bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-Year Visual Outcomes of Evolution Implantable Collamer Lens and Small Incision Lenticule Extraction for the Correction of Low Myopia
Authors: Fu Mengjun , Li Meiyan , Xian Yiyong , Yu Zhiqiang , Zhang Haorun , Choi Joanne , Niu Lingling , Wang Xiaoying , Zhou Xingtao 
Published: April 2022

PurposeTo investigate the 2-year visual quality of Evolution Implantable Collamer Lens (EVO-ICL) and small incision lenticule extraction (SMILE) for the correction of low myopia.MethodsIn this prospective study, we included 25 eyes of 25 patients (7 men) who underwent EVO-ICL and 36 eyes of 36 patients (16 men) who underwent SMILE between January 2018 and December 2018. Subjective and objective visual outcomes were compared between ICL and SMILE. All patients were followed for 2 years.ResultsAt the postoperative 2-year visit, the percentage of patients with uncorrected distance visual acuity (UDVA) greater than or equal to preoperative corrected distance visual acuity (CDVA) was comparable in the ICL group (80%, 20/25) and SMILE group (88.89%, 32/36). Spherical equivalent (SE) was within ± 0.50 D in 96% (24/25) of the ICL group and 94.44% (34/36) of the SMILE group. No eyes lost more than 2 lines of CDVA. Postoperative high-order aberrations (HOAs) were significantly increased in the ICL group (p &lt; 0.01) and in the SMILE group (p &lt; 0.01). The most common visual complaint was halo after ICL and starburst after SMILE. There was no correlation between HOAs and visual complaints (p &gt; 0.05).ConclusionEvolution Implantable Collamer Lens provides comparable safety, efficacy, long-term visual stability, and high patient satisfaction when compared to SMILE in correcting low myopia. EVO-ICL could be a favorable alternative for low myopia.Key messages What was known?•Visual outcomes of Evolution Implantable Collamer Lens (EVO-ICL) versus small incision lenticule extraction (SMILE) for correction of mild myopia remain unclear.What this paper adds?•Evolution Implantable Collamer Lens (EVO-ICL) provides comparable safety, efficacy, long-term visual stability, and high patient satisfaction when compared to small incision lenticule extraction (SMILE) in correcting low myopia.•The most common visual complaint was halo after ICL and starburst after SMILE.
Updating Understanding of Macular Microvascular Abnormalities and Their Correlations With the Characteristics and Progression of Macular Edema or Exudation in Coats' Disease
Authors: Zhang Juan , Ruan Lu , Jiang Chen , Yang Qian , Ju Yuqiao , Chang Qing , Huang Xin 
Published: April 2022

ObjectiveTo investigate the associations of macular microvascular abnormalities with the characteristics and progression of macular edema or exudation in Coats' disease, toward an updated understanding of possible risk factors for macular edema or exudation.MethodsTwenty-six eyes (26 patients) with Coats' disease and macular edema or exudation underwent multimodal imaging and were followed for 18 months. The eyes were classified according to their outcomes (refractory or improved). Macular capillary affections were assessed by optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Histopathological analysis of the macular region of an additional enucleated eye was performed.ResultsOCTA revealed telangiectasia in the deep capillary plexus (DCP) in 76.9% and the superficial capillary plexus (SCP) in 34.6% of 26 eyes with macular edema or exudation of Coats' disease, exceeding the rate detected by FA (21.4%). Eyes with intraretinal cystoid spaces/exudates of the macula presented higher presence of telangiectasia in the SCP (57.1% with vs. 8.3% without, X2 = 6.801, P = 0.009) and DCP (92.9 with vs. 58.3% without, X2 = 4.338, P = 0.037). The parafoveal vessel densities (VDs) and fractal dimension in the SCP and DCP were lower in affected eyes than in contralateral eyes (all P &lt; 0.001). The VD in SCP (P = 0.009) and DCP (P = 0.010) were lower in refractory group than in improved group. Dilated capillaries with incomplete vessel walls and adjacent inflammatory cells were detected in the neuroretina of the macula in histopathological specimen.ConclusionsMacular capillary abnormalities, including telangiectasia and VD loss, were positively detected in eyes with macular edema or exudation of Coats' disease. Intraretinal cystoid spaces/exudates of the macula, rather than subretinal exudates, may be related to macular telangiectasia. VD losses in the SCP and DCP may be risk factors for refractory macular edema or exudation.
Effects of Electroacupuncture on Opioid-Induced Constipation in Patients With Cancer: Study Protocol for a Multicenter Randomized Controlled Trial
Authors: Wang Weiming , Wang Xinlu , Liu Yan , Sun Yuanjie , Liu Xiaoxu , Yan Yan , Liu Zhishun 
Published: April 2022

BackgroundOpioid-induced constipation (OIC) is one of the most prevalent adverse events associated with cancer patients who receive opioid analgesics for moderate to severe pain. Acupuncture may be an effective treatment for OIC. We designed this trial to assess the efficacy and safety of electroacupuncture for OIC in cancer patients.MethodsThis is a multicenter, sham-controlled, parallel-group, subject- and assessor-blinded randomized trial. A total of 100 cancer patients with OIC will be randomly assigned to either the electroacupuncture group or the sham electroacupuncture group at a ratio of 1:1. Patients in each group will receive a total of 24-session treatment over 8 weeks, three sessions a week and 30 min each session. Thereafter, patients will be followed up for another 8 weeks. The primary outcome will be the proportion of responders, defined as a patient who has ≥3 spontaneous bowel movements (SBMs)/wk and ≥ increase of 1 SBM from baseline simultaneously for at least 6 out of 8 weeks of the treatment period. The secondary outcomes will include the mean weekly SBMs and complete spontaneous bowel movements, the mean Bristol Stool Form Scale score for stool consistency, the mean score for straining of SBM, the total and subscale scores of Patient Assessment of Constipation-Symptom questionnaires, and the total and subscale scores of Patient Assessment of Constipation-Quality of Life questionnaire. Patients' global assessment of treatment effectiveness, patients' expectation toward the effectiveness of acupuncture and safety of acupuncture will also be assessed. All efficacy analyses will be performed in the intention-to-treat population.DiscussionTo improve the adherence to intervention protocols, the majority of the participants will be recruited from an inpatient setting. The results will help to determine the clinical effects and safety of electroacupuncture for the treatment of OIC among patients with cancer.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03797586, registered on 4 January 2019, https://clinicaltrials.gov/ct2/show/NCT03797586.
Nitazoxanide in Patients Hospitalized With COVID-19 Pneumonia: A Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Rocco Patricia R. M. , Silva Pedro L. , Cruz Fernanda F. , Tierno Paulo F. G. M. M. , Rabello Eucir , Junior Jéfiton Cordeiro , Haag Firmino , de Ávila Renata E. , da Silva Joana D. G. , Mamede Mariana M. S. , Buchele Konrad S. , Barbosa Luiz C. V. , Cabral Anna C. , Junqueira Antônio A. F. , Araújo-Filho João A. , da Costa Lucianna A. T. J. , Alvarenga Pedro P. M. , Moura Alexandre S. , Carajeleascow Ricardo , de Oliveira Mirella C. , Silva Roberta G. F. , Soares Cynthia R. P. , Fernandes Ana Paula S. M. , Fonseca Flavio Guimarães , Camargos Vidyleison Neves , Reis Julia de Souza , Franchini Kleber G. , Luiz Ronir R. , Morais Sirlei , Sverdloff Carlos , Martins Camila Marinelli , Felix Nathane S. , Mattos-Silva Paula , Nogueira Caroline M. B. , Caldeira Dayene A. F. , Pelosi Paolo , Lapa-e-Silva José R. 
Published: April 2022

BackgroundNitazoxanide exerts antiviral activity in vitro and in vivo and anti-inflammatory effects, but its impact on patients hospitalized with COVID-19 pneumonia is uncertain.MethodsA multicentre, randomized, double-blind, placebo-controlled trial was conducted in 19 hospitals in Brazil. Hospitalized adult patients requiring supplemental oxygen, with COVID-19 symptoms and a chest computed tomography scan suggestive of viral pneumonia or positive RT-PCR test for COVID-19 were enrolled. Patients were randomized 1:1 to receive nitazoxanide (500 mg) or placebo, 3 times daily, for 5 days, and were followed for 14 days. The primary outcome was intensive care unit admission due to the need for invasive mechanical ventilation. Secondary outcomes included clinical improvement, hospital discharge, oxygen requirements, death, and adverse events within 14 days.ResultsOf the 498 patients, 405 (202 in the nitazoxanide group and 203 in the placebo group) were included in the analyses. Admission to the intensive care unit did not differ between the groups (hazard ratio [95% confidence interval], 0.68 [0.38–1.20], p = 0.179); death rates also did not differ. Nitazoxanide improved the clinical outcome (2.75 [2.21–3.43], p &lt; 0.0001), time to hospital discharge (1.37 [1.11–1.71], p = 0.005), and reduced oxygen requirements (0.77 [0.64–0.94], p = 0.011). C-reactive protein, D-dimer, and ferritin levels were lower in the nitazoxanide group than the placebo group on day 7. No serious adverse events were observed.ConclusionsNitazoxanide, compared with placebo, did not prevent admission to the intensive care unit for patients hospitalized with COVID-19 pneumonia.Clinical Trial RegistrationBrazilian Registry of Clinical Trials (REBEC) RBR88bs9x; ClinicalTrials.gov, NCT04561219.
Comparison of Efficacy of Lokomat and Wearable Exoskeleton-Assisted Gait Training in People With Spinal Cord Injury: A Systematic Review and Network Meta-Analysis
Authors: Zhang Lingjie , Lin Fabin , Sun Lei , Chen Chunmei 
Published: April 2022

ObjectiveLokomat and wearable exoskeleton-assisted walking (EAW) have not been directly compared previously. To conduct a network meta-analysis of randomized and non-randomized controlled trials to assess locomotor abilities achieved with two different types of robotic-assisted gait training (RAGT) program in persons with spinal cord injury (SCI).MethodsThree electronic databases, namely, PubMed, Embase, and the Cochrane Library, were systematically searched for randomized and non-randomized controlled trials published before August 2021, which assessed locomotor abilities after RAGT.ResultsOf 319 studies identified for this review, 12 studies were eligible and included in our analysis. Studies from 2013 to 2021 were covered and contained 353 valid data points (N-353) on patients with SCI receiving wearable EWA and Lokomat training. In the case of wearable EAW, the 10-m walk test (10-MWT) distance and speed scores significantly increased [distance: 0.85 (95% CI = 0.35, 1.34); speed: −1.76 (95% CI = −2.79, −0.73)]. The 6-min walk test (6-MWT) distance [−1.39 (95% CI = −2.01, −0.77)] and the timed up and go (TUG) test significantly increased [(1.19 (95% CI = 0.74, 1.64)], but no significant difference was observed in the walking index for spinal cord injury (WISCI-II) [−0.33 (95% CI = −0.79, 0.13)]. Among the patients using Lokomat, the 10-MWT-distance score significantly increased [−0.08 (95% CI = −0.14, −0.03)] and a significant increase in the WISCI-II was found [1.77 (95% CI = 0.23, 3.31)]. The result of network meta-analysis showed that the probability of wearable EAW to rank first and that of Lokomat to rank second was 89 and 47%, respectively, in the 10-MWT speed score, while that of Lokomat to rank first and wearable EAW to rank second was 73 and 63% in the WISCI-II scores.ConclusionLokomat and wearable EAW had effects on the performance of locomotion abilities, namely, distance, speed, and function. Wearable EAW might lead to better outcomes in walking speed compared with that in the case of Lokomat.
Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial
Authors: Yan Xiu-Li , Liu Zhuo , Sun Ye , Zhang Peng , Lu Xue-Yan , Mu Fei , Du Juan , Yang Yi , Guo Zhen-Ni 
Published: April 2022

ObjectivesPost-stroke dysphagia may cause aspiration pneumonia, malnutrition, dehydration, and other complications. However, data on the effects of nutritional supplementation and its value after stroke are insufficient. We aimed to evaluate the effect of an individualized 1-week nutrition intervention program on swallowing function and nutritional status in stroke patients with oropharyngeal dysphagia.MethodsThis study comprised the control group receiving oral nutritional support and continuous nasogastric tube feeding according to the results of the water swallow test (WST). The intervention group additionally underwent a volume-viscosity swallowing test (V-VST) and intermittent oroesophageal tube feeding based on WST. The outcomes were measured after 7 days of intervention, including the improvement of swallowing function assessment by WST, biochemical parameters, such as total serum protein, serum albumin, hemoglobin levels and body composition. This trial was registered with the Chinese Clinical Trial Registry, identifier ChiCTR 2100054054.ResultsIn total, 173 participants completed the study between September 1, 2020, and April 30, 2021. Patients receiving individualized nutritional support showed a more significant improvement in the total effective rate of swallowing function (95.3% vs. 85.1%, P &lt; 0.05). After the intervention, the total serum protein level (0.97 ± 0.41 vs. −0.83 ± 0.47 g/L; P &lt; 0.05), serum albumin level (0.33 ± 0.28 vs. −1.39 ± 0.36 g/L; P &lt; 0.001) and lean tissue mass (0.13 ± 0.35 vs. −1.00 ± 0.40 g/L; P &lt; 0.05) increased in the intervention group. The decrease of hemoglobin levels in the control group was more evident (−6.17 ± 1.63 vs. −0.64 ± 1.40 g/L; 95%CI, −9.78 to −1.28; P = 0.001). The difference of phase angle between the two groups was statistically significant (5.93 ± 0.88° vs. 5.77 ± 0.78°; P = 0.035), but not in body fat mass.ConclusionsIn stroke patients with oropharyngeal dysphagia, the use of individualized nutritional support based on V-VST and intermittent oroesophageal tube feeding during the first week of hospitalization improved swallowing function and maintained nutritional status.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier: ChiCTR 2100054054.
Association of Dietary Energy Intake With Constipation Among Men and Women: Results From the National Health and Nutrition Examination Survey
Authors: Yang Shuai , Wu Xiao-Li , Wang Shou-Qing , Guo Xiang-Ling , Guo Fu-Zheng , Sun Xiao-Feng 
Published: April 2022

BackgroundPrevious studies supported that dietary factor was associated with constipation, but the relationship between dietary energy intake and constipation has not been well-studied. Therefore, we aimed to evaluate the prevalence and correlation between energy intake and constipation among men and women.MethodsThese observational analyses included 12,587 adults (≥20 years) from the 2005–2010 cycles of the National Health and Nutrition Examination Surveys (NHANES). Constipation was defined as Bristol Stool Scale Type 1 (separate hard lumps, like nuts) or Type 2 (sausage-like but lumpy). Total energy intake was obtained from the two 24-h dietary recalls and averaged. We used the logistic regression model in Generalized Linear Model (GLM) function, controlling demographic, lifestyle, and dietary factors, to estimate the association between energy intake and constipation among men and women.ResultsThe overall weighted incidence of constipation in this research was 7.4%, the incidence in women and men was 10.4 and 4.3%, respectively. After multivariable adjustment, middle energy consumption correlated with decreased risk of constipation in men (OR:0.5, 95% CI:0.29–0.84), and lower-middle energy intake increased the constipation risk in women (OR: 1.56, 95% CI: 1.15–2.13). High energy consumption was not associated with increased or decreased constipation risk.ConclusionsTo our knowledge, this is the first research to investigate the association between energy intake and constipation; the study demonstrates that appropriate energy consumption can help reduce the risk of constipation in men, and relatively low energy intake is associated with increased constipation risk in women.
De novo Creation and Assessment of a Prognostic Fat-Age-Inflammation Index “FAIN” in Patients With Cancer: A Multicenter Cohort Study
Authors: Yin Liangyu , Song Chunhua , Cui Jiuwei , Lin Xin , Li Na , Fan Yang , Zhang Ling , Liu Jie , Chong Feifei , Wang Chang , Liang Tingting , Liu Xiangliang , Deng Li , Yang Mei , Yu Jiami , Wang Xiaojie , Liu Xing , Yang Shoumei , Zuo Zheng , Yuan Kaitao , Yu Miao , Cong Minghua , Li Zengning , Weng Min , Yao Qinghua , Jia Pingping , Li Suyi , Guo Zengqing , Li Wei , Shi Hanping , Xu Hongxia 
Published: April 2022

Background and AimsMalnutrition is highly prevalent and is related to multiple impaired clinical outcomes in cancer patients. This study aimed to de novo create an objective, nutrition-related index specially for prognostic purposes in oncology populations.MethodsWe performed a multicenter cohort study including 14,134 cancer patients. The prognostic impact for each baseline characteristic was estimated by calculating Harrell's C-index. The optimal parameters reflecting the nutritional and inflammatory impact on patients' overall survival were selected to develop the fat-age-inflammation (FAIN) index. The associations of the FAIN with the nutritional status, physical performance, quality of life, short-term outcomes and mortality of patients were comprehensively evaluated. Independent external validation was performed to further assess the prognostic value of the FAIN.ResultsThe study enrolled 7,468 men and 6,666 women with a median age of 57 years and a median follow-up of 42 months. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)]. There were significant associations of the FAIN with the nutritional status, physical performance, quality of life and short-term outcomes. The FAIN also showed better discrimination performance than the Nutritional Risk Index, the Prognostic Nutritional Index and the Controlling Nutritional Status index (all P &lt; 0.05). In multivariable-adjusted models, the FAIN was independently associated with a reduced death hazard both as a continuous variable (HR = 0.57, 95%CI = 0.47–0.68) and per one standard deviation (HR = 0.83, 95%CI = 0.78–0.88). External validation in a multicenter lung cancer cohort (n = 227) further confirmed the prognostic value of the FAIN.ConclusionsThis study created and assessed the prognostic FAIN index, which might act as a feasible option to monitor the nutritional status and help develop intervention strategies to optimize the survival outcomes of cancer patients.
Pretreatment Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker in Unresectable or Metastatic Esophageal Cancer Patients With Anti-PD-1 Therapy
Authors: Gao Yiming , Zhang Zhibo , Li Yao , Chen Siyuan , Lu Jiangyue , Wu Liangliang , Ma Zhiqiang , Hu Yi , Zhang Guoqing 
Published: April 2022

BackgroundThe neutrophil-to-lymphocyte ratio (NLR) is an inflammatory index calculated by the absolute neutrophil count dividing the absolute lymphocyte count, and its prognostic role in esophageal cancer (EC) patients with anti-PD-1 therapy remains unclear.MethodsA total of 140 unresectable or metastatic EC patients receiving PD-1 inhibitor treatment were included from Jan 2016 to Mar 2020. Kaplan–Meier method and log-rank test were used for comparing overall survival (OS) and progression-free survival (PFS) between groups. Multivariate Cox analysis was performed to assess the prognostic value of NLR.ResultsThe cutoff value of NLR was set at 5, and the median follow-up time was 20.0 months. Patients with pretreatment NLR &lt;5 had higher ORR (46.7% vs. 12.1%; p &lt; 0.001) and DCR (85.0% vs. 69.7%; p = 0.047) than those with NLR ≥5. Kaplan–Meier curves showed that pretreatment NLR &lt;5 was associated with longer PFS (median: 10.0 vs. 3.5 months, p &lt; 0.0001) and OS (median: 22.3 vs. 4.9 months, p &lt; 0.0001). Multivariate analysis demonstrated that pretreatment NLR ≥5 independently and significantly increased the risk of disease progression (hazard ratio (HR), 1.77 (95% confidence interval (CI), 1.12–2.82); p = 0.015) and death (HR, 4.01 (95% CI, 2.28–7.06); p &lt; 0.001). Subgroup analysis showed that pretreatment NLR ≥5 was associated with poor efficacy and survival in most subsets.ConclusionsOur findings showed that pretreatment NLR was independently and significantly associated with the efficacy and prognosis of EC patients treated with PD-1 inhibitors. NLR could serve as a convenient and useful prognostic biomarker for EC patients with anti-PD-1 therapy.
Esophageal Mucoepidermoid Carcinoma: A Review of 58 Cases
Authors: Wang Xin , Chen Yu-ping , Chen Shao-bin 
Published: April 2022

BackgroundEsophageal mucoepidermoid carcinoma (EMEC) is a rare disease. The biological behavior and treatment of this malignancy are not well established.MethodsData from 58 patients with EMEC who underwent esophagectomy were retrospectively analyzed and compared with 5028 patients with esophageal squamous cell carcinoma (ESCC). Kaplan–Meier and multivariate Cox regression analyses were conducted to investigate the association between clinicopathological factors and survival.ResultsThe study cohort included 36 males and 22 females with a median age of 59 years (range, 40-78 years). Of the 47 patients who underwent preoperative esophagoscopic biopsy, only 1 patient was diagnosed with EMEC. EMEC was more often found in female patients (39.7% versus 25.8%, P=0.036) and patients with EMEC had a significantly lower rate of lymph node metastasis (25.0% versus 49.4%, P&lt;0.001) than patients with ESCC. After 1:1 propensity score matching, the 5-year overall survival rate of 55.2% for patients with EMEC was similar to that of 61.9% for patients with ESCC (P=0.399).ConclusionsEMEC is a rare disease that more often affects females and these patients has less lymph node metastasis than patients with ESCC. Preoperative esophagoscopic biopsy has difficulty obtaining an accurate pathological diagnosis for EMEC patients. The prognosis for EMEC is similar to that for ESCC.