bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hacking teamwork in health care: Addressing adverse effects of ad hoc team composition in critical care medicine
Authors: McLeod Poppy L. , Cunningham Quinn W. , DiazGranados Deborah , Dodoiu Gabi , Kaplan Seth , Keyton Joann , Larson Nicole , LeNoble Chelsea , Marsch Stephan U. , O’Neill Thomas A. , Parker Sarah Henrickson , Semmer Norbert K. , Shuffler Marissa , Su Lillian , Tschan Franziska , Waller Mary , Wang Yumei 
Published: December 2019

Background
The continued need for improved teamwork in all areas of health care is widely recognized. The present article reports on the application of a hackathon to the teamwork problems specifically associated with ad hoc team formation in rapid response teams.

Purposes
Hackathons—problem-solving events pioneered in computer science—are on the rise in health care management. The focus of these events tends to be on medical technologies, however, with calls for improvements in management practices as general recommendations. The hackathon reported here contributes to health care management practice by addressing improvements in teamwork as the focal problem.

Methodology
The hackathon event took place over 2.5 days in conjunction with an academic conference focused on group research. Three teams comprised of practicing healthcare professionals, academic researchers and students developed solutions to problems of ad hoc team formation in rapid response teams.

Findings
The event fulfilled several goals. The teams produced three distinct, yet complementary solutions that were backed by both field-based experience and solid research evidence. The event provided the opportunity for two-way translation of research and practice through direct collaboration among key stakeholders. The hackathon produced long term effects through establishing or strengthening collaborations, dissemination of the ideas through presentations, workshops, and publications, and changes in participantsâ work practices.

Practice Implication
The event demonstrated that hackathons, classically focused on technology, can also offer a spur to innovation around organizational processes. The article provides advice for organizing other hackathons focused on similar topics. The solutions offered by the participants in the event yields the clear insight that multipronged solutions for emergency-oriented teamwork are needed. The hackathon highlighted the scaled of collaboration and effort needed to tackle the many complexities in health care that impact outcomes for providers, patients, and health organizations.
Impact of number of medications and age on adherence to antihypertensive medications
Authors: Kim Seung Jae , Kwon Oh Deog , Han Eunice Bormee , Lee Cheol Min , Oh Seung-Won , Joh Hee-Kyung , Oh Bumjo , Kwon Hyuktae , Cho BeLong , Choi Ho Chun 
Published: December 2019

Abstract
This study tried to investigate the effects of number of medications and age on antihypertensive medication adherence in a real-world setting using a nationwide representative cohort.
We obtained data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of Korea, which is a sample of 2.2% (N = 1,048,061) of total population (N = 46,605,433). Patients aged 20 years or older (N = 150,550) who took antihypertensive medications for at least 1 year were selected. Medication possession ratio (MPR) was used for measuring adherence. The subjects were divided into 5 subgroups according to total number of medications: 1–2, 3–4, 5–6, 7–8, and 9 or more. The mean age and the mean number of medications were 60.3 ± 12.6 years and 4.1 ± 2.2, respectively. The mean MPR was 80.4 ± 23.9%, and 66.9% (N = 100,645) of total subjects were adherent (MPR ≥ 80%). The overall tendency of antihypertensive medication adherence according to the total number of medications displayed an inverted U-shape with a peak at 3–4 drugs. Adherence consistently increased as the age increased until age 69 and started to decrease from age 70. The proportion of adherent patients (MPR ≥ 80%) according to the total number of medications also showed an inverted U-shape with a peak at 3–4 drugs. When the same number of drugs was taken, the proportion of adherent patients according to age featured an inverted U- shape with a peak at 60 to 69 years. Patients taking 9 or more total drugs had the overall odds ratio (95% CI) of non-adherence (MPR < 80%) with 1.17 (1.11–1.24) compared with those taking 1 to 8 total drugs and the odds ratios in the age subgroups of 40 to 49, 50 to 59, 60 to 69 years were 1.57 (1.31–1.87), 1.21 (1.08–1.36), and 1.14 (1.04–1.25), respectively (P < .05).
Association between age, total number of medications, and antihypertensive adherence displayed an inverted U-shape with a peak at 3 to 4 total medications and at age 60 to 69 years. When the total number of drugs was 9 or more, adherence decreased prominently, regardless of age.
A very rare presentation of lung cancer
Authors: Afrăsânie Vlad-Adrian , Adavidoaiei Anca Maria , Zamisnicu Iuliana Hunea , Funingănă Ionut Gabriel , Marinca Mihai Vasile , Gafton Bogdan , Clement Dana Elena , Păduraru Marius-Ionut , Demşa Irina , Miron Lucian , Alexa-Stratulat Teodora 
Published: December 2019

Abstract

Rationale:
Acrometastases of the hand are an unusual sign of lung cancer onset and may often be mistaken for other benign disorders, thus delaying diagnosis and treatment.

Patient concerns:
A 58-year-old man presented at the Rheumatology Clinic with a lump in the distal phalanx of the right index finger associated with intense pain, swelling, rib pain, and hemoptysis.

Diagnoses:
Given the clinical manifestations, an x-ray of the right hand was performed, and it revealed an osteolytic lesion in the distal phalanx of the right index finger. The subsequent CT of the thorax and abdomen showed a lung tumor, osteolytic lesions in the ribs, sternum, and the thoracic spine.

Interventions:
Amputation of the phalanx was decided on account of intense pain refractory to NSAIDs and opioids. Pathology assessment established the diagnosis of bone metastases secondary to lung adenocarcinoma. The patient underwent 6 cycles of first-line palliative chemotherapy with cisplatin and gemcitabine with partial response according to the RECIST 1.1. criteria. EGFR and ALK testing were not available at the time. A year later, the patient presented with progressive disease, which lead to 6 more cycles of chemotherapy with docetaxel. The disease progressed during chemotherapy and the patient was switched to erlotinib.

Outcomes:
After 7 months of anti-EGFR treatment, the patient passed away due to disease progression, thus having an overall survival of 25 months.

Lessons:
On rare occasions, acrometastases of the hand may be the first manifestation of a lung cancer and, as such, they must be taken into consideration in the differential diagnosis of rheumatologic disorders. They are a poor prognosis marker, but some cases like this one can have a better survival than reported in the literature, most likely due to that particular cancer's biology.
Reactive arthritis induced by active extra-articular tuberculosis
Authors: Endo Yushiro , Kawashiri Shin-ya , Koga Tomohiro , Okamoto Momoko , Tsuji Sosuke , Takatani Ayuko , Shimizu Toshimasa , Sumiyoshi Remi , Igawa Takashi , Iwamoto Naoki , Ichinose Kunihiro , Tamai Mami , Nakamura Hideki , Origuchi Tomoki , Kawakami Atsushi 
Published: December 2019

Abstract

Rationale:
Rare cases of reactive arthritis induced by active extra-articular tuberculosis (Poncet disease) have been reported. Complete response to antitubercular treatment and evidence of active extra-articular tuberculosis are the most important clinical features of Poncet disease. We report the case of successfully treated a patient with reactive arthritis induced by active extra-articular tuberculosis with a TNF inhibitor after sufficient antitubercular treatment.

Patient concerns:
A 56-year-old Japanese man was admitted to our department with polyarthralgia, low back pain, and high fever. The results of rheumatoid factor, anti-citrullinated protein antibody, human leukocyte antigen B27, and the assays for the detection of infections (with an exception of T-SPOT.TB) were all negative. Fluoro-deoxy-D-glucose–positron emission tomography with CT (PET/CT) showed moderate uptake in the right cervical, right supraclavicular, mediastinal, and abdominal lymph nodes. As magnetic resonance imaging and power Doppler ultrasonography showed peripheral inflammation (tendinitis, tenosynovitis, ligamentitis, and enthesitis in the limbs).

Diagnosis:
A diagnosis of tuberculous lymphadenitis was eventually established on the basis of lymph node biopsy results. There was no evidence of a bacterial infection including acid-fast bacteria in his joints, and the symptoms of polyarthralgia and low back pain were improved but not completely resolved with NSAID therapy; in addition, a diagnosis of reactive arthritis induced by active extraarticular tuberculosis was made.

Interventions:
The patient experienced persistent peripheral inflammation despite antitubercular treatment for more than nine months and was then successfully treated with a tumor necrosis factor inhibitor (adalimumab 40 mg every 2 weeks).

Outcomes:
Finally, the patient responded to the treatment and has been in remission for over 4 months as of this writing.

Lessons:
In patients who present with symptoms associated with spondyloarthritis, it is important to distinguish between classic reactive arthritis and reactive arthritis induced by extra-articular tuberculosis infection. Introduction of biological agents should be carefully considered in settings where reactive arthritis induced by active extra-articular tuberculosis shows progression to chronicity despite sufficient antitubercular treatment.
The effect and safety of acupuncture on patients with functional constipation
Authors: Xu Mingmin , Zhang Wei , Wang Lu , Feng Xiumei , Li Ying 
Published: December 2019

Abstract

Background:
Functional constipation (FC) is a prevalent clinical disease that affects a considerable proportion of the population of all ages. Persistent FC significantly reduces quality of life and influences physical and emotional well-being, as well as consumes many substantial healthcare resources. Acupuncture originates from Traditional Chinese Medicine (TCM), and emerging evidence of several randomized controlled trials (RCTs) published suggest that acupuncture has positive effects for FC. Since 2019, several new results of high quality RCTs about acupuncture treatment for FC have been published. Thus a systematic review will be designed to appraise the effectiveness and safety of acupuncture for improvement of FC in patients based on high quality RCTs.

Methods:
We carried out a rigorous literature search in English and Chinese electronic database from inception to present. Two reviewers will identify relevant studies, extract and manage trial information, and then assess the risk of bias in included studies by the Cochrane risk of bias assessment tool. Only high quality RCTs will be included. Data will be synthesized by either fixed-effects or random-effects model regarding to a heterogeneity test. The primary outcome measurement will be the change from baseline in mean complete spontaneous bowel movements and stool form. The secondary outcomes involved disappearance rate of symptoms, proportion of responders, mean transit time, health-related quality of life, and safety of intervention. Meta-analysis will be performed by using Cochrane's RevMan software.

Results:
This systematic review will summarize high quality clinical evidence to assess and appraise the effectiveness and safety of acupuncture treatment for FC patient.

Expected conclusion:
This systematic review and meta-analysis will provide evidence to determine whether acupuncture treatment is an effective and safe therapy for the prevention and treatment of FC compared with medication treatment.
Manipulation for treatment of degenerative lumbar spondylolisthesis
Authors: Sun Kai , Liang Long , Yin He , Yu Jie , Feng Minshan , Zhan Jiawen , Jin Zhefeng , Yin Xunlu , Wei Xu , Zhu Liguo 
Published: December 2019

Abstract

Background:
Degenerative lumbar spondylolisthesis (DLS) is one of the common orthopedic diseases which causes low back pain in patients, which seriously affects people's daily life and work. As a method of conservative treatment of this disease, manipulation is widely used in clinical practice. We will summarize the current published evidence of manipulation in the treatment of DLS, and evaluate the effectiveness and safety of manipulation through systematic review and meta-analysis, so as to provide more reliable evidence for future clinical practice.

Methods:
We will conduct a comprehensive search of the following 9 databases until January 2019: PubMed, Embase, Cochrane Library, ClinicalTrials.gov, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technique Journals Database, Wan Fang Database, and Chinese Biomedical Database. The 2 researchers will independently search, screen, extract data, and evaluate the quality of the literatures. The primary outcomes include clinical effectiveness, Japanese Orthopaedic Association scores, and the secondary outcomes include visual analog scale scores, symptom scores, and adverse events. Bias risk tools provided by Cochrane Collaboration will be used for literature quality assessment, and RevMan 5.3 software will be used for meta-analysis.

Results:
The results of this study will systematically evaluate the effectiveness and safety of manipulation intervention for people with DLS, especially in improving lumbar function scores and pain scores.

Conclusion:
The systematic review of this study will summarize the current published evidence of manipulation for the treatment of DLS, which can further guide the promotion and application of it.

Ethics and dissemination:
This study does not require ethical approval and the results will be published in a peer-reviewed journal.

PROSPERO registration number:
CRD42019139933.
Multiple sites of soft-tissue metastases secondary to lung cancer
Authors: Zhu Xingxing , Chen Jialu , Yang Fanfan , Tang Congsheng 
Published: December 2019

Abstract

Rationale:
The prognosis of lung cancer is dismal, which has resulted in lung carcinoma being one of the leading causes of cancer-related deaths worldwide. Non-small cell lung cancer accounts for approximately 80% of all types of lung carcinoma. The skeletal system and central nervous system are the most common distal metastatic sites in patients with lung cancer, while cutaneous and soft tissues metastasis is rare.

Patient concerns:
We report a case of concomitant metastasis in the nasal tip and suspected buttocks metastasis secondary to lung cancer, who complained of repeated cough and white sputum for 6 months.

Diagnose:
Primary lung cancer was diagnosed by bronchoscopy and biopsy, lesion on nasal tip was confirmed by biopsy. Furthermore, PET-CT scan identified the untouchable buttocks lesion that could have been easily missed.

Interventions:
This patient refused systemic treatments, but he chose traditional Chinese medicine at home.

Outcomes:
He died 6 months after the diagnosis.

Lessons:
The possibility of metastasis of primary cancers should be considered when encountering soft-tissue neoplasm lesions, and a biopsy of the suspicious cutaneous lesions could likely aid in the histological identification of the primary cancer. PET-CT scan could be an effective supplementary tool for the diagnosis and evaluation of cancers.
Non-traumatic perforation of the jejunum in a human immunodeficiency virus-infected patient receiving combination antiretroviral therapy
Authors: Lee Yi-Chien , Chiou Chien-Chun , Wang Jann-Tay , Yang Yi-Chun , Tung Shao-Hsien , Hsieh Szu-Min 
Published: December 2019

Abstract

Rationale:
Non-traumatic bowel perforation caused by cytomegalovirus (CMV) and Mycobacterium avium complex (MAC) infections has become rare among patients with acquired immunodeficiency syndrome (AIDS) in the era of combination antiretroviral therapy (cART); however, CMV-associated and MAC-related immune reconstitution inflammatory syndrome (IRIS) has subsequently emerged owing to the wide use of integrase inhibitor-based regimens. Here we report a case of spontaneous perforation of the jejunum in a patient with human immunodeficiency virus (HIV) infection with good compliance to cART.

Patient concerns:
A 32-year-old HIV-infected man developed CMV disease and DMAC infection, as unmasking IRIS, 3 days after the initiation of cART. After appropriate treatment for opportunistic infections, intermittent fever with enlarged lymph nodes in the abdomen occurred as paradoxical IRIS. The patient was administered prednisolone with subsequent tapering according to his clinical condition.

Diagnoses:
Unexpected perforation of hollow organ during the titration of steroid dose with clinical presentations of severe abdominal pain was diagnosed by chest radiography.

Interventions:
He underwent surgical repair with peritoneal toileting smoothly.

Outcomes:
He was discharged well with a clean surgical wound on post-operative day 10.

Lessons:
Bowel perforation may be a life-threatening manifestation of IRIS in the era of cART. Steroids should be avoided, if possible, to decrease the risk of bowel perforation, especially in IRIS occurred after opportunistic diseases involving the gastrointestinal tract.
A typical carcinoid of the lung – a case report with pathological correlation and propagation of the cancer stem cell line BKZ1 with synaptophysin expression
Authors: Windmöller Beatrice Ariane , Greiner Johannes F.W. , Förster Christine , Wilkens Ludwig , Mertzlufft Fritz , Schulte am Esch Jan , Kaltschmidt Barbara , Kaltschmidt Christian , Beshay Morris 
Published: December 2019

Abstract

Rationale:
Neuroendocrine tumors (NETs) of the lung account for 5% of all cases of lung cancer, which itself is the leading cause of cancer-related death worldwide. In accordance to its rarity, only few cell lines of NETs exist, which even often lack key characteristics of the primary tumor, making it difficult to study underlying molecular mechanisms.

Patient concerns:
The patient reported in this case is a 71-year old woman, which never smoked but suffered under dry cough.

diagnoses:
Chest CT-scan showed a paracardiac nodule of the lingula with 2 × 1.8 cm in diameter.

Interventions:
The detected paracardiac nodule of the lingula was anatomically resected using video assisted thoracic surgery.

Outcomes:
Histopathological diagnostic of the removed tissue identified the tumor as a well-differentiated typical carcinoid (TC), which represents one of the four subgroups of pulmonary NETs. Next to the successful treatment of the patient, we were able to propagate cancer stem cells (CSCs) out of the resected tumor tissue. To the best of our knowledge, we firstly isolated CSCs of a typical carcinoid, which were positive for the prominent CSC markers CD44, CD133 and nestin, confirming their stem cell properties. Additionally, CSCs, further referred as BKZ1, expressed the neuroendocrine marker synaptophysin, verifying their neuroendocrine origin. However, nuclear synaptophysin protein was also present in other stem cell populations, suggesting a role as general stem cell marker.

Lesson:
In line with the importance of CSCs in cancer treatment and the lack of CSC-models for neuroendocrine neoplasms, the here described BKZ1 cancer stem cell line of a typical carcinoid represents a promising new model to study pulmonary carcinoids and particular NETs.
Melanotic neuroectodermal tumor of infancy in ovary
Authors: Liu Zan , Li Ming , Tang Xianglian , Xiao Yaling , Xiao Zhenghui , Li Yong 
Published: December 2019

Abstract

Rationale:
Melanotic neuroectodermal tumor of infancy (MNTI) is an extremely rare benign pigmented neoplasm of neural crest origin with rapid expansile growth and a high recurrence rate. It is predominantly found in infants of <1 year of age, involvement of the head-and-neck region is the most common presentation though it is reported at other sites including mediastinum, shoulder, thigh, foot, epididymis, uterus and ovary. The patient reported here is the third case of MNTI presenting in an ovary, and the first reported in the infant ovary.

Patient concerns:
A 33-month-old girl was presented to our unit for a huge abdominal mass.

Diagnosis:
MNTI was eventually diagnosed by histological manifestations supplemented with immunohistochemical findings.

Interventions:
Exploratory laparotomy and complete resection were conducted successfully.

Outcomes:
Postoperative course was uneventful and no recurrence was displayed in the 6-month follow-up.

Lessons:
This case emphasizes that pediatric surgeons and pathologists must always consider the possibility of MNTI while dealing with ovarian neoplasms in infants. Although considered to be a benign tumor, proper treatment and close clinicoradiological follow-up of this tumor are of great importance
Clinical efficacy of extracranial-intracranial bypass for the treatment of adult patients with moyamoya disease
Authors: Yang Jun , Song Guang-fu , Li Hong-bin , Zhang Shi-hua , Yang Fu-yi 
Published: December 2019

Abstract

Background:
Moyamoya disease (MMD) is a major health concern associated with blocked arteries at the base of the brain. The aim of this study will synthesize the current evidence of the efficacy and safety of extracranial-intracranial bypass (EIB) for the treatment of adult patients with MMD.

Methods:
A systematically and comprehensively literature search will be performed in PubMed, EMBASE, Web of Science, CENTRAL, CINAHL, AMED, CBM, and CNKI to identify relevant randomized controlled trails (RCTs) investigating the efficacy and safety of EIB for treating MMD. We will search all above electronic databases from their inception to the July 30, 2019. Two review authors will independently perform study selection, data extraction, and conduct risk of bias evaluation using Cochrane risk of bias tool. We will also explore heterogeneity across studies. RevMan 5.3 software will be applied for statistical analysis performance.

Results:
This study will evaluate the efficacy and safety of EIB for the treatment of adult patients with MMD.

Conclusion:
The results of this study will provide latest evidence of the efficacy and safety of EIB for MMD.

Dissemination and ethics:
This study is based on published studies, thus, no ethical consideration is needed. The results of this study are expected to be published in peer-reviewed journals or will be presented on conference meeting.

Systematic review registration: PROSPERO CRD42019155839.