bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significant role of savolitinib in a case of advanced gastric cancer with abnormal mesenchymal‐epithelial transition factor (MET): A case report
Authors: He XinCheng , An GaiLi 
Published: December 2022

Rationale:
Gastric cancer is a common and lethal malignancy worldwide. It lacks specific clinical symptoms during the early stages, and when detected, the optimal surgical opportunity is lost. Chemotherapy alone offers limited benefits in advanced inoperable disease or postoperative recurrence. Gastric cancer is a heterogeneous tumor involving multiple gene regulations; thus, multi-target combination therapy is the trend in research. The c-MET protein is a tyrosine kinase receptor belonging to the MET family, encoded by the MET proto-oncogene. After binding with its ligand, the hepatocyte growth factor, MET activates cellular signaling pathways in proliferation, motility, migration, and invasion. In addition, it may be abnormally activated in cancers via mutation, amplification, and protein overexpression.

Patient concerns and diagnosis:
We report a 35-year-old male with advanced gastric cancer and bone metastasis who was intolerant to chemotherapy. He was in poor general condition, with thrombocytopenia and anemia.

Interventions and outcome:
Next-generation sequencing (NGS) suggested MET gene amplification in the tumor. After savolitinib treatment, the condition improved significantly without noticeable adverse reactions and maintained a progression-free status for 14 weeks.

Lessons:
This case report provides evidence for MET tyrosine kinase inhibitors in treating gastric cancer patients with MET gene amplification. It also shows that MET detection is a target in gastric cancer.
Combined effect of external treatment of herbal medicine and tuina in congenital muscular torticollis: Systematic review and meta-analysis
Authors: Kim Eunjin , Choi Jungyoon , Min Sang Yeon 
Published: December 2022

Background:
Congenital muscular torticollis (CMT) is the third most common musculoskeletal disease in children. With no standardized treatment method hence, so it is necessary to find an effective treatment method that can be received comfortably by children. This review assessed the efficacy of an external treatment of herbal medicine (ETHM) with tuina for CMT in children.

Methods:
This study searched the English, Chinese, and Korean databases (total of 10) until June 7 2022, without any language restrictions. All included studies were randomized clinical trials (RCTs) of ETHM with tuina as an intervention comparted to the same tuina alone according to the inclusion and exclusion criteria. The mean differences (MD), standardized mean differences (SMD), risk ratio (RR) with the 95% confidence interval (CI), and risk of bias (ROBs) were calculated using Review Manager Version 5.4 software. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) rating system was used to assess the quality of evidence. The publication bias was evaluated using a funnel plot, the Egger test, the fail-safe N test, and the Duval and Tweedle’s trim and fill method using Review Manager Version 5.4 software, the software R Version 4.1.1 and R studio Version 1.4.1106 program.

Results:
Nineteen RCTs with 1710 patients were included in the meta-analysis. ETHM plus tuina improved the outcomes of the total effective rate (TER) [RR 1.21, 95% CI:1.15 to 1.26, P < .001], sternocleidomastoid (SCM) muscle thickness [MD: −1.82, 95% CI: −2.23 to −1.41, P < .001], cervical rotation range [MD: 13.43, 95% CI: 10.41–16.45, P < .001] and lateral flexion range [MD: 8.50, 95% CI: 6.15–10.85, P < .001], tissue elasticity grade [SMD: −0.46; 95% CI: −0.71 to −0.22, P = .0002], muscle elasticity scores [RR: 1.56; 95% CI: 1.04 to 2.34, P = .03], and clinical symptom and sign scores [SMD: −0.78; 95% CI: −1.09 to −0.47, P < .001].

Conclusions:
ETHM plus tuina have a combined effect on CMT children. However, further studies with high-quality clinical trials are needed to obtain more robust clinical evidence.
First case report of human infection with Micrococcus yunnanensis identified by 16S rRNA gene sequencing: A case report
Authors: Zhang Yingmiao , Jiang Yan , Zhan Yu , Wang Hui , Qin Tian , Lu Zhongxin 
Published: December 2022

Background:

Micrococcus yunnanensis (M. yunnanensis) is an endophytic actinomycete that was originally isolated from the roots of Polyspora axillaris in 2009, and no human infections caused by this organism have yet been reported. We report the first case of community-acquired pneumonia caused by M. yunnanensis and propose that M. yunnanensis should be considered as an emerging pathogen in medical practice. A 30-year-old woman was admitted to our hospital with fever, paroxysmal dry cough with sputum, and pharyngalgia. Laboratory tests revealed an increase in several inflammatory indicators, and a computerized tomography scan of the chest showed scattered infection foci in both lungs. Bronchoalveolar lavage fluid was collected via bronchoscopy for microbial culture and pathological examination.

Methods:
The isolate from bronchoalveolar lavage fluid was identified as M. yunnanensis by 16S rRNA gene sequencing. The patient was diagnosed with community-acquired pneumonia based on the diagnostic criteria.

Results:
The patient was treated with intravenous amoxicillin/clavulanate potassium, levofloxacin hydrochloride tablets, and compound methoxyphenamine capsules on the day after admission. After 3 days of treatment, the patient’s physiological conditions and inflammatory indicators normalized, and 6-month follow-up showed no abnormalities.

Conclusion:
Although the pathogenicity of M. yunnanensis is unclear, the present case indicates an emerging pathogen in medical practice. MALDI-TOF MS has a limited ability to identify novel or rare pathogenic species, and 16S rRNA gene sequencing is of great value in some circumstance.
A case report of encapsulating peritoneal sclerosis followed by cesarean section: Clinical diagnosis and treatment experience
Authors: Liang Jin Long , Chen Zheng Quan , Yi Zhang , Kun Ming Wen 
Published: December 2022

Rationale:
Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome, is an uncommon condition that typically presents with features of bowel obstruction. EPS followed by cesarean section is extremely rare. Intestinal obstruction caused by EPS lacks specificity and poses clinical difficulties for diagnosis and treatment. We present the case of a patient with recurrent intestinal obstruction followed by cesarean section, and the diagnosis of EPS was confirmed intraoperatively. The patient recovered well postoperatively, and achieved satisfactory therapeutic results. Management of this condition tests the surgeon’s knowledge and experience of the disease.

Patient concerns:
A 27-year-old woman with recurrent abdominal pain and distention accompanied by reduced anal discharge and defecation there months. The patient had a history of cesarean section 4 months earlier and recovered well after operation. She had no other history of abdominal surgery or diseases. On examination, a 10-cm long transverse incision was made in the lower abdomen, and marking on the intestinal movements were observed in the left mid-abdomen. A long, soft lump with good mobility was touched in the left lower abdomen. The abdominal computed tomography and small bowel barium meal examination revealed incomplete intestinal obstruction.

Diagnosis:
Incomplete small bowel obstruction due to abdominal adhesions after the cesarean section was initially considered.

Interventions:
After conservative treatment, the symptom of intestinal obstruction still recurred. Thus, we decided to perform a surgery of repeated decortication of fibrous peritoneal membranes.

Outcomes:
The operation successfully released the intestinal obstruction and abdominal pain, postoperative course recovered smoothly.

Lessons:
After cesarean section could develop EPS. Intestinal obstruction caused by EPS lacks specificity and poses clinical difficulty in diagnosis and treatment. The management of this condition tests the surgeon’s knowledge and experience, and surgery is an effective treatment measure.
Radical radiotherapy for cervical cancer and meningioma with a history of Guillain-Barré syndrome: A case report
Authors: Deng Kangli , Yu Yanxin , Ge Liben , Deng Kangyan , Zhang Mo 
Published: December 2022

Rationale:
Guillain-Barré syndrome (GBS) is a rare autoimmune disease. Patients with cervical malignancies and intracranial meningiomas after the course of GBS are even rarer. There are no relevant reports at present.

Patient concerns:
We report a patient who developed cervical cancer (CC) and intracranial meningioma simultaneously after the course of GBS.

Diagnoses:
The history, pelvic enhanced magnetic resonance imaging (MRI) and pathology confirmed cervical squamous cell carcinoma, and the head enhanced MRI confirmed meningioma.

Intervention:
After multi-disciplinary team, the patient received head stereotactic radiosurgery for meningioma and radical radiotherapy for CC.

Outcomes:
The follow up for 1 year after treatment revealed a complete remission of the cervical tumor, stable disease of the meningioma, and no signs of GBS recurrence. Up to now, the general condition of the patient is acceptable and the curative effect is satisfactory.

Lessons:
This case report aims to improve the oncologists’ understanding of malignant tumors with rare autoimmune diseases and provide treatment reference for similar diseases in the future.
Unilateral thalamic infarction onset with lethargy: A case report and literature review
Authors: Kong Wei , Ma Lei , Yin Changyou , Zhao Wei , Wang Yanbin 
Published: December 2022

Introduction:
Infarct-induced lethargy is a common disabling symptom that lacks a consensual definition and a standardized method of care. Identifying the causes of the infarct in the thalamic reticular nucleus (TRN) induced lethargy is crucial in stroke patients.

Case presentation:
A 68-year-old female patient was admitted to the hospital with lethargy and weakness in the right limb. A computed tomography (CT) scan performed at the presentation showed no bleeding. She was given intravenous thrombolysis. A head computed tomography (CT) scan clearly showed that the infarct was located in the TRN. After 1 hour of treatment, the weakness in the patient’s limb was relieved. However, she was still lethargic, but her lethargy symptoms improved after 3 days.

Discussion and conclusions:
Our case highlights that despite the small size of the infarct, the patient was unconscious, which makes it difficult for physicians to understand and treat the condition, resulting in trouble managing the case. We performed a literature review and proposed that the infarction located in the TRN causes lethargy. However, further clinical and pathophysiological research is still needed to improve patient care.
Treatment-resistant idiopathic multicentric Castleman disease with thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly managed with Janus kinase inhibitors: A case report
Authors: Kakutani Takuya , Nunokawa Takahiro , Chinen Naofumi , Tamai Yotaro 
Published: December 2022

Rationale:
Thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome are nonmalignant but life-threatening systemic inflammatory disorders. However, many patients are refractory to treatment, resulting in significant morbidity and mortality. Additionally, established treatment options are unavailable. Therefore, we present 2 cases of adults with the iMCD-TAFRO syndrome refractory to initial treatment but responded to Janus kinase (JAK) inhibitors with ruxolitinib. The report reveals that these rare adult cases of the refractory and treatment-resistant iMCD-TAFRO syndrome can be treated using JAK inhibitors.

Patient concerns:
Case 1 is a 36-year-old previously healthy male patient who presented with fever and general fatigue for 2 weeks. Case 2 is a 42-year-old previously healthy female patient who presented with fever and general fatigue.

Diagnosis:
The diagnosis met the 2015 criteria for TAFRO syndrome, as determined by All Japan TAFRO Syndrome Research Group in the Research Program for Intractable Disease by the Ministry of Health, Labor and Welfare (MHLW) Japan.

Interventions:
Treatment with tocilizumab and several immunosuppressants were ineffective. So, we performed ruxolitinib.

Outcomes:
Each patient received ruxolitinib, the general condition improved, and CRP levels decreased.

Lessons:
These cases showed that ruxolitinib was effective for treatment-resistant/ refractory TAFRO syndrome. Further prospective studies are needed on using ruxolitinib with a small number of cases.
A case report of multiple extramedullary plasmacytoma of the head and neck
Authors: Zhang Jin , Ding Detao , Sun Juxing , Zhang Hui , Dai YunBing , Li Xiaoying , Ma Xu , Li Xiaoyu , Wu Yungang 
Published: December 2022

Rationale:
Multiple extramedullary plasmacytoma (EMP) of the head and neck is rare and a definitive first-line treatment has not been established. EMP successively as a benign mass occurring in multiple areas of the head and neck is rare. This report describes an atypical case with EMP occurring in multiple areas of the head and neck.

Patient concerns:
A 35-year-old woman was admitted due to complaints of sore throat discomfort accompanied by hoarseness. The patient had undergone surgical excision of the thyroid gland and parotid gland excision several years ago. Postoperative pathological examination both indicated EMP. This time, the woman suffered EMP in head and neck who was treated with a simple surgery.

Diagnosis:
Postoperative pathological examination of the tumor indicated EMP, and histopathological findings revealed the tumor to be a plasmacytoma. Immunopathological examination were consistent with the diagnosis of EMP.

Interventions:
The patient underwent surgical resection without radiotherapy.

Outcomes:
Histopathological and immunopathological examination findings revealed the tumor to be EMP. The patient was recurrence-free and did not progress to multiple myeloma (MM) during 19 months follow-up.

Lessons:
Increasing the awareness of EMP of head and neck is warranted. Our case confirmed that surgical excision is beneficial in the treatment of small, localized EMP.
Expanding Medicaid to Reduce Human Immunodeficiency Virus Transmission in Houston, Texas
Authors: Lee Francis , Khanna Aditya S. , Hallmark Camden J. , Lavingia Richa , McNeese Marlene , Zhao Jing , McNeese Melanie L. , Khuwaja Salma , Ardestani Babak M. , Collier Nicholson , Ozik Jonathan , Hotton Anna L. , Harawa Nina T. , Schneider John A. , Fujimoto Kayo 
Published: December 2022

Context:
Medicaid expansion has been nationally shown to improve engagement in the human immunodeficiency virus (HIV) treatment and prevention continua, which are vital steps to stopping the HIV epidemic. New HIV infections in the United States are disproportionately concentrated among young Black men who have sex with men (YBMSM). Houston, TX, is the most populous city in the Southern United States with a racially/ethnically diverse population that is located in 1 of 11 US states that have not yet expanded Medicaid coverage as of 2021.

Methods:
An agent-based model that incorporated the sexual networks of YBMSM was used to simulate improved antiretroviral treatment and pre-exposure prophylaxis (PrEP) engagement through Medicaid expansion in Houston, TX. Analyses considered the HIV incidence (number of new infections and as a rate metric) among YBMSM over the next 10 years under Medicaid expansion as the primary outcome. Additional scenarios, involving viral suppression and PrEP uptake above the projected levels achieved under Medicaid expansion, were also simulated.

Results:
The baseline model projected an HIV incidence rate of 4.96 per 100 person years (py) and about 368 new annual HIV infections in the 10th year. Improved HIV treatment and prevention continua engagement under Medicaid expansion resulted in a 14.9% decline in the number of annual new HIV infections in the 10th year. Increasing viral suppression by an additional 15% and PrEP uptake by 30% resulted in a 44.0% decline in new HIV infections in the 10th year, and a 27.1% decline in cumulative infections across the 10 years of the simulated intervention.

Findings:
Simulation results indicate that Medicaid expansion has the potential to reduce HIV incidence among YBMSM in Houston. Achieving HIV elimination objectives, however, might require additional effective measures to increase antiretroviral treatment and PrEP uptake beyond the projected improvements under expanded Medicaid.
Factors Affecting Breast Screening Behavior of First-Degree Relatives of Breast Cancer Patients in China
Authors: Lu Ningning , Zhang Chi , You Hua , Ma Zhuyue , Zhu Ping , Cheng Fang 
Published: December 2022

Background
Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear.

Objective
The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs.

Methods
A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior.

Results
The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = −0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior.

Conclusion
Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior.

Implications for Practice
Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.
Timing of Tracheostomy in Critically Ill Infants and Children With Respiratory Failure: A Pediatric Health Information System Study
Authors: Mehrotra Priyanka , Thomas Charlene , Gerber Linda M. , Maresh Alison , Nellis Marianne 
Published: December 2022

OBJECTIVES:
Tracheostomy placement in infants and children with respiratory failure has steadily increased over time, yet there is no consensus for optimal timing. We sought to: 1) describe tracheostomy timing and associated demographic and clinical characteristics in a large ICU cohort and 2) compare clinical outcomes between subgroups based on tracheostomy timing.

DESIGN:
Retrospective observational study using the Pediatric Health Information System (PHIS).

SETTING:
Neonatal ICUs and PICUs in the United States.

PATIENTS:
PHIS was queried for patients less than 18 years who underwent tracheostomy from 2010 to 2020. Patients were included if admitted to an ICU with need for mechanical ventilation (MV) prior to tracheostomy in the same hospitalization. Patients were categorized as early tracheostomy (ET) (placement at MV day ≤ 14), late tracheostomy (LT) (MV days 15–60), and extended tracheostomy (ExT) (MV day > 60). Primary endpoints included demographic and clinical characteristics. Secondary endpoints included patient outcomes: in-hospital mortality, length of stay (LOS), hospital-acquired pneumonia (HAP), and hospital costs.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Sixteen thousand one hundred twenty-one patients underwent tracheostomy at 52 children’s hospitals. Ten thousand two hundred ninety-five had complete data and were included in the analysis. Thirty-nine percent (4,006/10,295) underwent ET, 40% (4,159/10,295) underwent LT, and 21% (2,130/10,295) underwent ExT. Majority of patients in all subgroups had complex chronic conditions. Median age was significantly different between subgroups with ET being the oldest (p < 0.001). A multivariable regression analysis showed that ET was associated with lower in-hospital mortality (p < 0.001), shorter hospital LOS (p < 0.001), shorter ICU LOS (p < 0.001), shorter post-tracheostomy LOS (p < 0.001), decreased HAP (p < 0.001), and lower hospital costs (p < 0.001) compared with those who underwent LT or ExT.

CONCLUSIONS:
In a large cohort of pediatric patients with respiratory failure, tracheostomy placement within 14 days of MV was associated with improved in-hospital outcomes. ET was independently associated with decreased mortality, LOS, HAP, and hospital costs.
Mapping of biomarker efficacy in SARS-CoV-2: tracking the impact of viral mutations and vaccinations
Authors: Shuvo ME Rahman , Schwiening Max , Avramidis Nikos , Soares Felipe , Feng Oliver , Abreu Susana , Veale Niki , Gao Q , Thomas William , Thompson AA Roger , Samworth Richard J , Morrell Nicholas W , Baillie Kenneth , Marciniak Stefan J , Soon Elaine 
Published: December 2022

Rationale: Sophisticated prognostic scores have been proposed for SARS-CoV-2 but do not always perform consistently. We conducted these meta-analyses to uncover why and to investigate the impact of vaccination and variants.Methods: We searched the PubMed database for the keywords “SARS-CoV-2” with “biomarker” and “mortality” for the baseline tranche (01/12/2020-30/06/2021) and either “SARS-CoV-2” or “Covid19” with “biomarker” and either “vaccination” or “variant” from 01/12/2020 to 31/10/2023. To aggregate the data, the meta library in R was used, and a random effects model fitted to obtain pooled AUCs and 95% confidence intervals for the European/North American, Asian, and overall datasets.Results: Biomarker effectiveness varies significantly in different continents. Admission CRP levels were a good prognostic marker for mortality due to wild-type virus in Asian countries, with a pooled area under curve (AUC) of 0.83 (95%CI 0.80-0.85), but only an average predictor of mortality in Europe/North America, with a pooled AUC of 0.67 (95%CI 0.63-0.71, P<0.0001). We observed the same pattern for D-dimer and IL-6. This variability explains why the proposed prognostic scores did not perform evenly. Notably, urea and troponin had pooled AUCs ≥0.78 regardless of location, implying that end-organ damage at presentation is a key prognostic factor. The inflammatory biomarkers (CRP, D-dimer and IL-6) have generally declined in effectiveness in the vaccinated and variant cohorts. We note a significant lag from the pandemic advent to data availability and this has no doubt impacted on patient care.Conclusions: Biomarker efficacies vary considerably by region. It is imperative that the infrastructure for collecting clinical data should be put in place ahead of a future pandemic.