bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronavirus 2019: clinical and neuropathological aspects
Authors: Younger David S.
Published: November 2020

Purpose of review

To understand the role of postinfectious autoimmune vascular inflammation in the pathogenesis of coronavirus disease 2019-related neurological illness caused by the novel severe acute respiratory syndrome coronavirus 2 virus and its effects on the brain in children and adults.

Recent findings

There are a very small number of postmortem neuropathological series of coronavirus disease 2019-related cerebrovascular and parenchymal disease. However, they fall into at least three major categories, with the majority manifesting those of terminal hypoxia, and others demonstrating inflammatory vascular leptomeningeal, cerebral and brainstem interstitial changes suspicious for encephalitis in a minority of cases. It remains uncertain whether these histopathological features have a relationship to post-infectious inflammatory immune mechanisms and microscopic vasculitis in adults as it appears to be in affected children with multisystem inflammatory syndrome.

The reasons for this dichotomy are unclear but may related to inherent and epigenetic factors that remain poorly understood. Treatment addressing postinfectious mechanisms of pulmonary, systemic, and nervous system injury may avert early mortality.
Pathophysiology of COPD
Authors: Leap Jennifer , Arshad Obaid , Cheema Tariq , Balaan Marvin
Published: November 2020

This article provides an overview of the pathophysiology of chronic obstructive pulmonary disease including the physiological mechanisms that are known precursors. The roles of environmental and genetic causes are considered. α1-Antitrypsin deficiency is also discussed as it relates to the development of airflow obstruction.
Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Baqdunes Mohammad Wisam , Leap Jennifer , Young Meilin , Kaura Amit , Cheema Tariq
Published: November 2020

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and results in an economic and social burden that is both substantial and increasing. The natural history of COPD is punctuated by exacerbations, which have major short- and long-term implications on the patient and health care system. Evidence-based guidelines stipulate that early detection and prompt treatment of exacerbations are essential to ensure optimal outcomes and to reduce the burden of COPD. In this review, we provide a concise overview of COPD exacerbations and their risk factors and etiology (infection vs noninfectious), outlining the initial evaluation, triaging, and current management including invasive and noninvasive ventilation, in addition to the prognosis and the preventive strategies.
Comorbidities Associated With Chronic Obstructive Pulmonary Disease
Authors: Villgran Vipin , Gordon Ayla , Malik Khalid , Cheema Tariq
Published: November 2020

Chronic obstructive pulmonary disease or COPD is characterized by airflow obstruction, causing respiratory symptoms. There are treatments available for COPD; however, COPD has significant extrapulmonary effects, including well-recognized ones as cardiovascular disease and often underdiagnosed ones as osteoporosis. It is imperative to be aware of these comorbidities to optimize COPD patient care.
Developing a Multidisciplinary Approach to the COPD Care Pathway
Authors: Young Meilin , Villgran Vipin , Ledgerwood Chelsea , Schmetzer Amy , Cheema Tariq
Published: November 2020

Chronic obstructive pulmonary disease (COPD) is characterized as a predominately preventable and treatable inflammatory lung disease caused by progressive obstructed airflow from the lungs. In the United States and worldwide, it is becoming a major cause in hospital admissions as well as an increase in morbidity and mortality. The rising total cost of care for COPD is concerning for all health care industries. The disease has significant impact on the patient's quality of life and psychological well-being. A worldwide initiative is underway in developing a care model that is multifactorial through continuous monitoring of patients to manage and control symptoms, achieve medication adherence, and provide socioeconomic resources. The primary aim of this study was to prevent exacerbations, hospital admissions, and readmissions. Various models have shown positive results; however, the significant financial investment is the major barrier to success. Recently, one health system in the United States was able to improve care, decrease readmissions, and reduce total cost of care by investing in a multidisciplinary team of specialists. In the utilization of the care model, the primary endpoint will conclude that COPD is financially and socioeconomically manageable.
Adapting Interdisciplinary Transitional Ambulatory Practice to Meet the Challenges of COVID-19
Authors: Dowd-Green Caitlin , McLaughlin Heather , Seymour Charlotte , Diffenderffer Chrissy , Bertram Amanda , Stewart Rosalyn W.
Published: November 2020

COVID-19 restructured the health care delivery process, catapulting telemedicine to the mainstream. The Johns Hopkins After Care Clinic (JHACC) continued transprofessional health care delivery in the telemedicine space by shifting to remote, asynchronous collaboration and a triage system. In 1 month after starting telemedicine, the JHACC had 907 encounters for 376 unique patients. Most patients reported satisfaction with their visits. Telemedicine lengthened visit completion times. Providers encountered many failed call attempts and limited access to videoconferencing. Barriers to sustainable interprofessional telemedicine include poor social determinants of health, limited reimbursement for nonphysician health professionals, and increased clinical and administrative time.
Widespread Metastasis to the Stomach 10 Years After Primary Breast Cancer
Authors: Fu Ji-Xin , Zou Ya-Nan , Long-Li  , Wang Xin-Jian
Published: November 2020

Rationale:

Breast cancer is a common malignant tumor. The most common metastatic sites of breast cancer are the bone, brain, liver and lung, and gastrointestinal metastases are rare. Considering that the median time interval from the initial breast cancer diagnosis to stomach metastasis is 77.5 months, gastrointestinal metastases are rarely observed 10 years after primary breast cancer.

Patient concerns:

Here, we present a 63-year-old female with unusual endoscopy results that revealed scattered polyps and mucosal infiltration throughout the stomach, which were later confirmed to be metastatic lobular carcinoma of the breast that had been surgically removed 10 years earlier.

Diagnosis:

The patient was diagnosed with gastric metastases of breast cancer by immunohistochemistry.

Interventions:

The patient underwent endocrine therapy with palbociclib and tamoxifen.

Outcomes:

After 1 year of endocrine therapy, the symptoms of upper abdominal discomfort and fatigue were relieved and a new gastroscopy revealed there had been no significant progression of the gastric metastasis. According to the Response Evaluation Criteria in Solid Tumors (RECIST), the patient reached a state of stable disease.

Lessons:

Gastric metastases of breast cancer are rare in the clinical setting. However, considering the possibility of gastric metastases from breast cancer and performing an upper endoscopy are crucial for patients who present with any subtle gastric symptoms and have a past medical history of breast cancer, even if the breast cancer occurred more than 10 years ago.
Cross-sectional evaluation of the interaction between activity relative-time expenditure and comorbidity concerning physical quality of life
Authors: Suarez-Villar Rafael , Martinez-Urbistondo Diego , Fernandez Maria Agud , Lopez-Cano Maria , Fernandez Eva , Dominguez Andrea , Prosper Laura , Rodriguez-Cobo Ana , Tinoco Maria Elena Caro , Nadal Paula , Risco Carlos Risco , Fernández Paula Villares , Martínez Jose Alfredo
Published: November 2020

Quality of life (QoL) is a matter of concern in both healthy and diseased individuals. Lifestyle factors such as physical activity and sleep have a direct impact on QoL. In this context, interactions between activity time expenditure and QoL might be different in comorbid and non comorbid patients. Besides, the quantification and evaluation of time expenditure is ordinarily measured as the absolute time devoted to each activity. The objective of this study is the evaluation of the influence and interactions of activity-relative time expenditure and co-morbidity in Physical QoL.

The study involved 302 consecutive patients, from an Internal Medicine ambulatory evaluation. Validated questionnaires were used to collect demographic variables and time expenditure variables. QoL was gathered with de survey short form-36questionnaire. Comorbidity was compiled with de Charlson Comorbidity Index. SPSS v20.0 was used for statistical analysis.

As hypothesized, healthy subjects had higher Physical QoL score than comorbid subjects (P < .05). Physical activity and sleep relative time expenditure were statistically significant and associated to a better QoL in comorbid patients (P < .05). Interestingly, sleep was found to have statistically significant interaction with a score of ≥2 in the Charlson Comorbidity Index. Age, gender, comorbidity, physical activity relative time expenditure, and the interaction between relative time dedicated to sleep and comorbidity were found statistically significant in a multivariate model on Physical QoL prediction.

Activity-relative time expenditure could be an adequate measure of daily activity pattern in the evaluation of QoL. Relative time spent in physical activity and sleep might be positively associated to Physical QoL. Sleep and comorbidity could have a statistically significant interaction in the prediction of Physical QoL.
Evaluation of circulating microRNA expression in patients with trigeminal neuralgia
Authors: Li Xihan , Wang Dongxu , Zhou Jianbin , Yan Yanfeng , Chen Leiyao
Published: November 2020

Trigeminal neuralgia (TN) is a chronic neuropathic pain that seriously affects the daily life of patients. There is increasing evidence that microRNAs (miRNAs) play an important role in the development of neuropathic pain.

In this study, the TaqMan Low Density Array (TLDA) was used to analyze the serum miRNA levels of 28 TN patients, and 31 healthy people without any neuropathic pain were used as controls.

The results showed that the expression profile of serum miRNA in TN patients was different from that in healthy controls. Compared with the control group, 13 miRNAs in the serum of TN patients were up-regulated and 115 miRNAs were down-regulated by >2 times. Quantitative reverse transcription PCR (RT-qPCR) analysis and receiver operating characteristic (ROC) curve were performed. The analysis further confirmed that the expression levels of 4 miRNAs, including miR-132-3p, miR-146b-5p, miR-155-5p, and miR-384, were significantly higher than those of healthy controls, and the difference was statistically significant.

This study preliminarily confirmed the changes of serum miRNA expression profile in TN patients. Among them, 4 kinds of serum miRNA are likely to be related to the occurrence and development of TN.
Hypertension in adolescents and young adults referred to a tertiary hypertension clinic in Cape Town, South Africa
Authors: Jones Erika S. W. , Esack Ilhaam , Mangena Phetho , Rayner Brian L.
Published: November 2020

To audit the young patients referred to the Hypertension Clinic at Groote Schuur Hospital that predominately serves the underprivileged communities of Cape Town.

Folders of patients between the ages of 15 and 30 years over a 2 year period were reviewed. The data collected included demographic, clinical and laboratory data, investigations, causes of hypertension, and presence of hypertensive organ damage.

Of the 110 patients reviewed, 61 (55.5%) were females, 22 (20%) Black African, and 88 (80%) of Mixed Ancestry. Eight (7.3%) were found to be normotensive, 16 (14.5%) had a secondary cause and 86 (78.2%) had essential hypertension. Thirty five (31.8%) were current or previous smokers, and 11 (10%) admitted to current or prior use of metamphetamines. A family history of hypertension in a first degree relative was present in 80 (72.7%) patients. Comorbidities present were diabetes in 7 (6.4%) patients, metabolic syndrome in 13 (11.8%), and obesity in 26 (23.6%), but 42.6% had a body mass index (BMI) <25 kg/m2. Chronic kidney disease (CKD) was present in 29 (26.4%) patients and ECG left ventricular hypertrophy in 56 (50.9%). Overall organ damage was present in 72 (65.5%) patients.

In this cohort of young hypertensives most patients had essential hypertension with a strong family history. Significant organ damage was identified. High risk behavior, including smoking and illicit drug use, and obesity were identified as contributing factors. Secondary causes were identified in 14.2%. These results suggest a targeted approach to the investigation of young hypertensives for secondary causes, and significant opportunities for lifestyle intervention.
A retrospective study of Yiqi-Huoxue Decoction on blood pressure in patients with acute ischemic stroke
Authors: Jiang Chao , Wang Ting , Xu Yong-Cheng , Gao Ying , Fang Bang-Jiang
Published: November 2020

This retrospective study investigated the effect of Yiqi-Huoxue Decoction (YQHXD) on blood pressure (BP) in patients with acute ischemic stroke (AIS).

A total of 72 patients with BP following AIS who received routine treatment were included in this retrospective study. Of those, 36 patients received YQHXD and were assigned to a treatment group. The other 36 patients were allocated to a control group. All patients were treated for a total of 4 months. The outcomes were assessed by systolic blood pressure (SBP), diastolic blood pressure (DBP), National Institutes of Health Stroke Scale (NIHSS) score and Barthel index scale (BIS). All outcomes were measured after 4-month treatment.

After treatment, all subjects in the treatment group showed greater improvements in SBP (P < .05), DBP (P < .05), NIHSS (P < .05) score, and BIS (P < .05) than those of patients in the control group. In addition, the safety profile is similar in both groups.

The findings of this study demonstrated that YQHXD may benefit on BP in patients with AIS. Future studies should focus on warranting the current results.
Maxingshigan decoction for treating COVID-19
Authors: Shao Guoliang , Huang Shaolei , Cui Yuying , Yang Dianhui
Published: November 2020

Background:

Coronavirus disease 2019 (COVID-19) is a rapidly spreading disease that has been in a public health emergency of international concern since its outbreak in 2020. Due to the complex pathogenesis and susceptibility of COVID-19, many commonly used drugs for the treatment of COVID-19 have not shown excellent clinical effects. Traditional Chinese medicine has a long clinical history of preventing and treating this respiratory infectious disease. Maxingshigan Decoction (MXSG) is widely used in China to treat COVID-19. However, there is no comprehensive and systematic evidence on the effectiveness and safety of Maxingshigan Decoction.

Methods:

PubMed, EMBASE, Clinical Trials, the Cochrane Library, Sino Med, and China National Knowledge Infrastructure up to September 2020. This study only screens clinical randomized controlled trials on MXSG for COVID-19 to evaluate its efficacy and safety. Data were extracted by 1 investigator and checked by an independent investigator. Review Manager 5.3 software was used for the data analysis. The dichotomous data is represented by relative risk, and the continuous is expressed by mean difference or standard mean difference, eventually the data is synthesized using a fixed effect model or a random effect model depending on whether or not heterogeneity exists.

Results:

The time from a positive diagnosis to a negative result of 2 consecutive nucleic acid tests (not on the same day), cure rate. The results of our research will be published in a peer-reviewed journal.

Conclusion:

The purpose of this systematic review is to provide new evidence for the effectiveness and safety of Maxingshigan decoction in the treatment of COVID-19.

PROSPERO registration number:

CRD42020211962.
Clinical pain management by a multidisciplinary palliative care team
Authors: Yang Bo , Cui Zhi , Zhu Xiuqin , Deng Muhong , Pan Yu , Li Ruixin , Guo Mei , Lu Guijun , Zhang Xuehua , Guo Liping , Huang Yurong , Li Fang
Published: November 2020

To investigate the effect of multidisciplinary interventions on pain management in cancer inpatients.

Four hundred thirty eight patients with cancer pain, who performed the multidisciplinary intervention were recruited. Before and after intervention, the Brief Pain Inventory (BPI) and the MD Anderson Symptom Inventory (MDASI) score as the primary endpoints and QOL scores as the secondary endpoint were all evaluated. To investigate the factors that led to different responses to multidisciplinary interventions, patients were classified as non-responders or responders.

Finally, 92 patients (63 male and 29 female) scheduled for cancer pain management by inter-professional team were studied. After individualized multidisciplinary therapy, both pain and symptom severity was improved, as demonstrated by lowered BPI worst and average pain scores, as well as symptom severity score measured by MDASI (P = .017, P = .003, and P = .011, respectively). The proportion of patients with mild pain increased regarding the BPI worst and average pain at baseline and after treatment (P < .05). The QOL analyses showed multidisciplinary interventions could significantly improve the function and symptom scores (P < .001). More patients in responder group received chemotherapy (58, 70.7%, P = .003), while fewer received mini-invasive therapy (6, 7.32%, P = .011).

Multidisciplinary interventions had certain beneficial effect on cancer pain management, especially in patients with moderate or severe pain.
Clinical symptoms, comorbidities and complications in severe and non-severe patients with COVID-19
Authors: Wang Zhufeng , Deng Hongsheng , Ou Changxing , Liang Jingyi , Wang Yingzhi , Jiang Mei , Li Shiyue
Published: November 2020

Background:

The pandemic of COVID-19 poses a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 38%, and it is particularly important to identify risk factors that aggravate the disease.

Methods:

We performed a systematic review of the literature with meta-analysis, using 7 databases to identify studies reporting on clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% confidence interval (CI). Measure of heterogeneity was estimated by Cochran's Q statistic, I
2 index and P value.

Results:

A total of 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe: 33.4%, 95% CI: 25.4%–41.4%; non-severe 21.6%, 95% CI: 9.9%–33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5%–17.3%; non-severe: 8.5%, 95% CI: 6.1%–11.0%). The prevalence of acute respiratory distress syndrome, acute kidney injury and shock were all higher in severe cases, with 41.1% (95% CI: 14.1%–68.2%), 16.4% (95% CI: 3.4%–29.5%) and 19.9% (95% CI: 5.5%–34.4%), rather than 3.0% (95% CI: 0.6%–5.5%), 2.2% (95% CI: 0.1%–4.2%) and 4.1% (95% CI: −4.8%–13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI: 13.8%–46.8%) than non-severe cases (1.5%, 95% CI: 0.1%–2.8%).

Conclusion:

Hypertension, diabetes and cardiovascular diseases may be risk factors for severe COVID-19.
Relationship between digestive diseases and COVID-19 severity and mortality
Authors: Li Jinjuan , Yue Jia , Zhang Shunan , Wu Jianjun , Lian Rongna , Zhang Ruinian , Cheng Peng
Published: November 2020

Background:

Digestive diseases have been often reported in COVID-19 patients, but whether COVID-19 patients with existing digestive comorbidities are at an increased risk of serious disease and death remains unclear. This study aims to evaluate the association between digestive diseases and COVID-19 severity and mortality.

Methods:

PubMed, Embase.com, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Wanfang, and SinoMed will be searched to identify relevant studies up to October 1, 2020. We will use the Newcastle-Ottawa quality assessment scale to assess the quality of included studies. We will use Stata to perform pairwise meta-analyses using the random-effects model with the inverse variance method to estimate the association between digestive diseases and the mortality and severity of COVID-19. Subgroup analyses and sensitivity analyses will be conducted to investigate the sources of heterogeneity. We will create a “Summary of findings" table presenting our primary and secondary outcomes using the GRADEpro Guideline Development Tool software.

Results:

The results of this study will be published in a peer-reviewed journal.

Conclusions:

This study will comprehensively evaluate the association between digestive diseases and the severity and mortality of patients with COVID-19. The results of this study will provide high-quality evidence to support clinical practice and guidelines development.
Single-center experience on actual mid-term (≥5 years) and long-term (≥10 years) survival outcome in patients with hepatocellular carcinoma after curative hepatectomy
Authors: Fung Andrew K.Y. , Cheng Nicole M.Y. , Chong Charing C.N. , Lee Kit-Fai , Wong John , Cheung Sunny Y.S. , Lok Hon-Ting , Lai Paul B.S. , Ng Kelvin K.C.
Published: November 2020

Analysis for actual mid-term (≥5 years) and long-term (≥10 years) survivors with hepatocellular carcinoma (HCC) following curative hepatectomy are rarely reported in the literature.

This retrospective study aims to study the mid- and long-term survival outcome and associated prognostic factors following curative hepatectomy for HCC in a tertiary referral center.

The clinical data of 325 patients who underwent curative hepatectomy for HCC were reviewed. They were stratified into 3 groups for comparison (Group 1, overall survival <5 years; Group 2, overall survival ≥5, and <10 years; Group 3, overall survival ≥10 years). Favorable independent prognostic factors for mid- and long-term survival were analyzed.

A bimodal distribution of actual survival outcome was observed, with short-term (<5 years) survival of 52.7% (n = 171), mid-term survival of 18.1% (n = 59), and long-term survival of 29.2% (n = 95). Absence of microvascular invasion (OR 3.690, 95% CI: 1.562–8.695) was independent good prognostic factor for mid-term survival. Regarding long-term overall survival, young age (OR 1.050, 95% CI: 0.920–0.986), ASA grade ≤2 (OR 3.746, 95% CI: 1.325–10.587), high albumin level (OR 1.008, 95% CI: 0.920–0.986), solitary tumor (OR 3.289, 95% CI: 1.149–7.625) and absence of microvascular invasion (OR 4.926, 95% CI: 2.192–11.111) were independent good prognostic factors.

Curative hepatectomy results in bimodal actual survival outcome with favorable long-term survival rate of 29.2%. Favorable independent prognostic factors (age, ASA grade, albumin level, tumor number, and microvascular invasion) are identified for overall survival.
Effects of a preoperative forced-air warming system for patients undergoing video-assisted thoracic surgery
Authors: Xiao Yan , Zhang Rui , Lv Na , Hou Chunmiao , Ren Chunguang , Xu Huiying
Published: November 2020

Background:

The incidence of intraoperative hypothermia is still high despite the proposal of different preventive measures during thoracoscopic surgery. This randomized control study evaluated the effects of 30-minute prewarming combined with a forced-air warming system during surgery to prevent intraoperative hypothermia in patients undergoing video-assisted thoracic surgery under general anesthesia combined with erector spinae nerve block.

Methods:

Ninety-eight patients were randomly and equally allocated to prewarming or warming groups (n = 49 each). The primary outcome was the incidence of intraoperative hypothermia. Secondary outcomes were core temperature, irrigation and infused fluid, estimated blood loss, urine output, type of surgery, intraoperative anesthetic dosage, hemodynamics, recovery time, the incidence of postoperative shivering, thermal comfort, postoperative sufentanil consumption and pain intensity, patient satisfaction, and adverse events.

Results:

The incidence of intraoperative hypothermia was significantly lower in the prewarming group than the warming group (12.24% vs 32.65%, P 
= .015). Core temperature showed the highest decrease 30 minutes after surgery start in both groups; however, the rate was lower in the prewarming than in the warming group (0.31 ± 0.04°C vs 0.42 ± 0.06°C, P 
< .05). Compared with the warming group, higher core temperatures were recorded for patients in the prewarming group from T1 to T6 (P 
< .05). Significantly fewer patients with mild hypothermia were in the prewarming group (5 vs 13, P 
= .037) and recovery time was significantly reduced in the prewarming group (P 
< .05). Although the incidence of postoperative shivering was lower in the prewarming group, it was not statistically significant (6.12% vs 18.37%, P 
= .064). Likewise, the shivering severity was similar for both groups. Thermal comfort was significantly increased in the prewarming group, although patient satisfaction was comparable between the 2 groups (P 
> .05). No adverse events occurred associated with the forced-air warming system. Both groups shared similar baseline demographics, type of surgery, total irrigation fluid, total infused fluid, estimated blood loss, urine output, intraoperative anesthetic dosage, hemodynamics, duration of anesthesia and operation time, postoperative sufentanil consumption, and pain intensity.

Conclusion:

In patients undergoing video-assisted thoracic surgery, prewarming for 30 minutes before the induction of anesthesia combined with a forced-air warming system may improve perioperative core temperature and the thermal comfort, although the incidence of postoperative shivering and severity did not improve.
Factors associated with glycemic control among South African adult residents of Mkhondo municipality living with diabetes mellitus
Authors: Masilela Charity , Pearce Brendon , Ongole Joven Jebio , Adeniyi Oladele Vincent , Benjeddou Mongi
Published: November 2020

This study examines the rate and the influencing factors of glycemic control among adult residents living with DM in Mkhondo Municipality of South Africa.

In this cross-sectional study, 157 individuals attending care for DM were recruited. Glycemic control status was categorized as poor if glycated hemoglobin (HbA1c) > 7% and very poor if HbA1c ≥ 9%. Multivariate regression analysis was used to identify the significant determinants of poor and very poor glycemic control.

The majority of the study participants were females (84.71%) and above 45 years old (88.55%). The overall prevalence of poor glycemic control was 77.71% (n = 122), while very poor glycemic control occurred in 50.6% (n = 80) of the study cohort. In the multivariate logistic regression model analysis, African traditional [AOR = 0.15; 95% confidence interval (95% CI) 0.04–0.57], fast food consumption (AOR = 5.89; 95% CI 2.09–16.81), elevated total cholesterol (TC) [odds ratio (OR) = 2.33; 95% CI 1.50–5.17], elevated low-density lipoprotein cholesterol (LDL-C) (AOR = 5.28; 95% CI 1.89–14.69), and triglyceride (TG) (AOR = 4.39; 95% CI 1.48–13.00) were the independent and significant determinants of poor glycemic control. Age (AOR = 0.46; 95% CI 0.23–0.92) was the only independent and significant determinant of very poor glycemic control.

We found a high rate of poor glycemic control (77.71%) possibly attributed to religious affiliation, fast food consumption, and dyslipidemia. On the contrary, about half of the study sample had very poor glycemic control (HbA1c ≥9%), which was predominant among younger cohort with diabetes mellitus. Interventions aimed at improving glycemic control in this population must also target religious practice, dietary patterns and dyslipidemia as well as tailored-approach for young people.
Efficacy of massage therapy for postprandial distress syndrome
Authors: Zhou Ke-Lin , Dong Shuo , Shen Qian , Wang Kang , Wei Pei-Dong , Bai Xiao , Cai Ming-Heng , Guo Sheng , Liu Yang
Published: November 2020

Background:

Postprandial distress syndrome (PDS), characterized by the presence of prevalently meal-related early satiation and fullness, is a highly prevalent condition with major socioeconomic and healthcare impact. To date, there is a lack of pharmacological treatment proven value for PDS. Therefore, an ideal strategy to relieve PDS is urgently needed. In recent years, massage therapy has been increasingly accepted by PDS patients due to its lower costs, fewer unwanted side effects and safety for clinical use. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with postprandial distress syndrome.

Methods:

We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating postprandial distress syndrome: Wanfang and Pubmed Database, CNKI, CENTRAL, CINAHL, and EMBASE. Each database will be searched from inception to October 2020. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses.

Results:

This proposed study will evaluate the effectiveness and safety of massage therapy for patients with postprandial distress syndrome. The outcomes will include changes in PDS relief and adverse effect.

Conclusions:

This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with postprandial distress syndrome.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.

OSF Registration number:

DOI 10.17605/OSF.IO/9WRX8.
Outcome of bone–patellar tendon–bone vs hamstring tendon autograft for anterior cruciate ligament reconstruction
Authors: Zhao Lilian , Lu Mingfeng , Deng Mingcong , Xing Jisi , He Lilei , Wang Changbing
Published: November 2020

Background:

Many systematic reviews have compared the short-term outcomes of anterior cruciate ligment (ACL)reconstruction with hamstring and patellar tendon autograft,but few differences have been observed. The purpose of this meta-analysis was to compare the medium-term outcome of bone–patellar tendon–bone and hamstring tendon autograft for anterior cruciate ligament reconstruction in terms of clinical function, knee stability, postoperativecomplications, and osteoarthritis changes.

Methods:

This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and the Cochrane Library databases were searched from inception to November 2, 2019. This meta-analysis included only randomized controlled trials that compared BPTB and HT autografts for ACL reconstruction with a 5-year minimum follow-up. The Cochrane Collaboration's risk-of-bias tool was used to estimate the risk-of-bias for all included studies. RevMan 5.3 software was used to performed statistical analysis of the outcomes.

Results:

Fifteen RCTs, involving 1298 patients (610 patients in the BPTB group and 688 patients in the HT group) were included. In terms of clinical function, no significant difference was found in the objective International Knee Documentation Committee score (OR = 0.94, 95%CI: 0.64–1.37, P = .75), Lysholm knee score (MD = −2.26, 95%CI: −4.56 to 0.05, P = .06), return to preinjury activity level (OR = 1.01, 95%CI: 0.67–1.52, P = .96), and Tegner activity level (OR = 0.03, 95%CI: −0.36 to 0.41, P = .89). There was no statistically significant difference in the Lachman test (OR = 0.86, 95%CI: 0.5–1.32, P = .50), pivot-shift test (OR = 0.68, 95%CI: 0.44–1.06, P = .09), and side-to-side difference (MD = −0.32, 95%CI: −0.81 to 0.16, P = .19). As for postoperative complications and OA changes, there were no statistically significant difference in flexion loss (OR = 1.09, 95%CI: 0.47–2.54, P = .85) and OA changes (OR = 0.76, 95%CI: 0.52–1.10, P = .15), but we found significant differences in favor of the HT group in the domains of kneeling pain (OR = 1.67, 95%CI: 1.04–2.69, P = .03), anterior knee pain (OR = 2.90, 95%CI: 1.46–5.77, P = .002), and extension loss (OR = 1.75, 95%CI: 1.12–2.75, P = .01). There was a significant difference in favor of the BPTB group in the domain of graft failure (OR = 0.59, 95%CI: 0.38–0.91, P = .02).

Conclusions:

Based on the results above, HT autograft is comparable with the BPTB autograft in terms of clinical function, postoperative knee stability, and OA changes, with a medium-term follow-up. The HT autograft for ACL reconstruction carries a lower risk of complications, such as anterior knee pain, kneeling pain, and extension loss, but an increased incidence of graft failure. Patients should be informed of the differences when deciding on graft choice with their physician.
Effect of Nonelastic Compression With an Adjustable Wrap After Total Knee Arthroplasty
Authors: Hendrickx Ad A. , Krijnen Wim P. , Bimmel Richard , van der Schans Cees P. , Damstra Robert J.
Published: November 2020

Swelling is a common phenomenon after total knee arthroplasty, with potential for negative impact on the rehabilitation process and final outcome. The aim of this study was to investigate the effectiveness of a new compression protocol with a self-adjustable, nonelastic compression wrap for the knee region. This study was conducted as a prospective comparative study. Total leg volume and the circumference of the knee at three levels were compared between groups. The results of our study suggest that the application of the new compression protocol has no effect on swelling in the acute postoperative phase (0–2 days) but reduces swelling at Day 14 within the subacute phase. The observed positive effect of the compression protocol could be of clinical importance in the subacute phase as well as for a subgroup of patients suffering from aberrant quadriceps weakness concomitant with knee swelling.
Preoperative Nutritional Status and Risk for Subsyndromal Delirium in Older Adults Following Joint Replacement Surgery
Authors: Denny Dawn L. , Trotter Tanya , Lindseth Glenda
Published: November 2020

BACKGROUND:

Subsyndromal delirium following surgery in older adults is related to increased lengths of hospital stay and increased admissions to long-term care. Impaired nutrition increases risk for delirium, but its relationship to subsyndromal delirium remains unclear.

PURPOSE:

This correlational study examined the relationship between nutritional status and subsyndromal delirium in older adults.

METHODS:

Assessments for subsyndromal delirium in 53 adults 65 years or older were completed for three consecutive days following joint replacement surgery. Relationships between nutritional status and subsyndromal delirium were analyzed. Level of significance for all tests was set at p ≤ .05.

RESULTS:

Participants' scores from the Mini Nutritional Assessment screen were significantly related (p = .05) to subsyndromal delirium severity after accounting for variability posed by age and cognition status.

CONCLUSION:

When preoperative risk assessment of older adults indicates nutritional risk, preoperative optimization may improve effectiveness of delirium prevention efforts.
Impact of a Smartphone App Reminder on Adherence to Aspirin Prescribed as Antithrombotic Therapy
Authors: Wittig-Wells Deborah , Higgins Melinda , Carter Jessica , Holmes Estella , Jacob Ani , Samms-McPherson Jacqueline , Sapp Pam , Sims Sandra , Titus Bobina , Haupt Jessica , Holstad Marcia
Published: November 2020

BACKGROUND:

Many patients are discharged with aspirin (ASA) as an anticoagulant after joint replacement surgery. In studies in which ASA was prescribed, doses were frequently missed. Adherence to postoperative ASA regimen is critical to preventing thrombotic complications. This randomized controlled study evaluated the impact of an existing medication adherence smartphone application (app) on adherence to twice daily ASA 81 mg for 35 days after knee or hip arthroplasty.

METHODOLOGY:

Patients were randomized to either the app (intervention) group or the usual care (control) group. All patients received a baseline interview with a survey and demographics collected prior to randomization, a 36-day follow-up call for phone pill count, and a 6-week in-office interview with surveys and an in-person pill count. A convenience sample of 195 patients enrolled; 122 completed pill counts at both baseline and end of study. Ages ranged from 29 to 89 (mean: 60.4, SD: 10.1) years. The majority had a bachelor's degree or higher (59.3%), made more than $75,000 (or were retired; 51.9%), were of White race (75.9%), and female (53.8%). There were no significant demographic differences between the groups.

RESULTS:

There were no significant group differences in final pill counts, adherence (reasons for missed pills), or ASA Medication self-efficacy scores. However, the intervention group scored significantly higher on the ASA Adherence measure (general ease in and ability to take ASA; p = .020). Higher ASA Adherence scores were associated with lower pill counts at the end of study (better adherence) in the intervention group. There was a high rate of attrition related to failure to bring the ASA to hospital or to the follow-up appointment.

CONCLUSIONS:

Although there were no significant differences in final pill counts between groups, the app group reported more ease in taking pills. With smartphone use virtually ubiquitous, this project provided an opportunity to educate patients and nurses about how technology can support medication adherence. It was also an excellent opportunity to involve clinical nurses in a funded research project.
Nonsteroidal Anti-Inflammatory Drugs
Authors: Cunningham Kathleen , Candelario Danielle M. , Angelo Lauren B.
Published: November 2020

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used medications due to their prescription and nonprescription availability, various dosage formulations, and therapeutic efficacy. Although NSAIDs have many known benefits, their effects on gastrointestinal, cardiovascular, bone, and renal physiology limit their widespread and long-term use. This article provides an update on dosage formulations, product availability, and pertinent adverse effects and warnings regarding the use of NSAIDs, with an emphasis on nonaspirin NSAIDs.
The lunar surface as a recorder of astrophysical processes
Authors: Crawford Ian A. , Joy Katherine H. , Pasckert Jan H. , Hiesinger Harald
Published: November 2020

The lunar surface has been exposed to the space environment for billions of years and during this time has accumulated records of a wide range of astrophysical phenomena. These include solar wind particles and the cosmogenic products of solar particle events which preserve a record of the past evolution of the Sun, and cosmogenic nuclides produced by high-energy galactic cosmic rays which potentially record the galactic environment of the Solar System through time. The lunar surface may also have accreted material from the local interstellar medium, including supernova ejecta and material from interstellar clouds encountered by the Solar System in the past. Owing to the Moon's relatively low level of geological activity, absence of an atmosphere, and, for much of its history, lack of a magnetic field, the lunar surface is ideally suited to collect these astronomical records. Moreover, the Moon exhibits geological processes able to bury and thus both preserve and ‘time-stamp' these records, although gaining access to them is likely to require a significant scientific infrastructure on the lunar surface.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)'.
Concentrated lunar resources: imminent implications for governance and justice
Authors: Elvis Martin , Krolikowski Alanna , Milligan Tony
Published: November 2020

Numerous missions planned for the next decade are likely to target a handful of small sites of interest on the Moon's surface, creating risks of crowding and interference at these locations. The Moon presents finite and scarce areas with rare topography or concentrations of resources of special value. Locations of interest to science, notably for astronomy, include the Peaks of Eternal Light, the coldest of the cold traps and smooth areas on the far side. Regions richest in physical resources could also be uniquely suited to settlement and commerce. Such sites of interest are both few and small. Typically, there are fewer than ten key sites of each type, each site spanning a few kilometres across. We survey the implications for different kinds of mission and find that the diverse actors pursuing incompatible ends at these sites could soon crowd and interfere with each other, leaving almost all actors worse off. Without proactive measures to prevent these outcomes, lunar actors are likely to experience significant losses of opportunity. We highlight the legal, policy and ethical ramifications. Insights from research on comparable sites on Earth present a path toward managing lunar crowding and interference grounded in ethical and practical near-term considerations.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)'.
Discovering the sky at the longest wavelengths with a lunar orbit array
Authors: Chen Xuelei , Yan Jingye , Deng Li , Wu Fengquan , Wu Lin , Xu Yidong , Zhou Li
Published: November 2020

Due to ionosphere absorption and the interference of natural and artificial radio emissions, astronomical observation from the ground becomes very difficult at the wavelengths of decametre or longer, which we shall refer to as the ultralong wavelengths. This unexplored part of the electromagnetic spectrum has the potential for great discoveries, notably in the study of cosmic dark ages and dawn, but also in heliophysics and space weather, planets and exoplanets, cosmic ray and neutrinos, pulsar and interstellar medium (ISM), extragalactic radio sources, and so on. The difficulty of the ionosphere can be overcome by space observation, and the Moon can shield the radio frequency interferences (RFIs) from the Earth. A lunar orbit array can be a practical first step to opening up the ultralong wave band. Compared with a lunar surface observatory on the far side, the lunar orbit array is simpler and more economical, as it does not need to make the risky and expensive landing, can be easily powered with solar energy, and the data can be transmitted back to the Earth when it is on the near-side part of the orbit. Here, I describe the discovering sky at the longest wavelength (DSL) project, which will consist of a mother satellite and 6–9 daughter satellites, flying on the same circular orbit around the Moon, and forming a linear interferometer array. The data are collected by the mother satellite which computes the interferometric cross-correlations (visibilities) and transmits the data back to the Earth. The whole array can be deployed on the lunar orbit with a single rocket launch. The project is under intensive study in China.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)’.
Human habitats: prospects for infrastructure supporting astronomy from the Moon
Authors: Heinicke C. , Foing B.
Published: November 2020

There is strong interest in lunar exploration from governmental space agencies, private companies and the public. NASA is about to send humans to the lunar surface again within the next few years, and ESA has proposed the concept of the Moon Village, with the goal of a sustainable human presence and activity on the lunar surface. Although construction of the infrastructure for this permanent human settlement is envisaged for the end of this decade by many, there is no definite mission plan yet. While this may be unsatisfactory for the impatient, this fact actually carries great potential: this is the optimal time to develop a forward-looking science input and influence mission planning. Based on data from recent missions (SMART-1, Kaguya, Chang’E, Chandrayaan-1 and LRO) as well as simulation campaigns (e.g. ILEWG EuroMoonMars), we provide initial input on how astronomy could be incorporated into a future Moon Village, and how the presence of humans (and robots) on the Moon could help deploy and maintain astronomical hardware.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)’.
Lunar optical interferometry and hypertelescope for direct imaging at high resolution
Authors: Labeyrie Antoine
Published: November 2020

Following earlier proposals for optical stellar interferometer concepts in space and on the Moon, the improved ‘hypertelescope’ version capable of direct high-resolution imaging with a high limiting magnitude became tested on Earth, proposed for space, and is now also proposed for the Moon. Many small mirrors can be dilutely arrayed in a lunar impact crater spanning 10–25 km. And a larger version, modified for a flat lunar site and spanning up to several hundred kilometres can be built later if needed for a higher resolution and limiting magnitude. Even larger versions, at the scale of many thousand kilometres, also appear feasible in space at some stage, in the form of a controlled flotilla of mirrors. Among the varied science targets considered with the imaging resolution expected, reaching 100 nano-arcseconds on the Moon, are: (a) the early detection and resolved imaging of Near Earth Objects, and their monitoring for eventual collision avoidance by orbital deflection; (b) multi-pixel imaging of exoplanets as part of the search for exolife by mapping local seasonal spectral variations; (c) the physics of neutron stars and black holes at the galactic centre and in other Active Galactic Nuclei; and (d) distant galaxies of cosmological interest.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)’.
Reaching small scales with low-frequency imaging: applications to the Dark Ages
Authors: Morabito L. K. , Silk J.
Published: November 2020

The initial conditions for the density perturbations in the early Universe, which dictate the large-scale structure and distribution of galaxies we see today, are set during inflation. Measurements of primordial non-Gaussianity are crucial for distinguishing between different inflationary models. Current measurements of the matter power spectrum from the cosmic microwave background only constrain this on scales up to
k
 ∼ 0.1 Mpc
−1
. Reaching smaller angular scales (higher values of
k
) can provide new constraints on non-Gaussianity. A powerful way to do this is by measuring the HI matter power spectrum at

z
≳
30

. In this paper, we investigate what values of
k
can be reached for the Low-Frequency Array (LOFAR), which can achieve

≲

1″ resolution at approximately 50 MHz. Combining this with a technique to isolate the spectrally smooth foregrounds to a wedge in

k

∥

–
k
⊥
space, we demonstrate what values of
k
we can feasibly reach within observational constraints. We find that LOFAR is approximately five orders of magnitude away from the desired sensitivity, for 10 years of integration time.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)’.