bluuebunny/crossref_metadata_2025_split huggingface dataset:
A protocol of systematic review and meta-analysis of acupuncture for drug resistant epilepsy
Authors: Wang Ze-Yu , Jiang Yao-Jia , Wang Zeng-Mian , Ren Ming-Yu 
Published: July 2020

AbstractBackground:This study aims to appraise the effectiveness and safety of acupuncture for drug resistant epilepsy (DRE).Methods:We will search all potential randomized controlled trials (RCTs) of acupuncture for patients with DRE from their origin to March 1, 2020: MEDLINE, EMBASE, Cochrane Library, CINAHL, Scopus, WANGFANG, and Chinese Biomedical Literature Database. We will not apply any restrictions to the language and publication date. All RCTs investigating the effectiveness and safety of acupuncture for patients with DRE will be included. Study quality will be appraised by Cochrane risk of bias, and statistical analysis will be scrutinized by RevMan 5.3 software. Whenever possible, a narrative summary to describe study quality and content of the evidence will be performed.Results:This study will provide summarize high quality evidence and will utilize a variety of outcome measurements to verify effectiveness and safety of acupuncture for DRE.Conclusion:The results of this study will seek to explore the effectiveness and safety of acupuncture for DRE.Systematic review registration:PROSPERO CRD42020170517.
Novel airway device Vie Scope in several pediatric airway scenario
Authors: Maslanka Maciej , Szarpak Lukasz , Ahuja Sanchit , Ruetzler Kurt , Smereka Jacek 
Published: July 2020

Abstract

Context:
Endotracheal intubation of pediatric patients is challenging, especially in the pre-hospital emergency setting and if performed by less experienced providers. Securing an airway should be achieved with a single intubation attempt, as each intubation attempt contributes to morbidity and mortality. A new airway device, the VieScope, was recently introduced into clinical market, but efficacy to reduced intubation attempts remains unclear thus far.

Objective:
We aimed to compare endotracheal intubation by paramedics using the Vie Scope in different pediatric airway simulation conditions.

Methods:
We conducted a randomized, cross-over simulation study. Following a theoretical and practical training session, paramedics performed endotracheal intubation in 3 different pediatric emergency scenarios: normal airway; tongue edema; cardiopulmonary resuscitation using the VieScope. Overall intubation success rate was the primary outcome. Secondary outcomes included number of intubation attempts, time to intubation, Cormack-Lehane grade, POGO score, and ease of use (using 1–100 scale).

Results:
Fifty-five paramedics with at least 2 years of clinical experience and without any previous experience with the VieScope participated in this study. The overall intubation success rate was 100% in all 3 scenarios. The median intubation time was 27 (24–34) versus 27 (25–37) versus 29 (25–40) s for scenarios A, B, and C, respectively. In scenario A, all paramedics performed successful intubation with 1 single intubation attempt, whereas 2% of the paramedics had to perform 2 intubation attempts in scenario B and 9% in scenario C.

Conclusions:
Results of this simulation study indicate preliminary evidence, that the VieScope enables adequate endotracheal intubation in the pediatric setting. Further clinical studies are needed to confirm these results.
Different clinical courses of various radiologic findings in fibromuscular dysplasia during a 7-year follow-up
Authors: Park Sangil , Choi Hye-Yeon 
Published: July 2020

Abstract

Rationales:
The natural history of fibromuscular dysplasia (FMD) is unclear. Furthermore, the correlation between radiologic findings and clinical significance has not been documented. Previously, the development of new vascular symptoms was reported in a small number of patients, but some of these symptoms were from other vascular causes. New arterial lesions were rarely observed during follow-up in the previous reports.

Patient concerns:
A 40-year-old man was admitted due to dysarthria and left-sided weakness. He had developed flank pain due to bilateral renal infarction about 10 months earlier. He had no known risk factors for atherosclerosis. Initial neurological examination revealed a mild weakness and central facial palsy on the left side.

Diagnoses:
Diffusion-weighted magnetic resonance imaging revealed a small acute infarction in the right insular cortex. Magnetic resonance angiography and digital subtraction angiography showed a severe stenosis with post-dilatation in the right internal carotid artery (ICA). There was a focal ectatic lesion in the left ICA. On the previous abdominal computed tomography angiography (CTA), there were arterial lesions suggestive of dissection in the bilateral renal arteries and a rod-shaped ectasia in the left common iliac artery (CIA). The pathological diagnosis was mixed-type FMD involving the intima and media.

Interventions:
The patient was prescribed antiplatelet agents for prevention of further ischemic events and followed up regularly.

Outcomes:
Seven years after the initial renal infarction, the patient developed abdominal pain radiating to the back. Abdominal CTA revealed that an aortic dissection had developed in the infrarenal aorta, which was shown as normal previously. The ectasia in the left CIA and left ICA showed no interval changes during follow-up.

Lessons:
We present a patient who developed spontaneous symptomatic dissection of the bilateral renal arteries, right ICA, and abdominal aorta during 7 years of follow-up, which were caused by pathologically confirmed FMD. Besides the symptomatic multifocal dissection, the patient showed an asymptomatic multifocal ectasia on cerebral and abdominal angiographies that had not changed over 7 years.
Lithium toxicity with prolonged neurologic sequelae following sleeve gastrectomy
Authors: Lin Yi-Hsin , Liu Sheng-Wen , Wu Hsein-Lin , Kang Jung-Cheng , Huang Kuo-Yang , Huang Hsuan 
Published: July 2020

Abstract

Rationale:
Lithium is the first-line medication for bipolar disorder, given a narrow therapeutic window of 0.8 to 1.2 mEq/L. Change of lithium pharmacokinetics following bariatric surgery may lead to lithium toxicity, which is particularly concerned.

Patient concerns:
We presented a 39-year-old man with morbid obesity and bipolar affective disorder for 20 years, who was treated with lithium. He developed serious lithium toxicity following sleeve gastrectomy and prolonged neurologic sequelae.

Diagnoses:
He suffered from persistent watery diarrhea, general weakness, and then drowsy consciousness. Lithium level was checked immediately to be 3.42 mEq/L and lithium toxicity was diagnosed.

Interventions:
After 3 courses of hemodialysis, his serum lithium level subsequently declined to 0.63 mEq/L, while his consciousness returned normal. Lithium was replaced by lamotrigine.

Outcomes:
The patient was discharged thirty-five days after admission, while his serum lithium declined to 0.06 mEq/L. Neurologic sequelae were noted by muscle weakness and pain sensation in both feet. The nerve conduction test revealed sensorimotor polyneuropathy with conduction block. He was advised to keep a passive range of motion exercise.

Lessons:
Although the consensus guideline remains lacking, our report reviewed cases of relevance in the literature and highlighted the awareness of the potential risk of lithium toxicity following bariatric surgery. We suggest close monitoring of the lithium levels and perhaps a dosage adjustment for the postoperative period.
Establishing an acquisition and processing protocol for resting state networks with a 1.5 T scanner
Authors: Moreno-Ayure Michela , Páez Cristian , López-Arias María A. , Mendez-Betancurt Johan L. , Ordóñez-Rubiano Edgar G. , Rudas Jorge , Pulido Cristian , Gómez Francisco , Martínez Darwin , Enciso-Olivera Cesar O. , Rivera-Triana Diana P. , Casanova-Libreros Rosangela , Aguilera Natalia , Marín-Muñoz Jorge H. 
Published: July 2020

Abstract

Objective:
The aim of this study was to characterize the capability of detection of the resting state networks (RSNs) with functional magnetic resonance imaging (fMRI) in healthy subjects using a 1.5T scanner in a middle-income country.

Materials and methods:
Ten subjects underwent a complete blood-oxygen-level dependent imaging (BOLD) acquisition on a 1.5T scanner. For the imaging analysis, we used the spatial independent component analysis (sICA). We designed a computer tool for 1.5 T (or above) scanners for imaging processing. We used it to separate and delineate the different components of the RSNs of the BOLD signal. The sICA was also used to differentiate the RSNs from noise artifact generated by breathing and cardiac cycles.

Results:
For each subject, 20 independent components (IC) were computed from the sICA (a total of 200 ICs). From these ICs, a spatial pattern consistent with RSNs was identified in 161 (80.5%). From the 161, 131 (65.5%) were fit for study. The networks that were found in all subjects were: the default mode network, the right executive control network, the medial visual network, and the cerebellar network. In 90% of the subjects, the left executive control network and the sensory/motor network were observed. The occipital visual network was present in 80% of the subjects. In 39 (19.5%) of the images, no any neural network was identified.

Conclusions:
Reproduction and differentiation of the most representative RSNs was achieved using a 1.5T scanner acquisitions and sICA processing of BOLD imaging in healthy subjects.
Prevalence of cardiometabolic risk factors and selected cardiovascular diseases in hypertensive and normotensive participants in the adult Polish population
Authors: Niklas Arkadiusz , Marcinkowska Justyna , Kozela Magdalena , Pająk Andrzej , Zdrojewski Tomasz , Drygas Wojciech , Piwońska Aleksandra , Bielecki Wojciech , Kozakiewicz Krystyna , Tykarski Andrzej 
Published: July 2020

Abstract
Hypertension is one of the most important causes of cardiovascular disease (CVD) incidence and mortality. The aim of the study was to assess the prevalence of metabolic syndrome and its individual components i.e., diabetes, obesity, elevated triglycerides (TG), low HDL (high-density lipoprotein) cholesterol, as well as selected manifestations of CVD i.e., atrial fibrillation (AF), peripheral artery disease (PAD), coronary artery disease (CAD), myocardial infarction (MI), and stroke in persons with and without hypertension in the Polish population.
The analysis included participants of Polish multicentre WOBASZ II Study i.e., 6163 persons aged 19 and above. The Mantel Haenszel anlysis and multidimensional logistic regression model were used to assess the relations between the prevalence of metabolic syndrome and its individual components as well as selected manifestations of CVD with hypertension.
Compared to normotensives, metabolic syndrome was over 5 times more prevalent in participants with hypertension (OR = 5.35, 95% CI:4.71–6.09). Components of the metabolic syndrome and selected manifestations of CVD were more prevalent in participants with hypertension compared to normotensives. The Mantel-Haenszel odds ratios (95% confidence intervals) were as follows: obesity counted as BMI > 30 kg/m2 OR = 2.58 (2.26–2.96), raised triglycerides OR = 2.34 (2.07–2.64), reduced HDL-C OR = 1.81 (1.59–2.06), metabolic syndrome OR = 5.35 (4.71–6.09), diabetes OR = 2.54 (1.98–3.26), AF OR = 1.47 (1.09–2.00), PAD OR = 1.51 (1.14–1.99), CAD OR = 1.94 (1.52–2.49), MI OR = 1.89 (1.32–2.70), hospitalization due to HF OR = 2.02 (1.43–2.87), hospitalization due to exacerbation of CAD OR = 2.13 (1.58–2.86), hospitalization due to revascularization OR = 2.38 (1.49–3.80), hospitalization due to stroke OR = 1.72 (1.1–2.68).
Compared to normotensive participants, persons with hypertension had higher prevalence of diabetes, obesity, MS, PAD, CAD, stroke, MI and AF, and more frequent need for hospitalization due to HF, exacerbation of CAD and for coronary revascularization.
Correlation between the small dense LDL level and nonalcoholic fatty liver disease
Authors: Hwang Ha Won , Yu Jung Hwan , Jin Young-Joo , Suh Young Ju , Lee Jin-Woo 
Published: July 2020

Abstract
Small dense low-density lipoprotein (sdLDL) is a distinct low-density lipoprotein (LDL) cholesterol subclass that has been reported to be associated with metabolic disease. On the other hand, the relationship between the sdLDL level and the nonalcoholic fatty liver disease (NAFLD) severity is unclear. In this study, the sdLDL level was measured in patients with NAFLD to assess its potential as a biomarker for evaluating NAFLD. One hundred and twenty-six patients diagnosed with NAFLD at a single referral hospital from January 2018 to August 2019 were enrolled. The lipoprotein profile was analyzed from a blood test of NAFLD patients, and transient elastography (TE, Fibroscan) was performed to evaluate the degree of NAFLD. Among the 126 patients, 83 patients that could confirm the lipoprotein profile and TE results were finally enrolled in the study. The controlled attenuation parameter (CAP) value obtained from TE did not show any correlation with the total cholesterol, LDL. But, the sdLDL level showed a significant positive correlation with the CAP value (r = 0.237, P = .031), and the sdLDL/LDL ratio also showed a significant positive correlation with the CAP value (r = 0.235, P = .032). The liver stiffness (LS) measured by TE and the sdLDL level were positively correlated in patients with NAFLD (rho = 0.217, P = .049). The sdLDL/LDL ratio also showed a significant positive correlation with the LS value (rho = 0.228, P = .038). In addition, the fatty liver index also showed a significant positive correlation with the sdLDL/LDL ratio (r = 0.448, P = .000). In this study, the sdLDL level measured by a blood test of NAFLD patients showed a positive correlation with the CAP value and LS, which indicate the degree of hepatic steatosis and fibrosis. These results suggest the possibility of the sdLDL level as a new biomarker of NAFLD, but further studies will be needed to support these results.
Blue rubber bleb nevus syndrome with the complication of intussusception
Authors: Hu Zeming , Lin Xuan , Zhong Jianing , He Qingfang , Peng Qin , Xiao Jianbo , Chen Bin , Zhang Jianhong 
Published: July 2020

Abstract

Rationale:
Blue rubber bleb nevus syndrome (BRBNS) is an extremely rare disorder characterized by multifocal venous malformations involving various organs such as the skin and gastrointestinal tract. Severe complications of BRBNS, such as intussusception, volvulus, and intestinal infarction are rarer and require surgery. This report describes a 33-year-old male of BRBNS complicated with intussusception that was successfully diagnosed and treated with surgery.

Patient concerns:
A 33-year-old Chinese man presented with persistent, colicky pain accompanied by nausea, abdominal distension, and dizziness. The patient presented with sporadic bluish nodules on his skin involving his head, neck, thorax, abdomen, and planta pedis.

Diagnoses:
BRBNS with the complication of intussusception.

Interventions:
An emergency laparotomy was performed, and postoperative management included blood transfusions and oral iron supplementation for 2 weeks.

Outcomes:
The patient's postoperative course of hospitalization was uneventful. During the 4-month follow-up, the patient showed no signs of intussusception recurrence.

Lessons:
Patients diagnosed with BRBNS who present with acute abdominal pain and distension should raise suspicion for the presence of intussusception, which requires emergent surgical intervention.
Acute compartment syndrome secondary to anterolateral thigh flap harvesting in a pediatric patient
Authors: Qu Wenrui , Pan Junbo , Jin Hongjuan , Wang Xuejie , Tian Heng 
Published: July 2020

Abstract

Introduction:
The anterolateral thigh (ALT) flap is the most popularly used flap for major soft tissue reconstruction. Although it is widely used, acute compartment syndrome (ACS) in pediatric patients has rarely been reported in the literature. We herein reported a case of ACS in a 6-year-old girl after ALT flap harvest with direct closure of the donor site.

Patient concerns:
A 6-year-old girl was admitted to the Second Hospital of Jilin University with crush injury on the palmar aspect of the right hand and wrist.

Diagnosis:
Examination showed soft tissue defect of the hand and wrist, damage on the thenar muscles, lightly crushed flexor tendons, crushed median nerve, and ulnar artery thrombosis.

Interventions:
The defect was closed with an ipsilateral ALT flap measuring 9 cm in length by 6 cm in width.

Outcomes:
After debridement was performed 3 times, the majority of the rectus femoris and lateral femoris were removed. Secondary closure by skin grafting was performed 2 weeks later. Three days after the procedure, necrotic tissues were noted on the edges of the wound. The diagnosis of ACS of the right was made. A second exploration was decided, and an extensive anterior compartment fasciotomy was performed. After 6 weeks of vacuum sealing drainage therapy, the defect was closed with a free latissimus dorsi musculocutaneous flap. At 4 months of follow-up, the right thigh wound had healed. At 6 months of follow-up, quadriceps muscle weakness remained. At 1 year of follow-up, the patient's mobility had been significantly improved, but diminished sensation remained on the lateral aspect of the thigh.

Conclusion:
ACS can occur after ALT flap harvesting in pediatric patients and should be recognized as early as possible to avoid devastating complications.
Durvalumab and tremelimumab combination therapy versus durvalumab or tremelimumab monotherapy for patients with solid tumors
Authors: Wang Bi-Cheng , Li Peng-Cheng , Fan Ji-Quan , Lin Guo-He , Liu Quentin 
Published: July 2020

Abstract

Background:
The combination of durvalumab and tremelimumab results in clinical benefit, with a tolerable safety profile in patients with solid tumors.

Objective:
To evaluate the efficacy and safety of durvalumab in combination with tremelimumab compared with either drug alone.

Methods:
The online databases (PubMed, Web of Science, EMBASE, and Cochrane Library) were searched for potential clinical studies up to Nov 26, 2019. Eligible studies were prospective and registered clinical trials. Pooled odds ratios for objective response rate and disease control rate and pooled risk ratios for treatment-related adverse events were meta-analyzed. A random-effect model was used due to the synthesis of different cancer types.

Results:
Overall, 5 studies were eligible for systematic review, 3 of which were further meta-analyzed. Durvalumab plus tremelimumab was superior to tremelimumab monotherapy in improving disease control rate in head and neck squamous cell carcinoma. However, there were no significant differences between dual immunotherapy and mono-immunotherapy in pancreatic ductal adenocarcinoma and gastric and gastroesophageal junction adenocarcinoma. Additionally, pooled analyses illustrated that no significant differences in treatment-related adverse events were displayed between the 2 groups.

Conclusion:
Durvalumab and tremelimumab combination therapy had a good safety profile and resulted in clinical benefit in head and neck squamous cell carcinoma. Future explorations are needed to further confirm the application of durvalumab plus tremelimumab.
Implementation of a Modified Neonatal Early-onset Sepsis Calculator in Well-baby Nursery: a Quality Improvement Study
Authors: Zayek Michael , Bhat Jayalakshmi , Bonner Katie , Blake Michelle , Peevy Keith , Jha Om Prakash , Gulati Rashmi , Bhat Ramachandra 
Published: July 2020

Background:
The use of sepsis risk scores (SRSs), calculated based on the neonatal early-onset sepsis (EOS) calculator, has been shown to limit the unwarranted sepsis evaluations and to reduce the empirical use of antibiotics in neonates.s

Purpose:
To reduce both the sepsis evaluation rate (SER) and antibiotic initiation rate (AIR) by 25% from baseline by incorporating conservative SRS cutoff values into the routine sepsis risk assessment of well-appearing neonates born at 34 weeks and older gestation.

Methods:
During a pre quality improvement (QI) period (June 2016–August 2016), a QI team calculated SRS on all newborn infants to determine safe SRS cutoff values. During the QI-study period (September 2016–November 2017), we implemented an EOS evaluation algorithm based on 2 SRS cutoff values, 0.05 (later increased to 0.1) for sepsis evaluation and 0.3 for the initiation of antibiotic therapy. Monthly SER and AIR were summarized and analyzed by using standard statistical tests and statistical process control charts. During the surveillance phase (January 2019–June 2019), we evaluated whether previously attained improvements in SER and AIR were sustained.

Results:
During the pre-QI period, the mean (±SD) of monthly SER and monthly AIR were 23.8% (±5.7%) and 6.2% (±0.4%), respectively. During the QI-study period, the mean (±SD) of monthly SER and monthly AIR decreased to 15% (±4.7%), P = 0.01, and 3.2% (±1.5%), P = 0.005, respectively. During the surveillance period, both outcome measures were comparable with the QI-study period.

Conclusion:
The implementation of a modified EOS calculator-based EOS algorithm using a conservative approach was successful in reducing antibiotic exposure and the need for blood work in well-appearing neonates.
The Impact of Full-Scale Simulation Training Based on Kolb’s Learning Cycle on Medical Prehospital Emergency Teams
Authors: Secheresse Thierry , Pansu Pascal , Lima Laurent 
Published: July 2020

Introduction
Using simulation to train teams in out-of-hospital cardiac arrest management is recommended to improve team effectiveness. The aim of this study was to assess the impact of a specific cardiac arrest management simulation training program inspired by the principles of Kolb’s learning cycle.

Method
All the staff in a medical prehospital emergency unit participated in this program. Both individual and team levels were evaluated: on an individual level, we assessed attitudes toward training and medical knowledge of cardiac arrest management; on a team level, we assessed team behavior during simulated cardiac arrest and learning transfer in clinical practice.

Results
In addition to the satisfaction of the participants, the results showed a positive effect on medical knowledge and team behavior and an improvement in the management of patients suffering cardiac arrest.

Conclusions
These findings confirm the usefulness of a simulation training program containing the 4 steps of Kolb’s cycle for emergency teams.
“Who Am I and Why Am I Here?” A Scoping Review Exploring the Templates and Protocols That Direct Actors in Their Roles as Simulated (Standardized) Patients
Authors: Davies Ellen L. , Pelentsov Lemuel J. , Montagu Adam , Gordon Andrea L. , Hooper Kenneth J. , Esterman Adrian J. 
Published: July 2020

Summary Statement
Simulated patients (SPs) are increasingly used in health education and research. The aim of this article was to investigate templates and protocols that enable SPs to accurately and consistently adopt these roles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guided the search strategy for articles that detailed such templates or protocols. Embase Classic + Embase, ProQuest ERIC, Ovid MEDLINE, Ovid EMCare, psycINFO, and Scopus were searched, and 17 articles were included in the review. The templates and protocols that were located differed in structure, length, and depth and were developed or used in medical, nursing, allied health, and veterinary medicine disciplines. The validity, reliability, and replicability of studies are explored, and the quality of reporting is evaluated using the Simulation Research Rubric. Recommendations for increasing the rigor of programs and the reporting of research where SPs are adopted are considered.