bluuebunny/crossref_metadata_2025 huggingface dataset:
Developmental Disabilities in the Context of Fragile Families: Racial and Ethnic Disparities at Age Nine
Authors: Lopez Kristina , Oh Hyunsung
Published: September 2021

Racial–ethnic disparities in the diagnosis of certain developmental disabilities (DDs), such as autism spectrum disorder (ASD), contribute to delayed treatment for Latinx children. Although recent data suggest the disparities are mitigated over time, Latinx children are still less likely to have an ASD diagnosis, and those from low-income families are disproportionately affected. To build on previous research emphasizing these racial–ethnic disparities, this study focused on families in vulnerable or underserved communities, including female-headed and low-income households. Multiple waves of the Fragile Families and Child Wellbeing Study were analyzed, so that this sample represents populations mainly served by social workers. After controlling for demographic and socioeconomic factors, and behavioral health symptoms, authors estimated the likelihood of receiving a diagnosis for a particular developmental disorder and overall DDs. Compared with children of non-Latina White mothers, children of Latina mothers were less likely to have an ASD diagnosis. Findings confirm the lingering racial–ethnic gaps in diagnoses, even among female-headed households and low-income families. Further, authors suggest interventions addressing systematic and cultural barriers for equitable diagnosis of DDs that target pediatricians and other behavioral health providers, teachers, and Latinx families and communities.
Natural disaster warning system for safe operation of a high-speed railway
Authors: Qizhou Hu , Xin Fang , Lishuang Bian
Published: September 2021

In this paper, the least square support vector machine (LSSVM) is used to study the safety of a high-speed railway. According to the principle of LSSVM regression prediction, the parameters of the LSSVM are optimized to model the natural disaster early warning of safe operation of a high-speed railway, and the management measures and methods of high-speed railway safety operation under natural disasters are given. The relevant statistical data of China's high-speed railway are used for training and verification. The experimental results show that the LSSVM can well reflect the nonlinear relationship between the accident rate and the influencing factors, with high simulation accuracy and strong generalization ability, and can effectively predict the natural disasters in the safe operation of a high-speed railway. Moreover, the early warning system can improve the ability of safety operation evaluation and early warning of high-speed railway under natural disasters, realize the development goals of high-speed railway (safety, speed, economic, low-carbon and environmental protection) and provide a theoretical basis and technical support for improving the safety of a high-speed railway.
Persistent Opioid Use After Spine Surgery
Authors: Uhrbrand Peter , Helmig Peter , Haroutounian Simon , Vistisen Simon Tilma , Nikolajsen Lone
Published: September 2021

Study Design.

Single-center, investigator-initiated, prospective cohort study.

Objective.

This study aimed to determine patient-reported reasons for persistent opioid use following elective spine surgery, assess the frequency of withdrawal symptoms, and characterize pain-related care sought after discharge.

Summary of Background Data.

Patients are often prescribed opioids at discharge from hospital following surgery. Several studies have shown that a large number of patients fail to discontinue opioid treatment and use opioids even months to years after surgery. Spine surgery has proven to be a high-risk procedure in regard to persistent opioid use. There is, however, limited evidence on why patients continue to take opioids.

Methods.

Three hundred patients, scheduled to undergo spine surgery at Aarhus University Hospital, Denmark, were included. Baseline characteristics and discharge data on opioid consumption were collected. Data on opioid consumption, patient-reported reasons for opioid use, withdrawal symptoms, and pain-related care sought were collected at 3- and 6-month follow-up via a REDCap survey.

Results.

Before surgery, opioid use was reported in 53% of patients. Three months after surgery, opioid use was reported in 60% of preoperative opioid-users and in 9% of preoperative opioid non-users. Patients reported the following reasons for postoperative opioid use: treatment of surgery-related pain (53%), treatment of surgery-related pain combined with other reasons (37%), and reasons not related to spine surgery (10%). Withdrawal symptoms were experienced by 33% of patients during the first 3 months after surgery and were associated with failure to discontinue opioid treatment (P < 0.001). Half of patients (52%) contacted health care after discharge with pain-related topics the first 3 months.

Conclusion.

Patients use opioids after spine surgery for reasons other than surgery-related pain. Withdrawal symptoms are frequent even though patients are given tapering plans at discharge. Further studies should address how to facilitate successful and safe opioid tapering in patients undergoing spine surgery.

Level of Evidence: 3
A 3D-printed Personalized, Combined, Modular Pedicle Subtraction Osteotomy Guide Plate System
Authors: Xin Xin , Wang Fumin , Liu Xinxin
Published: September 2021

Study Design.

Experimental study.

Objectives.

The goal of this study was to develop a threedimensional (3D)-printed pedicle subtraction osteotomy (PSO) guide plate system. A 3D model and postoperative computed tomography (CT) data were used to evaluate the accuracy of osteotomy with this system.

Summary of Background Data.

The key to the success of spinal orthopedic treatment is an effectively performed osteotomy. A 3D-printed osteotomy plate can be used for preoperative surgical planning. Due to the anatomical complexity of the spinal region, the clinical application of 3D-printed osteotomy plates remains challenging.

Methods.

The CT scans of 10 patients with thoracolumbar spinal deformities were obtained in the digital imaging and communication in medicine (DICOM) format. The diseased vertebrae and adjacent vertebrae were reconstructed and reduced by computer- aided design software, and an osteotomy plate was designed for the diseased vertebrae. The 3D-printed spinal model and osteotomy plate were used to simulate the operation for PSO. After the operation, the vertebral body treated by osteotomy underwent a CT scan, and the findings were compared with the preoperative design to evaluate the osteotomy accuracy.

Results.

The new 3D guide plate and spine model were used to successfully simulate 10 cases of PSO, and the comparison of the preoperative and postoperative states indicated that the osteotomy outcomes were excellent.

Conclusions.

The new 3D-printed PSO guide plate system can be used for preoperative osteotomy planning and demonstrates good accuracy. The results can be used to develop 3D-printed plans for PSO in clinical practice.
Isthmic Spondylolisthesis is Associated with Less Revisions for Adjacent Segment Disease After Lumbar Spine Fusion Than Degenerative Spinal Conditions
Authors: Toivonen Leevi A. , Mäntymäki Heikki , Häkkinen Arja , Kautiainen Hannu , Neva Marko H.
Published: September 2021

Study Design.

Prospective, follow-up study.

Objective.

We aim to compare the rate of revisions for ASD after LSF surgery between patients with IS and DLSD.

Summary of Background Data.

ASD is a major reason for late reoperations after LSF surgery. Several risk factors are linked to the progression of ASD, but the understanding of the underlying mechanisms is imperfect. If IS infrequently becomes complicated with ASD, it would emphasize the role of the ongoing degenerative process in spine in the development of ASD.

Methods.

365 consecutive patients that underwent elective LSF surgery were followed up for an average of 9.7 years. Surgical indications were classified into 1) IS (n = 64), 2) DLSD (spinal stenosis with or without spondylolisthesis) (n = 222), and 3) other reasons (deformities, postoperative conditions after decompression surgery, posttraumatic conditions) (n = 79). All spinal reoperations were collected from hospital records. Rates of revisions for ASD were determined using Kaplan–Meier methods.

Results.

Altogether, 65 (17.8%) patients were reoperated for ASD. The incidences of revisions for ASD in subgroups were 1) 4.8% (95% CI: 1.6%–22.1%); 2) 20.5% (95% CI: 15.6%–26.7%); 3) 20.6% (95% CI: 12.9%–31.9%). After adjusting the groups by age, sex, fusion length, and the level of the caudal end of fusion, when comparing with IS group, the other groups had significantly higher hazard ratios (HR) for the revision for ASD [2) HR (95% CI) 3.92 (1.10–13.96), P = 0.035], [3) HR (95% CI) of 4.27 (1.11–15.54), P = 0.036].

Conclusion.

Among patients with IS, the incidence of revisions for ASD was less than a 4th of that with DLSD. Efforts to prevent the acceleration of the degenerative process at the adjacent level of fusion are most important with DLSD.

Level of Evidence: 3
Comparison of Mid- to Long-term Follow-up of Patient-reported Outcomes Measures After Single-level Lumbar Total Disc Arthroplasty, Multi-level Lumbar Total Disc Arthroplasty, and the Lumbar Hybrid Procedure for the Treatment of Degenerative Disc Disease
Authors: Scott-Young Matthew , Lee So Mang (Simon) , Nielsen David , Rathbone Evelyne , Rackham Matthew , Hing Wayne
Published: September 2021

Study Design.

Prospective cohort study.

Objective.

The aim of this article is to compare the mid- to long-term patient-reported outcome measures (PROMs) between single-level total disc arthroplasty (TDA), multi-level TDA, and hybrid constructs (combination of TDA and anterior lumbar interbody fusion [ALIF] across multiple levels) for symptomatic degenerative disc disease (DDD).

Summary of Background Data.

The treatment of single-level DDD is well documented using TDA. However, there is still a paucity of published evidence regarding long-term outcomes on multi-level TDA and hybrid constructs for the treatment of multi-level DDD, as well as lack of long-term comparisons regarding treatment of single-level DDD and multi-level DDD.

Methods.

A total of 950 patients underwent surgery for single-level or multi-level DDD between July 1998 and February 2012 with single-level TDA (n = 211), multi-level TDA (n = 122), or hybrid construct (n = 617). Visual Analog Score for the back (VAS-B) and leg (VAS-L) were recorded, along with the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ).

Results.

All PROMs in all groups showed statistically and clinically significant improvements (P < 0.005) in pain and function that is well above the corresponding minimum clinically important difference (MCID) and exceeds literature thresholds for substantial clinical benefit (SCB). Unadjusted analyses show that there were no statistically significant differences in the change scores between the surgery groups for VAS back and leg pain, and RMDQ up to 8 years’ follow-up. Adjusted analyses showed the ODI improvement score for the single group was 2.2 points better (95% confidence interval [CI]: 0.6–3.9, P = 0.009) than in the hybrid group. The RMDQ change score was better in the hybrid group than in the multi-level group by 1.1 points (95% CI: 0.4–1.9, P = 0.003) at 6 months and a further 0.4 point at 2 years (95% CI: 0.1–0.8, P = 0.011).

Conclusion.

In the setting of meticulous preoperative evaluation in establishing a precision diagnosis, clinically and statistically equivalent results can be achieved when treating symptomatic DDD through single-level TDA, multi-level TDA, and hybrid constructs. These results are sustained at mid- to long-term follow-up.

Level of Evidence: 3
Do Women Need Androgens Like a Fish Needs a Bicycle? A Review of the Literature and Clinical Guidelines
Authors: Santoro Nanette , Wierman Margaret E.
Published: September 2021

Biopotent androgens such as testosterone circulate in low levels in women. However, androgen precursors, such as dehyroepiandrosterone, are among the most abundant hormones produced in both men and women. While testosterone exerts obvious phenotypic effects in men and is essential for male sexual function, considerable debate and controversy abounds over the role of androgens in women and whether androgens exert an analogous role in women as they do in men. This piece reviews androgen economy in women and the clinical case for and against androgen treatment for women for specific indications.
The mTOR Inhibitor Temsirolimus Added to Rituximab Combined With Dexamethasone, Cytarabine, and Cisplatinum (R-DHAP) for the Treatment of Patients With Relapsed or Refractory DLBCL – Results From the Phase-II STORM Trial
Authors: Witzens-Harig Mathias , Viardot Andreas , Keller Ulrich , Wosniok Julia , Deuster Oliver , Klemmer Jennifer , Geueke Anne-Marie , Meißner Julia , Ho Anthony D. , Atta Johannes , Marks Reinhard , La Rosée Paul , Buske Christian , Dreyling Martin H. , Hess Georg
Published: September 2021

There is a high need for novel treatment options in relapsed and refractory diffuse large B-cell lymphoma. Single agent mammalian target of rapamycin (mTOR) inhibitor treatment has shown promising efficacy in this entity. Here, we report on the results of the mTOR-inhibitor temsirolimus combined to standard rituximab-DHAP salvage regimen in a prospective, multicenter, phase II, open-label study. The STORM regimen consisted of rituximab 375 mg/m2 (day 2) and DHAP (dexamethasone 40 mg day 3-6, cisplatinum 100 mg/m2 day 3, cytarabine 2 × 2  g/m2 day 4) with temsirolimus added on day 1 and 8 of a 21-day cycle, with 2 to 4 cycles planned. In part I, dose levels of 25, 50, 75, and 100 mg for temsirolimus were predefined. Based on the observed toxicity profile, a temsirolimus dose of 25 mg was defined as recommended dose for the part II extension cohort of the trial. The intention-to-treat cohort comprised 53 patients. Median age was 63 years and median number of prior regimen was 1. All but 1 patient had prior rituximab exposure. Temsirolimus dose was 50 mg on day 1 and 8 in 6 patients from the part I of the trial and 25 mg in the remaining 47 patients. In general, treatment was well tolerated with leucopenia and thrombocytopenia as most frequent severe adverse events. The overall response rate after the last cycle of temsirolimus R-DHAP was 66% with 24% complete responses. The ability to mobilize stem cells was not impaired by the treatment regimen. Twenty-eight patients received consolidation treatment with high-dose therapy (HDT) and stem cell transplantation. Median duration of response was not reached. The total 2-year progression-free survival (PFS) and overall survival (OS) were 53% and 59%. Patients who were consolidated with HDT achieved a 2-year PFS and a 2-year OS of 77.8% and 82.1%, respectively. We conclude that temsirolimus can be safely added to rituximab and DHAP with promising activity.
The 100 Most Mentioned Glaucoma Articles Online With Highest Altmetric Attention Scores
Authors: Chien Jason L. , Sabharwal Jasdeep , Namoglu Esin C. , Ghassibi Mark P. , Yuan Melissa , Gandy Christiana , Wei Chapman , Somohano Karina , Engelhard Stephanie B. , Petrakos Paul , Van Tassel Sarah H. , Chien Gwo-Farn , Belyea David A.
Published: September 2021

Précis:

Characteristics of the most mentioned glaucoma articles on the internet were analyzed, allowing a better understanding of the dissemination of glaucoma research to the general public.

Purpose:

The aim was to determine the 100 most mentioned articles on the internet in the field of glaucoma and analyze their characteristics.

Materials and Methods:

We identified the top 100 glaucoma articles with the highest Altmetric Attention Score (AAS), an automatically calculated metric for monitoring social media. Each article was evaluated for several characteristics including year of publication, title, journal name, journal impact factor (IF), article topic, article type, affiliation, and online mentions (news, blog, policy, Twitter, Facebook, etc.). Correlation analysis was conducted for AAS with these characteristics.

Results:

The selected 100 articles came from 44 journals with more than half (56%) published in ophthalmology-specific journals. There was no significant correlation between IF and number of articles in a specific journal or AAS (P>0.1), but the number of articles in the top 100 was higher for ophthalmology journals with a higher IF (P<0.05). Original study was the most common study type (87%), of which clinical observation study was the most common subgroup (40%). Epidemiology/risk factor and basic science were the most common article topics (each 24%), followed by medical treatment (13%). Article topics regarding medical treatment had a significantly greater AAS than other topics (P<0.05). Of the top 5 articles, more than half (60%) were related to “Lifestyle choice” topics.

Conclusions:

There was no association between journal IF and AAS, consistent with previous studies. 90% of journals that had articles in the top 100 had a Twitter page. “Lifestyle choice” activities and other modifiable risk factors attracted significant online attention regarding glaucoma studies, with two of the top three most mentioned articles related to dietary intake. The present study thus provides a better understanding of online engagement with glaucoma research and the dissemination of this research to the general public.
The Effect of Adding Memantine to Clonidine in Reducing Withdrawal Symptoms in Opioid-Dependent Patients
Authors: Kheirabadi Gholamreza , Najafian Narges , Khodadadi Farinaz
Published: September 2021

Objective

Addiction is a complex condition and a brain disease manifested by compulsive substance use despite its harmful consequence. Addicted individuals have an intense focus on using substances. This study aimed to investigate the effect of adding memantine to clonidine and buprenorphine in reducing withdrawal symptoms, compared with placebo, in drug-dependent patients (opium and heroin).

Materials and Methods

In this double-blind, randomized clinical trial study, 60 patients using opium or heroin were assigned to the intervention (n = 30) and control (n = 30) groups. Both groups were treated with buprenorphine and clonidine at the same dose in the detoxification process. The intervention group received memantine 10 mg daily for 10 days and then 20 mg daily for 21 days, and the control group received a placebo prepared in the same shape and size as memantine tablets. The severity of withdrawal symptoms was measured using the Short Opioid Withdrawal Scale over 3 weeks. Data analysis was performed using SPSS and descriptive and inferential tests.

Results

The results showed that despite memantine's superiority in controlling some withdrawal symptoms such as feeling sick, stomach pain, muscle spasm, and feeling cold, no significant difference was found between the 2 groups. There was also no statistically significant difference between the 2 groups in the total score of symptoms.

Conclusions

No specific advantage of memantine was found for reducing the symptoms of withdrawal syndrome in the present study. However, this drug was well tolerated without any evidence of serious or significant adverse effects.
Factors Associated With Work-Life Balance and Productivity Before and During Work From Home
Authors: Tejero Lourdes Marie S. , Seva Rosemary R. , Fadrilan-Camacho Vivien Fe F.
Published: September 2021

Objectives:

Considering the prevailing work from home (WFH) arrangement globally due to COVID-19, this paper aims to compare job-related and psychosocial factors before and during WFH setup; and to determine the relationship of these factors to work-life balance (WLB) and productivity.

Methods:

A total 503 employees from 46 institutions answered the online questionnaire, 318 of whom met the inclusion criteria. Pairedttest and structural equation modeling (SEM) with multigroup analysis were used for the statistical analyses.

Results:

Psychological detachment (PD), sleep, stress, social support (SS), WLB, and productivity declined during WFH. SEM showed that PD significantly influenced stress and sleep, subsequently affecting productivity. SS significantly helped the participants maintain WLB.

Conclusion:

The key to increasing productivity and WLB during WFH is to foster PD and SS among employees.
Introducing clinical pharmacy specialists into interprofessional primary care teams
Authors: McCullough Megan B. , Zogas Anna , Gillespie Chris , Kleinberg Felicia , Reisman Joel I. , Ndiwane Ndindam , Tran Michael H. , Ourth Heather L. , Morreale Anthony P. , Miller Donald R.
Published: September 2021

Clinical pharmacy specialists (CPS) were deployed nationally to improve care access and relieve provider burden in primary care.

The aim of this study was to assess CPS integration in primary care and the Clinical Pharmacy Specialist Rural Veteran Access (CRVA) initiative's effectiveness in improving access.

Concurrent embedded mixed-methods evaluation of participating CRVA CPS and their clinical team members (primary care providers, others).

Health care providers on primary care teams in Veterans Health Administration (VHA).

Perceived CPS integration in comprehensive medication management assessed using the MUPM and semi-structured interviews, and access measured with patient encounter data.

There were 496,323 medical encounters with CPS in primary care over a 3-year period. One hundred twenty-four CPS and 1177 other clinical team members responded to a self-administered web-based questionnaire, with semi-structured interviews completed by 22 CPS and clinicians. Survey results indicated that all clinical provider groups rank CPS as making major contributions to CMM. CPS ranked themselves as contributing more to CMM than did their physician team members. CPS reported higher job satisfaction, less burn out, and better role fit; but CPS gave lower scores for communication and decision making as clinic organizational attributes. Themes in provider interviews focused on value of CPS in teams, relieving provider burden, facilitators to integration, and team communication issues.

This evaluation indicates good integration of CPS on primary care teams as perceived by other team members despite some communication and role clarification challenges. CPS may play an important role in improving access to primary care.
Comparative efficacy and safety for second-line treatment with ramucirumab, regorafenib, and cabozantinib in patients with advanced hepatocellular carcinoma progressed on sorafenib treatment
Authors: Chen Jianxin , Wang Junhui , Xie Fangwei
Published: September 2021

Background:

The present network meta-analysis was conducted to perform an indirect comparison among ramucirumab, regorafenib, and cabozantinib in patients with advanced hepatocellular carcinoma (HCC) progressed on sorafenib treatment.

Methods:

A systematic review through Medline, Embase, and Cochrane library was developed, with eligible randomized clinical trials been included. Hazard ratios (HRs) including progression-free survival (PFS), overall survival (OS), odds ratios of disease control rate (DCR), objective response rate (ORR), and adverse events were compared indirectly with network meta-analysis using random model in software STATA version 13.0.

Results:

A total of 4 randomized clinical trials including 2137 patients met the eligibility criteria and enrolled. Indirect comparisons showed that there was no statistical difference observed in the indirect comparison of PFS, OS, ORR, or DCR among agents of regorafenib, cabozantinib, and ramucirumab in advanced HCC patients with elevated α-fetoprotein (AFP) (400 ng/mL or higher). However, in patients with low-level AFP (lower than 400 ng/mL), regorafenib was the only agent associated with significant superiority in OS, compared with placebo (hazard ratio 0.67, 95% CI, 0.50–0.90).

Conclusions:

The present network meta-analysis revealed that there might be no statistical difference observed in the indirect comparison of PFS, OS, ORR, or DCR among regorafenib, cabozantinib, or ramucirumab in advanced HCC patients with elevated AFP (400 ng/mL or higher). However, in patients with low-level AFP (lower than 400 ng/mL), regorafenib might be associated with significant superiority in OS, compared to placebo, which need further investigation in clinical practice.
Pharmacopuncture and joint movement manual therapy for post-traumatic phalangeal osteoarthritis
Authors: Lim Jinwoong , Kim Kyu-hyeong , Shin Sang-Hoon , Lee Seung-Hwan , Lee Jiyeon , Ahn Hae In , Kim NamKwen
Published: September 2021

Introduction:

Post-traumatic osteoarthritis (PTOA) is a type of osteoarthritis that develops after ligament injury, meniscus injury, or fracture. Currently, there is no specific treatment approved for PTOA. This report describes the case of a 38-year-old man who suffered from PTOA of the right second distal interphalangeal (DIP) joint after practicing judo.

Patient concerns:

He visited the author's clinic at 3 months after the onset of symptoms. Symptoms included pain, limited motion, and joint enlargement of the right second DIP joint.

Diagnosis:

Partial tear of the ulnar collateral ligament of the DIP was revealed by magnetic resonance imaging. As the symptoms appeared after the traumatic event, PTOA was diagnosed.

Interventions:

Intra-articular hominis placenta pharmacopuncture and joint movement manual therapy were performed on each visit. Altogether, 10 sessions were performed until the symptoms improved remarkably.

Outcomes:

Visual analogue scale score (VAS) for pain; Quick Disabilities of the Arm, Shoulder, and Hand score (QuickDASH); joint circumference; and range of motion showed improvements at the end of the treatment. VAS decreased from 8.4 to 0.4, QuickDASH decreased from 44 to 13, joint circumference decreased from 5.5 to 5.4 cm, and range of motion was almost recovered, which was measured by the photographs.

Lessons:

There are not enough studies on phalangeal joint PTOA and its treatment. This case suggests pharmacopuncture and joint movement manual therapy as treatment options for phalangeal PTOA.
The efficacy and safety of Yijinjing exercise in the adjuvant treatment of ankylosing spondylitis
Authors: Chen Yuxuan , Ma Yixiao , Zhang Zhiqiang , Zhang Yaning , Jia Jian
Published: September 2021

Background:

Ankylosing spondylitis (AS) is a chronic systemic autoimmune disease with high disability rate. Conventional treatment regimens have long medication cycles and are associated with adverse reactions. Therapeutic exercise is also considered to be an effective treatment for AS. Evidence suggests that Yijinjing as a low-energy exercise has advantages in adjuncting AS, but there is a lack of standard clinical studies to evaluate its efficacy and safety.

Methods:

This is a prospective randomized controlled trial to investigate the efficacy and safety of Yijinjing in the adjuvant treatment of AS. Approved by the Clinical Research Ethics Association of our hospital, patients were randomly divided into treatment or control groups in a ratio of 1:1. The treatment group received 4-month Yijinjing training on the basis of conventional treatment, while the control group received conventional treatment and maintained their current lifestyle. The outcome indicators included: activity index, functional ability, Bath Ankylosing Spondylitis Metrology Index, adverse reaction, etc. Finally, SPASS 22.0 software was used for statistical analysis of the data.

Discussion:

This study evaluated the clinical efficacy of Yijinjing exercise in the adjuvant treatment of AS, and the results of our study will provide a reference for the clinical use of Yijinjing exercise as an effective complementary alternative for the treatment of AS.
Traditional Chinese medicine for septic patients undergoing ulinastatin therapy
Authors: Shan Ren-Fei , Zhu Yan-An , Qin Jie , Chen Jian-Ping
Published: September 2021

Purpose:

This study aimed to assess the efficacy of traditional Chinese medicine (TCM) in septic patients treated with ulinastatin.

Methods:

PubMed, EmBase, and the Cochrane library were searched up to January 2021 to identify randomized controlled trials. The weight mean difference (WMD) and relative risk (RR) with 95% confidence intervals were used with the random-effects model.

Results:

Twenty-three randomized controlled trials with 1903 septic patients were included. TCM significantly reduced the APACHE II score (WMD: −5.18; P < .001), interleukin-6 (WMD: −63.00; P < .001), tumor necrosis factor-α (WMD: −8.86; P < .001), c-reactive protein (WMD: −9.47; P < .001), mechanical ventilation duration (WMD: −3.98; P < .001), intensive care unit stay (WMD: −4.18; P < .001), procalcitonin (WMD: −0.53; P < .001), lipopolysaccharide (WMD: −9.69; P < .001), B-type natriuretic peptide (WMD: −159.87; P < .001), creatine kinase isoenzyme MB (WMD: −45.67; P < .001), cardiac troponin I (WMD: −0.66; P < .001), and all-cause mortality risk (RR: 0.55; P < .001).

Conclusions:

TCM lowers inflammation levels and reduces the risk of all-cause mortality for septic patients.
Computational study on novel natural inhibitors targeting c-MET
Authors: Hou Yuanyuan , Xie Haoqun , Dou Gaojing , Yang Wenzhuo , Ge Junliang , Zhou Baolin , Ren Junan , Li Juncheng , Wang Jing , Zhang Zhiyun , Wang Xinhui
Published: September 2021

This study was designed to select ideal lead compounds and preclinical drug candidates http://dict.youdao.com/w/eng/preclinical_drug_candidate/javascript:void (0); with inhibitory effect on c-MET from the drug library (ZINC database).

A battery of computer-aided virtual techniques was used to identify possible inhibitors of c-MET. A total of 17,931 ligands were screened from the ZINC15 database. LibDock is applied for structure-based screening followed by absorption, distribution, metabolic, and excretion, and toxicity prediction. Molecular docking was conducted to confirm the binding affinity mechanism between the ligand and c-MET. Molecular dynamics simulations were used to assess the stability of ligand-c-MET complexes.

Two new natural compounds ZINC000005879645 and ZINC000002528509 were found to bind to c-MET in the ZINC database, showing higher binding affinity. In addition, they were predicted to have lower rodent carcinogenicity, Ames mutagenicity, developmental toxicity potential, and high tolerance to cytochrome P4502D6. Molecular dynamics simulation shows that ZINC000005879645 and ZINC000002528509 have more favorable potential energies with c-MET, which could exist stably in the natural environment.

This study suggests that ZINC000005879645 and ZINC000002528509 are ideal latent inhibitors of c-MET targeting. As drug candidates, these 2 compounds have low cytotoxicity and hepatotoxicity as well as important implications for the design and improvement of c-MET target drugs.
Risk factors and management of pulmonary infection in elderly patients with heart failure
Authors: Peng Qi , Yang Qin
Published: September 2021

Pulmonary infection is common in patients with heart failure, yet the risk factors remain unclear. We aimed to evaluate the clinical characteristics and risk factors of pulmonary infection in elderly patients with heart failure, to provide reference to the prevention of pulmonary infection.

This study was a retrospective study design. We included elderly heart failure patient admitted to our hospital from April 1, 2018 to August 31, 2020. The characteristics and clinical data of pulmonary infection and no infection patients were assessed. Logistic regression analyses were conducted to identify the risk factors of pulmonary infections in patients with heart failure.

A total of 201 patients were included. The incidence of pulmonary infection in patients with heart failure was 23.88%. There were significant differences in the age, diabetes, New York Heart Association (NYHA) grade, left ventricular ejection fraction (LVEF), C-reactive protein (CRP) between infection and no infection group (all P < .05), and there were not differences in the sex, body mass index, alcohol drinking, smoking, hypertension, hyperlipidemia, length of hospital stay between 2 groups (all P > .05). Logistic regression analyses indicated that age ≥70 years, diabetes, NYHA grade III, LVEF ≤55%, and CRP ≥10 mg/L were the independent risk factors of pulmonary infections in patients with heart failure (all P < .05). Pseudomonas aeruginosa (34.48%), Staphylococcus aureus (19.57%), and Klebsiella pneumoniae (15.22%) were the most common 3 pathogens in patients with pulmonary infection.

Heart failure patients with age ≥70 years, diabetes, NYHA grade III, LVEF ≤55%, and CRP ≥10 mg/L have higher risks of pulmonary infections, preventive measures targeted on those risk factors are needed to reduce pulmonary infections.
Comparison between remifentanil and other opioids in adult critically ill patients
Authors: Yang Shuguang , Zhao Huiying , Wang Huixia , Zhang Hua , An Youzhong
Published: September 2021

Background and aims:

To identify the efficacy and safety of remifentanil when compared with other opioids in adult critically ill patients.

Methods:

We searched for studies in the Cochrane Library, MEDLINE, and EMBASE that had been published up to May 31st, 2019. Randomized clinical trials using remifentanil comparing with other opioids for analgesia were included. Two reviewers independently applied eligibility criteria, assessed quality, and extracted data. Duration of mechanical ventilation was the primary outcome, and secondary outcomes included weaning time, intensive care unit (ICU), length of stay (LOS), hospital LOS, mortality, side effects, and costs.

Results:

Fifteen studies with 1233 patients were included. Remifentanil was associated with a significant reduction in the duration of mechanical ventilation in the adult ICU patients when compared with other opioids (P = .01). Remifentanil also reduced the weaning time (P = .02) and the ICU LOS when compared with other opioids (P = .01). There was no difference in the hospital LOS (P = .15), side effects (P = .39), and mortality (P = .79) between remifentanil and other opioids, what's more, remifentanil increased the costs of anesthesia (P < .001) but did not increase cost of hospitalization (P = .30) when comparing with other opioids.

Conclusions:

Remifentanil reduced the duration of mechanical ventilation, weaning time, and ICU LOS when compared with other opioids in adult critically ill patients. Higher quality RCTs are necessary to prove our findings.

PROSPERO registration number:

CRD42016041438.
Serum prolactin level and lactate dehydrogenase activity in patients with epileptic and nonepileptic seizures
Authors: Yilmaz Murat , Tekten Beliz Oztok
Published: September 2021

It is important to diagnose epilepsy in a timely and accurate manner, and also to distinguish it from non-epileptic conditions. The present study was aimed at determining postictal serum prolactin levels and lactate dehydrogenase (LDH) activities in patients with new-onset seizure admitted to the emergency department in order to assess whether they could be used in the differentiation of epileptic seizure (ES) from nonepileptic seizure (NES).

Eighty-five patients were included prospectively in this study. Patients were divided into 2 groups with respect to epilepsy diagnosis, and the final groups were comprised of 36 patients with ES and 49 patients with NES. Blood samples were obtained within 1 hour of seizure.

No significant differences between groups were observed in prolactin levels and in the percentage of patients with abnormal prolactin level (P = .569 and .239, respectively). The median LDH activity was significantly higher in those with ES compared with those with NES (P = .031). The percentage of patients with elevated LDH levels was similar between 2 groups (P = .286).

This was the first study to examine LDH activities in terms of its role in differentiation of seizure origin in the postictal period in patients hospitalized with seizure. Our study demonstrated that serum LDH activities within 1 hour after the seizure appear to be increased in patients with ES compared with those with NES, suggesting the potential role of LDH activities as a diagnostic tool in distinction of seizure types. Our study supports the hypothesis that LDH-antagonists may have a role in the management of seizure and epilepsy.
Effectiveness of empowerment-based intervention on HbA1c and self-efficacy among cases with type 2 diabetes mellitus
Authors: Chen Yanyan , Tian Yao , Sun Xiaohong , Wang Boqiao , Huang Xiao
Published: September 2021

Objective:

The aim of this study was to determine the effect of empowerment-based interventions on glucose metabolism control and psychosocial self-efficacy in people with type 2 diabetes mellitus (T2DM).

Methods:

The Cochrane Library, Embase, PubMed, and Web of Science electronic databases were searched up to 22 February 2021 for randomized controlled trials (RCTs) that evaluated the effectiveness of empowerment-based intervention versus conventional treatment in type 2 diabetes cases. At least two investigators independently screened the literature, extracted data and evaluated the methodological quality. We calculated the pooled effect size using the mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) through RevMan V 5.4.1.

Results:

Fifteen randomized controlled trials (RCTs) were eligible for inclusion in the present study. A total of 2344 adults (1128 in the intervention groups and 1216 in the control) were covered. Five of these studies involved 671 cases of psychosocial self-efficacy, and 4 studies included 622 cases of diabetes knowledge. The meta-analysis showed that compared to routine care, empowerment-based intervention was associated with reduced glycated hemoglobin levels (SMD −0.20; 95% CI −0.31 to −0.08; Z = 3.40, P < .001, I
2 = 42%), increased diabetes empowerment scores (SMD 0.24; 95% CI 0.10–0.37; Z = 3.42, P < .001, I
2 = 0%), and increased diabetes knowledge scores (SMD 0.96; 95% CI 0.55–1.36; Z = 4.61, P < .001, I
2 = 80%).

Conclusions:

Empowerment-based intervention in adults with T2DM results in improvements in glycated hemoglobin, psychosocial self-efficacy and diabetes knowledge.
The impact of vaginal microbiome composition, race, and immunological factors on preterm birth
Authors: Nouri-Nikbakht Roxana , Honsa Erin S.
Published: September 2021

This systematic review will summarize: the various diverse bacterial species that populate the vaginal microbiome to identify what strains of vaginal flora can contribute to preterm birth; how the composition differs among race; how those strains influence the inflammatory response that triggers preterm birth. This review revealed that preterm birth is associated with an overall increase in microbiome diversity. The composition between races also varies; African American women have a more diverse mix of bacteria with very little Lactobacillus dominance compared with Caucasian or Asian women. Further, this review uncovered a new conceptual linkage immunology, the vaginal microbiome diversity, and preterm birth. Although high levels of specific cytokines and inflammatory markers [i.e. IL-6, IL-8, IL-1β, TNF-α, and matrix metallo-proteases (mmPs)] are associated with infection, this review identifies, which of these factors contribute to preterm birth. Specifically, a change in microbiome composition may lead to the production of pro-inflammatory cytokines that contribute to preterm birth. The association between vaginal microbiome composition, race, and immunological processes must be better understood in order to recognize who may be at risk of preterm birth, and to effectively design interventions aimed at lowering preterm birth rates.
The status of Streptococcus pneumoniae in Iran compared to the world: a systematic review
Authors: Asadollahi Parisa , Darbandi Atieh , Lohrasbi Vahid , Hasannejad-Bibalan Meysam , Talebi Malihe
Published: September 2021

Introduction:

Streptococcus pneumoniae is a leading cause of vaccine-preventable deaths worldwide. Sero-epidemiological data on S. pneumoniae is needed in each country to monitor the burden of this important pathogen in each population. The aim of this study was to evaluate the prevalence, antibiotic resistance, prevalent serotypes and virulence factors of S. pneumoniae in Iran, compared to other parts of the world.

Methods:

A search via Google Scholar, Scopus, PubMed, ISI, Iranmedex, Magiran, SID and ISC was conducted for original articles investigating S. pneumoniae in Iran. The search terms were ‘Streptococcus pneumoniae’, ‘S. pneumoniae’, ‘prevalence’, ‘antibiotic resistance’, ‘antimicrobial resistance’, ‘typing’, ‘serotyping’, ‘virulence factors’, ‘Iran’.

Results:

The overall prevalence of invasive pneumococcal disease had an increasing trend in Iran. The most common serotypes amongst Iranian population were 1, 19A, 6A/ 6B, 23F, 14,18C, 20, 19, 3, 6, 9 V, 11A and 19F. Resistance to penicillin and co-trimoxazole had significant decreasing trends whilst resistance to erythromycin was increasing although insignificantly. The most prevalent pneumococcal virulence genes were lytA and pspC.

Conclusion:

Since pneumococcal serotypes differ in invasiveness, virulence, and antibiotic resistance it is important to closely monitor the changes on evolving serotypes, antibiotic resistance and virulence factors of this pathogen to be able to implement suitable prevention and therapeutic strategies.
Many but small HIV-1 non-B transmission chains in the Netherlands
Authors: Bezemer Daniela , Blenkinsop Alexandra , Hall Matthew , van Sighem Ard , Cornelissen Marion , Wessels Els , van Kampen Jeroen , van de Laar Thijs , Reiss Peter , Fraser Christophe , Ratmann Oliver
Published: September 2021

Objective:

The aim of this study was to investigate introductions and spread of different HIV-1 subtypes in the Netherlands.

Design:

We identified distinct HIV-1 transmission chains in the Netherlands within the global epidemic context through viral phylogenetic analysis of partial HIV-1 polymerase sequences from individuals enrolled in the ATHENA national HIV cohort of all persons in care since 1996, and publicly available international background sequences.

Methods:

Viral lineages circulating in the Netherlands were identified through maximum parsimony phylogeographic analysis. The proportion of HIV-1 infections acquired in-country among heterosexuals and MSM was estimated from phylogenetically observed, national transmission chains using a branching process model that accounts for incomplete sampling.

Results:

As of 1 January 2019, 2589 (24%) of 10 971 (41%) HIV-1 sequenced individuals in ATHENA had non-B subtypes (A1, C, D, F, G) or circulating recombinant forms (CRF01AE, CRF02AG, CRF06-cpx). The 1588 heterosexuals were in 1224, and 536 MSM in 270 phylogenetically observed transmission chains. After adjustments for incomplete sampling, most heterosexual (75%) and MSM (76%) transmission chains were estimated to include only the individual introducing the virus (size = 1). Onward transmission occurred mostly in chains size 2–5 amongst heterosexuals (62%) and in chains size at least 10 amongst MSM (64%). Considering some chains originated in-country from other risk-groups, 40% (95% confidence interval: 36–44) of non-B-infected heterosexuals and 62% (95% confidence interval: 49–73) of MSM-acquired infection in-country.

Conclusion:

Although most HIV-1 non-B introductions showed no or very little onward transmission, a considerable proportion of non-B infections amongst both heterosexuals and MSM in the Netherlands have been acquired in-country.
TMS Bursts Can Modulate Local and Networks Oscillations During Lower-Limb Movement
Authors: Espinoza Arturo I. , Scholl Jamie L. , Singh Arun
Published: September 2021

Purpose:

Lower-limb motor functions involve processing information via both motor and cognitive control networks. Measuring oscillations is a key element in communication within and between cortical networks during high-order motor functions. Increased midfrontal theta oscillations are related to improved lower-limb motor performances in patients with movement disorders. Noninvasive neuromodulation approaches have not been explored extensively to understand the oscillatory mechanism of lower-limb motor functions. This study aims to examine the effects of repetitive transcranial magnetic stimulation on local and network EEG oscillations in healthy elderly subjects.

Methods:

Eleven healthy elderly subjects (67–73 years) were recruited via advertisements, and they underwent both active and sham stimulation procedures in a random, counterbalanced design. Transcranial magnetic stimulation bursts (θ-transcranial magnetic stimulation; 4 pulses/second) were applied over the midfrontal lead (vertex) before a GO-Cue pedaling task, and signals were analyzed using time–frequency methods.

Results:

Transcranial magnetic stimulation bursts increase the theta activity in the local (p = 0.02) and the associated network during the lower-limb pedaling task (p = 0.02). Furthermore, after task-related transcranial magnetic stimulation burst sessions, increased resting-state alpha activity was observed in the midfrontal region (p = 0.01).

Conclusions:

This study suggests the ability of midfrontal transcranial magnetic stimulation bursts to directly modulate local and network oscillations in a frequency manner during lower-limb motor task. Transcranial magnetic stimulation burst–induced modulation may provide insights into the functional roles of oscillatory activity during lower-limb movement in normal and disease conditions.
Paenibacillus oceani sp. nov., isolated from surface seawater
Authors: Chen Yu-feng , Ye Lin , Huang Hui-qin , Jiang Ming-guo , Hu Yong-hua , Sun Dong-mei , Mo Kun-lian
Published: September 2021

A Gram-stain-positive and motile bacterial strain, designated IB182363T, was isolated from surface seawater of the South China Sea. Cells grew at pH 5.0–9.5 (optimum, pH 7.0–8.0), 20–40 °C (optimum, 30 °C) and with 1–8 % (w/v) NaCl (optimum, 2–4 %). On the basis of 16S rRNA gene sequence analysis, strain IB182363T was affiliated to the genus

Paenibacillus

and the closest phylogenetically related species was

Paenibacillus ginsengarvi

DSM18677T with 96.9 % sequence similarity. The values of whole genome average nucleotide identity analysis and digital DNA–DNA hybridization between the isolate and the closely related type strains were less than 86.3 and 25.6 %, respectively. Chemotaxonomic analysis revealed that strain IB182363T possessed meso-diaminopimelic acid in the cell-wall peptidoglycan and contained menaquinone MK-7 as the predominant isoprenoid quinone. The major cellular fatty acids were anteiso-C15 : 0, C16 : 0 and iso-C16 : 0. The polar lipids comprised phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, one unidentified glycolipid, two unidentified aminolipids, two unidentified phospholipids and four unidentified aminophospholipids. The genomic DNA G+C content was 54.5 mol%. On the basis of the above results, strain IB182363T represents a novel species of the genus

Paenibacillus

, for which we propose the name Paenibacillus oceani sp. nov. with the type strain IB182363T (=MCCC 1K04630T=JCM 34214T).