-based, alignment-free and ensemble models have been developed.Prediction of appropriate phage/virus that can lyse a given strain of bacteria.Webserver and standalone package provided to predict phage-host interactions.
Olfactory decoding is positively associated with ad libitum food intake in sated humans
Authors: Perszyk Emily E. , Davis Xue S. , Small Dana M. 
Published: June 2022

AbstractThe role of olfaction in eating behavior and body weight regulation is controversial. Here we used functional magnetic resonance imaging to test whether central olfactory coding is associated with internal state, food intake, and change in body weight over one year in healthy human adults. Since odor quality and category are coded across distributed neural patterns that are not discernible with traditional univariate analyses, we used multi-voxel pattern analyses to decode patterns of brain activation to food versus nonfood odors. We found that decoding accuracies in the piriform cortex and amygdala were greater in the sated compared to hungry state. Sated decoding accuracies in these and other regions were also associated with post-scan ad libitum food intake, but not with weight change. These findings demonstrate that the fidelity of olfactory decoding is influenced by internal state and is associated with immediate food intake, but not longer-term body weight regulation.