bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-health literacy of nursing students and investigation of factors affecting e-health literacy during COVID-19 pandemic process: A cross-sectional study
Authors: Cetinkaya Senay , Askan Fahri , Gunes N. Ecem Oksal , Todil Tugba , Yuruk Emel 
Published: September 2022

The lack of knowledge on health literacy affects all segments of society, particularly health workers.
The objectives were to identify nursing students’ means of accessing information during the coronavirus disease 2019 pandemic, their level of health literacy, and the factors that affect it.
This cross-sectional study was conducted in Turkey among 398 nursing students of Çukurova University and Van Yüzüncü Yil University between June 1 and June 30, 2020. As a data collection tool, E-Health Literacy Scale was used, with students’ characteristics and personal information form related to Internet use. These forms were converted to the online format. The survey link was sent to the students’ smartphones and/or e-mails to ask them to participate.
Majority of participants were Van Yüzüncü Yil University nursing students (63.8%). E-SYO score average of all students was found to be 29.42 ± 4.39 (min = 14, max = 40); it was is found be at a good level. They used the Internet as the first source of information about coronavirus disease 2019 (65.1%).Among the participants, 65.8% stated that it was important to access the health resource on the Internet and 19.1% of the participants thought that it was very important. It was found that Internet use was being used for >3 times a day (72.9%). The age, class, gender, family type, income level, high school from which they graduated from, and their working status significantly were statistically affecting their health literacy (P < .05). The health literacy scale scores were significant and higher than those who did not know the concept of health literacy, and those who perceived Internet skills well and very well than those who perceived them poorly (P < .05).
Nursing students were found to have good average health literacy averages. Improving the health literacy is important for making individuals healthier.
Thrombocytosis predicts poor prognosis of Asian patients with colorectal cancer: A systematic review and meta-analysis
Authors: Xia Shijun , Wu Wenjiang , Yu Linchong , Ma Lijuan , Chen Shiwei , Wang Hao 
Published: September 2022

Background:
There is no study analyzing and evaluating the prognostic role of thrombocytosis in Asian patients with colorectal cancer (CRC).

Methods:
A systematic search of articles (PubMed, Embase, and the Cochrane Library) was performed to identify studies using the terms Platelet count, Thrombocytosis, Thrombocytoses, Thrombocythemia or Thrombocythemias with colon, colonic, rectal, rectum, colorectal and prognostic, prognosis, survival or outcome.

Results:
Thirteen eligible studies with 3964 patients were included. Thrombocytosis was associated with a poorer overall survival (HR of 1.88 [95% CI: 1.24–2.85; P = .003] with univariate analyses, HR of 2.07 [95% CI: 1.2–3.56; P = .008] with multivariate analyses), disease-free survival (HR of 2.58 [95% CI: 1.87–3.57; P < .00001] with multivariate analyses) and cancer specific survival (HR of 2.55 [95% CI: 1.68–3.85; P < .00001]) in Asian patients with CRC. Thrombocytosis had a significant association with female gender, tumor location in the colon, higher pathological T-stage, pathological positive N-stage, but not with lymphatic involvement and venous involvement.

Conclusion:
The present meta-analysis demonstrates that thrombocytosis is a potentially useful tool for predicting poor survival in Asian patients with CRC, especially for overall survival.
Cellular angiofibroma of the vagina: A case report and literature review
Authors: Cai Xia-Qin , Ye Xi-Gang , Zhang Ya-Zhen , Shen Zeng-Li , Hong Ke , Zhang Shu-Zhi 
Published: September 2022

Background:
Cellular angiofibroma (CAF), a rare benign mesenchymal tumor, is histologically characterized by abundant thick-walled vessels with a spindle cell component. As one of the female reproductive system tumors, its clinical and pathological features are not well characterized.

Methods:
A 47-year-old woman presented for the removal of intrauterine device on October 28, 2021, as she had achieved menopause one year back. The patient had no discomfort or awareness of any mass in her vagina. She has history of breast cancer and papillary thyroid cancer. Till date, no progression of thyroid cancer or breast cancer has been observed. Her menstrual cycle was regular, and she had one child delivered vaginally.

Results:
Pelvic examination revealed a mass sized 2.5 × 2.0 cm located near the fornix in the upper segment of the left vaginal wall. Thin prep cytologic test (TCT) revealed negative intraepithelial lesion or malignancy (NILM). HPV test was negative and leucorrhea routine inspection cleanliness II degree. No cervical mass was detected by ultrasound examination. The patients underwent the operation for intrauterine device removal plus vaginal tumor resection on November 1, 2021. Postoperative antibiotics (intravenous cefuroxime sodium 0.75 g bid for 1 day) were administered to prevent infection. The patient showed no signs of recurrence at one-month follow-up.

Conclusion:
In summary, CAF is a rare benign soft tissue tumor. Surgery is the only treatment method, and the definitive diagnosis of CAF is based on histopathological examination of surgical specimen. Long-term follow-up is needed for surveillance of recurrence.
15-Year progression to liver cancer in the lack of treatment for lysosomal acid lipase deficiency: A case report
Authors: Cunha-Silva Marlone , de França Eloy Vianey Carvalho , Veiga Clauber Teles , Greca Raquel Dias , de Moraes Priscilla Brito Sena , de Campos Mazo Daniel Ferraz , de Ataíde Elaine Cristina , Perales Simone Reges , Monici Leonardo Trevizan , Sevá-Pereira Tiago 
Published: September 2022

Rationale:
Lysosomal acid lipase deficiency (LAL-D) is a poorly diagnosed genetic disorder characterized by the accumulation of cholesteryl esters and triglycerides in many tissues, leading to dyslipidemia and cardiovascular complications. In the liver, deposits are found within hepatocytes and Kupffer cells, generating microvesicular steatosis, progressive fibrosis, and cirrhosis. Sebelipase alfa is the target therapy which can improve laboratory changes and reduce the progression of liver damage, but this is not yet widely available.

Patient Concerns:
We are reporting a 15-year follow-up of a Brazilian man who was diagnosed with cirrhosis at age 43 and with LAL-D at age 53, but he has never been treated with sebelipase alfa for economic reasons. During the coronavirus disease 2019 (COVID-19) pandemic, he lost follow-up and missed three 6-month ultrasound exams for liver cancer screening.

Diagnosis:
At age 58, a remarkable deterioration in liver function was observed and he was diagnosed with hepatocellular carcinoma (HCC) outside the Milan Criteria (two nodules measuring 48mm and 25mm). Three other individuals with LAL-D and progression to liver cancer have been reported so far and none of them underwent enzyme replacement therapy: an 11-year-old girl with HCC, a 51-year-old male with cholangiocarcinoma, and a 21-year-old male with hepatocellular-cholangiocarcinoma. The latter had the same mutation in the gene LIPA as our patient, but a relationship between this variant and malignancies has not yet been established.

Lessons:
We emphasize how important is to treat LAL-D patients after diagnosis in order to avoid worsening liver function and progression to neoplasms. Untreated individuals should be considered at a higher risk but the most appropriate liver cancer screening program for this subgroup is still unknown.
A case report of secondary synchronous diagnosis of multiple myeloma and systemic lupus erythematosus after breast cancer treatment: A CARE-compliant article
Authors: Chen Pei-Hsin , Tung Heng-Hsin , Lin Chin-Husan , Huang Kuan-Po , Ni Yung-Lun , Lin Chin-Yao 
Published: September 2022

Introduction:
Breast cancer (BC) is the most diagnosed cancer worldwide. Multiple myeloma (MM) is a hematologic malignancy characterized by the overproduction of monoclonal antibodies in the bone marrow. Systemic lupus erythematosus (SLE) is distinguished by the aberrant activity of the immune system with heterogeneous clinical manifestations. The coexistence of more than one major illness in a patient can present a diagnostic challenge for clinical physicians, especially when the comorbid diseases share a similar clinical presentation. Herein, we report an unusual case of secondary synchronous diagnosis of MM and SLE after BC treatment.

Patient concerns:
A 69-year-old female patient with breast cancer experienced severe skin itching and rashes on the face, anterior chest wall, back, and trunk for two days before admission. She had high levels of immunoglobulin and anti-nuclear antibodies; low levels of complements 3 and 4; positive anti-cardiolipin-IgM, anti-beta 2 glycoprotein-1 (anti-β2GP1) antibodies, and lupus anticoagulant results at serological testing.

Diagnosis:
The postoperative pathology report showed ductal carcinoma in situ in the right breast. SLE was confirmed based on the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) criteria. IgG-κ type multiple myeloma was confirmed by bone marrow biopsy, and the patient was synchronously diagnosed with SLE and MM after BC treatment.

Interventions:
Glucocorticoids and immunosuppressive agents, including intravenous hydrocortisone (5 g every 8 hours) and oral hydroxychloroquine (Plaquenil) (200 mg twice daily) were administered to treat SLE. One capsule of thalidomide 50 mg was administered orally every night at bedtime for MM.

Outcomes:
The patient died two days later, shortly after the administration of drugs, due to multiple organ failures secondary to pneumonia and respiratory failure.

Conclusion:
This is a case of MM and SLE after BC treatment. The present challenge was the early detection and accurate diagnosis of the secondary major illnesses, as the clinical manifestations were similar and non-specific between these two diseases. Awareness and prompt recognition of the common clinical symptoms of SLE and MM should be considered by clinical physicians to avoid delayed diagnoses and facilitate early treatment for a better prognosis.
Therapeutic experience of a pancreatic mixed serous neuroendocrine neoplasm invading peripancreatic vessels: A case report
Authors: Zhang Zongming , Liu Limin , Li Youwei , Liu Zhuo , Zhang Chong , Zhao Yue , Zhu Mingwen , Wan Baijiang , Deng Hai , Xie Xiyuan , Tian Kun , Guo Zhentian , Yang Haiyan , Liao Jiahong , Zhu Hongyan , Liu Lili , Wang Man , Ma Xiaoting , Liu Tiantian , Huang Niuniu , Gao Yujiao , Zhao Jing , Liao Fang , Li Fengyuan , Wang Xueting , Yuan Ruijiao , Liu Xinying , Chang Lidan 
Published: September 2022

Rationale:
Pancreatic mixed serous neuroendocrine neoplasm (PMSNN) is an extremely rare disease. Only a few cases on the surgical treatment of PMSNN have been reported in the literature, and it is unclear whether there is invasion of important peripancreatic vessels.

Patient concerns:
We report the case of a 39-year-old female patient with PMSNN accompanied by invasion of important peripancreatic vessels. She underwent surgery and achieved satisfactory recovery.

Diagnosis:
Abdominal enhanced CT images showed an enhanced mass with a nonenhanced cyst involving the head and body of the pancreas, which invaded important peripancreatic vessels. The lesion had been misdiagnosed and mistreated as a metastatic carcinoma before admission.

Interventions:
CT 3-dimensional (3D) visualization reconstruction images showed intact peripancreatic vessels. Radical pancreatoduodenectomy was successfully performed and confirmed that the main blood vessels around the pancreas were only compressed or even wrapped by the mass, but not penetrated.

Outcomes:
The patient recovered well and was discharged on the 19th day after surgery. Pathological examination reported the diagnosis of PMSNN with the collision type combination and the well-differentiated grade 2 pancreatic neuroendocrine tumor. She was followed up for 18 months without any abnormalities.

Lessons:
This case demonstrates that surgical treatment of PMSNN with invasion of peripancreatic vessels can be successful. Preoperative abdominal CT 3D visualization reconstruction is helpful in determining the degree of invasion of important peripancreatic vessels, and plays a key role in formulating an accurate surgical plan and improving patient outcome.
Predictive value of baseline C-reactive protein level in patients with stable coronary artery disease: A meta-analysis
Authors: Luo Shuangyan , Zhang Jin , Li Biyan , Wu Hui 
Published: September 2022

Background:
Conflicting results have been reported on the association of C-reactive protein (CRP) level with adverse outcomes in patients with stable coronary artery disease (CAD). The objective of this meta-analysis was to evaluate the predictive value of baseline CRP level in stable CAD patients.

Methods:
Two reviewers independently searched PubMed and Embase databases from their inception to November 28, 2021 to identify studies assessing the value of baseline CRP level in predicting adverse outcomes in stable CAD patients. The endpoints of interest included cardiovascular mortality, all-cause mortality, or major adverse cardiovascular events (MACEs). The predictive value of CRP level was estimated by pooling the multivariable adjusted risk ratio with 95% confidence intervals (CI) compared the highest to the lowest CRP level.

Results:
Twenty-six studies involving of 22,602 patients with stable CAD satisfied the inclusion criteria. In a comparison of the highest with the lowest CRP level, the pooled multivariable adjusted risk ratio was 1.77 (95% CI 1.60–1.96) for MACEs, 1.64 (95% CI 1.13–2.33) for cardiovascular mortality, and 1.62 (95% CI 2.62–5.12) for all-cause mortality, respectively. Subgroup analyses indicated that the values of elevated CRP level in predicting MACEs were consistently observed in each subgroup.

Conclusion:
Elevated baseline CRP level was an independent predictor of MACEs, cardiovascular mortality, and all-cause mortality in patients with stable CAD. Baseline CRP level can provide important predictive information in stable CAD patients.
Variability of pulmonary nodule volumetry on coronary CT angiograms
Authors: Pinto Erique , Penha Diana , Hochhegger Bruno , Monaghan Colin , Marchiori Edson , Taborda-Barata Luís , Irion Klaus 
Published: September 2022

This study aims to investigate the variability of pulmonary nodule (PN) volumetry on multiphase coronary CT angiograms (CCTA).
Two radiologists reviewed 5973 CCTA scans in this cross-sectional study to detect incidental solid noncalcified PNs measuring between 5 and 8 mm. Each radiologist measured the nodules’ diameters and volume, in systole and diastole, using 2 commercially available software packages to analyze PNs.
Bland-Altman analysis was applied between different observers, software packages, and cardiac phases. Bland-Altman subanalysis for the systolic and diastolic datasets were also performed.
A total of 195 PNs were detected within the inclusion criteria and measured in systole and diastole. Bland-Altman analysis was used to test the variability of volumetry between cardiac phases ([−47.0%; 52.3%]), software packages ([−50.2%; 68.2%]), and observers ([−14.5%; 27.8%]). The inter-observer variability of the systolic and diastolic subsets was [−13.6%; 31.4%] and [−13.9%; 19.7%], respectively.
Using diastolic volume measurements, the variability of PN volumetry on CCTA scans is similar to the reported variability of volumetry on low-dose CT scans. Therefore, growth estimation of PNs on CCTA scans could be feasible.
A randomized, controlled simulation study comparing single and double operator ultrasound-guided regional nerve block techniques using a gelatine-based home-made phantom
Authors: Güven Aytaç Betül , Ünal Şeyma , Aytaç İsmail 
Published: September 2022

Background:
The aim of this study was to compare anesthesiology residents’ acquisition of gripping and needling skills in either single-or double-operator ultrasound-guided nerve block using a hand-made phantom.

Design:
Prospective, randomized controlled study.

Methods:
After a tutorial session, 47 ultrasound-novice residents performed needling with double and single operator (Jedi, Bedforth, On-lock) grip techniques in each of the 3 interventional task sessions.

Results:
The time to perform the correct grip and needling decreased significantly between sessions for each technique (P < .001). While the double operator tasks required a shorter time than the single operator tasks in all 3 sessions (P < .001), there was no significant difference between the single-operator techniques. The number of needling attempts was similar between techniques and sessions. Participants rated the workload higher for the single-operator techniques on the National Aeronautics and Space Administration Task Load Index.

Conclusion:
Hands-on training of phantom models may be beneficial for the acquisition of single-operator grip skills.
Effects of bevel direction of endotracheal tube on the postoperative sore throat when performing fiberoptic‐guided tracheal intubation: A randomized controlled trial
Authors: Kim Hyunjee , Kim Jeong Eon , Yang Woo Seok , Hong Seong Wook , Jung Hoon 
Published: September 2022

Background:
During fiberoptic-guided tracheal intubation, impingement between the distal tip of the endotracheal tube and the airway tissue can cause difficulties in tube insertion or tissue damage during the tube advancement over the bronchoscope. This randomized controlled study aimed to investigate the effects of the endotracheal tube’s bevel direction on the complications associated with airway injury when performing fiberoptic-guided tracheal intubation.

Methods:
The study subjects were divided into 2 groups: L (control) and D (study). When advancing the tube over the bronchoscope, the tube’s bevel was facing the patients’ left in Group L and the dorsal direction in Group D. According to the degree of resistance at the time of tube advancement, the insertion score was graded in 3 stages; the severity of the patients’ sore throat and hoarseness was evaluated and recorded postoperatively.

Results:
The severity of postoperative sore throat was higher in Group L than in Group D 3 hours and 24 hours after surgery. (P = .008, P = .023, respectively). The tube insertion score was comparable between the groups. The severity of postoperative hoarseness did not vary significantly between the groups.

Conclusion:
Endotracheal tube insertion with the bevel facing the dorsal direction of the patient during fiberoptic-guided tracheal intubation reduced the severity of postoperative sore throat in patients undergoing laparoscopic gynecologic surgery.
Yangxin decoction for the treatment of angina pectoris of coronary heart disease: A systematic review of randomized controlled trial
Authors: Yu Xiao-hong , Yu Xi-wen , Xu Zhe-ming , Li Hai-xiang 
Published: September 2022

Background:
This study assessed the effectiveness of Yangxin Decoction (YXD) in the treatment of coronary heart disease (CHD) patients with angina pectoris (AP).

Methods:
In this study, we systematically and comprehensively searched the PUBMED, EMBASE, Cochrane Library, CNKI, WANGFANG, and VIP databases from their establishment to June 1, 2022. Clinical randomized controlled trials of YXD for the management of AP in patients with CHD were considered for inclusion. The outcomes included the response rate of AP, response rate based on electrocardiogram, and the rate of nitroglycerin use. Two authors independently performed literature selection, data extraction, and methodological quality assessment. Any differences were resolved by a third author through a discussion.

Results:
Nine trials involving 819 patients were included. The meta-analysis results showed that YXD significantly improved the response rate of AP (OR = 2.98, 95% CI: 1.96–4.55, I2 = 0%, P < .01) and the response rate based on the electrocardiogram (OR = 1.88, 95% CI: 1.28–2.78, I2 = 26%, P < .01), and significantly reduced the rate of nitroglycerin use (OR = 2.04, 95% CI: 1.19–3.52, I
2 = 0%, P = .01).

Conclusions:
The results of this study showed that YXD was effective in the treatment of patients with AP of CHD. Further studies are required to confirm these results.
Uterine tumor resembling ovarian sex cord tumor: A rare case report
Authors: Wang Xue-Ying , Zhang Mao-Chun , Chen Jiao , Huang Jiang-Hua 
Published: September 2022

Rationale:
A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a clinically rare disease with an unclear origin and biological behavior.

Patient concerns:
We present a case of UTROSCT in a 42-year-old woman who presented with abnormally increased menstrual volume for 2 years.

Diagnoses:
Initially, only ultrasound examination was performed to diagnose uterine fibroids, and then the tumor was surgically removed and sent for pathological examination. The patient was ultimately diagnosed with UTROSCT mainly based on pathological immunohistochemical examination and was further diagnosed with low malignant potential for recurrence based on genetic testing.

Interventions and Outcomes:
The patient underwent hysterectomy and bilateral adnexectomy, and no adjuvant radiotherapy or chemotherapy was performed after the surgery. Follow-up to date has indicated that she is in good condition.

Lessons:
UTROSCT is a rare disease that requires pathological immunohistochemical examination to confirm the diagnosis and genetic testing when necessary so that a clear diagnosis can inform better decision-making regarding treatment measures.
A rare case of alveolar hemorrhage with hypertensive emergency
Authors: Hamaguchi Sho , Suzuki Hitoshi , Hamaguchi Maki , Iwasaki Masako , Fukuda Hiromitsu , Takahara Hisatsugu , Tomita Shigeki , Suzuki Yusuke 
Published: September 2022

Introduction:
Alveolar hemorrhage presents with severe respiratory failure, requiring prompt diagnosis and treatment. Alveolar hemorrhage is often caused by autoimmune diseases accompanied by progressive renal dysfunction. However, few cases without autoimmune diseases occur, making diagnosis difficult. Here, we report a case of alveolar hemorrhage with hypertensive emergency.

Patient concerns:
A 28-year-old man presented with dyspnea and bloody sputum. His blood pressure was 200/120 mm Hg.

Diagnosis:
The chest computed tomography showed suggestive of alveolar hemorrhage. Renal dysfunction and proteinuria were observed. However, autoantibodies were not detected. Echocardiogram revealed left ventricular function decrease. Ejection fraction was 20% to 30% with no ventricular asynergy or any valvular diseases. Brain magnetic resonance imaging showed hyperintense lesions on fluid-attenuated inversion recovery in the white matter of both cerebral and right cerebellar hemispheres, which were compatible with posterior reversible encephalopathy syndrome. Renal biopsy did not reveal any immune-mediated glomerulonephritis or vasculitis, but hypertensive nephropathy was diagnosed.

Interventions:
Blood pressure was controlled with combination therapy using calcium channel blocker, angiotensin II receptor blocker, α1 blocker, and β blocker.

Outcomes:
Alveolar hemorrhage and proteinuria improved with strict blood pressure control.

Conclusion:
This case indicates that severe hypertension can possibly cause alveolar hemorrhage. Accumulating these cases is important for general physicians to diagnose the alveolar hemorrhage with hypertensive emergency in its early stage and to avoid unnecessary treatment such as immunosuppressive therapy.