bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between Helicobacter pylori infection and psoriasis: a nationwide population-based longitudinal cohort study
Authors: Wu Meng-Che , Ma Kevin Sheng-Kai , Chen Huang-Hsi , Huang Jing-Yang , Wei James Cheng-Chung 
Published: June 2020

AbstractBackground:In the current literature, studies assessing the role ofHelicobacter pylori(HP) infection in psoriasis have reported conflicting data. Therefore, we investigated the association between HP infection and psoriasis using a nationwide population-based longitudinal cohort study.Methods:We identified 41,539 patients with HP infection and 83,078 matched controls between 2000 and 2013 from the Longitudinal Health Insurance Research Database of the National Health Insurance Research Database in Taiwan. Propensity score analysis was used to match age, sex, comorbidities, and medical visits at a ratio of 1:2. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio of psoriasis. Furthermore, sensitivity tests and a stratified analysis were conducted.Results:The incidence rates of psoriasis did not differ significantly between the HP and control cohorts (4.58 vs 4.20 per 100,000 person-months, crude relative risk: 1.092, 95% confidence interval: 0.917–1.302). After multivariate adjustment, no significant difference in psoriasis risk was observed in patients with HP infection (adjusted hazard ratio: 1.081, 95% confidence interval: 0.907–1.288). Risk of psoriasis was significantly higher in men and the elderly, and in those with diabetes, hyperlipidemia, chronic obstructive pulmonary disease, or tuberculosis. Stratified analysis also confirmed that HP infection was not correlated with an increased risk of psoriasis based on follow-up duration, sex, and age.Conclusion:This retrospective population-based longitudinal cohort study, conducted in Taiwan, found no association between HP infection and risk of psoriasis. Further research may be warranted.
Depression in children with epilepsy from western China
Authors: Yang Chunsong , Hao Zilong , Mao Yifei , Xu Qunfen , Zhao Li , Zhang Ling-Li 
Published: June 2020

AbstractThis study investigated the prevalence of depression among children with epilepsy and evaluated factors associated with depression.Participants who met the selection criteria were included in this cross-sectional study, which was conducted at the Pediatric Neurology Department of the West China Women's and Children's Hospital from January to May 2018. Depression status among children with epilepsy was evaluated by the Depression Self-Rating Scale for Children (DSRSC). Information on sociodemographic characteristics, co-morbid diseases and family conditions were collected as independent variables. Variables found in univariate analysis to affect depression were used in a multiple linear regression model on factors related to depression among children with epilepsy.A total of 124 patients participated in the study, with a response rate of 93.9% (124/132). In this sample, 60.5% (75/124) of patients were male and the mean age of patients was 11.17 ± 2.29 years. The mean score on the DSRSC was 9.65 ± 6.45 and 16.9% (21/124) of children with epilepsy were considered to have depression. According to the multiple linear regression analysis, the DSRSC scores showed a significant correlation with comorbidities (B = 0.178; standard error (SE) = 1.123;P = .043), attitude towards seizures (B = -0.180; SE = 1.171;P = .039) and adverse reaction to medications (B = 0.233; SE = 1.797;P = .008).There is relatively high prevalence of depression in children with epilepsy in western China. More health education is needed to reduce the rate of depression in children with epilepsy, particularly for those patients with comorbidities, negative attitudes towards seizures and adverse reactions to medications.
Complications during hospitalization and at 30 days in the intensive cardiac care unit for patients with ST-elevation versus non-ST-elevation acute coronary syndrome
Authors: Yang Qian , Du Jinlong , Wang Bing 
Published: June 2020

Abstract

Background:
In this meta-analysis, we aimed to systematically compare the complications during hospitalization and at 30 days respectively, in intensive cardiac care unit (ICCU) for patients with ST elevation (STE) vs non-STE acute coronary syndrome (NSTE ACS).

Methods:
Electronic search databases including http://www.ClinicalTrials.gov, EMBASE, Cochrane Central, Google Scholar, Web of Science, and MEDLINE were searched for publications comparing complications observed in STE ACS vs NSTE ACS patients admitted in ICCU, intensive care unit (ICU) or coronary care unit (CCU). This is a meta-analysis and risk ratios (RR) with 95% confidence intervals (CI) were used to illustrate the data following analysis by the RevMan 5.3 software.

Results:
Six studies consisting of a total number of 25,604 participants (12,880 participants admitted due to STE ACS and 12,724 participants admitted due to NSTE ACS) were included. Our results showed that the total outcomes including severely abnormal electrocardiography (ECG) (RR: 1.48, 95% CI: 1.27–1.73; P = .00001) and mortality (RR: 1.83, 95% CI: 1.64–2.04; P = .00001) were significantly higher in patients with STE ACS. Re-infarction (RR: 0.86, 95% CI: 0.62–1.19; P = .37) and heart failure (RR: 1.04, 95% CI: 0.88–1.23; P = .62) were similarly manifested in those patients with ACS. However, the risk for recurrent angina was significantly higher with NSTE ACS (RR: 0.65, 95% CI: 0.46–0.92; P = .01).

Conclusions:
Patients with STE ACS were at a higher risk for in-hospital and 30 days mortality in this analysis. In hospital, severely abnormal ECG was also significantly higher in this category of patients compared to NSTE ACS. However, re-admission for heart failure and re-infarction was similar in both groups. Future studies should be able to confirm this hypothesis.
Effects of bushen huoxue method for knee osteoarthritis
Authors: Chen Guocai , Ye Xiangling , Guan Yingxin , Liu Wengang , Du Jianping , Yao Nan , Xu Xuemeng 
Published: June 2020

Abstract

Background:
Knee osteoarthritis (KOA) is a common progressive joint disorder in old people. Bushen huoxue (BSHX) is a classical method of TCM in treating KOA. However, there is no systematic review related to BSHX for KOA. The purpose of this study is to provide a comprehensive and reliable evaluation of the clinical evidence of BSHX in the treatment of KOA.

Methods:
We searched relevant studies on BSHX for KOA from the databases of PubMed, Embase, MEDLINE, Cochrane Library Central Register of Controlled Trials, China national knowledge infrastructure database (CNKI), Wan fang database, Chongqing VIP information, and SinoMed from their inception to May 2020. Two researchers will select and evaluate qualified studies independently. The primary outcomes of this review will focus on pain intensity. The meta-analyses will be performed by using the RevMan 5.3.

Results:
The study will provide a comprehensive evaluation of the efficacy and safety of the BSHX method for patients with KOA.

Conclusion:
The results of this systematic review will provide evidence to judge whether BSHX is an effective intervention for patients with KOA.
A randomized controlled study for Yuanhu Zhitong dropping pills in the treatment of knee osteoarthritis
Authors: Gu Yubiao , Huang Jin , Guo Honggang , Song Xuewen , Li Jianguo , Shi Yanlong , Xie Xingwen 
Published: June 2020

Abstract

Background:
Knee osteoarthritis (KOA) is a common chronic disorder of knee and the leading cause of pain in the elderly with an overall prevalence of 50% in people over 60 years of age. This disease is an important factor affecting the quality of life of middle-aged and elderly people, and its main symptom is knee joint pain. Due to the pain, the knee joint activity function is limited, bringing great pain to patients, affecting their quality of life, effective prevention, and treatment of KOA is a modern medical problem.

Methods:
The 60 patients who met the inclusion criteria were randomly divided into the treatment group and the control group. In this study, single center, randomized control and equivalent clinical trial were used for treatment. The treatment group received Yuanhu Zhitong dropping pills within 4 weeks, and the control group received diclofenac sodium sustained-release capsule treatment within 4 weeks. The main measures were visual analogue scale (VAS), WOMAC osteoarthritis index score and gastrointestinal symptoms rating scale (GSRS).Secondary measures included biochemical markers and adverse reactions during treatment.

Result:
The results of this trial will be published on the website of China Clinical Trial Registration Center (http://www.chictr.org.cn/searchprojen.aspx) and in peer-reviewed journals or academic conferences.

Conclusions:
This study is to assess the efficacy and safety of Yuanhu Zhitong dropping pills for knee osteoarthritis (KOA).

Registration:
PROSPERO (registration number ChiCTR1900024712).
Cytological, histological, and molecular characteristics of pure invasive micropapillary carcinoma of pancreas
Authors: Lee Sun-Jae , Bae Han-Ik , Yoon Ghilsuk , Cho Chang Min , Kwon Hyung Jun , Park Jongmin , Cho Seung Hyun , Seo An Na 
Published: June 2020

Abstract

Introduction:
Pure invasive micropapillary carcinoma (IMPC) is a rare histologic subtype of pancreatic cancer which has a high propensity for lymph node metastasis and poor prognosis.

Patient concerns:
An 81-year-old woman was admitted to our institution with a 3-month history of back pain. Computed tomography of the abdomen and pelvis confirmed the presence of a low-density mass in the tail of the pancreas.

Diagnosis:
Endoscopic ultrasound-guided fine needle aspiration cytology (FNAC) from the pancreatic mass showed small tumor cell clusters with three-dimensional aggregates and morula-like structures. The tumor was diagnosed as adenocarcinoma with micropapillary features.

Interventions:
The patient underwent radical antegrade modular pancreatosplenectomy and regional lymph node dissection. Histological examination showed small clusters of tumor cells that were closely adhered to one another. The cells were located in empty stromal spaces mimicking lymphovascular channels. All tumor cells showed reverse polarity, resulting in an “inside-out” pattern. An extensive search was performed, and no typical ductal adenocarcinoma component was found. The tumor measured 1.5 × 1.3 cm and invaded into the peripancreatic fat tissue without adjacent organ invasion. One of the 12 regional lymph nodes showed metastasis. Ion Torrent next-generation sequencing identified missense mutations in KRAS, TP53, and SMAD4 using the Oncomine Comprehensive Panel version 1.

Outcomes:
Twelve months following surgical resection the patient remained healthy with no evidence of recurrence at clinical follow-up.

Lessons:
This report highlights the diagnostic features and molecular characteristics of pure pancreatic IMPC and the challenges with diagnosis by FNAC. A centralized and collaborative accumulation of additional cases of pure IMPC could further elucidate its pathogenesis.
The efficacy of angiotensin converting enzyme inhibitors versus angiotensin II receptor blockers on insulin resistance in hypertensive patients
Authors: Yao Jia , Gong Xiayu , Shi Xiaoyan , Fan Simin , Chen Junmin , Chen Qiu 
Published: June 2020

Abstract

Background:
Previous studies have shown inconsistent outcomes in the efficacy of angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) on insulin resistance (IR). Hence, we aim to compare the efficacy of ACE inhibitors with ARBs on IR in hypertensive patients.

Methods:
Five electronic databases (included The Cochrane Library, MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) will be searched. Randomized controlled trials (RCTs) will be included if they recruited hypertensive participants for assessing the effect of ACE inhibitors on IR versus ARBs. The primary outcome will be IR (using recognized methods such as homeostasis model assessment of insulin resistance), secondary outcomes will be blood pressure, fasting plasma glucose, fasting plasma insulin. Relevant literature search, data extraction, and quality assessment will be performed by 2 researchers independently, and the third researcher will be involved in a discussion for any disagreements. All analyses will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Stata 12.0 software will be used for statistical analysis. The effect size of dichotomous data will be measured using the odds ratio (OR), and the effect size of continuous data will be measured using the standardized mean difference. And 95% confidence intervals will be calculated. Heterogeneity will be tested by χ
2-based Cochran Q statistic and I2 statistic. Sensitivity analysis and subgroup analysis will be used to observe changes in the pooled effect size and heterogeneity between included studies, to assess the reliability and stability of the pooled results. The funnel plot and Egger's and Begg's tests will be used to judge publication bias, and the trim and fill method will be used to correct the funnel asymmetry caused by publication bias. P < 0.05 will be considered to indicate a statistically significant result.

Results:
This systematic review and meta-analysis will assess the efficacy of ACE inhibitors versus ARBs on IR in hypertensive patients.

Conclusions:
Our study will show the efficacy of ACE inhibitors versus ARBs on IR in hypertensive patients. And it may find a more beneficial therapeutic option to assist clinicians in making clinical decisions.

Ethics and dissemination:
This study is a protocol for systematic review and meta-analysis of the efficacy of ACE inhibitors and ARBs on IR in hypertensive patients. This systematic review and meta-analysis will be published in a journal and disseminated in print by peer-review.

INPLASY registration number:
INPLASY202050032.
Comparing the Effects of Regular Lecture and Branching Path Simulation on Nursing Students' Academic Performance Evaluation
Authors: Rababa Mohammad 
Published: June 2020

Background
Nursing education in Jordan is predominantly centered on regular lectures (RLs) that fail to empower students to self-assess their academic performance. Branching path simulation (BPS) is an innovative teaching method that consistently guides the student through a logically defensible analytical thought process to make correct decisions.

Purpose
The aim was to determine the effect of BPS on students' academic performance.

Method
An experimental design with control group design was used.

Results
Students trained by BPS had significant improvement in their academic performance as measured by the mean scores of the Advanced Adult Health Nursing examination compared with RL students.

Conclusion
BPS is an innovative teaching method that requires more attention to be incorporated into the nursing curricula. Given the current learning barriers associated with the high student-educator ratio in Middle Eastern countries, with BPS nursing students have a unique opportunity to self-assess their learning needs.
Developing a Psychiatric Mental Health Dedicated Education Unit
Authors: Schoening Anne M. , Williams Jacqueline , Saldi Debra 
Published: June 2020

Background
There is an urgent need to increase the psychiatric mental health (PMH) nursing workforce in the United States. The dedicated education unit (DEU) model may provide a creative solution to this need.

Purpose
The purpose of this study was to describe the student, staff nurse, and patient experience in a PMH DEU.

Methods
Thirty-three students and 7 staff nurses participated in focus group interviews. Sixty-one patients were asked to describe their experience with students in the PMH DEU.

Results
Students reported that participation in the PMH DEU helped in breaking the stigma surrounding mental illness. Staff nurses described the benefit of staying current and faculty presence. Both students and staff nurses identified teamwork and understanding the PMH nursing role as key themes. All patients reported positive interactions with students.

Conclusions
The PMH DEU is a potential strategy to provide students with a deeper understanding of the PMH nursing role.
CD4 Trajectory Models and Onset of Non–AIDS-Defining Anal Genital Warts, Precancer, and Cancer in People Living With HIV Infection-1
Authors: Ye Yuanfan , Burkholder Greer A. , Wiener Howard W. , Aslibekyan Stella , Khan Ashraf , Shrestha Sadeep 
Published: June 2020

Background
It is unclear how the characteristics of CD4 counts predict non–AIDS-defining human papillomavirus–related anogenital warts (AGWs) and anal high-grade squamous intraepithelial lesions/cancer (HSIL+) in people living with HIV infection-1 (PLWH). We compared the associations between 3 CD4 counts measures and these disease outcomes in the study.

Methods
Retrospective sociobehavioral and clinical data from electronic health records of 4803 PLWH from 2006 to 2018 were included. Three different measurements of CD4 counts—(a) nadir, (b) median, and (c) trajectory—were estimated. Six CD4 trajectory groups were constructed using the group-based trajectory modeling from all patients older than 18 years with ≥3 clinical visits. Univariate and multivariable logistic regression models were used to assess the associations with AGW and HSIL+, separately.

Results
A total of 408 AGW, 102 anal HSIL+ (43 HSIL, 59 cancer), 4 penile cancer, and 15 vaginal cancer cases were observed. Median CD4 (<200 cell/μL) was associated with AGW (odds ratio [OR], 2.2 [95% confidence interval {CI}, 1.6–3.0]), and anal HSIL+ (OR, 2.7 [95% CI, 1.5–5.0]; each, P < 0.001). Low nadir CD4 (<200 cell/μL) was associated with AGW (OR, 1.8 [95% CI, 1.3–2.6]) and anal HSIL+ (OR, 2.4 [95% CI, 1.2–4.7]; each, P ≤ 0.001). Different patterns (declining and sustained low CD4 counts) of CD4 trajectories showed the strongest associations with onset of both AGW (OR, 1.8–3.1) and HSIL+ (OR, 2.7–6.7).

Conclusions
People living with HIV infection-1 with the same median CD4 could have very different CD4 trajectories, implying different dynamics of immune status. CD4 trajectory could be a better predictor of incident AGW and HSIL+ among PLWH.
The Feasibility of Using Comic-Based Concussion Discharge Instructions
Authors: Kolberg Kristen , Larson Jennifer , Almeida Andrea , Ichesco Ingrid , Johnson Abigail , Van Tubbergen Marie , Nagappan Bella S. , Saleem Noor , Cranford James A. , Hashikawa Andrew 
Published: June 2020

ObjectiveThe objective of this study was to evaluate feasibility of supplementing emergency department (ED) concussion discharge instructions for adolescents and parents with a newly created educational comic and a publicly available comic-based video at an outpatient sports neurology clinic.MethodsWe created a gender-neutral, 2-page comic to augment text-only ED concussion discharge instructions. A sample of patients evaluated at a sports neurology clinic and their parents/guardians participated. Patients and their parents were randomized to view either the comic only or both the comic and publicly available comic-based video. Patients and parents completed preintervention and postintervention surveys to assess likeability and concussion knowledge including concussion definition, symptoms, return-to-ED criteria, and resuming normal activity. Data were analyzed using descriptive and comparative statistics.ResultsA total of 57 patients (47.4% female; mean age, 15 years) and 37 guardians were enrolled. Most (73%) concussions were sports related, with the majority having sought care within 24 hours in an ED (80%). Over half (51%) had experienced 2 or more prior concussions. Overall, 31 adolescents and 20 guardians viewed both comic and video, whereas 26 adolescents and 17 guardians viewed the comic only. Both comic and video were favorably reviewed, but a higher proportion of respondents rated the video more positively than the comic for likability (P< 0.01), comprehensibility (P< 0.05), and increasing understanding (P< 0.05). Patients' knowledge of some concussion symptoms emphasized in the comic increased after reading (emotional changes,P= 0.02; vomiting,P= 0.04).ConclusionsPatients showed increased concussion knowledge using the favorably endorsed comic-based discharge instructions. Using comic-based supplemental discharge tools may optimize concussion education for adolescents.
Pediatric Trauma Readiness
Authors: Genovese Timothy J. , Roberts-Santana Carolina , Wills Hale 
Published: June 2020

Objectives
The National Pediatric Readiness Project of the Emergency Medical Services for Children surveyed emergency departments in the United States in 2013 for readiness to provide emergency care to children. However, that survey did not query for many elements considered essential to Advanced Trauma Life Support (ATLS).

Methods
Our pediatric trauma center and state department of health collaborated to develop a survey reflecting ATLS principles regarding pediatric-specific trauma stabilization, clinical/administrative resources, and interfacility transfer to complement the 2017 PedsReady survey. We distributed the survey to all emergency department medical directors in our state in 2017.

Results
Medical directors of all 11 emergency departments responded. Only 2 reported having physician or nurse pediatric trauma coordinators. Two reported comfort with all emergency procedures at all ages (eg, airway, traumatic pneumothorax treatment, etc), whereas 9 had variable thresholds of comfort by age and procedure. Reported utilization of pediatric trauma-specific protocols varied the following: hyperosmolar therapy (1), neurological assessment (3), chest injury (4), massive transfusion (1), triage (5), trauma transfer agreements (10), imaging-limitation protocols (4), internal (1) and inter-facility (4) quality assurance/quality improvement process (1), and real-time image transfer (11).

Conclusions
This survey identified gaps in the readiness of emergency departments to treat injured children in our state that were not detected by the 2013 PedsReady surveys. Future surveys of emergency department pediatric readiness should consider more detailed, trauma-specific readiness questions. This will allow for assignment of more accurate goals and benchmarking standards for national pediatric trauma readiness.
Hemorrhage Control Training
Authors: Sidwell Richard A. , Spilman Sarah K. , Feist Brian , Fuchsen Elizabeth A. , Taber Philip S. , Pelaez Carlos A. 
Published: June 2020

Objectives
Uncontrolled bleeding is the leading cause of preventable death after a traumatic event, and early intervention to control bleeding improves opportunities for survival. It is imperative to prepare for local and national disasters by increasing public knowledge on how to control bleeding, and this preparation should extend to both adults and children. The purpose of this study is to describe a training effort to teach basic hemorrhage control techniques to early adolescent children.

Methods
The trauma and emergency departments at a combined level I adult and level II pediatric trauma center piloted a training initiative with early adolescents (grades 6–8) focused on 2 skills: packing a wound and holding direct pressure, and applying a Combat Application Tourniquet. Students were evaluated on each skill and completed presurveys and postsurveys indicating their likelihood to use the skills.

Results
Of the 194 adolescents who participated in the trainings, 97% of the students could successfully pack a wound and hold pressure, and 97% of the students could apply a tourniquet. Before the training, 71% of the adolescents indicated that they would take action to assist a bleeding victim; this increased to 96% after the training.

Conclusions
Results demonstrate that basic hemorrhage control skills can be effectively taught to adolescents as young as 6th grade (ages 11–12 years) in a small setting with age-appropriate content and hands-on opportunities to practice the skills and such training increases students’ perceived willingness to take action to assist a bleeding victim.