bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case for Genetic Testing in Isolated Tympanic Paragangliomas
Authors: Shrivastava Manu K. , Curran John F. , Sheerin Fintan , Mohammadi Bahram Jafar , Halliday Dorothy , MacKeith Samuel A. C. 
Published: July 2022

Objective
The aim of this study is to describe two clinical cases, which we believe highlight the need to consider routine genetic testing of all patients with new diagnosis of a tympanic paraganglioma (PGL).

Patients
Two patients seen in the ENT clinic at a tertiary center with a diagnosis of isolated tympanic PGL, without family history.

Intervention
Since 2016, all patients with newly diagnosed isolated tympanic PGL (glomus tympanicum) are offered review by the clinical genetic team and genetic testing of a panel of paraganglioma/phaeochromocytoma predisposition genes. Previously only those with multiple PGL or a family history were tested.

Main Outcome Measures
We describe the results of genetic testing, the clinical course and discuss the ongoing implications for management.

Results
Both cases were identified to have a pathogenic variant in the SDHB gene after initial surgery. The clinical course for both cases was complicated by disease recurrence, as well as metastatic and secretory disease in one case. Knowledge of genetic status has influenced ongoing management, with annual MRI surveillance for other SDH-related tumors.

Conclusion
These two cases reinforce the importance of offering genetic testing for all cases of isolated tympanic PGL. The discovery of a significant underlying genetic variant may affect management decisions and subsequent follow-up.
Audiometric Outcomes Comparing Endoscopic Versus Microscopic Ossiculoplasty
Authors: Sakai Mark , Killeen Daniel E. , Ma Connie , Newcomer Mark , Hunter Jacob B. , Isaacson Brandon , Kutz Joe Walter 
Published: July 2022

Objective
To assess endoscopic and microscopic ossiculoplasty audiometric outcomes.

Study Design
Retrospective review.

Setting
Tertiary academic center.

Patients
Adult patients who underwent ossiculoplasty with either partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) from 2010 to 2019 with at least 1 year of audiometric follow-up were included.

Interventions
Endoscopic or microscopic ossiculoplasty.

Main Outcome Measures
Postoperative air-bone gap (ABG) after at least 1 year.

Results
A total of 198 patients, 53.5% female, and a median age of 47.5 years, met inclusion criteria. 64.1% of patients were reconstructed with a PORP, and 31.8% were reconstructed using an endoscopic approach. The median audiometric follow-up was 27 months. The median postoperative ABG was 16.9 dB overall, 15.6 dB for PORP reconstruction, and 19.4 dB for TORP reconstruction (PORP versus TORP, p = 0.002). For TORP reconstructions, the median ABG for both endoscopic and microscopic TORP was 19.4 dB (p = 0.92). For PORP reconstructions, the median ABG for endoscopic PORP was 12.3 dB compared with 16.3 dB for microscopic PORP (p = 0.02). Using multivariate linear regression to predict postoperative PORP ABG, and controlling for age, prior ossiculoplasty, middle ear mucosal disease (granulation, fibrosis, polyposis), middle ear atelectasis, myringitis, contralateral middle ear disease, and use of byte prostheses, endoscopic PORP reconstruction was associated with improvement in ABG over the microscopic approach by 4.4 dB (p = 0.04).

Conclusions
For PORP ossiculoplasty procedures, endoscopic ossiculoplasty is associated with improved postoperative ABG compared with microscopic ossiculoplasty.
Association Between Tinnitus and Hypertension: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey
Authors: Patel Shrey D. , Patel Shiv , Finberg Ariel , Shah Viraj N. , Mittal Rahul , Eshraghi Adrien A. 
Published: July 2022

Objective
Evaluating the association between arterial hypertension and tinnitus while controlling for gender, race, diabetes, hearing loss, and depression as potential confounders.

Study Design
The present study employed a cross-sectional design.

Setting
Health interviews were conducted in the respondents’ homes.

Patients
Respondents represent a nationwide sample of the noninstitutionalized civilian population of the United States. A total of 5,735 adults were identified by the NHANES 2015 to 2016 questionnaires.

Interventions
Questionnaires were administered to each participant.

Main Outcome Measures
Participants’ responses regarding tinnitus, hypertension, hearing loss, depression, diabetes, and demographics were used to evaluate potential associations. Multivariate logistic regression analyses were conducted on different age groups with the presence of hypertension as the response variable.

Results
Participants aged 20 to 39 with tinnitus were significantly more likely to be diagnosed with hypertension (OR = 2.49; p = 0.024) after adjusting for potential confounding. No significant association between tinnitus and hypertension was found for older age groups. The diagnosis of diabetes was associated with hypertension in ages 20 to 39 (OR = 7.11; p = 0.001), 40 to 59 (OR = 3.45; p = 0.020), and 60 to 69 (OR = 3.89; p = 0.032).

Conclusions
Tinnitus is associated with hypertension in younger age groups of 20 to 39 years of age but not in age groups greater than 40 years. Diabetes is also associated with hypertension in individuals aged 20 to 69 years. This finding of tinnitus as a risk factor for hypertension in younger populations may inform better clinical practice and lead to earlier detection of hypertension in at-risk patients.
Development and Future Trends of Traditional Kampo Medicine in Japan
Authors: Shibata Risa , Chu Gui-Xiang , Lin Xun , Fu Jin-Rong 
Published: July 2022

Abstract
Traditional Kampo medicine is based on traditional Chinese medicine, which spread to Japan via the Korean Peninsula in the 5th century. The practice of Kampo developed gradually under the influence of local Japanese culture and prospered until the Meiji Restoration. Kampo appeared in schools successively, such as the School of Later Developments, the School of Classic Methods, the School of Textual Research, and the Integrated School. However, the practice of Kampo gradually declined after the Meiji Restoration. Today, through the continuous efforts of knowledgeable Japanese Kampo practitioners, the practice of Kampo has entered a new era as an indispensable aspect of contemporary Japanese medicine.
Edward H. Hume's Contributions to Introducing Chinese Medicine to the West
Authors: Gui Ting 
Published: July 2022

Abstract
Known as the founder of Xiangya School of Medicine and Xiangya Hospital, Edward H. Hume is frequently praised for his pioneering work in bringing Western medicine to China. Some researchers have investigated his efforts in introducing Chinese medicine to the West; less known is the role that he later played as a lecturer on medical history at Johns Hopkins University. This paper presents an exhaustive review of Hume's English writings on Chinese medicine, thus revealing what Hume did to introduce Chinese medicine to Western academia, and how he pioneered research into Chinese medicine from cultural and philosophical perspectives.
Survey of the History and Applications of Saffron
Authors: Asgari Motahareh , Yu Qun , Abdi Meghdad , Du Guang-Li , Shen Yun-Hui 
Published: July 2022

Abstract
Fan Hong Hua (李时珍 saffron) is a natural product that has long been used in food and dye industries and fortreating various disorders. Saffron has a long history of applications in traditional Chinese medicine, following its introduction to China in 1979. According to the theory of traditional Chinese medicine, saffron is sweet, slightly cold in nature and enters heart and liver meridians. Moreover, this spice can invigorate blood circulation, eliminate blood stasis, cool blood and eliminate heat toxins. Saffron has been used to treat asthma, phlegm, insomnia, Alzheimer's disease, depression, fright, shock, hemoptysis, heartburn, and pain. Among the almost 70 bioactive ingredients of saffron, major constituents of this herb include safranal, crocin, and crocetin, which are responsible for the unique taste and color of saffron. These ingredients have been investigated using modern pharmaceutical research methods as potential therapeutics to treat disorders such as Alzheimer's disease, cardiovascular diseases, cancer, digestive system disorders, ocular issues, and COVID-19 infections. However, focus and emphasis on understanding the pharmacological effects of saffron in treating diseases are required. This article briefly reviews the history, cultivation processes, different qualities properties, and traditional and modern applications of this unique herb.
Efficacy of Shugan Hewei Therapy for Chronic Atrophic Gastritis: A Systematic Review and Meta-Analysis
Authors: Niu Jing-Bin , Gai Xiao , Yang De-Cai , Zheng Yi-Xin , Cao Yang , Zhu Chun-Mei , Qian Peng , Yan Hai-Xia , Song Hua-Ling , Liu Guo-Ping 
Published: July 2022

Abstract

Objective:
Shugan Hewei therapy (SHT) acts to soothe the liver and harmonize the stomach. It is a classical traditional Chinese medicine method widely used in China to treat chronic atrophic gastritis (CAG) due to liver qi invading the stomach. However, the clinical effects of SHT remain unclear. We aimed to evaluate the overall clinical effective rate and safety of SHT in treating CAG.

Methods:
We used the Jadad scale and Cochrane Collaboration risk of bias tool to evaluate the methodological quality of studies investigating SHT. Eight medical databases were searched to identify relevant studies. After data extraction and quality evaluation, 27 randomized controlled trials, including 2,441 patients, were considered eligible for analysis. No serious heterogeneity or publication bias was observed across the included studies. We used Revman 5.3 statistical software to evaluate the general clinical effective rate and safety of SHT.

Results:
The results showed that SHT was more effective (RR=1.25; 95% CI [1.20, 1.29]; P<0.01) and safer (MD=0.24, 95% CI [0.08, 0.75]; P<0.01) than control interventions comprising western medicine, Chinese patent medicine, and/or western medicine + Chinese patent medicine. Compared with the control interventions, SHT resulted in greater improvements in the symptom scores for stomach distension and stomachache, serum gastrin level, histopathologic changes, Helicobacter pylori (HP) inhibition rate, and gastric mucosal inflammation.

Conclusion:
SHT was more effective and safer than control interventions for CAG.
Next-generation point-of-care testing in pediatric human immunodeficiency virus infection facilitates diagnosis and monitoring of treatment
Authors: Bengu Nomonde , Mchunu Noxolo , Mokhethi Sijabulile , Fillis Rowena , Cromhout Gabriela , Lobenstein Jeroen van , Graza Yeney , Kapongo Constant , Chinniah Kogielambal , Bhoola Roopesh , Adland Emily , Puertas Mari C. , Ndung’u Thumbi , Martinez-Picado Javier , Archary Moherndran , Goulder Philip J. R 
Published: July 2022

Point-of-care (PoC) testing facilitates early infant diagnosis (EID) and treatment initiation, which improves outcome. We present a field evaluation of a new PoC test (Cepheid Xpert® HIV-1 Qual XC RUO) to determine whether this test improves EID and assists the management of children living with human immunodeficiency virus (HIV) infection.
We compared 2 PoC tests with the standard-of-care (SoC) test used to detect HIV infection from dry blood spots in newborn infants at high risk of in utero infection. We also evaluated the ability of the PoC tests to detect HIV total nucleic acid (TNA) in children living with HIV infection who had maintained undetectable plasma viremia following very early combination antiretroviral therapy (cART) initiation.
Qualitative (Qual) detection of HIV using the Xpert® HIV-1 Qual XC RUO (“RUO”) and Xpert® HIV-1 Qual (“Qual”) PoC tests was compared in 224 infants with the SoC DBS Roche COBAS® HIV-1/HIV-2 qualitative test. The same 2 PoC tests were also evaluated in 35 older children who had initiated cART before 21 days of age and maintained undetectable plasma viremia for a mean of 25 months.
No discrepancies were observed in detection of HIV infection via the 2 PoC tests or the SoC test in the 224 neonates studied, but only 95% of the SoC test results were generated compared with 100% of the PoC test results (P = .0009). The cycle threshold values for the research use only (RUO) assay were the lowest of the 3 assays (P < .0001 in each case). In 6 of the 35 early-treated aviremic children, HIV TNA was detected by RUO but not Qual.
The RUO assay outperforms Qual in detecting HIV-1 infection. RUO would therefore potentially improve EID and assist in identifying cART-adherent early-treated children with the lowest HIV TNA levels and the highest HIV cure potential.
Persistent corneal blood staining after microhook trabeculotomy: A case report
Authors: Aoki Ryota , Nakakura Shunsuke 
Published: July 2022

Introduction:
Hyphema, that is, massive anterior chamber hemorrhage, is one of the major complications after a recent minimally invasive glaucoma surgery. Hyphema along with high intraocular pressure increases the risk of corneal bloodstaining.

Patient Concerns:
A 71-year-old female was receiving 0.1% fluorometholone drops in both eyes for severe dry eye. She was also receiving antiplatelet agents for platelet aggregation hyperactivity and prednisolone for interstitial pneumonia internally. Her right eye was suffering from increased intraocular pressure.

Diagnosis:
We diagnosed her right eye as steroid-induced glaucoma.

Interventions:
We performed microhook trabeculotomy.

Outcomes:
At postoperative day 10, she had total anterior chamber hemorrhage and high intraocular pressure, and subsequently developed corneal blood staining at postoperative day 15, for which we performed anterior chamber cleaning. After that, we did not perform additional anterior chamber cleaning, and during the 1-year follow-up, a gradual improvement was noted in the entire cornea with reddish-brown opacity, from the periphery to the center. However, almost the entire pupil was still covered with opacity, and her visual acuity was at the light perception at the final visit.

Lessons:
Corneal bloodstaining takes a considerable time to resolve and causes severe vision loss. Special attention should be given to persistent corneal blood staining when hyphema and high intraocular pressure are observed after minimally invasive glaucoma surgeries.
Diagnosis of keratoconus in a young male by electrophysiological test findings: A case report
Authors: Yan Weiming , Chen Yanjin , Chen Xiaohong , Ye Qian , Wang Yutong , Jiang Chuan , Zheng Xiangrong , Wang Yunpeng , Chen Meizhu 
Published: July 2022

Rationale:
The purpose of this report was to describe the diagnostic process of a case of keratoconus (KCN) after electrophysiological examination.

Patient concerns:
A 23-year-old male army officer presented with decreased visual acuity (VA) in the left eye for 5 months. Best-corrected VA was 20/20 in the right eye and 20/300 in the left eye. The cornea and lens were clear in both eyes with a normal anterior chamber. No specific abnormalities were found on fundus photography, optical coherence tomography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), or full-field electroretinography (ffERG) of both eyes. Pattern visual-evoked potentials (PVEP) detected a reduced amplitude and delayed peak time of the P100-wave in both eyes, which was more severe in the left eye. The amplitude and peak time of the P2-wave in flash VEP (FVEP) were comparable in both eyes and were within the normal ranges.

Diagnosis:
Corneal topography was performed, and KCN was diagnosed by the presence of an asymmetrical bowtie pattern in both eyes, which was worse in the left eye.

Interventions:
Transepithelial corneal collagen cross-linking was performed.

Outcomes:
The BCVA of both eyes remained stable after treatment at follow-up.

Lessons:
KCN should be suspected in cases of unimproved VA and significant irregular stigmatism, while no obvious lesions exist in other parts of the eyes. The evidence of lesion location by electrophysiological examinations could sometimes be of favor in diagnosing KCN.
The association between amniotic fluid-derived inflammatory mediators and the risk of retinopathy of prematurity
Authors: Jang Ji Hye , Kim Jae-Gon , Lee Yu Hyun , Bae Jin Gon , Park Jae Hyun 
Published: July 2022

Prenatal and perinatal infections and inflammation appear to associated with the development of retinopathy of prematurity (ROP). In this study, we evaluated whether inflammatory mediators in amniotic fluid (AF) retrieved during cesarean delivery influence the development of ROP in very low birth weight (VLBW) infants.
This retrospective study included 16 and 32 VLBW infants who did and did not develop any stage of ROP, respectively. Each infant with ROP was matched with 2 infants without ROP based on days of ventilation care, gestational age, and birth weight. AF was obtained during cesarean delivery, and the levels of intra-amniotic inflammatory mediators such as interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, matrix metalloproteinase (MMP)-2, MMP-8, MMP-9, and tumor necrosis factor (TNF)-α were measured using a Human Magnetic Luminex assay (R&D Systems, Minneapolis, MN). The differences in the levels of inflammatory mediators according to the presence or absence of ROP were compared.
In patients who developed ROP, the level of MMP-2 in the AF was significantly increased (P = .011), whereas the levels of IL-10 and TNF-α were significantly decreased (P = .028 and .046, respectively) compared with those in infants who did not develop ROP. The levels of the other mediators were not significantly different between the 2 groups. Multivariate regression analysis showed that MMP-2 was a risk factor for the development of ROP (odds ratio, 2.445; 95% confidence interval, 1.170-5.106; P = .017).
The concentration of MMP-2 in AF is an independent factor in the development of ROP. Further studies are needed to determine whether the levels of inflammatory mediators in AF affect the ROP severity.
Intraocular lens power calculation after radical keratotomy and photorefractive keratectomy: A case report
Authors: Xiong Tianxu , Mu Jiancheng , Chen Hao , Fan Wei 
Published: July 2022

Rationale:
To report a rare case of calculating the IOL power in a cataract patient who underwent both radial keratotomy (RK) and photorefractive keratectomy (PRK).

Patient concerns:
A 48-year-old woman underwent bilateral RK at age 22 and bilateral PRK at age 46. She developed bilateral corneal haze and corneal endothelial inflammation and received steroids therapy for long time after PRK. Then she was referred to our hospital due to decreased vision in the both eyes.

Diagnoses:
The patient was diagnosed with binocular complicated cataract, corneal haze, high myopia and post corneal refractive surgery (RK and PRK).

Interventions:
The patient underwent bilateral phacoemulsification. The IOL power was calculated using SRK/T formula for RK and Haigis-L formula for PRK, respectively. We finally selected the Haigis-L formula and the intraocular lens (SN60WF) was implanted within the capsular bag.

Outcomes:
After the surgery, both eyes showed myopia drift, and the right eye continuously fluctuated in refractive results. However, by nearly 1 year later, refractive results in both eyes had stabilized, and no other complications had occurred.

Lessons:
IOL power in patients who undergo both RK and PRK can be reliably calculated using the Shammas-PL, Average of multiple formulas, or Barret True-K No History formulas. Haigis-L formula is not suitable. Such patients require at least three months after surgery to attain refractive stability in both eyes.
Surgical strategy for metastatic spinal tumor patients with surgically challenging situation
Authors: Shin Hong Kyung , Kim Myeongjong , Lee Subum , Lee Jung Jae , Park Danbi , Jeon Sang Ryong , Roh Sung Woo , Park Jin Hoon 
Published: July 2022

The incidence of spinal metastasis is increasing as cancer patients live longer owing to the improvement of cancer treatments. However, traditional surgery (TS) which fixates at least 2 levels above and 2 levels below the affected vertebrae is sometimes difficult to perform as it is burdensome to the patients. In this article, we introduce our experience and strategy in treating spinal metastasis, focusing particularly on challenging cases.
We retrospectively reviewed the data of 110 patients who underwent spinal surgery for metastatic spinal tumors from April 2018 to March 2020. Among them, 5 patients who received anterior approach surgery were excluded. The remaining 105 patients were enrolled. In addition to TS, we also performed cervical pedicle screw, cervicothoracic junction fixation, thoracolumbar short fixation, and decompression surgery, depending on the characteristics of the tumor. The overall survival was analyzed, and the local tumor control rate was evaluated using magnetic resonance imaging. Perioperative clinical characteristics including Spine Oncology Study Group Outcomes Questionnaire, visual analog scale, Eastern Cooperative Oncology Group performance score, and Karnofsky Performance Score were also investigated.
The overall survival rate was 57.9% at 1 year, and the local tumor control rate was 81.1% after surgery. There was a statistically significant difference according to the type of the tumor in the survival analysis: the overall survival rates were 72.7% for favorable tumors and 48.6% for unfavorable tumors at 12 months after surgery (P = .04). Spine Oncology Study Group Outcomes Questionnaire, visual analog scale, Eastern Cooperative Oncology Group performance score, and Karnofsky Performance Score was improved after surgery. All surgical methods, including TS, cervical pedicle screw, cervicothoracic junction fixation, thoracolumbar short fixation, and decompression surgery, showed good clinical and radiological outcomes.
Optimized surgical methods show similarly good clinical outcomes in managing spinal metastasis as TS.
Usefulness of monocyte distribution width and presepsin for early assessment of disease severity in COVID-19 patients
Authors: Kim Sei Won , Lee Heayon , Lee Sang Haak , Jo Sung Jin , Lee Jehoon , Lim Jihyang 
Published: July 2022

Early predictors of severe coronavirus disease 2019 (COVID-19) would identify patients requiring intensive care. Recently, the monocyte distribution width (MDW) and presepsin level have been used for the early diagnosis of sepsis. Here, we assessed the utility of MDW and presepsin for the early assessment of COVID-19 severity.
Eighty-seven inpatients with confirmed COVID-19 were enrolled and divided into 3 groups by the type of respiratory support: (1) mechanical ventilation or high-flow nasal cannula oxygen therapy (MVHF-OT), (2) conventional oxygen therapy, and (3) no oxygen therapy. We measured the complete blood count; MDW; erythrocyte sedimentation rate; and the levels of presepsin, C-reactive protein, procalcitonin, lactate dehydrogenase, ferritin, Krebs von den Lungen-6 (KL-6), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibody.
Thirteen (14.9%) patients on MVHF-OT exhibited a significantly higher mortality and a longer hospital stay than did the others. The MDW and presepsin levels were significantly elevated on admission, and correlated with COVID-19 severity (both P < .001). Notably, only the MDW correlated significantly with symptoms in the no oxygen therapy group (P < .012). In the first week after admission, the MDW fell and no longer differed among the groups. The KL-6 level did not differ by disease severity at any time. Neutralizing antibodies were detected in 74 patients (91.4%) and the level of neutralization correlated significantly with COVID-19 severity (P < .001).
The MDW and presepsin are useful indicators for early assessment of disease severity in COVID-19 patients.