bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Hospital Readmissions Among U.S. Dialysis Facilities
Authors: Paulus Amber , Baernholdt Marianne , Kear Tamara , Jones Terry , Thacker Leroy
Published: June 2021

Introduction:

The Centers for Medicare and Medicaid uses the standardized readmission ratio (SRR) to evaluate 30-day readmissions among dialysis providers in the U.S. Readmissions among dialysis recipients remains 37%. This study investigates associations among dialysis facilities and patient characteristics with facility's performance on the SRR.

Methods:

Descriptive, longitudinal, approach using multivariate regression analysis on data retrieved from the Dialysis Facility Report to evaluate the associations between facility-level (staffing, profit status, chain membership, clinic size, care, length of care, vascular access type, glomerular filtration rate (GFR), creatinine, hemoglobin, use of erythropoietin-stimulating agent, albumin, and primary dialysis modality) with the SRR.

Results:

Factors associated with a high SRR included nurse ratios, facility average GFR, and Northeast geographic location. Factors associated with a low SRR included patient care technician ratio, length of predialysis nephrology care, initiation of dialysis with an arteriovenous fistula, average hemoglobin, and Western geographic location.

Conclusions:

This study defines the influence predialysis nephrology care has on dialysis facilities SRRs. Access to care, adequate preparation for dialysis, and transitional support affect facilities' performance; however, without an appropriate staffing model, dialysis facilities may continue to struggle to reduce readmissions.
Epidemiological study on severe acute respiratory syndrome coronavirus 2 virus transmission network in northeast China
Authors: Feng Tianyu , Zhang Yulong , Sun Helin , Zhang He , Sun Mengzi , Wang Yudan , Sun Chong , Li Kexin , Wang Yingshuang , Chai Ruiyu , Zheng Pingping , Chen Yang , Pan Pan , Bi Chunli , Yao Yan , Liu Siyu
Published: June 2021

In this study, corona virus disease 2019 (COVID-19) transmission networks were built to analyze the epidemic situation of COVID-19 in Liaoning and Jilin provinces in early 2020. We explore the characteristics of the spread of COVID-19, and put forward effective recommendations for epidemic prevention and control. We collected demographic characteristics, exposure history, and course of action of COVID-19 cases. We described the demographic and case characteristics of these cases to show the basic characteristics of COVID-19 cases in both provinces. Combined with the spatial analysis of confirmed cases, the distribution law of the number of confirmed cases in different regions was analyzed. We exhibit the relationship among COVID-19 cases with a transmission network. The transmission characteristics of COVID-19 were analyzed through the transmission network. Mainly cases in Liaoning and Jilin provinces were imported cases from other provinces and the vast majority of these cases were related to Hubei province. The number of confirmed cases in different regions was positively correlated with their GDP and population. The main clinical symptoms of the cases were fever. Judge from the transmission network relationship between the 2 provinces, the transmission chain in Liaoning province contains fewer cases than that in Jilin province. The main transmission routes of the local cases in the 2 provinces were the family members, and the infection of the imported cases were mainly occurred in public places. It was estimated that the unidentified asymptomatic infected cases in the 2 provinces account for approximately 7.3% of the total number of infected cases. The length of the transmission chain suggests that the spread of COVID-19 can be effectively controlled with effective prevention measures.
Adjuvant treatment with adipose-derived mesenchymal stem cells (ADSC) reduces severe refractory hemorrhagic cystitis after RIC-PBSCT
Authors: Yang Ruixue , Chen Gang , Muhashi Maria , Aizezi Gulibadanmu , Jiang Ming , Yuan Hailong
Published: June 2021

Introduction

Severe hemorrhagic cystitis (HC) is still a common complication after allogeneic hematopoietic stem cell transplantation, which affects the quality of life of patients, and may even cause kidney failure. This study reports the clinical effect of adjuvant treatment of adipose-derived mesenchymal stem cells (ADSCs) on severe refractory HC after of reduced intensity conditioning haplotype high-dose peripheral blood hematopoietic stem cell transplantation (RIC-PBSCT) in one case.

Patient concerns

A 53-year-old female patient with acute myeloid leukemia (FLT3-ITD) at high risk received RIC-PBSCT. The patient was relieved with complete donor chimerism of 99.01%, and normal hemogram. However, the patient developed frequent urination, urgency, and dysuria with gross hematuria with blood clots and difficult urinating, especially at night and early in the morning. There were obvious hyperemia and bleeding points in the mucosa of the posterior wall of the bladder.

Diagnosis

The patient was diagnosed as delayed HC of degree IV.

Interventions and Outcomes

The patient was treated with antiviral drugs, urine alkalization, and diuretic drugs for more than 1 month, but no significant effect was obtained. Thus, the patient was then given ADSCs (1 × 106 kg per kg of body weight, infused once a week for a total of 3 infusions). Symptoms of frequent urination, urgency, and dysuria that happened during the first infusion were improved, and blood clots in the urine were also reduced. After the third infusion, HC symptoms disappeared, the red blood cells were normal, and there was no fever, chills, low infusion blood pressure, or rash. The patient's HC was cured. During follow-up, HC recurrence was not observed.

Conclusion

ADSCs adjuvant treatment of relapsed and refractory severe HC is safe and reliable with good clinical efficacy. It shows certain clinical application value, which however requires more clinical cases to further verify this.
Clinical therapeutic effects of acupuncture in treating patients with dysphagia after radiotherapy in nasopharyngeal carcinoma
Authors: Wang Ying-Huai , Cheng Hong-Zheng , Liu Kun , Cai Bin-Lin , Luo Yi , Kan Dan , Zhang Jie
Published: June 2021

Background:

Dysphagia is a commonly occurring condition in nasopharyngeal carcinoma (NPC) patients after radiotherapy. There has been an increasing number of studies focused on assessing the use of acupuncture to manage dysphagia. Moreover, the quality of the research has gradually increased. The present research will be conducted to systematically evaluate the efficiency and safety of using acupuncture to treat cases of dysphagia after radiation therapy in NPC patients.

Methods:

Literature search will include all potential randomized controlled trials using MEDLINE, Cochrane Library, Web of Science, EMBASE, Chinese National Knowledge Infrastructure, Chinese BioMedical Literature, and WanFang database from their inception to May, 2021 without language or publication status restrictions, to evaluate the efficiency and safety of using acupuncture to treat dysphagia cases following radiation therapy in NPC patients. A couple of independent authors will select related literature, extract data from studies, and estimate this risk in the bias of the selected study articles. In the instance of contrasting opinions, the outcome is mediated through discussion with a different independent author. The data synthesis and statistical analysis will be completed with the RevMan software (version 5.3).

Results:

This study will evaluate the efficiency and safety of using acupuncture to treat dysphagia cases after radiation therapy in NPC patients.

Conclusion:

This study will determine the suitability of acupuncture as an effective and safe intervention for dysphagia in NPC patients after radiotherapy.

Ethics and dissemination:

The present study does not need ethical approval.

Registration number:

May 19, 2021.osf.io/f2cvt. (https://osf.io/f2cvt/).
Organizing pneumonia in ALK+ lung adenocarcinoma treated with ceritinib
Authors: Wu Yonghui , Chen Huiguo , Guan Jiexia , Zhang Kai , Wu Weibin , Li Xiaojun , Zhang Jian
Published: June 2021

Rationale:

Anaplastic lymphoma kinase (ALK) inhibitors have been approved for patients with ALK-rearrangement lung cancer. The effect is superior to the standard first-line therapy of pemetrexed plus platinum-based chemotherapy. However, ALK inhibitors are associated with rare and sometimes fatal adverse events. Organizing pneumonitis (OP) is a rare and serious adverse event usually caused by ceritinib, and it is easily misdiagnosed as infectious pneumonia, metastasis, or cancer progression.

Patient concerns:

A 56-year-old female presented with chest tightness and dyspnea for more than 10 days. She was previously healthy with no significant medical history. Workup including chest computed tomography (CT), pathological examination of a biopsy specimen, and next-generation sequencing was consistent with a diagnosis of IVA ALK-rearrangement lung adenocarcinoma. She was treated with pemetrexed plus platinum-based chemotherapy and crizotinib concurrently, followed by maintenance therapy with crizotinib alone and she had an almost complete response. However, about 26 months after beginning treatment she developed multiple brain metastases. Crizotinib was discontinued and she was begun on ceritinib. After about 3 months the brain metastases had almost complete response. After 5 months of ceritinib, however, multiple patchy lesions appeared in the bilateral upper lungs.

Diagnoses:

Treatment with antibiotics had no effect and blood and sputum cultures are negative. A CT-guided biopsy of the upper lung was performed, and pathological hematoxylin-eosin staining and immunohistochemical studies were consistent with OP.

Interventions:

Ceritinib was discontinued, she was begun on prednisone 0.5 mg/kg orally every day, and regular follow-up is necessary.

Outcomes:

CT of the chest 2 and 4 weeks after beginning prednisone showed the lung lesions to be gradually resolving, and she was continued on prednisone for 2 months and gradually reduced the dose of prednisone every 2 weeks. No related adverse events were occurred in patient.

Lessons:

OP must be differentiated from infectious pneumonia, metastasis, or cancer progression. The mechanism of OP is still unknown and needs further research. Biopsy plays a role in making a diagnosis of OP. In our patient, discontinuing ceritinib and treating her with prednisone resulted in a good outcome.
Immunoadsorption treatment for dilated cardiomyopathy
Authors: Bian Ru-tao , Wang Zhen-tao , Li Wei-yu
Published: June 2021

Background:

As one of the leading causes of heart failure, dilated cardiomyopathy (DCM) is characterized by dysfunctional muscle contraction and enlarged ventricular chamber. Patients with DCM have been shown to respond well to immunoadsorption (IA) therapies. However, the efficacy and safety of IA treatment for DCM patients remained to be evaluated.

Methods:

This study was designed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis. We searched the databases such as Cochrane library, Cochrane Central Register of Controlled Trials, Embase, OVID, and Web of Science from January 1990 to March 20, 2020, and performed meta-analysis using Stata MP Version 13.0.

Results:

We performed meta-analysis on 12 studies that included a total of 395 patients with DCM. Overall, IA treatment significantly improved the left ventricular ejection fraction (6.01, 95% confidence interval [CI] [4.84–7.19]), reduced the left ventricular end diastolic diameter (–3.62, 95% CI [–4.06 to –3.19]), reduced severity of symptoms according to the New York Heart Association (NYHA) functional classification (–1.37, 95% CI [–1.73 to –1.02]) as compared with the controls, but had no effect on values for safety parameters (1.13, 95% CI [0.58–2.19]).

Conclusions

Results of this meta-analysis indicated that the IA treatment can improve the left ventricular ejection fraction, reduce left ventricular end diastolic diameter, and thus improve clinical outcome in DCM patients. However, further evidence are required to validate the relative safety of IA treatment. Multi-center, double blind studies should be conducted to elucidate the precise effect of IA treatment in DCM patients.
Detrimental effect of antiepileptic drugs dose in pediatric children with epilepsy in Saudi Arabia
Authors: Alotaibi Badriyah S. , Alodhayani Abdulaziz A. , Alwan Ashraf , Alotaibi Khalid Nijr , Melaiki Brahim Tabarki , Almadhi Aljawharah Mohammad , Alfares Lulwah Haitham , Alalkami Nahlah Ahmed
Published: June 2021

This study aims to evaluate the effect of dose titration for different oral antiepileptic medications among children with epilepsy in Riyadh, Saudi Arabia.

A single-center prospective pilot, cohort study was undertaken at a tertiary hospital in Riyadh, Saudi Arabia. All medical records of pediatric patients below the age of 14 years of age who has been newly diagnosed with epilepsy by attending a medical specialist or on a new epileptic treatment plans were enrolled in the study.

A total of 76 epileptic patients were screened for 3 months’ period and 48 patients were included in this study. Out of the 48 patients, 31 patients followed the regular practice in the titration processes and 17 patients were in the British national formulary (BNF) guideline. Fifteen children who were on monotherapy of levetiracetam were in regular practice guideline experienced poor seizure control with a recorded number of seizure incidence (n = 10). The patient in regular practice guidelines using a combination therapy of phenytoin and levetiracetam were experiencing some behavioral disturbance and sedation effect. Seventeen patients followed in the BNF guideline who were on levetiracetam were experienced less adverse effect (n = 2) with no behavioral changes.

The group who followed the regular practice found having a greater incidence of documented adverse effects compared to the patients following the BNF guideline. The titrating antiepileptic medication has a detrimental effect on the pediatric population as observed in this study.
Prognostic impact of the pre-treatment controlling nutritional status score in patients with non-small cell lung cancer
Authors: Peng Jing , Hao Yan , Rao Bihua , Cao Yunxia
Published: June 2021

Background:

The influence of pre-treatment controlling nutritional status (CONUT) score on the prognosis of non-small cell lung cancer (NSCLC) patients is inconclusive. We performed this meta-analysis to evaluate the prognostic significance of CONUT score in NSCLC patients.

Methods:

A systematic literature review was conducted using PubMed, Embase, and the Cochrane Library databases. The hazard ratio (HR) and 95% confidence interval (CI) were extracted to assess the correlation between the CONUT score and the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), as well as the cancer-specific survival.

Results:

A total of 11 studies with 3029 patients were included in the analysis. Pooled results indicated that a high CONUT score was positively correlated with poor OS (HR: 1.63, 95%CI: 1.40–1.88, P < .001) and shortened DFS/RFS (HR: 1.65, 95%CI: 1.35–2.01, P < .001), but no significant relationship with the cancer-specific survival (HR: 1.28, 95%CI: 0.60–2.73, P = .517) was identified. The negative effect of high CONUT score on the OS and DFS/RFS was detected in every subgroup with varying treatment methods, cancer stage, CONUT cut-off values, sample size, and analysis methods of HR. Additionally, preoperative high CONUT score was an independent predictor of postoperative complications (odds ratio: 1.58, 95%CI: 1.21–2.06, P = .001) in NSCLC. Last but not least, high CONUT score was not significantly correlated with the patients’ sex, smoking status, cancer stage, lymphatic invasion, vascular invasion, pleural invasion, and pathological cancer type.

Conclusion:

These results demonstrate that high CONUT score is positively related to poor prognoses. The CONUT score may therefore be considered as an effective prognostic marker in NSCLC patients.
Comprehensive analysis of DNA methylation and gene expression profiles in gestational diabetes mellitus
Authors: He Jing , Liu Kang , Hou Xiaohong , Lu Jieqiang
Published: June 2021

Gestational diabetes mellitus (GDM) has a high prevalence during pregnancy. This research aims to identify genes and their pathways related to GDM by combining bioinformatics analysis.

The DNA methylation and gene expression profiles data set was obtained from Gene Expression Omnibus. Differentially expressed genes (DEG) and differentially methylated genes (DMG) were screened by R package limma. The methylation-regulated differentially expressed genes (MeDEGs) were obtained by overlapping the DEGs and DMGs. A protein–protein interaction network was constructed using the search tool for searching interacting genes. The results are visualized in Cytoscape. Disease-related miRNAs and pathways were retrieved from Human MicroRNA Disease Database and Comparative Toxic Genome Database. Real-time quantitative PCR further verified the expression changes of these genes in GDM tissues and normal tissues.

After overlapping DEGs and DMGs, 138 MeDEGs were identified. These genes were mainly enriched in the biological processes of the “immune response,” “defense response,” and “response to wounding.” Pathway enrichment shows that these genes are involved in “Antigen processing and presentation,” “Graft-versus-host disease,” “Type I diabetes mellitus,” and “Allograft rejection.” Six mRNAs (including superoxide dismutase 2 (SOD2), mitogen-activated protein kinase kinase kinase kinase 3 (MAP4K3), dual specificity phosphatase 5 (DUSP5), p21-activated kinases 2 (PAK2), serine protease inhibitor clade E member 1 (SERPINE1), and protein phosphatase 1 regulatory subunit 15B (PPP1R15B)) were identified as being related to GDM. The results obtained by real-time quantitative PCR are consistent with the results of the microarray analysis.

This study identified new types of MeDEGs and discovered their related pathways and functions in GDM, which may be used as molecular targets and diagnostic biomarkers for the precise diagnosis and treatment of GDM.
Systems controls are needed to reduce mistaken tests for hemophagocytic lymphohistiocytosis, results of a prospective quality-improvement cohort study
Authors: Safi Salahuddin , Shanbhag Satish , Hambley Bryan C. , Merrill Samuel A.
Published: June 2021

Medical diagnosis and therapy often rely on laboratory testing. We observed mistaken testing in evaluations for hemophagocytic lymphohistiocytosis (HLH) that led to delays and adverse outcomes. Physicians were mistakenly ordering interleukin-2 and quantitative natural killer cell flow cytometry, rather than soluble interleukin 2 receptor (sIL2R) or qualitative natural killer functional tests in the evaluation of patients suspected to have HLH.

We initiated a prospective quality improvement project to reduce mistaken testing, reduce delays in correct testing due to mistaken ordering, and improve HLH evaluations. This consisted of provider education, developing an evaluation algorithm, and ultimately required systems interventions such as pop-ups and removal of the mistaken tests from the electronic ordering catalog.

Active education reduced mistaken testing significantly in HLH evaluations from baseline (73.3% vs 33.3%, P = .003, relative risk reduction (RRR) 54.5%), but failed to meet the pre-specified RRR cutoff for success (70%). Education alone did not significantly reduce the proportion of HLH evaluations with delays in sIL2R testing (23.3% vs 7.4%, P = .096). Mistaken testing increased after the active intervention ended (33.3% vs 43.5%, P = .390, with RRR 40.7% from baseline. Mistaken test removal was successful: mistaken testing dropped to 0% (P < .001, RRR 100%), saved $14,235 yearly, eliminated delays in sIL2R testing from mistaken testing (23.3% vs 0%, P = .008), and expedited sIL2R testing after admission for HLH symptoms (14.6 days vs 3.8 days, P = .0012). These data show systems controls are highly effective in quality improvement while education has moderate efficacy.
Investigation of the home-reablement program on rehabilitation outcomes for people with stroke
Authors: Chiu En-Chi , Chi Fang-Chi , Chen Pei-Tsen
Published: June 2021

Background:

Reablement is 1 approach to conduct rehabilitation in the community (ie, home environment), which aims to enhance an individual's functional ability to perform everyday activities that individuals perceive as important. We investigated the effects of a home-reablement program on different rehabilitation outcomes in people with stroke.

Methods:

A single-blind randomized clinical trial was conducted. Twenty-six people with stroke were randomly assigned to the home-reablement group or control group. For 6 weeks, participants in the home-reablement group received training for activities of daily living (ADL) that they perceived as important but difficult to perform. Participants in the control group received conventional rehabilitation in the hospital. Outcome measures included the Fugl–Meyer Assessment for the upper-extremity (FMA-UE) and the Stroke Impact Scale 3.0 (SIS 3.0) subscales.

Results:

No statistically significant differences between the 2 groups were noticed in the FMA-UE and the SIS 3.0 subscales (P = .226–1.000). Small effect size (success rate difference = 0.12–0.25) were noticed in the FMA-UE and the 5 SIS 3.0 subscales. The home-reablement group exhibited a greater proportion of participants with scores greater than the minimal detectable change in the FMA-UE and the 6 SIS 3.0 subscales (ie, strength, ADL/instrumental ADL, mobility, emotion, memory, and participation).

Conclusions:

People with stroke that underwent the 6-week home-reablement program showed potential for improving their motor function, ADL/instrumental ADL, emotion, memory, and activity participation.
Efficacy of GCWB106 (Chrysanthemum zawadskii var. latilobum extract) in osteoarthritis of the knee
Authors: Ha Jeong Ku , Kim Jin Seong , Kim Joo Young , Yun Jong Bok , Kim Yun Young , Chung Kyu Sung
Published: June 2021

Background:

GreenCross Wellbeing Corporation (GCWB) 106 is a food item based on Chrysanthemum zawadskii var. latilobum extract. It has an inhibitory effect on joint inflammation.

Objective:

This study investigated the efficacy and safety of GCWB106 for osteoarthritis (OA) of the knee joint.

Methods:

Overall, 121 participants with mild OA were recruited and randomly divided into two groups. One group received GCWB106 for 12 weeks and the other group received placebo for 12 weeks. Outcomes were evaluated using the Korean-Western Ontario and McMaster Universities Index (K-WOMAC), visual analog scale, Korean Short Form Health Survey 36 score, and laboratory test results.

Results:

After 12 weeks of study treatment, the GCWB106 group exhibited a significant improvement compared with the placebo group in overall K-WOMAC score (P = .042) and K-WOMAC physical function score (P = .015). The GCWB106 group showed significant improvement in the visual analog scale pain score (P < .001) compared with the placebo group after 6 weeks and 12 weeks; no adverse drug reactions or serious adverse events were reported in either group.

Conclusion:

GCWB106 can safely reduce pain and improve knee function with therapeutic effects in OA of the knee joint.

Level of evidence:

Randomized, double-blind, placebo-controlled clinical study, Level I
Development and validation of m6A regulators’ prognostic significance for endometrial cancer
Authors: Pang Xuecheng , Zhang Xiang , Huang Yue , Qian Sumin
Published: June 2021

Background:

Endometrial cancer (EC) is the sixth most common cancer in women globally. It has been found that the expression levels of m6A regulators can be potentially used for prognostic stratification in some cancers, but the role of m6A regulators in EC prognosis remains unclear.

Methods:

The data of 584 EC samples were downloaded from The Cancer Genome Atlas and the mRNA expression profiles of 20 m6A regulators were analyzed, followed by functional enrichment analysis, immune infiltration analysis, and least absolute shrinkage and selection operator method-COX regression analysis.

Results:

The mRNA expression levels of 20 m6A regulators were significantly different between cancer samples across different grades. The 548 EC samples could be clearly divided into 2 clusters. Kaplan-Meier survival analysis proved that these two groups had highly different overall survival probabilities. Besides, the univariate regression analysis further reserved eight genes related to overall survival from the 20 m6A regulators. We established a prognostic signature including two genes, that is, IGF2BP1 and YTHDF3, that showed a strong ability for stratifying prognostically different EC patients. We identified 3239 differentially expressed genes between the high- and low-risk groups, involving in multiple biological processes and signaling pathways. Meanwhile, 6 differentially infiltrated immune cell types between the high- and low-risk groups could effectively distinguish the high- and low-risk EC groups. The expressions of immune checkpoints were different between high- and low-risk EC patients.

Conclusion:

We first report the prognostic role of m6A regulators in EC, which should contribute to a better understanding of the underlying mechanisms of EC pathogenesis and progression.
Primary prevention of cardiovascular disease events with renin-angiotensin system blockade in autosomal dominant polycystic kidney disease dialysis patients
Authors: Lu Chien-Lin , Lin Chien-Yu , Lin Lian-Yu , Chen Pau-Chung , Zheng Cai-Mei , Lu Kuo-Cheng , Yeih Dong-Feng
Published: June 2021

Although renin-angiotensin system (RAS) blockade has been shown to reduce cardiovascular disease (CVD) in the general population and high-risk subjects, their protective effect in autosomal dominant polycystic kidney disease (ADPKD) patients under dialysis was still unknown. By using the database from 1995 to 2008 Taiwan National Health Insurance Research Database (Registry for Catastrophic Illnesses), we included 387 ADPKD patients who received dialysis therapy, aged ≥ 18 year-old, and with no evidence of CVD events in 1997 and 1998. We utilized Cox proportional hazards regression analysis and propensity score matching to evaluate adjusted hazard ratios for all-cause mortality and CVD events in users (n=231) and nonusers (n = 156) of an angiotensin-converting enzymes inhibitor (ACEI) / angiotensin II receptor blocker (ARB) during the 12 years of follow-up. All study subjects were followed up for more than 3 months. There was no significant difference between the ACEI/ARB treatment group and the control group in incident CVD events except ischemic stroke and transient ischemic accident (TIA). The results remain similar between groups before and after propensity score matching. Moreover, there was no significant difference in outcomes between ACEI/ARB treatment over 50% of follow-up period and without ACEI/ARB treatment after propensity score matching. This nationwide cohort study failed to prove the protective effects of long-term ACEI or ARB on incident CVD events among APKD dialysis patients. Further larger scale, multicenter and randomized control trials are warranted to show the causal association
Prognosis of solitary bone plasmacytoma of the extremities
Authors: Zhao Renbo , Chen Zhaoxin , Zhao Sujun , Cheng Yali , Zhu Xiaobo
Published: June 2021

Due to the rarity of solitary bone plasmacytoma (SBP), few studies reported the prognosis and survival predictors of SBP, especially for patients with extremity SBP.

A total of 552 patients with extremity SBP were identified from the Surveillance Epidemiology and Ends Results (SEER) database between 1973 and 2016. In order to obtain independent predictors of survival, we performed both univariate and multivariate analysis via Cox proportional hazards model. Additionally, we used the Kaplan-Meier method to construct survival curves.

The mean and median age at diagnosis of all patients were 64 and 65 years, respectively. The ratio of male versus women was 1.3:1. Overall survival for this special population was 51.2% and 34.9% at 5 and 10 years, respectively. Cancer-specific survival (CSS) for this special population was 63.5% and 47.5% at 5 and 10 years, respectively. Age at diagnosis and radiotherapy treatment were found to be significant independent predictors of both overall survival and CSS. Additionally, multivariate analysis showed that year of diagnosis and marital status were significantly correlated with CSS.

This is the first study to identify prognostic factors of extremity SBP by using the SEER database. Our findings highlight that radiotherapy is the mainstream treatment for extremity SBP. Additionally, age, year of diagnosis, and marital status were significant independent predictors of survival. Knowledge of these survival predictors may help clinicians provide appropriate management for extremity SBP patients.
Association study of the serum 25(OH)D concentration and myopia in Chinese children
Authors: Gao Fan , Li Peng , Liu Ya-Qian , Chen Yan
Published: June 2021

To analyze the serum 25 hydroxyvitamin D (25[OH]D) concentration in Chinese children with myopia and explore its correlation with myopia.

From July to September in 2019, myopic children were collected from the Myopia Influencing Factors Survey Project. The basic information and vision related behaviors of the subjects were collected by questionnaire. The diopter of the children without dilated pupils was measured by the computerized refractometer. Meanwhile, 5 ml fasting venous blood samples were collected for the determination of serum 25(OH)D concentration.

A total of 186 children were included in this study, including 90 males and 96 females, with an average age of 8 ± 3.26 years. The detection rate of serum 25(OH)D deficiency in myopic children was 65.59% (122/186). There was statistical significance in the detection rate of serum 25(OH)D deficiency in children with different myopic degrees (χ2 = 6.635, P = .010). The average serum 25(OH)D concentration in myopic children was 14.86 (10.67–18.96) ng/ml, and the difference of serum 25(OH)D concentration in children with different myopia degrees was statistically significant (Z = 20.23, P < .001). Logistic regression analysis showed that after controlling for gender, parental myopia, after-school class, and outdoor activities, the prevalence of developing moderate and high myopia was 2.051 times (95% confidence interval: 1.272–3.724) higher in the serum 25(OH)D deficiency group than in the serum 25(OH)D sufficiency group. There is a positive correlation between serum 25(OH)D concentration and the equivalent spherical degree of myopic children.

The study found that serum 25(OH)D concentration is closely related to the prevalence of myopia in Chinese children. The results further support the conclusion that children with a higher level of serum 25(OH)D have a lower prevalence of moderate to high myopia. The results of this study provide a basis for further research into the relationship between vitamin D and visual development in children and its mechanisms.
Rehabilitation of severe COVID-19 patients in the hospital and post-hospital phase
Authors: Long Qi , Cao Fang , Jiao Yang
Published: June 2021

Background:

Corona Virus Disease 2019 (COVID-19) has been raging around the world for almost one year. Considering the high burden of respiratory, physical, and psychological impairment following the acute phase of COVID-19, a great number of patients, specifically those with the severe form, should start rehabilitation programs during and/or after hospitalization. However, until now, there is no clinical evidence to prove what kind of rehabilitation technique is effective and safe to be conducted. This protocol of systematic review and meta-analysis will clarify the effectiveness and safety of hospital and post-hospital rehabilitation on patients with severe COVID-19.

Methods and analysis:

The following databases will be searched from their inception to the latest issue: the Cochrane Library, PubMed, EMBASE, SinoMed, Chinese VIP information, Chinese National Knowledge Infrastructure Database, Chinese Science and Technique Journals Database, the Wan-fang Database and China Important Conference Papers Database, and China Dissertation Database. All types of study design will be included. Primary outcomes will include pulmonary function, psychological health of all patients, incidence of adverse events of all patients, mortality of hospitalized patients, length of hospital and/or intensive care unit stay of hospitalized patients, quality of life of discharged patients, and exercise capacity of discharged patients. The length of time from diagnosis to SARS-CoV-2 RT-PCR test negative in upper respiratory samples of all patients will be assessed as the secondary outcome. Study selection, extraction of data, and assessment of study quality will be independently undertaken. Funnel charts, subgroup analysis, and sensitivity analysis will be used to explore the sources of heterogeneity. Statistical analysis will be conducted using Review Manager and SPSS software.

Result:

This study will assess the effects and safety of hospital and post-hospital rehabilitation on patients with severe COVID-19.

Conclusion:

The conclusion of this study will provide clinical evidence of effects and safety of hospital and post-hospital rehabilitation on patients with severe COVID-19.
Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade
Authors: Janssen Guus W.B. , Ramkumar Rathika R. , Lee Byron H. , van der Heijden Antoine G.
Published: June 2021

Purpose of review

Orthotopic urinary diversion (OUD), or neobladder, is believed to be the gold standard for surgical bladder reconstruction following radical cystectomy though it is performed far less often than ileal conduits. As both a continent and intracavitary diversion, OUDs offer unique advantages for patients. Their utilization has decreased overall though, especially with the advent of robotic surgery. In this review, we will cover patient selection for OUD, functional outcomes (i.e., continence, sexual activity, quality of life [QoL]), and robotic orthotopic diversions.

Recent findings

OUDs have seen a proportionally greater decline in utilization compared with ileal conduits as the number of robotic radical cystectomies being performed with intracorporeal diversions increases. Multiple robotic series have demonstrated less perioperative blood loss and shorter hospital stays when compared with the open approach though operative times are longer, the learning curve is steeper, and overall costs may be higher in some settings. Perioperative safety and short-term oncological outcomes appear comparable. Since robotic OUDs are relatively new, functional outcomes are not yet well established. Patient satisfaction with urinary diversion is associated with informed decision-making tailored to the patient. A thorough understanding of expected short- and long-term functional outcomes and the care required to maintain an OUD improves QoL and satisfaction with diversion choice.

Given the potential advantages of OUD, its decreasing use is a remarkable trend. Shared decision-making and a patient-centered approach should be used when selecting the type of urinary diversion.
Postoperative medical treatment of lower urinary tract symptoms after benign prostatic hyperplasia surgery. Are we underestimating the problem?
Authors: Spivak Leonid , Morozov Andrey , Shpikina Anastasia , Enikeev Dmitry , Rapoport Leonid
Published: June 2021

Purpose of review

The aim of this study was to determine whether well timed start of medical and surgical treatment of benign prostatic obstruction (BPO) influences the treatment's effectiveness and thus the patients’ overall functional outcomes and quality of life.

Recent findings

Pharmacological therapy even in high-volume (>80 cm3) BPH typically begins with α-blockers sole and only subsequently are 5ARI added. Several studies showed that acute urinary retention (AUR) developed more frequently in men who suffered severe lower urinary tract symptoms (LUTS) and who did not start combination therapy immediately. Moreover, there are no strict criteria which determine the right time for performing surgery in patients with mild and moderate LUTS, especially when pharmacological therapy fails. However, sometimes, the surgery does not eliminate all the symptoms, as it deals effectively with BPO, but does not treat an overactive bladder. Also, data show that surgery should be performed as soon as possible and be more radical after the first episode of AUR.

A combination of α-blockers and 5ARI makes for a good starting point where the treatment of high volume BPH is concerned. Ideally, surgery should be performed immediately or as soon as possible in patients with the first episode of AUR and ‘anatomic’ BPH tissue removal is preferable (dissection of tissue along the prostate capsule to remove its maximum volume).
Update on the management of complex strictures of the bulbar urethra
Authors: Lumen Nicolaas , Verla Wesley , Waterloos Marjan , Waterschoot Mieke
Published: June 2021

Purpose of review

This narrative review summarizes the most relevant literature published in 2019–2020 regarding urethroplasty for bulbar strictures.

Recent findings

We identified relevant papers focussing on new insights in the field of excision and primary anastomosis, graft augmentation urethroplasty and perineostomy for bulbar strictures and bulbomembranous strictures after radiotherapy or surgery for benign prostatic hyperplasia.

Respecting the vascularity of the anterior urethra and maintaining the integrity of surrounding structures during bulbar urethroplasty does not appear to deteriorate surgical outcomes and might be associated with improved functional outcomes.
Assessment of the Transitional Care Model-Based TEMpEST Program by Caregivers of Stroke Patients
Authors: Avci Yasemin Demir , Gozum Sebahat
Published: June 2021

With advancing technology, patients with stroke often survive the critical acute phase, but require supportive care by informal caregivers after discharge from the hospital. Little is known about the experiences of these caregivers during the immediate posthospital period. The purpose of this qualitative study was to explore the opinions and experiences of caregivers of stroke patients who were enrolled in the Transitional Care Model Stroke Turkey (TEMpEST) discharge planning program. Individual interviews were conducted with 23 caregivers of stroke patients about their experiences with the TEMpEST discharge program. Seven subthemes were identified: trust, information, morale, satisfaction, care and concern, follow-up, and continuity. The effectiveness of the program can be assessed by applying the TEMpEST program to different patient groups and conducting in-depth interviews with both patients and their caregivers.
Reducing Fall Risks Among Visually Impaired Older Adults
Authors: Nguyen Thien , Combs Elizabeth M. , Wright Pamela J. , Corbett Cynthia F.
Published: June 2021

Falls are the leading cause of death due to unintentional injuries in the older adult population, and fall-related death rates among older adults are escalating annually. Visual deficits are underrecognized and underdiagnosed, which increases fall risk. The purpose of this article is to provide a review of the common types of visual impairment, their etiology, and treatment and to present strategies to reduce falls among older adults with visual impairments. Both traditional home safety interventions and emerging technology-based interventions to reduce falls are described. Appropriate use of both traditional and emerging fall prevention interventions may reduce fall risk and falls among older adult home healthcare patients.
Is Autologous Stem Cell Transplantation a Safe and Effective Alternative to Whole Brain Radiation as Consolidation Therapy in Patients With Primary Central Nervous System Lymphoma?
Authors: Gritsch David , Mrugala Maciej M. , Marks Lisa A. , Mangipudi Kartik , Neal Matthew , Wingerchuk Dean M. , O’Carroll Cumara B.
Published: June 2021

Background:

High-dose chemotherapy followed by autologous stem cell transplantation (HD-ASCT) is a promising alternative to whole brain radiation therapy (WBRT) in the treatment of primary central nervous system lymphoma (PCNSL). The objective of this study was to critically assess current evidence supporting the use of HD-ASCT as first-line consolidative therapy in PCNSL.

Methods:

The objective was addressed through the development of a critically appraised topic that included a clinical scenario, structured question, literature search strategy, critical appraisal, assessment of results, evidence summary, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and a content expert in the field of neuro-oncology.

Results:

A recent, open-label, noncomparative randomized phase II trial was selected for critical appraisal. This trial evaluated the efficacy and toxicity of consolidative therapy with HD-ASCT and WBRT in PCNSL in 2 separate treatment arms. A total of 140 patients with newly diagnosed PCNSL between the ages of 18 and 60 years were included. The primary endpoint of 2-year progression-free survival was met in 63% of patients in the WBRT arm and 87% in the HD-ASCT arm. Notably, an overall improvement in neurocognitive scores was observed following HD-ASCT, while WBRT was associated with worsened cognitive outcomes.

Conclusions:

In young patients with newly diagnosed PCNSL, consolidative therapy with HD-ASCT appears to be associated with less neurocognitive toxicity and may be more effective than WBRT at preventing relapses, however, at the cost of a higher treatment-related mortality.
‘Falsehood flies, and the truth comes limping after it’: social media and public health
Authors: Moore Justin B. , Harris Jenine K. , Hutti Ellen T.
Published: June 2021

Purpose of review

To highlight the various uses of social media by public health practitioners and organizations, with special emphasis on how social media has been successfully applied and where applications have struggled to achieve the desired effects.

Recent findings

Social media has been used effectively in improving the timeliness and accuracy of public health surveillance. Social media has also been used to communicate information between public health organizations and reinforce consistent messaging about enduring threats to public health. It has been applied with some success to coordinate of disaster response and for keeping the public informed during other emergency situations. However, social media has also been weaponized against the public health community to spread disinformation and misinformation, and the public health community has yet to devise a successful strategy to mitigate this destructive use of social media.

Social media can be an effective tool for public health practitioners and organizations who seek to disseminate information on a daily basis, rapidly convey information in emergent situations, and battle misinformation. Social media has been uniquely valuable and distinctly destructive when it comes to protecting and improving public health.
Enhancing Parental Knowledge of Child Safety: An Interventional Educational Campaign
Authors: Temsah Mohamad-Hani , Aljamaan Fadi , Alhaboob Ali , Almosned Badr , Alsebail Raghad , Temsah Reem , Senjab Abdulrahman , Alarfaj Abdulrahman , Aljudi Talal , Esmaeil Samia , Jamal Amr , Habash Alia , Alsohime Fahad , Alhasan Khalid , Al-Eyadhy Ayman
Published: June 2021

Background

Safeguarding children from unintentional injuries is a significant concern for parents and caregivers. With children staying more at home during the COVID-19 pandemic, more educational tools and valid educational programs are warranted to improve parental knowledge and awareness about children’s safety. This study aims to explore the effectiveness of child safety campaigns on parents’ knowledge and attitude towards preventable childhood injuries.

Methods

This was a pre-post experimental study, in which the pre-designed assessments were used as an evaluation tool before and after attending a Child Safety Campaign. The Pre – Post assessment question included questions to evaluate the socio-demographic status, followed by knowledge questions in line with the current child safety campaign. The outcomes of interest were assessed before and after attending the campaign’s stations.

Results

Three hundred and eight parents volunteered to participate in this study. Their knowledge score improved from 36.2 (SD 17.7) to 79.3 (SD 15.6) after attending the Child Safety Campaign (t-value= 34.6, p<0.001). Both, perceptions on the preventability of accidents and the parents’ perceived usefulness of educational campaigns showed improvements, with (t-value =6.3, p<0.001) and (t-value= 3.097, p<0.001), respectively.

Conclusion

The educational child safety campaign for caregivers in Saudi Arabia resulted in a significant increase in the overall knowledge and attitudes towards children’s safety. As children are currently staying at home more, additional educational tools and programs are warranted to promote childhood safe practices among parents and caregivers.
How does the local area deprivation influence life chances for children in poverty in Wales: A record linkage cohort study
Authors: Bandyopadhyay Amrita , Whiffen Tony , Fry Richard , Brophy Sinead
Published: June 2021

Background

Children growing up in poverty are less likely to achieve in school and more likely to experience mental health problems. This study examined factors in the local area that can help a child overcome the negative impact of poverty.

Method

This retrospective cohort study included 159,131 children who lived in Wales and completed their age 16 exams (Key Stage 4 (KS4)) between 2009 and 2016. Free School Meal (FSM) provision was used an indicator of household level deprivation. Area level deprivation was measured by the Welsh Index of Multiple Deprivation 2011. An encrypted unique Anonymous Linking Field was used to link the children with their health and educational records. The outcome variable of ‘Overall doing well’ was comprised of achieved at KS4, no mental health condition, no substance, and alcohol abuse records. Bidirectional logistic regression models were used to investigate the association between local areas deprivation and child’s outcome.

Results

22% of children on FSM were overall doing well compared to 54.9% of non-FSM children. FSM Children who lived in the least deprived areas are significantly more likely to do well (adjusted odds ratio (aOR) -2.20 (1.93-2.51)) than children lived in the most deprived areas. FSM children, living in areas with higher community safety, higher relative income, higher access to services, are more likely to do well than their peers.

Conclusion

This study highlights that investing in community development (e.g., safety, back to work schemes, connectivity) helps in child’s education attainment, mental health and reduce risk-taking behaviours.

What is already known on this subject?

In Wales, 29.3% of children are living in poverty

Welsh Index of Multiple Deprivation (WIMD) 2019 from Welsh Government highlighted the areas in Wales which remained as the topmost deprived areas for more than last 15 years and indicated a lack of social mobility in most of these areas.

Growing up in a disadvantaged area increases the risk of adverse health and social outcomes in children’s life.

What this study adds?

Children from disadvantaged households are significantly more likely to do well if they are living in least deprived areas than the children from most deprived areas.

The findings suggest that investing in community development and local area improvements such as promoting community safety, improving the access to public services and return to work schemes, can also help local children to do well in terms of education, mental health and reducing risk-taking behaviours (alcohol/drug use).