bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do patients with gestational diabetes mellitus and their own blood glucose meter have better pregnancy outcomes than those not using a glucose meter?
Authors: Dong Wei , Li Yan , Sun Jun-jie , Chen Li-hong , Guo Jia , Dong Ling 
Published: December 2020

Abstract
To compare pregnancy outcomes between patients with gestational diabetes mellitus (GDM) with and without their own blood glucose meter.
We conducted a retrospective-cohort study of 835 women with GDM at the Second Hospital of Tianjin Medical University, Tianjin, China from 1 January 2016 to 31 December 2018. Perinatal outcomes of these patients were monitored and collected in the Tianjin Maternal and Child Health System. Each patient was advised by a certified clinical nutritionist regarding dietary analysis and lifestyle recommendations. All pregnant women with GDM were divided into the following 2 groups according to whether they had their own blood glucose meter: women with self-measured blood glucose levels with a routine obstetric examination in the study group (n = 424); and those with non-self-measured blood glucose levels with a double obstetric examination in the control group (n = 411). Maternal and fetal pregnancy outcomes were compared between these 2 groups. According to different self-management modes, the women were also divided into eight subgroups to compare blood sugar control and compliance with recommended insulin therapy.
The cesarean section rate was significantly lower in the study group than in the control group (P < .05). The prevalence of large-for-gestational age (P < .05) and macrosomia was significantly lower in the study group than in the control group (both P < .05). The prevalence of appropriate-for-gestational age was significantly higher in the study group than in the control group (P < .05). Birth weight was significantly lower in the study group than in the control group (P < .05). The mean times for blood sugar control and from the doctor recommendation for insulin treatment to the patient compliance in the study group were significantly shorter than those in the control group (both P < .05). The proportion of insulin required in the study group was significantly lower than that in the control group (P < .05). There were no significant differences in the time of controlling blood sugar and compliance among the 4 subgroups of the study group. However, subgroups with a dietary diary in the control group were better.
Self-monitoring blood sugar plus a routine obstetric examination can help patients with GDM control blood sugar, even without dietary diaries and treadmills. In addition to increasing the number of obstetric examinations, recording dietary diaries is helpful for controlling blood sugar in patients with GDM who are unwilling to measure blood sugar by themselves.
Recurrence pattern and its predictors for advanced gastric cancer after total gastrectomy
Authors: Jiao Xuguang , Wang Yu , Wang Feng , Wang Xinbo 
Published: December 2020

Abstract
This study aimed to investigate the recurrence patterns of advanced gastric cancer (AGC) after curative total gastrectomy and further explore predictors for each pattern of recurrence.
Data of 299 AGC patients between 2010 and 2014 were retrospectively analyzed to investigate the clinicopathologic factors affecting the recurrence pattern of AGC patients underwent curative total gastrectomy.
Sixty-eight (22.7%) AGC patients had recurrence after total gastrectomy. Distant metastasis (DM) was the most prevalent pattern with 29 (42.6%) cases, followed by peritoneal recurrence (PR) with 25 (36.8%) patients, and locoregional recurrence (LR) occurred in 23 (33.8%) patients. The recurrence rates within 2 and 5 years were 77.9% and 97.1%. Extent of lymphadenectomy (P < .001, χ
2 = 17.366), depth of tumor invasion (P < .001, χ
2 = 21.638), lymph node metastasis (P = .046, χ
2 = 9.707), and number of negative lymph nodes (P = .017, χ
2 = 2.406) were associated with tumor recurrence by univariate analysis. Multivariate analyses revealed that the extent of lymphadenectomy (P = .034, 95% CI: 1.074–6.414) and T4b status (P = .015, 95% CI: 0.108–0.785) were independent predictors for LR; histological type (P = .041, 95% CI: 0.016–0.920) and T4b status (P = .007, 95% CI: 0.102–0.690) for PR; and pN status (P = .032) for DM.
In AGC patients following total gastrectomy, recurrent predictors various among locoregional, peritoneal, and distant recurrence. Recurrent predictors of tumor invasion, lymph node metastasis, and histological type could guide follow-up and risk-oriented adjuvant treatment, extended lymphadenectomy was considered to reduce LR of AGC patients after curative total gastrectomy.
A randomized controlled study for the treatment of middle-aged and old-aged lumbar disc herniation by Shis spine balance manipulation combined with bone and muscle guidance
Authors: Xu Jinhai , Ding Xing , Wu Jinze , Zhou Xiaoning , Jin Kun , Yan Ming , Ma Junming , Wu Xuequn , Ye Jie , Mo Wen 
Published: December 2020

Abstract
Ninety percent of elderly patients with lumbar disc herniation (LDH) have problems with the mechanics of the spine and muscle tissue. Shi-style spine balance manipulation combined with guidance (Daoyin) of muscle and bone as an alternative therapy for LDH can tone the muscle groups around the spine and maintain optimal mechanical and static sagittal balance of the spine. This study will be performed to investigate the effect of a combination of Shi-style spine balance manipulation and Daoyin therapy on LDH in middle-aged and elderly patients. In this non-blinded, randomized controlled trial, 72 eligible patients will be randomly divided into a treatment group (Shi-style spine balance manipulation combined with Daoyin therapy) and a control group (lumbar mechanical traction). Before and after the intervention, lumbar X-ray and magnetic resonance imaging examinations will be performed to observe the sagittal balance parameters of the spine and pelvis and the lumbar muscle strength. The visual analog scale score, Oswestry disability index score, and pressure pain threshold will be evaluated at baseline and at 2, 4, 12, and 24 weeks. During the treatment period, any signs of acute adverse events, such as paralysis of the lower extremities or cauda equina syndrome, will be recorded at each visit. Although Shi-style spine manipulation combined with Daoyin therapy has been used in the treatment of LDH in middle-aged and elderly people in China for many years, there is no consensus on its effectiveness. This experiment will provide convincing evidence of the efficacy of Shi-style spine manipulation combined with Daoyin therapy in the treatment of LDH in middle-aged and elderly people.
Efficacy and safety of pasireotide for Cushing's disease
Authors: Zhao Nairui , Yang Xinxin , Li Cuiliu , Ma Jie , Yin Xiuping 
Published: December 2020

Abstract

Background:
Cushing's disease (CD) is associated with increased risk of mortality, myocardial infarction, stroke, peptic ulcers, fractures and infections. The prevalence of CD is nearly 40 per million and higher in women than in men. When surgery has failed, is not feasible, or has been refused, pharmacotherapy can be considered a valuable option. Pasireotide is the first medical therapy officially approved for adult patients with CD. We will conduct a comprehensive systematic review and meta-analysis to systematically evaluate the efficacy and safety of pasireotide for CD.

Methods:
Five English databases (PubMed, Web of Science, Embase, Cochrane Library, and OVID) and 3 Chinese databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Chinese Biomedical Literature Database) will be searched from their respective inception of databases to December 2020. Two reviewers will select articles, extract data and assess the risk of bias independently. Any disagreement will be resolved by discussion with the third reviewer. Review Manager 5.3 software will be used for data synthesis. The Cochrane risk of bias assessment tool will be used to evaluate the bias risk.

Results:
This systematic review and meta-analysis will conduct a comprehensive literature search and provide a systematic synthesis of current published data to explore the efficacy and safety of pasireotide for CD.

Conclusions:
This systematic review and meta-analysis will provide clinical evidence for the efficacy and safety of pasireotide for CD, and inform our understanding of the value of pasireotide in improving CD clinical signs and symptoms. The conclusions drawn from this study may be beneficial to patients, clinicians, and health-related policy makers.

Study registration number:
INPLASY2020110070.
The relationship between hepatoma-derived growth factor and prognosis in non-small cell lung cancer
Authors: Koh Hyun Min , Hyun Chang Lim , Jang Bo Gun , Lee Hyun Ju 
Published: December 2020

Abstract

Background:
Hepatoma-derived growth factor (HDGF) promotes cancer progression and metastasis by interacting with vascular endothelial growth factor, thereby inducing epithelial-to-mesenchymal transition and angiogenesis. Recent studies have correlated increased HDGF levels with poor prognosis in various malignancies, including lung cancer. This meta-analysis systematically assessed the prognostic significance of HDGF expression in patients with non-small cell lung cancer (NSCLC).

Methods:
Eligible studies were identified by searching literature in PubMed, Embase, Scopus, and the Cochrane library until June 2020. The pooled hazard ratio (HR) or odds ratio (OR) with 95% confidence interval (CI) was determined to assess the relationship between HDGF expression and clinical outcome in patients with NSCLC.

Results:
The pooled HRs between high HDGF expression and clinical outcome were 2.20 (95% CI 1.75–2.76, P < .001) and 2.77 (95% CI 1.79–4.29, P < .001) for overall survival and disease-free survival, respectively. High HDGF expression was significantly correlated with a larger tumor size (OR 1.59, 95% CI 1.02–2.46, P = .040).

Conclusion:
HDGF expression is related to clinical outcome and may be a prognostic marker in patients with NSCLC.
Subarachnoid hemorrhage and COVID-19
Authors: Cezar-Junior Auricelio Batista , Faquini Igor Vilela , Silva José Laercio Junior , de Carvalho Junior Eduardo Vieira , Lemos Luiz Euripedes Almondes Santana , Freire Filho João Batista Monte , de Lira Filho Hetevaldo Tavares , Pontes Erton Cesar de Albuquerque , Almeida Nivaldo Sena , Azevedo-Filho Hildo Rocha Cirne 
Published: December 2020

Abstract
Some evidences suggest the involvement of the central nervous system in patients infected with SARS-CoV-2. We aim to analyze possible associations between coronavirus disease 2019 (COVID-19) pandemic and spontaneous subarachnoid hemorrhage (SAH), in a comprehensive neurological center.
We conducted a retrospective case series of 4 patients infected by COVID-19, who developed spontaneous SAH. Clinical data were extracted from electronic medical records.
Between March 24, 2020, and May 22, 2020, 4 cases (3 females; 1 male) of SAH were identified in patients infected with SARS-CoV-2, in a comprehensive neurological center in Brazil. The median age was 55.25 years (range 36 -71). COVID-19-related pneumonia was severe in 3 out of 4 cases, and all patients required critical care support during hospitalization. The patients developed Fisher grade III and IV SAH. Digital subtraction angiography (DSA) was performed in 3 of the 4 patients. However, in only 1 case, an aneurysm was identified. Inflammatory blood tests were elevated in all cases, with an average D-dimer of 2336 μg/L and mean C-reactive protein (CRP) of 3835 mg/dl The outcome was poor in the majority of the patients, with 1 death (25%); 2 (50%) remained severely neurologically affected (mRS:4); and 1 (25%) had slight disability (mRS:2).
This study shows a series of 4 rare cases of SHA associated with COVID-19. The possible mechanisms underlying the involvement of SARSCoV-2 and SHA is yet to be fully understood. Therefore, SHA should be included in severe neurological manifestations in patients infected by this virus.
Modular transitional nursing intervention improves pain-related self-management for cancer patients
Authors: Miao Beibei , Sun Yali , Gong Ling , Liu Wei 
Published: December 2020

Abstract

Objective:
To explore the effect of modular transitional nursing intervention on the improvement of self-management of the patients with cancer pain.

Method:
This study will be conducted from March 2021 to May 2022 at Affiliated Hospital of Beihua University. The experiment was granted through the Research Ethics Committee of Affiliated Hospital of Beihua University (4348–019). Eighty patients are analyzed in our study. The patients will be included if they are between 18 and 70 years old and are diagnosed with cancer, the pain intensity score on moderate level, the pain lasts for more than 3 days, and the patients who have signed the written informed consent. While the patients will be excluded if they have a documented history of drug or alcohol abuse, and patients with limited performance, and patients have a surgery in the past 3 days. The primary result mainly expresses as intergroup differences in self-management disorders (Barriers Questionnaire-II) associated with the cancer pain. And the secondary results include the quality of life (QOL) and pain intensity. All the analyses are implemented with SPSS for Windows Version 20.0.

Results:

Table 1

will show the clinical outcomes between the 2 groups.

Conclusion:
A modular transitional nursing intervention appears to reduce pain in cancer patients.

Trial registration number:
researchregistry6262.
Autonomous robots: a new reality in healthcare? A project by European Association of Urology-Young Academic Urologist group
Authors: Gómez Rivas Juan , Toribio-Vázquez Carlos , Taratkin Mark , Marenco Jose Luis , Grossmann Rafael 
Published: December 2020

Purpose of review
Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be ‘learner’ robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care.

Recent findings
The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human–robot interaction. Autonomous robots in healthcare may be classified in delivery, nurse, and surgical robots. The increasing capability of robots to perform independent actions and complex tasks raises responsibility and accountability issues in a wide variety of application domains. Ethical analyses of these issues are underway and are mostly oriented toward the development of ethical policies requiring a law frame on robotic autonomous behaviors.

Summary
Autonomous robots have the potential to improve current medical practice offering a more secure, reliable, and reproducible medicine. Many advancements are required for these new technologies to be fully integrated. Furthermore, the ethical implications of these technologies are yet to be evaluated.
Alternative Birth Plans and Unintended Maternal and Neonatal Consequences: A Review of the Literature
Authors: Whittington Julie R. , Rumpel Jennifer A. , Shnaekel Kelsey L. , Peeples Sara E. , Magann Everett F. , Burke Bryan L. 
Published: December 2020

Importance
Birth plans are an important part of childbirth preparation for many women.

Objective
The aim of this review was to discuss some common requests, specifically home birth, water birth, placentophagy, lotus birth, vaccination refusal, and vaginal seeding, including evidence-based recommendations, perceived benefits, and potential maternal and neonatal consequences.

Evidence Acquisition
A literature search for each topic was undertaken using PubMed and Web of Science. For the home birth section, the MeSH terms home AND birth OR childbirth AND outcomes OR complications OR recommendations OR guidelines were used. For the vaccination section, birth OR childbirth OR maternal AND vaccination refusal were searched. For the remainder of the sections, umbilical cord AND nonseverance OR placentophagy OR vaginal seeding OR lotus birth were searched. A total of 523 articles were identified. The abstracts were reviewed by 2 authors (J.R.W. and J.A.R.); 60 of these articles were selected and used for this review.

Results
Home birth is currently not recommended in the United States. Immersion in water for labor is acceptable, but delivery should not occur in water. Placentophagy and lotus birth should be discouraged because of risk of neonatal infection. Vaccines should be administered in accordance with national guidelines. Vaginal seeding should be discouraged until more is known about the practice.

Conclusion and Relevance
These evidence-based recommendations provide clear guidance for physicians so that the birthing experience can be enhanced for both mother and neonate without compromising safety.

Relevance Statement
This is an evidence-based literature review of alternative birth plans and recommendations for directive counseling.

Target Audience
Obstetricians, midwives, family practitioners, pediatricians, and nurse practitioners who provide obstetric and/or pediatric care.

Learning Objectives
After completing this activity, the learner should be better able to counsel patients on the risks and benefits of alternative birth plans; distinguish which maternal requests are associated with increased risk of neonatal infections; and risk stratify patients for home birth and identify absolute contraindications to home birth.
Estimates of Healthcare Spending for Preterm and Low-Birthweight Infants in a Commercially Insured Population: 2008–2016
Authors: Beam Andrew L. , Fried Inbar , Palmer Nathan , Agniel Denis , Brat Gabriel , Fox Kathe , Kohane Isaac , Sinaiko Anna , Zupancic John A. F. , Armstrong Joanne 
Published: December 2020

(Abstracted from J Perinatol 2020;40:1091–1099)
Preterm birth and low birthweight incur large medical, social, and economic costs on affected families and the US health care system. A 2007 study from the Institute of Medicine estimated that the total cost associated with preterm delivery in the United States was at least $26.2 billion annually or $51,600 per infant born preterm.
Towards achieving a vaccine-derived herd immunity threshold for COVID-19 in the U.S.
Authors: Gumel Abba B. , Iboi Enahoro A. , Ngonghala Calistus N. , Ngwa Gideon A. 
Published: December 2020

AbstractA novel coronavirus emerged in December of 2019 (COVID-19), causing a pandemic that continues to inflict unprecedented public health and economic burden in all nooks and corners of the world. Although the control of COVID-19 has largely focused on the use of basic public health measures (primarily based on using non-pharmaceutical interventions, such as quarantine, isolation, social-distancing, face mask usage and community lockdowns), three safe and highly-effective vaccines (by AstraZeneca Inc., Moderna Inc. and Pfizer Inc., with protective efficacy of 70%, 94.1% and 95%, respectively) have been approved for use in humans since December 2020. We present a new mathematical model for assessing the population-level impact of the three currently-available anti-COVID vaccines that are administered in humans. The model stratifies the total population into two subgroups, based on whether or not they habitually wear face mask in public. The resulting multigroup model, which takes the form of a deterministic system of nonlinear differential equations, is fitted and parametrized using COVID-19 cumulative mortality data for the third wave of the COVID-19 pandemic in the U.S. Conditions for the asymptotic stability of the associated disease-free equilibrium, as well as expression for the vaccine-derived herd immunity threshold, are rigorously derived. Numerical simulations of the model show that the size of the initial proportion of individuals in the masks-wearing group, together with positive change in behaviour from the non-masks wearing group (as well as those in masks-wearing group do not abandon their masks-wearing habit) play a crucial role in effectively curtailing the COVID-19 pandemic in the U.S. This study further shows that the prospect of achieving herd immunity (required for COVID-19 elimination) in the U.S., using any of the three currently-available vaccines, is quite promising. In particular, while the use of the AstraZeneca vaccine will lead to herd immunity in the U.S. if at least 80% of the populace is vaccinated, such herd immunity can be achieved using either the Moderna or Pfizer vaccine if about 60% of the U.S. population is vaccinated. Furthermore, the prospect of eliminating the pandemic in the US in the year 2021 is significantly enhanced if the vaccination program is complemented with nonpharmaceutical interventions at moderate increased levels of compliance (in relation to their baseline compliance). The study further suggests that, while the waning of natural and vaccine-derived immunity against COVID-19 induces only a marginal increase in the burden and projected time-to-elimination of the pandemic, adding the impacts of the therapeutic benefits of the vaccines into the model resulted in a dramatic reduction in the burden and time-to-elimination of the pandemic.
COVID-19 TARRACO Cohort Study: Development of a predictive prognostic rule for early assessment of COVID-19 patients in primary care settings
Authors: Vila-Corcoles Angel , Satue-Gracia Eva , Vila-Rovira Angel , de Diego-Cabanes Cinta , Forcadell-Peris Maria Jose , Hospital-Guardiola Imma , Ochoa-Gondar Olga 
Published: December 2020

SUMMARYPURPOSEClinical course in COVID-19 patients is uncertain. This study investigated possible early prognostic factors among middle-aged and older adult and explored prognostic rules stratifying risk of patients.METHODSCommunity-based retrospective cohort study that included 282 community-dwelling symptomatic patients ≥50 years with laboratory-confirmed COVID-19 (hospitalised and/or outpatient) during March-June 2020 in Tarragona (Southern Catalonia, Spain). Relationship between demographics, pre-existing comorbidities and early symptomatology (first 5-days) and risk of suffering critical outcome (ICU-admission/death) across clinical course was evaluated by logistic regression analyses, and simple predictive models were developed.RESULTSOf the 282 cases (mean age: 65.9 years; 140 men), 154 (54.6%) were hospitalised (30 ICU-admitted) and 45 (16%) deceased. In crude analyses, increasing age, male sex, some comorbidities (renal, respiratory or cardiac disease, diabetes and hypertension) and symptoms (confusion, dyspnea) were associated with an increased risk to suffer critical outcome, whereas other symptoms (rinorrhea, myalgias, headache, anosmia/disgeusia) were related with reduced risk. After multivariable-adjustment only age/years (OR: 1.04; 95% CI: 1.01-1.07; p=0.004), confusion (OR: 5.33; 95% CI: 1.54-18.48; p=0.008), dyspnea (OR: 5.41; 95% CI: 2.74-10.69; p<0.001) and myalgias (OR: 0.30; 95% CI: 0.10-0.93; p=0.038) remained significantly associated with increased or reduced risk. A proposed CD65-M prognostic rule (including the above mentioned 4 variables) showed a good correlation with the risk of suffering critical outcome (area under ROC curve: 0.828; 95% CI: 0.774-0.882).CONCLUSIONClinical course of COVID-19 is early unpredictable, but simple clinical tools as the proposed CD65-M rule (pending external validation) may be helpful assessing these patients in primary care settings.