bluuebunny/crossref_metadata_2025 huggingface dataset:
Astaxanthin ameliorates serum level and spinal expression of macrophage migration inhibitory factor following spinal cord injury
Authors: Fakhri Sajad , Abbaszadeh Fatemeh , Dargahi Leila , Pouriran Ramin , Jorjani Masoumeh
Published: September 2022

Astaxanthin (AST) is a lipid-soluble carotenoid with antioxidant and anti-inflammatory properties. Previous reports demonstrated the promising effects of AST on spinal cord injury (SCI)-induced inflammation and sensory-motor dysfunction. Macrophage migration inhibitory factor (MIF), as a cytokine, plays a critical role in the inflammatory phase of SCI. The aim of this study was to evaluate the effects of AST on post-SCI levels of MIF in serum and spinal cord. The possible correlation between MIF and mechanical pain threshold was also assessed. Adult male rats were subjected to a severe compression spinal injury and 30 min later were treated with AST (Intrathecal, 2 nmol) or vehicle. Neuropathic pain was assessed by von Frey filaments before the surgery, and then on days 7, 14, 21, and 28 post-SCI. Western blot and ELISA were used to measure the serum level and spinal expression of MIF following SCI in the same time points. AST treatment significantly attenuated the SCI-induced dysregulations in the serum levels and tissue expression of MIF. A negative correlation was observed between mechanical pain threshold and serum MIF level (r = −0.5463, P < 0.001), as well as mechanical pain threshold and spinal level of MIF (r = −0.9562; P < 0.001). AST ameliorates SCI-induced sensory dysfunction, probably through inhibiting MIF-regulated inflammatory pathways.
Little Finger Duplication
Authors: AlNojaidi Taif F. , AlAqil Sultan N. , Wani Shabir , Wafiq Wafa Ahmed
Published: September 2022

Polydactyly is defined as an extra finger or toe that is present at birth. It is a congenital anomaly that can manifest as a single disorder or as a component of a syndrome. Treatment can be conservative or operative depending on the anticipated function of the extra digit. In this report, we describe a case of a bifid 5th digit on the right hand. The aim of this report was to report a new variant of type IIIB described by Duran (2015). This will possibly lead to the modification of the current classifications, which will improve the diagnosis and treatment of patients.
Penetrating Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty in Children With Congenital Hereditary Endothelial Dystrophy: Long-Term Results
Authors: Al-Dahan Danya , AlRajhi Ali , AlHazzani Abeer , Alabdulwahid Rayanah , Alqarni Awad , Ahad Muhammad A
Published: September 2022

Purpose:

The purpose of this study was to compare the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP) in patients with congenital hereditary endothelial dystrophy (CHED).

Methods:

This was a retrospective, comparative study of all the patients with a histopathological diagnosis of CHED who underwent PKP or DSAEK between January 1, 1990, and December 31, 2016. All the cases were included except those patients who had clear grafts but did not complete 2 years of postoperative follow-up. The main outcome measure was graft clarity 2 years after surgery.

Results:

There were 111 eyes of 63 patients. Seventy-six eyes underwent PKP, and 35 eyes underwent DSAEK. The median age at surgery was 6.8 years in the PKP group and 10.32 years in the DSAEK group. At 2 years postoperatively, clear grafts were noted in 66 of 76 (86.8%) eyes in the PKP group and 30 of 35 (85.7%) eyes in the DSAEK group. At the last follow-up, 80.3% of PKP grafts and 82.8% of DSAEK grafts were clear (P=0.5). The type and timing of complications differed between the 2 groups. The PKP group had a statistically significant higher rate of graft rejection (19.5%) versus the DSAEK group (0%) (P=0.01). DSAEK complications were mainly lenticule detachment that developed within one month postoperatively. There was no statistically significant difference in the visual outcomes at the last follow-up between the groups.

Conclusion:

Endothelial keratoplasty is a safe alternative to conventional PKP in CHED. The visual outcome and survival rates were comparable, but DSAEK had a lower rejection rate and fewer suture-related complications.
Impact of Care in an Interdisciplinary Inflammatory Bowel Disease Specialty Clinic on Outcomes in Patients Insured with Medicaid
Authors: Wang Christina P. , Zylberberg Haley M. , Borman Zachary A. , Engelman Sally , Yanes Ricardo , Hirten Robert P. , Sands Bruce E. , Cohen Benjamin L. , Ungaro Ryan C. , Rao Bhavana B.
Published: September 2022

Background:

Inflammatory bowel disease (IBD) patients are known to benefit from care delivered in a specialized, interdisciplinary setting. We aimed to evaluate the impact of this model on health outcomes, quality metrics, and health care resource utilization (HRU) in IBD patients insured with Medicaid.

Materials and Methods:

In July 2017, IBD patients at our tertiary hospital were transitioned from a fellows’ general gastroenterology (GI) clinic to a fellows’ interdisciplinary IBD clinic. IBD patients were included if they were insured with Medicaid, had at least 1 visit in the general GI clinic between July 1, 2016 and June 30, 2017, and at least 1 visit between July 1, 2017 and June 30, 2018 in the IBD clinic. Characteristics related to patients’ IBD course, overall health care maintenance, and HRU were compared.

Results:

A total of 170 patients (51% male, mean age 39 y) were included. After the transition to the IBD clinic, use of corticosteroids (37% vs. 25%; P=0.004) and combination therapy were significantly lower (55% vs. 38%; P=0.0004), although use of high-dose biologics numerically increased (58.5% vs. 67%; P=0.05). Posttransition, patients showed significantly lower levels of mean C-reactive protein (P=0.04). After the transition, patients attended significantly fewer outpatient GI visits (P=0.0008) but were more often seen by other health care specialists (P=0.0003), and experienced a numeric decrease in HRU with fewer emergency department visits, hospitalizations, and surgeries.

Conclusions:

Care in an interdisciplinary, IBD specialty setting is associated with significantly decreased corticosteroid use, decreased C-reactive protein levels, and improved access to ancillary services in Medicaid patients.
Prevalence of comorbidities in deceased patients with COVID-19: A systematic review
Authors: Justino Dayane Caroliny Pereira , Silva David Franciole Oliveira , Costa Ketyllem Tayanne da Silva , de Morais Thiffany Nayara Bento , de Andrade Fábia Barbosa
Published: September 2022

Background:

In December 2019, a new disease, coronavirus disease (COVID-19), emerged, which put several countries on a state of alert. Because it is a novel virus, several aspects and factors that contribute to the evolution of pathogenesis are still unknown and need to be better understood. Therefore, a systematic review is necessary to investigate the association between COVID-19 infection and chronic nontransmissible disease in patients who have died of COVID-19.

Methods:

This was a systematic review of the literature for observational studies published between December 2019 and September 2020. The protocol for this systematic review was registered in the International prospective register of systematic reviews (PROSPERO) under the number CRD42020176249.

Results:

In the 31 studies analyzed, a total of 421,872 (100%) patients were infected with COVID-19, and, of these, 45,399 (10.8%) died. The 3 most prevalent comorbidities were hypertension, diabetes mellitus, and respiratory diseases, respectively. The cure/recovery rate was 89.2% (376,473).

Conclusion:

This review revealed a high percentage of comorbidities in the patients with COVID-19, especially those who died.
Authors who contributed most to the fields of hemodialysis and peritoneal dialysis since 2011 using the hT-index: Bibliometric analysis
Authors: Wang Hsien-Yi , Chien Tsair-Wei , Kan Wei-Chih , Wang Chen-Yu , Chou Willy
Published: September 2022

Background:

The h-index does not take into account the full citation list of a researcher to evaluate individual research achievements (IRAs). As a generalization of the h-index, the hT-index takes all citations into account to evaluate IRAs. Compared to other bibliometric indices, it is unclear whether the hT-index is more closely associated with the h-index. We utilized articles published on hemodialysis and peritoneal dialysis (HD/PD) to validate the hT-index as a measure of the most significant contributions to HD/PD.

Methods:

Using keywords involving HD/PD in titles, subject areas, and abstracts since 2011, we obtained 7702 abstracts and their associated metadata (e.g., citations, authors, research institutes, countries of origin). In total, 4752 first or corresponding authors with hT-indices >0 were evaluated. To present the author’s IRA, the following 4 visualizations were used: radar, Sankey, impact beam plot, and choropleth map to investigate whether the hT-index was more closely associated with the h-index than other indices (e.g., g-/x-indices and author impact factors), whether the United States still dominates the majority of publications concerning PD/HD, and whether there was any difference in research features between 2 prolific authors.

Results:

In HD/PD articles, we observed that (a) the hT-index was closer to and associated with the h-index; (b1) the United States (37.15), China (34.63), and Japan (28.09) had the highest hT-index; (b2) Sun Yat Sen University (Chian) earned the highest hT-index (=20.02) among research institutes; (c1) the authors with the highest hT-indices (=15.64 and 14.39, respectively) were David W Johnson (Australia) and Andrew Davenport (UK); and (c2) their research focuses on PD and HD, respectively.

Conclusion:

The hT-index was demonstrated to be appropriate for assessing IRAs along with visualizations. The hT-index is recommended in future bibliometric analyses of IRAs as a complement to the h-index.
Constructing a prognostic immune-related lncRNA model for colon cancer
Authors: Li Xinyun , Yang Lin , Wang Wen , Rao Xiangshu , Lai Yu
Published: September 2022

Colon cancer is a common digestive tract tumor. Although many gene prognostic indicators have been used to predict the prognosis of colon cancer patients, the accuracy of these prognostic indicators is still uncertain. Thus, it is necessary to construct a model for the prognostic analysis of colon cancer. We downloaded the original transcriptome data of colon cancer and performed a differential coexpression analysis of immune-related genes to obtain different immune-related long noncoding RNAs, which were paired as differentially expressed immune-related lncRNA pairs (DEirlncRNAPs). Then, the 1-year overall survival rate receiver operating characteristic curve was calculated, and the Akaike information criterion value was evaluated to determine the maximum inflection point, which was used as the cutoff point to identify groups of colon cancer patients at high and low risk for death. Subsequently, the optimal prediction model was established. Finally, we used the patients’ survival times, clinicopathological features, tumor infiltrating immune cells, chemotherapy responses, and immunosuppressive biomarkers to verify the DEirlncRNAP model. Seventy-one DEirlncRNAPs were obtained to build the risk assessment model. The patients were divided into a high-risk group and a low-risk group according to the cutoff point. Then, the DEirlncRNAP model was verified using patient survival times, clinicopathological features, tumor-infiltrating immune cells, chemotherapy responses, and immunosuppressive biomarkers. A new DEirlncRNAP model for predicting the prognosis of colon cancer patients was established, which could reveal new insights into the relationships of colon cancer with tumor-infiltrating immune cells and antitumor immunotherapy.
Relationship between MTHFR C677T, homocysteine, and ischemic stroke in a large sample of the Han Chinese population
Authors: Jin Ming , Wang Ningning , Li Xueyan , Zhang Hao , Zhou Jexin , Cong Mingyu , Niu Jun , Lin Chongyang , Hu Ying , Wu Nan , Liu Jicheng , Zhang Keyong , Qiu Changchun
Published: September 2022

Ischemic stroke, one of the prevalent causes of death and disability worldwide, is linked to environmental and genetic factors, including polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene involved in homocysteine metabolism. The present study aimed to explore the relationship between the MTHFR C677T variant, plasma homocysteine, and risk of developing large-artery atherosclerotic ischemic stroke (LAAIS) among Han Chinese.

A population-based case-control study, which included 1810 patients with LAAIS and 1765 unrelated control subjects, was conducted. Compared to the controls, LAAIS patients had a significantly higher prevalence of hypertension, diabetes mellitus, smoking, and alcohol consumption (P < .001), as well as significantly higher mean fasting blood glucose, triglyceride, total cholesterol, and plasma homocysteine levels (P < .001). The TT homozygous genotype correlated with increased risk of developing LAAIS, as indicated by a significantly higher odds ratio (OR) compared to the CT and CC genotypes, in both additive (OR = 3.215, P = .01) and recessive models (OR = 3.265, P = .01). The plasma homocysteine level was genotype-dependent according to the following trend: TT > CT > CC.

In conclusion, our data demonstrate that, in spite of its low prevalence in both patients and controls (1.5% vs 0.8%), the MTHFR C677T variant could, at least in part, affect homocysteine levels and this, either alone or in combination with other factors, increases the risk of LAAIS.
The prevention of stroke by statins: A meta-analysis
Authors: San Xiaoxu , Lv Zhiguo , Xu Peng , Wang Jian , Lan Tianye
Published: September 2022

Purpose:

The objectives of this study were to determine the preventive effects of statins on stroke.

Methods:

The published randomized controlled trials of statins for stroke prevention were searched from PubMed, EMBASE, Cochrane Library, and China Journal databases. We performed the meta-analysis via calculating the odds ratio (OR) and 95% confidence interval (CI) to study the mortality rate, incidence, and recurrence rate of patients with stroke in the prevention group and the control group. Chi-square-based Q test and I
2 statistics were performed to test the potential heterogeneity; we conducted the sensitivity analysis to assess the stability of our analysis. Moreover, we performed the Begg and Egger tests to assess the publication bias.

Results:

Nine studies were included to perform meta-analysis, which included 15,497 patients (prevention group [n = 4114]; control group [n = 11383]). We found that the statins were not associated with the patients with stroke in mortality rate (OR = 1.00, 95% CI [0.82, 1.23]) and incidence (OR = 0.94, 95% CI [0.46, 1.92]) between the 2 groups. However, there was a significant differences in recurrence rate between the 2 groups (OR = 0.31, 95% CI [0.19, 0.51]).

Conclusions:

Our findings indicated that the statins were associated with the patients with stroke in recurrence rate, but there was no significant correlation with the mortality and morbidity of patients with stroke.
Time trends and geographic distribution of hepatocellular carcinoma in Brazil: An ecological study
Authors: Balbi Elizabeth , Moreira Jessica Pronestino de Lima , Luiz Ronir Raggio , Perez Renata de Mello , de Souza Heitor Siffert Pereira
Published: September 2022

The incidence of hepatocellular carcinoma (HCC) is increasing globally, and HCC is the fourth leading cause of cancer-related death. This ecological study aimed to investigate the time trends and geographic distribution of HCC in Brazil. Data from the Brazilian Health Public System were retrospectively collected from January 2005 to December 2018. Hospitalization and intrahospital lethality rates for HCC were stratified by age and sex. Hospitalization rates and associated lethality per 100,000 inhabitants in each municipality were included in a worksheet to build maps displaying the estimates and the geographic distribution of HCC. From 2005 to 2018, a total of 75,466 admissions for HCC were registered and the mean hospitalizations increased from 2.1 to 5.8/100,000 inhabitants (176%). The greatest increase occurred among patients older than 50, particularly in males above 70 years old. Prevalence rates increased throughout the country, with the highest levels detected in the South and Southeast. However, the increase was proportionally higher in the Northeast (377%), especially in municipalities not integrated into metropolitan regions. The HCC lethality rate remained relatively stable in both sexes, ranging from 21% to 25% (19%), but it was higher among older patients. The length of hospital stay did not differ between survivors and nonsurvivors throughout the study period. HCC hospitalizations are rising, particularly above 50 years of age and in rural areas, not paralleled by lethality rates. This suggests ongoing changes in environmental and socioeconomic factors in Brazil.
Patients with blastic plasmacytoid dendritic cell neoplasm in pregnancy: A rare case report
Authors: Zhang Li , Wang Yidong , Lu Mingming , Shen Mengdan , Duan Zhao
Published: September 2022

Rationale:

Previous clinical reports of patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) in pregnancy are rare.

Patient concerns:

The present study presents the case of 37-year-old women exhibiting third trimester with progressive painless, abdominal skin nodules.

Interventions and outcomes:

A 37-year-old pregnant woman with BPDCN and partial placenta previa and racket-shaped placenta. After comprehensive evaluation, the pregnancy status ends at 37 weeks and 6 days by cesarean section of lower uterus and no abnormality in the newborn.

Lessons:

Pregnant women diagnosed with BPDCN in the third trimester should terminate the pregnancy promptly for further treatment.
Impact of COVID-19 pandemic on emergency department length of stay and clinical outcomes of patients with severe pneumonia: A single-center observational study
Authors: Ha Jun Young , Sung Won Young
Published: September 2022

We examined the impact of COVID-19 pandemic on the emergency department length of stay (EDLOS) and clinical outcomes of patients with severe pneumonia admitted to the intensive care unit (ICU) through the emergency department (ED). This single-center retrospective observational study included adult patients with pneumonia admitted to the ICU through the ED between January and December 2019 (pre-pandemic) and between March 2020 and February 2021 (during-pandemic). We compared and analyzed the EDLOS by dividing it into pre-, mid-, and post-EDLOS and in-hospital mortality of patients with pneumonia admitted to the ICU according to the time of ED visits before and during the COVID-19 pandemic. Risk factors for in-hospital mortality according to the time of ED visits were analyzed using multiple logistic regression analysis. In total, 227 patients (73 patients pre-pandemic and 154 patients during the pandemic) with pneumonia admitted to the ICU through the ED were analyzed. During the COVID-19 pandemic, pre-, mid-, and post-EDLOS increased (P < .05), and the in-hospital mortality rate increased by 10.4%; however, this was not significant (P = .155). Multivariate logistic regression analysis revealed post-EDLOS (ED waiting time after making ICU admission decision) as an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU, pre-pandemic (odds ratio [OR] = 2.282, 95% confidence interval [CI]: 1.367–3.807, P = .002) and during the pandemic (OR = 1.126, 95% CI: 1.002–1.266, P = .047). Mid-EDLOS (ED time to assess, care, and ICU admission decision) was an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU during the COVID-19 pandemic (OR = 1.835, 95% CI: 1.089–3.092, P = .023). During the pandemic of emerging respiratory infectious diseases, to reduce in-hospital mortality of severe pneumonia patients, it is necessary to shorten the ED waiting time for admission by increasing the number of isolation ICU beds. It is also necessary to accelerate the assessment and care process in the ED, and make prompt decisions regarding admission to the ICU.
Management of dermatomyositis patients amidst the COVID-19 pandemic: Two case reports
Authors: Cao Yumeng , Zhou Jingrun , Cao Tingting , Zhang Guqin , Pan Huaqin
Published: September 2022

Rationale:

In December 2019, a new epidemic of coronavirus disease 2019 (COVID-19) appeared in Wuhan, Hubei Province, and spread rapidly to other parts of China and worldwide. Although established methods exist for the diagnosis and treatment of COVID-19 infection, the management of dermatomyositis (DM) patients with COVID-19 is unknown.

Patient concerns:

In this article, we describe case reports of 2 patients with DM. The first case was a 67-year-old patient with DM and infected with COVID-19 who was admitted to Leishenshan Hospital for a 1-month history of fever, cough, and expectoration. The second case was a 51-year-old male patient who was admitted to Leishenshan Hospital due to fever with cough, expectoration and shortness of breath for 1 month.

Diagnoses:

The first patient was diagnosed with COVID-19 secondary to DM based on repeated SARS-CoV-2 real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) test, detailed medical history and chest computed tomography; The second patient was diagnosed with interstitial lung disease associated with anti-MDA5 DM based on the results of antirheumatic and anti-inflammatory therapy and the above 3 methods.

Interventions and outcomes:

The first patient received supportive and empirical treatment, including antiviral treatment, anti-inflammatory treatment, oxygen therapy and prophylactic anticoagulation therapy. The symptoms and laboratory results got improved after the treatments. He was discharged with thrice negative PCR tests for the SARS-CoV-2 virus. The second patient received a comprehensive treatment, including glucocorticoid and plasma exchange; his symptoms were relieved and improved.

Lessons:

These cases suggest that repeated new pathogenic test results for the coronavirus and a detailed diagnosis of the medical history are important means to distinguish these diseases. Increased attention to the individual characteristics of different cases may allow for more effective diagnosis and treatment.
Identification of potential biomarkers and pathogenesis in neutrophil-predominant severe asthma: A comprehensive bioinformatics analysis
Authors: Xu Shuanglan , Chen Zi , Ge Linyang , Ma Chenhui , He Quan , Liu Weihua , Zhang Liuchao , Zhou Linfu
Published: September 2022

Background:

Airway neutrophilia has been associated with asthma severity and asthma exacerbations. This study attempted to identify biomarkers, pathogenesis, and therapeutic molecular targets for severe asthma in neutrophils using bioinformatics analysis.

Methods:

Fifteen healthy controls and 3 patients with neutrophilic severe asthma were screened from the Gene Expression Omnibus (GEO) database. Based on the analysis of differentially expressed genes (DEGs), functional and pathway enrichment analyses, gene set enrichment analysis, protein–protein interaction network construction, and analysis were performed. Moreover, small-molecule drug candidates have also been identified.

Results:

Three hundred and three upregulated and 59 downregulated genes were identified. Gene ontology function enrichment analyses were primarily related to inflammatory response, immune response, leukocyte migration, neutrophil chemotaxis, mitogen-activated protein kinase cascade, Jun N-terminal kinase cascade, I-kappaB kinase/nuclear factor-κB, and MyD88-dependent toll-like receptor signaling pathway. Pathway enrichment analyses and gene set enrichment analysis were mainly involved in cytokine-cytokine receptor interaction, the TNF signaling pathway, leukocyte transendothelial migration, and the NOD-like receptor signaling pathway. Furthermore, 1 important module and 10 hub genes (CXCL8, TLR2, CXCL1, ICAM1, CXCR4, FPR2, SELL, PTEN, TREM1, and LEP) were identified in the protein–protein interaction network. Moreover, indoprofen, mimosine, STOCK1N-35874, trapidil, iloprost, aminoglutethimide, ajmaline, levobunolol, ethionamide, cefaclor, dimenhydrinate, and bethanechol are potential drugs for the treatment of neutrophil-predominant severe asthma.

Conclusion:

This study identified potential biomarkers, pathogenesis, and therapeutic molecular targets for neutrophil-predominant severe asthma.
Squamous cell carcinoma in mature cystic teratoma of the ovary induced by human papillomavirus 16 infection: A case report and literature review
Authors: Shi Zhixian , Yang Lingyun , Bian Ce
Published: September 2022

Rationale:

Mature cystic teratoma is the most common ovarian germ cell tumor. The malignant transformation of ovarian mature cystic teratoma (MCT) is very rare, but the prognosis is poor. We present a case of ovarian mature cystic teratoma with human papillomavirus infection and malignant transformation into ovarian squamous cell carcinoma (SCC). The occurrence of this case may prove that high-risk human papillomavirus infection is a pathogenic factor inducing malignant transformation of mature cystic teratoma to SCC.

Patient concerns:

A 38-year-old woman with a solid cystic mass of 8 cm on the right ovary, and human papillomavirus (HPV) test of her cervix showed HPV-16 infection.

Diagnosis:

The transvaginal ultrasound was performed, and there was a cystic solid mass of 5.9 × 4.5 × 5.5 cm in the right adnexal area with unclear cystic fluid and rich blood flow signals in the capsule wall. HPV test of cervix showed HPV-16 infection. Diagnostic suspicion: cystic teratoma.

Intervention:

The patient signed an laparoendoscopic surgery was performed to remove the right ovarian mass. Intraoperative pathology consultation revealed the malignant transformation of mature teratoma of the right ovary and the formation of squamous or adeno-SCC. We performed laparoscopic comprehensive surgical staging (hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy, pelvic and para-aortic lymph node dissection) were made.

Outcomes:

The operation was successful and the postoperative recovery was smooth, was discharged 7 days after operation. Now the patient is recovering well and is continuing chemotherapy as planned.

Conclusion:

HR-HPV infection might be a causal factor for inducing malignant transformation of ovarian MCT to SCC, and the Jumping metastasis of lymph nodes may be the characteristic of SCC-MCT, but further verification is still needed.
Effects of quarter heel raising exercise on balance and ankle strength in functional ankle instability subjects
Authors: Seo Joon Ho , Lee Mi Young
Published: September 2022

Background:

Functional ankle instability (FAI) is defined as the subjective sensation of instability or “giving way” after an ankle sprain and occurs in approximately 40% of patients with lateral ankle instability. As an ankle joint rehabilitation intervention, heel raising exercises, toe jumping exercises, ankle joint proprioceptive exercises, as well as orthosis and taping are commonly applied to prevent the recurrence of an ankle joint injury. So this study was evaluated effect of quarter heel raising exercise (QHR) on balance and peroneus longus muscle strength in FAI subjects.

Methods:

Among 26 FAI subjects, 13 with FAI were assigned to the QHR group, and 13 with FAI were assigned to the control group which was no intervention. All of 30 subjects were evaluated Teskscan included static balance ability, Y balance test included dynamic balance ability with three directions which is anterior, posterolateral, posteromedial direction. Commander muscle testing included eversion/inversion strength ratio at pre- and post-intervention.

Results:

There was a significant interaction between group and time in static, dynamic balance, and strength. In QHR group, there was simple effect on static, dynamic balance, and strength. But control group showed no simple effect on static, dynamic balance, and strength. In the pre- and post-intervention differences between the groups. There was a significant difference in pre-intervention condition between the groups, but no significant difference between the groups in post-intervention in all conditions.

Conclusions:

QHR exercise is useful for improving the balance ability and muscle strength of the peroneus longus muscle in FAI subjects.
Effect of intraoperative operating table rotation on lower limb perfusion index in patients in the lithotomy position
Authors: Hara Kentaro , Ichihara Kodai , Yamaguchi Michiko , Takeshita Hiroaki , Kuroki Tamotsu
Published: September 2022

We focused on “returning to the horizontal position,” one of the measures for preventing well leg compartment syndrome implemented at our hospital, and aimed to clarify the effect of intraoperative positional changes by operating table rotation on blood perfusion in the lower extremities during lithotomy in patients under general anesthesia. This prospective observational study examined 64 patients scheduled to undergo general anesthesia in the lithotomy position from March 2021 to May 2022. The primary endpoint was the perfusion index (PI) of the lower limb before and after operating table rotation. The baseline lower limb PI before the operating table rotation was 2.376 (1.591), and the lower limb PI after the change from Trendelenburg to the horizontal position was as follows: immediately after, 2.123 (1.405); 5 minutes, 1.894 (1.138); 10 minutes, 1.915 (1.167); and 15 minutes, 1.993 (1.218). Compared with the baseline, no significant difference was noted in the change in the lower limb PI due to the Trendelenburg to horizontal positional change. The baseline lower leg pressure before the operating table rotation was 51.4 (13.4) mm Hg, and the lower leg pressure after the change from the Trendelenburg to the horizontal position was as follows: immediately after, 36.6 (10.3) mm Hg; 5 minutes, 36.5 (10.2) mm Hg; 10 minutes, 36.4 (10.0) mm Hg; and 15 minutes, 36.5 (10.2) mm Hg. Compared with the baseline, the change in lower leg pressure due to the Trendelenburg to horizontal positional change showed a significant decrease immediately afterward (P < .001). After operating table rotation from the Trendelenburg to the horizontal position, the lower limb PI did not change significantly after 15 min. However, lower leg pressure showed a significant decrease immediately after returning to the horizontal position. This result provides evidence for operating table rotation as a preventive measure for well leg compartment syndrome.
The influence of involving patients in postoperative pain treatment decisions on pain-related patient-reported outcomes: A STROBE-compliant registering observational study
Authors: Jiang Bailin , Wu Yaqing , Wang Xiuli , Gan Yu , Wei Peiyao , Mi Weidong , Feng Yi
Published: September 2022

The evidence regarding the influence of allowing patients to participate in postoperative pain treatment decisions on acute pain management is contradictory. This study aimed to identify the role of patient participation in influencing pain-related patient-reported outcomes (PROs). This is a cross-sectional study. The data were provided by PAIN OUT (www.pain-out.eu). A dataset specific to adult Chinese patients undergoing orthopedic surgery was selected. The PROs were assessed on postoperative day 1. The patient participant was assessed using an 11-point scale. Participants who reported >5 were allocated to the “participation” group, and those who reported ≤5 were allocated to the “nonparticipation” group. A 1:1 propensity score matching was conducted. The primary outcome was the desire for more pain treatment. All other items of PROs were the secondary outcomes comprising pain intensity, interference of pain with function, emotional impairment, adverse effects, and other patient perception. From February 2014 to November 2020, 2244 patients from 20 centers were approached, of whom 1804 patients were eligible and 726 pairs were matched. There was no significant difference between the groups in the desire for more pain treatment either before (25.4% vs 28.2%, risk ratio [95% CI]: 0.90 [0.77, 1.05], P = .18) or after matching (26.7% vs 28.8%, risk ratio [95% CI]: 0.93 [0.79, 1.10], P = .43). After matching, patients in the participation group reported significantly better PROs, including pain intensity (less time spent in severe pain [P < .01]), emotional impairment (less anxiety [P < .01]), interference with function (less interference with sleep [P < .01]), adverse effects (less drowsiness [P = .01]), and patient perception (more pain relief [P < .01] and more satisfaction [P < .01]), than the nonparticipation group. Patient participation in pain treatment decisions was associated with improved pain experience but failed to mitigate the desire for more treatment.
Can EMS providers and emergency department nurses work together to identify home risk factors for falls in older people?
Authors: Chiang Tsai-Lien , Hsu Chan-Peng , Yuan Yu-Jie , Lin Chaou-Shune
Published: September 2022

Taiwan is an aging society and the ratio of falls among the older persons is high. Most falls occur at home, and multiple risk factors including home safety are involved. We propose a novel model of emergency medical technicians (EMTs) to assess home safety using scalable checklists. This study was conducted to evaluate its feasibility. This study was conducted between April 1, 2020 and March 31, 2021. The development of the risk factor assessment scale for falls in the home environment was divided into 2 stages. In stage 1, 2 researchers reviewed the extant literature. In stage 2, 6 experts judged the content validity index. According to EMT findings, emergency department (ED) nurses checked the items in the Checklist of Risk Factors for Falls in the Home Environment. The checklists were provided to the geriatric care manager (GCM) in the ED, who then discussed potential solutions with the patients or primary caregivers. A total of 235 participants were enrolled, and EMTs carried out environment assessment for 93.2% (219/235) of them. A total of 207 participants were at risk of falls at home and 79.7% (165/207) of them received intervention measures from the GCM according to the risk items. Education was the main intervention method, with 158 subjects. Moreover, seven subjects (4.2%, 7/165) were provided long-term care resources by the GCM with occupational therapists to help improve the environment at home. Our study provides an efficient method for EMTs to assess home fall hazards.
Serum creatinine to absolute lymphocyte count ratio effectively risk stratifies patients who require intensive care in hospitalized patients with coronavirus disease 2019
Authors: Ngiam Jinghao Nicholas , Liong Tze Sian , Chew Nicholas W.S. , Li Tony Yi-Wei , Chang Zi Yun , Lim Zhen Yu , Chua Horng Ruey , Tham Sai Meng , Tambyah Paul Anantharajah , Santosa Amelia , Cross Gail Brenda , Sia Ching-Hui
Published: September 2022

Patients with preexisting kidney disease or acute kidney injury had poorer outcomes in coronavirus disease 2019 (COVID-19) illness. Lymphopenia was associated with more severe illness. Risk stratification with simple laboratory tests may help appropriate site patients in a cost-effective manner and ease the burden on healthcare systems. We examined a ratio of serum creatinine level to absolute lymphocyte count at presentation (creatinine-lymphocyte ratio, CLR) in predicting outcomes in hospitalized patients with COVID-19. We analyzed 553 consecutive polymerase chain reaction-positive SARS-COV-2 hospitalized patients. Patients with end-stage kidney disease were excluded. Serum creatinine and full blood count (FBC) examination were obtained within the first day of admission. We examined the utility of CLR in predicting adverse clinical outcomes (requiring intensive care, mechanical ventilation, acute kidney injury requiring renal replacement therapy or death). An optimized cutoff of CLR > 77 was derived for predicting adverse outcomes (72.2% sensitivity, and 83.9% specificity). Ninety-seven patients (17.5%) fell within this cut off. These patients were older and more likely to have chronic medical conditions. A higher proportion of these patients had adverse outcomes (13.4% vs 1.1%, P < .001). On receiver operating curve analyses, CLR predicted patients who had adverse outcomes well (area under curve [AUC] = 0.82, 95%CI 0.72–0.92), which was comparable to other laboratory tests like serum ferritin, C-reactive protein and lactate dehydrogenase. Elevated CLR on admission, which may be determined by relatively simple laboratory tests, was able to reasonably discriminate patients who had experienced adverse outcomes during their hospital stay. This may be a simple and cost-effective means of risk stratification and triage.
Influence of psychological responses of caregiving on the perceived health of family caregivers to acute stroke survivors
Authors: Cheng Ho Yu , Li Yating , Chau Janita Pak-Chun , Chair Sek Ying
Published: September 2022

Family caregivers provide round-the-clock care to their family members who had a stroke. The detrimental effects of caregiving on caregiver’s health would lead to the abandonment of caregiver role and institutionalization of stroke survivors. This study aims to determine the factors associated with the perceived health status of family caregivers to stroke survivors. This study conducted a secondary analysis of the baseline data of 142 family caregivers of stroke survivors nested within a longitudinal randomized controlled trial. Potential factors were identified according to the Pittsburgh Mind-Body Center model and were analyzed with hierarchical multiple regression models. The results indicated that stroke caregivers exhibited comparable perceived physical health with general population but poorer perceived mental health. Severity of depressive symptoms (β = −0.37, P < .001) remained the strongest and most significant factor associated with perceived mental health, followed by confidence in problem-solving (β = −0.21, P < .05). Moreover, caregiving competence (β = 0.29, P < .001) was the sole significant psychological factor associated with perceived physical health. Caregiving competence, problem-solving abilities, and severity of depressive symptoms are significant modifiable correlates of the perceived health of caregivers. Intervention for improving these psychological responses of caregivers is suggested incorporated in stroke rehabilitation programs.
An observational study of health insured visits for children following Medicaid eligibility expansion for adults among a linked cohort of parents and children
Authors: Angier Heather , Hodes Tahlia , Moreno Laura , O’Malley Jean , Marino Miguel , DeVoe Jennifer E.
Published: September 2022

Despite its focus on adults, the Affordable Care Act (ACA) Medicaid expansion led to increased health insurance enrollment for children in the United States. Previous studies looked at parent and child insurance changes separately, or used a single survey response item to understand changes in health insurance for parents and children. It is, however, important to understand the connection between parent and child insurance changes together (not individually) using data sources that account for insurance over time. Therefore, to understand the association of parental health insurance on their children’s coverage, leveraging a cohort of linked families seen in community health centers (CHCs), we used electronic health records to link a cohort of parents and children with ≥1 visit to a CHC in a Medicaid expansion state pre- (1/1/2012–12/31/2013) and ≥1 visit post-ACA (1/1/2014–12/31/2018) and determined primary payer type for all visits. This observational, cohort study assessed the rate of insured visits for children pre- to post-ACA across four parental insurance groups (always insured, gained Medicaid, discontinuously insured, never insured) using Poisson mixed effects models. We included 335 CHCs across 7 United States. Insurance rates were highest (~95 insured visits/100 visits) for children of parents who were always insured; rates were lowest for children of parents who were never insured (~83 insured visits/100 visits). Children with a parent who gained Medicaid had 4.4% more insured visits post- compared to pre-ACA (adjusted relative rates  = 1.044, 95% confidence interval: 1.014, 1.074). When comparing changes from pre- to post-ACA between parent insurance groups, children’s insured visit rates were significantly higher for children of parents who gained Medicaid (reference) compared to children of parents who were always insured (adjusted ratio of rate ratio: 0.963, confidence interval: 0.935–0.992). Despite differences in Medicaid eligibility for children and adults, health insurance patterns were similar for linked families seen in CHCs. Findings suggest consideration should be paid to parent health insurance options when trying to increase children’s coverage.
Clinical characteristics of the delta variant of COVID-19 in Jingmen, China
Authors: Bie Fangfang , Yuan Wensheng , Chen Yafeng , Gao Qijun
Published: September 2022

There has been an epidemic of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) delta variant in Jingmen, China, and the clinical and epidemiological characteristics of all patients infected with SARS-CoV-2 delta variant in an epidemic are rarely reported. All the coronavirus disease 2019 (COVID-19) patients diagnosed in Jingmen in August 2021 were enrolled in this study. Epidemiological data and clinical characteristics were analyzed. Of 58 patients (38 male and 20 female), 11 were children. The mean age was 35 years, and the median age was 39 years (range, 1–60 years; interquartile range, 28–51). The infectivity of the SARS-CoV-2 Delta variant may have increased, but pathogenicity could have decreased significantly. The vast majority of patients had either no symptoms or mild symptoms. Even though the variant virus is highly contagious, control measures have proven effective. Symptoms included fever (53%), cough (48%), headache (6%), runny nose (13%), loss of smell and taste (6%), elevated C-reactive protein (26%), increased neutrophil count (13%), decreased eosinophil count (21%), and elevated mononuclear granulocytes (26%). Thirty-eight of the 47 adults showed lymphocyte decline, but none of the children showed a significant decline, and more than half of them showed an increase. Thirty patients had no pneumonia, 27 patients had mild pneumonia, and only one patient with multiple chronic diseases had severe pneumonia. None of the 11 children had been vaccinated, 10 did not have pneumonia, and 1 had a small lung lesion. The number of new patients disappeared in 15 days after the lockdown of the city.
Application of symptom-based mind mapping combined with PBL teaching method in emergency trauma standardized resident training in MDT model
Authors: Xu Zhou-Wei , Liu Na-Na , Zhang Jian-Lin , Wu Xue-Sheng , Chen Jia , Chang Jia-Wei , Ding Bai-Cheng , Wu Yu-Nuo , Wang Jia-Peng , Chen Wei-Dong , Wang Xing-Yu
Published: September 2022

Explore the feasibility and effectiveness of accepting mind mapping combined with problem-based learning (PBL) teaching method in the standardized training of emergency surgery residents in the multi-disciplinary team (MDT) model of emergency trauma. Eighty-nine doctors under training who rotated in the Department of Emergency Surgery of the First Affiliated Hospital of Anhui Medical University from January 2021 to January 2022 were selected as the study subjects, and randomly divided into a group receiving mind mapping combined with PBL teaching and a group receiving traditional lecture-based learning teaching. Mini-clinical evaluation exercise (Mini-CEX), direct observation of procedural skills (DOPS), teaching adherence, and satisfaction assessments were completed at the time of discharge from the department. There were no significant differences between the observation and control group trainees in terms of gender, age, education, and entry grades. Both groups of doctors were better able to participate in their respective teaching modes and made significant progress. The participants in the observation group had significantly higher Mini-CEX, DOPS, and teaching satisfaction scores than the control group (P < .05). Under the MDT model of emergency trauma, the combination of mind mapping and PBL teaching can improve the comprehensive clinical ability of the trainees more than participating in the traditional lecture-based learning teaching, which is worth promoting and implementing in the clinical standardized training.
Developing Sentinel Surveillance for Chlamydia and Gonorrhea Using Test Results From Routine Screening During Pregnancy
Authors: Lazenby Gweneth B. , Korte Jeffrey E. , Pekar Ekaterina , Peterman Thomas A. , Cope Anna B.
Published: September 2022

Background

Interpretation of case-based surveillance of chlamydia and gonorrhea is limited by the lack of negative tests for comparison. We sought to develop a sustainable electronic health record (EHR)-based approach to disease surveillance in a sentinel population of pregnant persons.

Methods

We conducted a 1-year assessment of sexually transmitted infections (STIs) in persons receiving at least 1 pregnancy-related visit within our university medical center. Data were obtained using EHR analytic structured query language code. Patients were categorized by whether they had an STI test during pregnancy and if screened, by the STI test results (positive or negative). We assessed screening and positivity by demographic using bivariate analyses. Predictors of a positive STI test were determined using logistic regression.

Results

We identified 4553 persons who received pregnancy care from January 1 to December 31, 2021. Seventy-six percent (n = 3483) of persons were screened for an STI during pregnancy. Those who identified as white or had private insurance were less likely to have a chlamydia test. Among persons screened, Trichomonas was the most commonly detected STI (5%, 141/2698) followed by chlamydia (4%, 135/3456), and gonorrhea (0.7% 24/3468). Predictors of a positive STI test during pregnancy were Black race (adjusted odds ratio [aOR], 6.0; 95% confidence interval [95% CI], 4.2–8.7), 25 years or younger (aOR, 2.5; 95% CI, 1.9–3.3), and public insurance (aOR, 1.6; 95% CI, 1.2–2.1).

Conclusions

We demonstrated that EHRs can be used to assess gonorrhea and chlamydia positivity. These methods could potentially be applied in other jurisdictions to improve the understanding of national STI surveillance.
Efficacy of prehabilitation prior to cardiac surgery: a systematic review and meta-analysis
Authors: Steinmetz Carolin , Bjarnason-Wehrens Birna , Walther Thomas , Schaffland Tim Fabian , Walther Claudia
Published: September 2022

Objective

Patients awaiting cardiac surgery seem to benefit from exercise-based-prehabilitation (EBPrehab) but the impact on different perioperative outcomes compared to standard care is still unclear.

Design

Eligible non-/randomized controlled studies investigating the impact of EBPrehab in adults scheduled for elective cardiac surgery were searched on 16th december 2020 from electronic databases, including MEDLINE, CENTRAL and CINAHL. The data were pooled and a meta-analysis was conducted.

Results

Out of 1.490 abstracts six studies (n = 665) were included into the review and meta-analysis. At post-intervention-interval and at post-surgery-interval, 6-minute-walking-distance (6MWD) improved significantly in EBPrehab-group compared to controls (mean difference (MD) = 75.4 m, 95% CI, 13.7–137.1 m; p = 0.02 and 30.5 m, 95% CI, 8.5–52.6 m; p = 0.007, respectively). Length of hospital stay (LOS) was significantly shorter in EBPrehab-group (MD = -1.00 day, 95% CI, -1.78 to -0.23; p = 0.01). Participation in EBPrehab revealed a significant decrease in the risk of postoperative atrial fibrillation (AF) in patients ≤65 years (risk ratio = 0.34, 95% CI, 0.14–0.83; p = 0.02).

Conclusion

The participation in EBPrehab significantly improves post-intervention and post-surgery 6MWD, LOS and decreases the risk of postoperative AF in patients ≤65 years compared to controls.