bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventing nausea and vomiting after gynecological laparoscopic surgery by patient-controlled intravenous analgesia with a naloxone admixture: A randomized controlled trial
Authors: Yang Haihong , Gu Xuedong , Xu Meiling , Yang Guan , Rao Yunju , Gao Liang , Gong Gu , He Siyi 
Published: July 2022

Background:
Opioid-induced nausea and vomiting are common side effects of patient-controlled intravenous analgesia (PCIA). This study aimed to explore the inhibitory effect of a naloxone admixture on the incidence of sufentanil-induced postoperative nausea and vomiting (PONV).

Methods:
A total of 132 Uyghur American Society of Anesthesiologists I and II patients scheduled to undergo elective gynecological laparoscopic surgery were recruited; among these, 120 patients were enrolled and randomly allocated into 4 groups: patients receiving PCIA but no naloxone were included in the control group (group A); patients receiving PCIA with a low-dose naloxone admixture at 0.2 μg·kg−1·h−1 were included in group B; patients receiving PCIA with naloxone admixture at 0.4 μg·kg−1·h−1 were included in group C; patients receiving PCIA with naloxone admixture at 0.6 μg·kg−1·h−1 were included in group D. All patients were administered sufentanil at 0.04 kg−1·h−1, butorphanol at 2 kg−1·h−1, and dexmedetomidine at 0.08 kg−1·h−1 using a PCIA device within 2 days of surgery. The occurrence of nausea and vomiting, visual analogue scores for pain intensity, mean arterial pressure, heart rate, oxygen saturation, pruritus, lethargy, respiratory depression, etc, was recorded at 2, 8, 12, 24, and 48 hours postoperatively.

Results:
There was a significant difference in the PONV scores between the groups at 8, 12, and 24 hours after surgery (P < 0.01). At 8 and 12 hours, the score of group C/D was significantly lower than that of group A/B (P < 0.01). At 24 hours after surgery, the PONV score of group B/C/D was significantly lower than that of group A (P < 0.01). No significant difference was observed in the general data and visual analogue scores for postoperative pain between the 4 groups.

Conclusion:
Naloxone admixture administered at 0.4 to 0.6 μg·kg−1·h−1 can exert an effective inhibitory effect on the incidence and intensity of PONV in gynecological laparoscopic surgery.
Multi-population generalizability of a deep learning-based chest radiograph severity score for COVID-19
Authors: Li Matthew D. , Arun Nishanth T. , Aggarwal Mehak , Gupta Sharut , Singh Praveer , Little Brent P. , Mendoza Dexter P. , Corradi Gustavo C.A. , Takahashi Marcelo S. , Ferraciolli Suely F. , Succi Marc D. , Lang Min , Bizzo Bernardo C. , Dayan Ittai , Kitamura Felipe C. , Kalpathy-Cramer Jayashree 
Published: July 2022

To tune and test the generalizability of a deep learning-based model for assessment of COVID-19 lung disease severity on chest radiographs (CXRs) from different patient populations.
A published convolutional Siamese neural network-based model previously trained on hospitalized patients with COVID-19 was tuned using 250 outpatient CXRs. This model produces a quantitative measure of COVID-19 lung disease severity (pulmonary x-ray severity (PXS) score). The model was evaluated on CXRs from 4 test sets, including 3 from the United States (patients hospitalized at an academic medical center (N = 154), patients hospitalized at a community hospital (N = 113), and outpatients (N = 108)) and 1 from Brazil (patients at an academic medical center emergency department (N = 303)). Radiologists from both countries independently assigned reference standard CXR severity scores, which were correlated with the PXS scores as a measure of model performance (Pearson R). The Uniform Manifold Approximation and Projection (UMAP) technique was used to visualize the neural network results.
Tuning the deep learning model with outpatient data showed high model performance in 2 United States hospitalized patient datasets (R = 0.88 and R = 0.90, compared to baseline R = 0.86). Model performance was similar, though slightly lower, when tested on the United States outpatient and Brazil emergency department datasets (R = 0.86 and R = 0.85, respectively). UMAP showed that the model learned disease severity information that generalized across test sets.
A deep learning model that extracts a COVID-19 severity score on CXRs showed generalizable performance across multiple populations from 2 continents, including outpatients and hospitalized patients.
Posterior scleritis with choroidal detachments and periaortitis associated with IgG4-related disease: A case report
Authors: Mase Yoko , Kubo Akiko , Matsumoto Akane , Masuda Kosuke , Kadoya Masatoshi , Koizumi Kan , Sotozono Chie , Kondo Mineo 
Published: July 2022

Background:
IgG4-related diseases (IgG4-RDs) are known to disrupt the functioning of multiple organs and are usually associated with mass lesions. Periaortitis, an inflammation of the adventitia and tissues surrounding the aorta, is an example of an IgG4-RD. In ophthalmology, an enlargement of the lacrimal gland is a well-known IgG4-RD, and scleritis has also been reported to be an IgG4-RD although it is rare. We report our findings in a case with periaortitis and posterior scleritis that were present at the same time, and they responded well to systemic steroid therapy.

Patients concerns:
A 79-year-old man with dementia and Lewy bodies was referred to our hospital because of uveitis in both eyes that did not respond to topical steroid therapy.

Diagnosis:
We found anterior scleritis in the right eye and uveitis with shallow anterior chambers in both eyes. B-mode echography showed choroidal detachments (CDs) and a T sign in the right eye. The CDs were assumed to have progressed to the posterior scleritis which then caused the severe vision reduction. The patient was referred to the Internal Medicine Department because the systemic inflammatory disease was suspected due to the high levels of C-reactive protein (CRP) and the fast erythrocyte sedimentation rate. Systemic CT scans showed periaortitis only at the lumbar region. Because of the high levels of IgG4, the patient was diagnosed with IgG4-RD.

Interventions:
The patient received intravenous and oral steroid therapy. The first 125 mg of methylprednisolone (mPSL) for 3 days was intravenous, after which it was switched to oral prednisolone (PSL) therapy and the dosage was gradually reduced.

Outcomes:
The posterior scleritis and periaortitis responded well to the systemic steroid therapy. One year and a half after the onset of the disease, the patient is still taking 5 mg of PSL.

Conclusions:
Scleritis with multiple CDs and periaortitis were strongly suspected to be due to IgG4-RD although no definitive diagnosis was made by biopsy of the lesions. Clinicians should be aware that IgG4-RD should be considered as one of the causes of posterior scleritis.
Hemolytic anemia caused by an excessively kinked prosthetic graft after total arch replacement detected by 4-dimensional flow magnetic resonance imaging: A case report
Authors: Takei Yusuke , Shibasaki Ikuko , Suzuki Kohei , Miyazaki Shohei , Hirota Shotaro , Ohashi Hirotaka , Saito Shunsuke , Fukuda Hirotsugu 
Published: July 2022

Rationale:
Hemolytic anemia is a rare postoperative complication of aortic surgery, which may be caused by an excessively kinked graft that causes abnormal blood flow. It has been reported that 4-dimensional flow magnetic resonance imaging (4D flow MRI) can identify abnormal flow. Herein, we report the guidance of 4D flow MRI in performing the revision procedure for a patient with hemolytic anemia by evaluating abnormal blood flow based on this method.

Patient concerns:
A 70-year-old woman presented with dizziness and fatigue. She had undergone total arch replacement with a frozen elephant trunk 5 years prior. We diagnosed hemolytic anemia caused by a kinked graft after total arch replacement.

Diagnosis:
Although computed tomography findings revealed 3 lesions of the kinked graft at the ascending portion and cervical branches, 4D flow MRI findings showed that only the kinked graft at the ascending portion caused hemolytic anemia due to an elevated viscous energy loss around it.

Intervention:
We performed surgery to remove the kinked section instead of revision surgery consisting of total arch replacement.

Outcomes:
The patient’s postoperative course was uneventful and there were no complications. Postoperative enhanced computed tomography findings showed that the repaired graft had an adequate length and smoothly curved shape. The 4D flow MRI findings revealed smooth flow in the ascending portion and decreased viscous energy loss.

Lessons:
Based on the 4D flow MRI findings, we adopted a less invasive approach, repairing only the ascending portion of the graft, instead of performing revision surgery comprising total arch replacement.
Protein-bound polysaccharide K prolonged overall survival in gastric cancer patients from a non-Japanese Asian country who received gastrectomy and adjuvant chemotherapy
Authors: Wang Ting-Yao , Chen Chao-Yu , Huang Tzu-Hao , Yang Yao-Hsu , Chen Ko-Jung , Chou Wen-Chi , Lu Chang-Hsien 
Published: July 2022

Adding protein-bound polysaccharide K (PSK) to adjuvant chemotherapy with mitomycin and fluorouracil after gastrectomy for gastric cancer was demonstrated to improve survival in a previous study in Japan. However, the efficacy of PSK outside Japan and in combination with other adjuvant chemotherapeutic agents remains unclear. The aims of this study were to evaluate the efficacy of PSK.
We conducted a population-based historical cohort study using the National Health Insurance Research Database of Taiwan. We performed sensitivity analysis with propensity score matching to control for possible confounders. Patients who used PSK (PSK group) were matched at a 1:4 ratio to those who had never used PSK (control group) after adjusting for covariates including sex, age, urbanization, income and comorbidities. The primary outcome was overall survival. Multivariate hazard ratios from competing risk analysis were calculated by adjusting for demographic data and all confounding factors.
From 1999 to 2008, we identified 10,617 patients with gastric cancer received gastrectomy and adjuvant chemotherapy. 1295 patients used PSK (PSK group) and 5180 patients never used PSK (control group) were analyzed after propensity score matching. The median overall survival was 6.49 years (95% confidence interval [CI] 5.22–7.63) in the PSK group and 3.59 years (95% CI 3.38–3.80) in the control group. After adjusting for age, sex, urbanization, income, and comorbidities, adding PSK to adjuvant chemotherapy was the most significant prognostic factor for improved survival (hazard ratio 0.76, P < .0001).
Adjuvant chemotherapy combined with PSK significantly prolonged overall survival in gastric cancer patients after gastrectomy.
Long-term impact of certain coexisting extrahepatic unisystem and multisystem manifestations on trends in incidence of liver cirrhosis in treatment-naïve patients with chronic hepatitis C: A nested case-control study
Authors: Wang Chun-Hsiang , Ou Shih-Fang , Tseng Yuan-Tsung 
Published: July 2022

Diabetes mellitus (DM) was found to be more common in hepatitis C virus (HCV)-related cirrhotic males. However, the association between DM, or other extrahepatic manifestations (EHMs), and liver cirrhosis is still undetermined. We used a large-scale long-term study to analyze the cirrhosis risk of treatment-naïve HCV patients with EHMs as compared to those without.
In this retrospective nested case-control study, we identified 11 872 treatment-naïve patients with chronic HCV between 2001 and 2013 from Taiwan National Health Insurance Research Database and divided them into patients with (cases) and without cirrhosis (controls). All patients were followed up from the index month (exact month of diagnosis) to the end of 2013, death, or study outcome, whichever occurred first. The cases and controls were 1:6 propensity score matched for age, sex, and exact month of diagnosis; finally, 8078 patients (1154 with and 6924 without cirrhosis) were included in the analysis. The presence of coexisting EHMs and a new diagnosis of cirrhosis was analyzed. Adjusted hazard ratios (HRs) and cumulative incidence for cirrhosis were calculated in conditional Cox regression models after propensity score matching.
Patients with high-cirrhosis-risk EHMs, such as DM (HR: 1.72, 95% CI: 1.51–1.96, P < .001), HCD (HR: 1.45, 95% CI: 1.27–1.67, P < .007), CKD (HR: 1.21, 95% CI: 1.05–1.38, P < .001), hyperlipidemia (HR: 0.53, 95% CI: 0.46–0.60, P < .001), lichen planus (HR: 2.71, 95% CI: 1.56–4.72, P < .001), and palpable purpura (HR: 2.67, 95% CI: 2.13–3.35, P < .001) exhibited significantly higher risk of liver cirrhosis than those without. Cumulative incidence (P < .001) of liver cirrhosis by pairwise comparisons of multiple high-cirrhosis-risk EHMs, and that of lichen planus was the highest.
Our study provided direct estimates of specific HCV-associated EHM time trends of cirrhosis risk, with an upward trend in incidence. Lichen planus was at the top of the list of single-EHM comparisons, and the maximum combination of certain EHMs was the greatest risk factor across a different array of multi-EHM comparisons for liver cirrhosis development.
Association of AGTR1 gene methylation and its genetic variant in Chinese farmer with hypertension: A case-control study
Authors: Li Zhi-yuan , Ma Qiang , Li Xing , Yu Shui-yuan , Zuo Juan , Wang Chong-jian , Li Wen-jie , Ba Yue , Yu Fang-fang 
Published: July 2022

The objective was to determine the potential associations of the angiotensin II receptor type 1 (AGTR1) gene polymorphism, methylation, and lipid metabolism in Chinese farmers with hypertension.
A case-control study was conducted in Wuzhi county of Henan province in China in 2013 to 2014. A total of 1034 local residents (35–74 years, 386 hypertensive cases, and 648 normotensive subjects) were enrolled in this study. Triglyceride (TG), total cholesterol (TC), high-density lipoprotein, and low-density lipoprotein were measured using automatic chemistry analyzer. The AGTR1 gene promoter methylation level was measured using quantitative methylation-specific polymerase chain reaction method. The single nucleotide polymorphism rs275653 was genotyped with TaqMan probe assay at an applied biosystems platform.
The gender, body mass index (BMI), TG, TC, and family history of hypertension in the hypertension group were significantly higher than those in control group (P < .05). No significant difference was observed in the distribution of AGTR1 rs275653 polymorphism in the hypertension and controls (P > .05). The AGTR1 gene methylation in subjects carrying different genotypes was not significantly observed (P > .05). The logistic regression analysis found the AGTR1 gene methylation level was negative correlation with hypertension in the present study (odds ratio, 0.946, 95% confidence interval, 0.896–0.999) through adjusting for age, gender, BMI, education, smoking, alcohol drinking, fruit and vegetable intake, pickles intake, and family history of hypertension.
The association of AGTR1 gene hypomethylation and essential hypertension was observed in Chinese farmers; no significant difference was observed in the distribution of AGTR1 rs275653 polymorphism.
Malignant testicular tumors in children: A single institution’s 12-year experience
Authors: Chiu Chia-Chi , Jaing Tang-Her , Lai Jin-Yao , Chen Shih-Hsiang , Chang Tsung-Yen , Hsueh Chuen , Wen Yu-Chuan , Tsay Pei-Kwei 
Published: July 2022

Testicular neoplasms are not commonly found in children and are a formidable threat if treated inappropriately. However, there is no consensus regarding its management. This study aimed to create a holistic picture of the interprofessional team in the management of malignant testicular tumors.
Seventeen patients had mixed germ cell tumors, 15 had pure yolk sac tumors, 2 had immature teratomas, 2 had teratocarcinomas, and 1 had a sex cord stromal tumor. Five lesions were diagnosed as nongerm cell tumors: 2 embryonal rhabdomyosarcomas, 2 lymphomas, and 1 acute myeloid leukemia. At initial presentation, retroperitoneal (n = 2), bone marrow (n =1), and mediastinal (n = 1) metastases were identified in 4 (10%) patients. The operative interventions performed included radical inguinal orchiectomy (n = 5), scrotal orchiectomy (n = 31), and testicular biopsy or testis-sparing enucleation of the tumor (n = 6). Postoperatively, 18 patients received either adjuvant chemotherapy (n = 14) or chemoradiation (n = 5). Five patients with mixed germ cell tumors (n = 2), group IV paratesticular rhabdomyosarcoma (n = 2), and acute myeloid leukemia with myeloid sarcoma (n =1) died of disease progression. Thirty-six patients remained alive and disease-free at the last visit.
Malignant testicular tumors in children deserve proper diagnostic support from a therapeutic perspective. Any concern or suspicion of a testicular tumor warrants an inguinal approach to avoid scrotal violation.
Comparison of pain and psychosocial correlates among Hispanic and Non-Hispanic White youth with chronic pain
Authors: Goya Arce Ana B. , Richardson Patricia A. , Tran Susan T. , Bhandari Rashmi P. 
Published: July 2022

Abstract

Introduction:
Despite well-documented pain disparities among adults from non-White and Hispanic groups, less is known about pain disparities in non-White and Hispanic pediatric populations.

Objectives:
We compare pain and related psychosocial factors at the individual (pain intensity, pain interference, pain catastrophizing, co-occurring symptoms), social (peer relations), and systemic (health insurance) levels among Hispanic and Non-Hispanic White (NHW) youth with chronic pain.

Methods:
Eight hundred thirty-seven (71.4% female) Hispanic (n = 268, 32%) and NHW (n = 569, 68%) youth ages 8 to 17 years (M = 14.00; SD = 2.54) completed a survey at their initial visit to a pain clinic. Independent sample t tests investigated mean differences in psychosocial factors at the individual and social levels. Chi-squared tests investigated differences at the systemic level. Bivariate correlations for each group were compared using Fisher r-to-z transformations.

Results:.
Hispanic youth reported higher levels of pain intensity (t[811] = −2.75, P = 0.006). Groups did not differ in reports of other individual or social factors. Non-Hispanic White youth were more likely to have private insurance (OR, 5.66). All examined variables were significantly correlated among NHW youth. Correlations were weaker or nonsignificant among Hispanic youth. Fisher r-to-z transformations revealed these group differences to be significant.

Conclusion:
Hispanic youth report higher pain levels than NHW counterparts and lower likelihood of having private insurance. Pain and psychosocial factors correlate differently among the 2 groups highlighting a need to better understand the chronic pain experiences of diverse youth because models derived primarily from NHW populations may not generalize across ethnic and racial groups.
11C-Acetate PET/CT Detects Reactive Astrogliosis Helping Glioma Classification
Authors: Kim Dongwoo , Chun Joong Hyun , Yi Ju Hyeon , Ko Hae Young , Chung Jee-In , Lee Misu , Park Yongmin Mason , Nam Min-Ho , Kim Jisu , Kim Seon Yoo , Park Youngjoo , Moon Ju Hyung , Kang Seok-Gu , Chang Jong Hee , Lee C. Justin , Kim Se Hoon , Yun Mijin 
Published: July 2022

Purpose

11C-acetate (11C-ACE) uptake on PET/CT was recently discovered to represent reactive astrocytes in the tumor microenvironment. This study aimed at evaluating the role of 11C-ACE PET/CT as an imaging biomarker of reactive astrogliosis in characterizing different types of gliomas.

Methods
In this prospective study, a total of 182 patients underwent 11C-ACE PET/CT before surgery. The ratio of SUVmax of a glioma to the SUVmean of the contralateral choroid plexus (11C-ACE TCR) on PET/CT was calculated. 11C-ACE TCRs were compared with the World Health Organization grades and isocitrate dehydrogenase 1 (IDH1) mutation status. Grade 2 was considered low-grade tumor, and grades 3 and 4 were considered high-grade tumors.

Results
The median 11C-ACE TCR was significantly higher in IDH1 wild-type (wt) tumors (n = 91) than in IDH1-mutant (mt) tumors (n = 91) (2.38 vs 1.30, P < 0.001). Of the 91 IDH1-mt tumors, there were no differences in the median 11C-ACE TCRs between oligodendrogliomas (ODs) and astrocytic tumors (1.40 vs 1.20, P > 0.05). In grading low- versus high-grade gliomas, the receiver operating characteristic curve analyses showed a higher area under the curve (0.951) in IDH1-wt tumors than in IDH1-mt tumors (0.783, P = 0.002). Grade 2 ODs were well differentiated from high-grade gliomas. The 11C-ACE TCR of grade 3 ODs was significantly lower than that of IDH1-wt glioblastomas.

Conclusions
High 11C-ACE uptake is associated with high-grade IDH1-wt tumors, thus facilitating differentiation from high-grade IDH1-mt and low-grade gliomas. In particular, low 11C-ACE uptake in ODs is advantageous in overcoming the limitation of radiolabeled amino acid tracers.
Serous Cystadenoma of the Pancreas Showing Increased Uptake on 68Ga-FAPI PET/CT
Authors: Xu Weizhi , Zhao Long , Meng Tinghua , Shang Qihang , Chen Haojun 
Published: July 2022

Abstract
Serous cystadenoma of the pancreas is a type of pancreatic cystic neoplasm frequently found in clinical practice. Serous cystadenoma of the pancreas can have a varied morphological presentation on imaging examinations. Therefore, it is sometimes very challenging to differentiate serous cystadenoma of the pancreas from pancreatic malignancy. In this study, we present a case of serous cystadenoma of the pancreas showing focally elevated radiotracer uptake on 68Ga-FAPI PET/CT. Considering potential future clinical use of 68Ga-FAPI PET/CT in malignancy, awareness of the false-positive findings is important for the differential diagnosis and management of these lesions.
Machine Learning Risk Prediction Model of 90-day Mortality After Gastrectomy for Cancer
Authors: Pera Manuel , Gibert Joan , Gimeno Marta , Garsot Elisenda , Eizaguirre Emma , Miró Mónica , Castro Sandra , Miranda Coro , Reka Lorena , Leturio Saioa , González-Duaigües Marta , Codony Clara , Gobbini Yanina , Luna Alexis , Fernández–Ananín Sonia , Sarriugarte Aingeru , Olona Carles , Rodríguez-Santiago Joaquín , Osorio Javier , Grande Luis ,   on behalf of the Spanish EURECCA Esophagogastric Cancer Group
Published: July 2022

Objective:
To develop and validate a risk prediction model of 90-day mortality (90DM) using machine learning in a large multicenter cohort of patients undergoing gastric cancer resection with curative intent.

Background:
The 90DM rate after gastrectomy for cancer is a quality of care indicator in surgical oncology. There is a lack of well-validated instruments for personalized prognosis of gastric cancer.

Methods:
Consecutive patients with gastric adenocarcinoma who underwent potentially curative gastrectomy between 2014 and 2021 registered in the Spanish EURECCA Esophagogastric Cancer Registry database were included. The 90DM for all causes was the study outcome. Preoperative clinical characteristics were tested in four 90DM predictive models: Cross Validated Elastic regularized logistic regression method (cv-Enet), boosting linear regression (glmboost), random forest, and an ensemble model. Performance was evaluated using the area under the curve by 10-fold cross-validation.

Results:
A total of 3182 and 260 patients from 39 institutions in 6 regions were included in the development and validation cohorts, respectively. The 90DM rate was 5.6% and 6.2%, respectively. The random forest model showed the best discrimination capacity with a validated area under the curve of 0.844 [95% confidence interval (CI): 0.841–0.848] as compared with cv-Enet (0.796, 95% CI: 0.784–0.808), glmboost (0.797, 95% CI: 0.785–0.809), and ensemble model (0.847, 95% CI: 0.836–0.858) in the development cohort. Similar discriminative capacity was observed in the validation cohort.

Conclusions:
A robust clinical model for predicting the risk of 90DM after surgery of gastric cancer was developed. Its use may aid patients and surgeons in making informed decisions.