bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic syndrome and 10-year cardiovascular risk among HIV-positive and HIV-negative adults
Authors: Masyuko Sarah J. , Page Stephanie T. , Kinuthia John , Osoti Alfred O. , Polyak Stephen J. , Otieno Fredrick C. , Kibachio Joseph M. , Mogaka Jerusha N. , Temu Tecla M. , Zifodya Jerry S. , Otedo Amos , Nakanjako Damalie , Hughes James P. , Farquhar Carey 
Published: June 2020

Abstract
To determine the prevalence and correlates of metabolic syndrome (MetS) and compare 10-year cardiovascular disease (CVD) risk among Kenyan adults with and without HIV infection.
We conducted a cross-sectional study among adults ≥30 years of age with and without HIV infection seeking care at Kisumu County Hospital. Participants completed a health questionnaire and vital signs, anthropomorphic measurements, and fasting blood were obtained. MetS was defined using 2009 Consensus Criteria and 10-year Atherosclerotic CVD (ASCVD) risk score was calculated. Chi-square, independent t tests, Wilcoxon ranksum test and multivariable logistic regression were used to determine differences and associations between HIV and MetS, CVD risk factors and ASCVD risk score.
A total of 300 people living with HIV (PLWHIV) and 298 HIV-negative participants with median age 44 years enrolled, 50% of whom were female. The prevalence of MetS was 8.9% overall, but lower among PLWHIV than HIV-negative participants (6.3% vs 11.6%, respectively; P = .001). The most prevalent MetS components were elevated blood pressure, decreased high density lipoprotein, and abdominal obesity. Adjusting for covariates, PLWHIV were 66% less likely to have MetS compared to HIV-negative participants (adjusted odds ratio [aOR] 0.34; 95% confidence interval [95%CI] 0.18, 0.65; P = .005). Median ASCVD risk score was also lower among PLWHIV compared to HIV-negative participants (1.7% vs 3.0%, P = .002).
MetS was more common among HIV-negative than HIV-positive adults, and HIV-negative adults were at greater risk for CVD compared to PLWHIV. These data support integration of routine CVD screening and management into health programs in resource-limited settings, regardless of HIV status.
Self-inflicted neck wounds under influence of lysergic acid diethylamide
Authors: Le Daré Brendan , Gicquel Thomas , Baert Alain , Morel Isabelle , Bouvet Renaud 
Published: June 2020

Abstract

Rationale:
Lysergic acid diethylamide (LSD) is a highly potent psychedelic drug derived from ergot alkaloids. The available literature data derived from controlled studies or usage in a medical setting seem reassuring; however the literature contains very rare cases of fatal self-inflicted injuries associated with LSD exposure. The behavioral disorder that created the conditions conducive to death is a maladaptive or irrational response to the psychiatric manifestations induced by the substance.

Patient concern:
Here, we report the case of a 26-year-old man found dead with large neck wounds in a locked house. No medical history other than recreational use of alcohol and narcotics was reported as well as any history of psychotic disease. The entirety of the other investigations carried out did not demonstrate the presence of a third party at the place of death and a dropper bottle containing LSD was found near the body.

Diagnosis:
We report the first case of fatal self-inflicted neck wounds with a cutting instrument in the context of acute exposure to LSD in a patient with no psychiatric history and without suicidal symptoms at the time of the self-aggressive act.

Intervention and outcomes:
In the present work, we used a validated method using liquid chromatography coupled with mass spectrometry for simultaneous quantification of LSD and its metabolites (O-H-LSD and Nor-LSD) in whole blood and urine samples. LSD and O-H-LSD were respectively found at 1460 and 182 pg/mL in blood. In the urine, the concentrations of LSD, nor-LSD, O-H-LSD were, respectively, 3670, 201, and 4890 ng/L.

Lessons:
This observation is particularly relevant in view of the resurgence of interest in the therapeutic use of LSD, notwithstanding the fact that the literature has not demonstrated a link between suicidal risk and acute or chronic exposure to LSD.
A risk stratification scoring system for new-onset atrial fibrillation after ischemic stroke
Authors: Chen Yung-Lung , Wang Hui-Ting , Chen Huang-Chung , Liu Wen-Hao , Hsueh Shukai , Chung Wen-Jung , Wu Po-Jui , Liu Chi-Hung , Chung Chang-Ming , Lin Yu-Sheng 
Published: June 2020

Abstract
Atrial fibrillation (AF) is a major independent risk factor of stroke and anticoagulation therapy is needed in patients with AF after ischemic stroke. However, the detection rate of AF is low after ischemic stroke. Developing a prediction model for newly diagnosed AF after ischemic stroke will help to assess the subclinical AF.
We identified 98,103 patients with diabetes mellitus (DM) and 261,893 patients without DM, who were not AF history and admitted for newly ischemic stroke from the National Health Insurance Research Database in Taiwan. The prediction model for 3-year incidence of AF after ischemic stroke was derived from multivariate logistic regression and also the accuracy rate of the prediction model was compared with CHA2DS2-VASC and CHADS2 scores as a reference.
Four thousand nine hundred seventy six patients in the DM cohort and 16,127 patients in the non-DM cohort developed AF during 3 years of follow-up. The variables in the point-based prediction model for non-DM patients (range: -3–28), included age, heart failure, coronary artery disease, gout, obstructive pulmonary disease, hypertension, female, and statin use, while those for DM patients (range: -2–30) included age, heart failure, coronary artery disease, chronic kidney disease, hypertension, obstructive pulmonary disease, and statin use. Compared to the CHADS2 and CHA2DS2-VASc scoring systems, this scoring system was better at predicting 3-year risk of AF after ischemic stroke in both cohorts.
This model might be useful in evaluating the benefit of insertable cardiac monitor implantation and anticoagulation agents in individual patients after ischemic stroke.
Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions
Authors: Vlad Olaru , Catalin Baston , Mihai Harza , Adrian Preda , Manuela Olaru , Gener Ismail , Ioanel Sinescu 
Published: June 2020

Abstract

Background:
Enhanced Recovery After Surgery (ERAS) protocols were introduced in clinical practice to reduce complication rates and hospital stay. We performed a randomized controlled single center study to evaluate perioperative benefits of an adapted ERAS protocol in patients with bladder cancer who underwent radical cystectomy (RC) and ileal urinary diversions (IUD).

Materials and methods:
Forty five from 90 consecutive randomized patients were enrolled in an adapted ERAS protocol. Length of stay, diet issues, return of bowel function, readmission rates and complications were examined.

Results:
Among patients following ERAS protocol, we found a significant reduction in time to first flatus (1 vs 5 days, P < .001), time to first stool (2 vs 5 days, P < .001), time to normal diet (5 vs 6 days, P < .001) and length of stay (16 vs 18 days, P < .001). Also, postoperative ileus at less than 4 days was lower than in non-ERAS patients (15.6% vs 24.4%), but with a marginal trend toward significance (P = .05). Readmission rate was lower in the ERAS group, but the difference did not reach statistical significance. We also found a lower readmission and complication rate in patients with ERAS protocol (6.6% vs 11.1%, P = .23 and 46.6% vs 57.5%, P = .29, respectively).

Conclusions:
Implementation of ERAS protocol for patients undergoing RC in our center was associated with a significant reduction in the time to the first flatus, time to the first stool, time to a normal diet, length of hospital stay.
Microarray analysis of differentially expressed microRNAs in myelodysplastic syndromes
Authors: Wan Chengyao , Wen Jing , Huang Ying , Li Hongying , Wu Wenqi , Xie Qiongni , Liang Xiaolin , Tang Zhongyuan , Zhao Weihua , Cheng Peng , Liu Zhenfang 
Published: June 2020

Abstract

Background:
Our study aimed to analyze differential microRNA expression between myelodysplastic syndromes (MDS) and normal bone marrow, and to identify novel microRNAs relevant to MDS pathogenesis.

Methods:
MiRNA microarray analysis was used to profile microRNA expression levels in MDS and normal bone marrow. Quantitative real-time polymerase chain reaction was employed to verify differentially expressed microRNAs.

Results:
MiRNA microarray analysis showed 96 significantly upregulated (eg, miR-146a-5p, miR-151a-3p, miR-125b-5p) and 198 significantly downregulated (eg, miR-181a-2-3p, miR-124-3p, miR-550a-3p) microRNAs in MDS compared with normal bone marrow. The quantitative real-time polymerase chain reaction confirmed the microarray analysis: expression of six microRNAs (miR-155-5p, miR-146a-5p, miR-151a-3p, miR-221-3p, miR-125b-5p, and miR-10a-5p) was significantly higher in MDS, while 3 microRNAs (miR-181a-2-3p, miR-124-3p, and miR-550a-3p) were significantly downregulated in MDS. Bioinformatics analysis demonstrated that differentially expressed microRNAs might participate in MDS pathogenesis by regulating hematopoiesis, leukocyte migration, leukocyte apoptotic process, and hematopoietic cell lineage.

Conclusions:
Our study indicates that differentially expressed microRNAs might play a key role in MDS pathogenesis by regulating potential relevant functional and signaling pathways. Targeting these microRNAs may provide new treatment modalities for MDS.
Effects of Gushukang for postmenopausal osteoporosis
Authors: Wang Guangwei , Huo Liwei , Chen Guocai , He Huayong 
Published: June 2020

Abstract

Background:
Postmenopausal osteoporosis (PMO) is one of the most common systemic bone diseases with a high risk of fracture. Traditional herbal formula Gushukang (GSK) has been used to treat PMO. However, there is no systematic review related to GSK for PMO. The object of this work is to evaluate the efficacy and safety of GSK in the management of PMO.

Methods:
We will search the 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. All randomized controlled trials (RCTs) of GSK for the treatment of PMO will be included. The improvement of vertebral fracture and bone mineral density (BMD) will be accepted as the primary outcomes. The meta-analyses will be performed by using the RevMan 5.3.

Results:
This study will provide a high-quality comprehensive evaluation of the efficacy and safety of GSK for treating patients with PMO.

Conclusion:
The conclusion of our systematic review will provide evidence to judge whether GSK is an effective intervention for patients with PMO.

Trial registration number:
10.17605/OSF.IO/MKN3F.
The efficacy of acupuncture for the treatment and the fertility improvement in child-bearing period female with Hashimoto Disease
Authors: Li Fangyuan , Qi Zhang , Hua Lu , Wang Xinxin , Ling Mi , Juan Du 
Published: June 2020

Abstract

Background:
Hashimoto thyroiditis (HT) is highly prevalent among reproductive-aged women and has a substantial negative impact on fertility. Currently, there is no specific treatment for Hashimoto thyroiditis. We hypothesize that acupuncture can halt or delay the progression of HT and improve fertility in child-bearing period female. We therefore designed a randomized controlled trial to test this hypothesis by comparing the therapeutic effect of acupuncture vs sham acupuncture in patients with Hashimoto thyroiditis.

Methods:
In this randomized controlled study, a total of 284 eligible patients will be assigned to acupuncture group (n = 142) or sham acupuncture group (n = 142) in a 1:1 ratio. All patients will receive 36 sessions in total for 12 consecutive weeks with the same acupoint prescription (RN23, ST9, RN17, RN4, RN6, ST36, SP6, KI6). The primary assessment is the titers of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibody (TGAb). Secondary outcomes include the thyroid function, ovarian function, the rate of primary ovarian insufficiency, and pregnancy outcome. The thyroid function and thyroid antibodies tests will be measured at weeks 0, 4, 8, and 12 after randomization. The ovarian function will be examined on the 2nd to 4th day of the menstrual period in the 1st month, 2nd month and 3rd month compared with baseline. Both the pregnancy outcome and the rate of primary ovarian insufficiency will be evaluated 1 year after treatment.

Discussion:
This will be the first large-scale trial specifically evaluating acupuncture therapy in child-bearing period female with Hashimoto thyroiditis. If the study confirms the effectiveness of acupuncture treatment, more consistent acupuncture therapy can be set up for clinical practice.

Trial registration:
Chinese Clinical Trials Register identifier, ChiCTR2000031320, registered on 27 March 2020.
Higher neutrophil-lymphocyte ratio is associated with better prognosis of hepatocellular carcinoma
Authors: Li Sheng-chao , Xu Zhuo , Deng Yan-li , Wang Ya-ni , Jia Yu-ming 
Published: June 2020

Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide; its morbidity and mortality have both recently increased. Lately, the role played by the neutrophil-lymphocyte ratio (NLR) in the development of HCC has attracted attention. However, the exact relationship is not fully understood.
A total of 538 participants diagnosed with HCC were recruited between 2010 and 2018. Their relevant routine blood parameters were measured, including NLR. Pearson Chi-Squared test, Spearman Rho test, and logistic regression analysis were performed to explore any correlations between NLR and HCC. A receiver operating characteristic (ROC) curve analysis was performed to determine the usefulness of NLR for predicting HCC. Univariate and multivariate Cox regression analysis for relevant routine blood parameters and any relationships with overall survival (OS) were performed. The Kaplan–Meier method was used to explore any further relationships with OS.
NLR was significantly correlated with HCC tumor size by Pearson Chi-Squared test (P = .008). Furthermore, Spearman correlation coefficient showed that HCC tumor size was significantly correlated with NLR (P = .115, P = .008). NLR could sensitively and specifically predict HCC tumor size (area under the curve [AUC], 0.605; 95% confidence interval [CI], 0.429–0.743; P = .000). Higher NLR in patients with HCC was correlated with better OS (hazard ratio [HR] = 0.584; P = .000).
A close correlation existed between increased NLR and HCC; NLR could sensitively and specifically predict HCC. High NLR might be an independent protective factor in the prognosis of patients with HCC.
Tailgut cyst with adenocarcinoma transition
Authors: Wang Min , Liu Guoliang , Mu Yu , He Hongyu , Wang Shuang , Li Jiannan 
Published: June 2020

Abstract

Rationale:
Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare.

Patient concerns:
A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day.

Diagnosis:
Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0–3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0–35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition.

Interventions:
The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well.

Lessons:
We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.
Effect of the international pharmacy education programs
Authors: Yi Zhan-Miao , Zhou Liang-Yu , Yang Li , Yang Ling , Liu Wenxi , Zhao Rong-Sheng , Zhai Suo-Di 
Published: June 2020

Abstract
Globalization has attracted much attention to universities over the past decade. The aim of this study was to evaluate the effect of the United States-China international pharmacy education programs (IPEP) in China.
Kirkpatrick's model of evaluation was used to evaluate IPEP from reaction and learning levels. In the reaction level, a questionnaire survey with a Likert scale was used. In the learning level, data from “Assessment Record of Advanced Clinical Pharmacy Practice of Peking University” were collected. Cronbach’ α coefficient of reliability was calculated, principal component analysis and independent t-test were conducted.
All of the students who attended IPEP (n = 36) completed the questionnaire survey. The scores of benefits were increased in 4 categories, including “Clinical practice competency improvement” (mean ranking [MR] = 3.11 points), “Understanding of doctor of Pharmacy education mode” (MR = 3.48 points), “English competency improvement” (MR = 3.64 points) and “International collaboration” (MR = 3.92 points). Meanwhile, the overall satisfaction was relatively high with the IPEP (MR = 4.22 points). In the learning level, a total of 22 records was obtained. Students who attended (n = 5) the IPEP achieved higher scores than those did not attend (n = 17) in the assessment records, although no statistical significant differences were observed. Personal in-depth interviews further supported the overall benefit of IPEP.
The Kirkpatrick model of evaluation can be used for IPEP. The benefit and satisfaction of students attended the IPEP were high in the reaction level; even though no statistically significant difference was shown in the learning level, higher scores were still demonstrated.
Coronavirus disease 2019 (COVID-19) pneumonia in a hemodialysis patient
Authors: Huang Luyan , Wang Yiru , Wang Lisheng , Lv Yongman , Liu Qingquan 
Published: June 2020

Abstract

Rationale:
The 2019 novel coronavirus disease (COVID-19) causes a novel, atypical pneumonia that has brought huge public health challenges across the globe. There is limited data about patients with end-stage renal disease who also suffer from COVID-19. In this report, we discuss the case of a hemodialysis patient who developed COVID-19 pneumonia in the clinical course.

Patient concerns:
A 79-year-old man who had end-stage renal disease (ESRD) and was taking regular hemodialysis was admitted to hospital for a fever and dry cough. The patient, who also had cardiovascular disease, had no history of contact with COVID-2019 patients.

Diagnosis:
The patient was diagnosed with COVID-2019 by the reverse-transcriptase polymerase chain reaction (RT-PCR), and his pharyngeal swab for SARS-CoV-2 was positive.

Intervention:
The treatment was mainly supportive and the patient was intensively monitored. He was treated with oxygen, broad-spectrum antibiotics, antiviral drugs, and methylprednisolone. The patient took continuous renal replacement therapy (CRRT) every 2 days.

Outcomes:
After 19 days, an RT-PCR assay for SARS-CoV-2 was negative, and computed tomography (CT) of the patient's thorax indicated that the pulmonary inflammatory exudation was absorbed and pulmonary infection improved significantly. He was discharged on day 29 after recovering from COVID-2019 pneumonia.

Lessons:
The courses of disease and treatment options for this individual were significantly more complicated than those for ordinary patients. Therefore, it was necessary to monitor the condition of the patient closely and to protect the dialysis unit staff from being infected. Compared with other severe COVID-2019 cases, this patient recovered more quickly following treatment, which was likely due to the removal of inflammatory mediators by CRRT. This implies that blood purification might be an important option for hemodialysis patients with COVID-19.
Safety and efficacy of INTRABEAM intraoperative radiotherapy for invasive thymoma
Authors: Cui Tian-xiang , Dai Ji-gang , Li Jing-meng , Qian Jin-dong , Li Guang-hui , Sun Jian-guo 
Published: June 2020

Abstract
Intraoperative radiotherapy (IORT) has been used to treat different residual solid tumors after tumor removal and has shown many advantages over other treatment methods. However, the use of IORT for invasive thymoma has not been reported. Therefore, in this study, we tried to determine the safety and efficacy of INTRABEAM IORT for the treatment of invasive thymoma.
Among the patients admitted to our hospital from September to December 2016 who were diagnosed with invasive thymoma, 14 were selected as study subjects. With medical histories taken beforehand, 8 of these patients were diagnosed with Masaoka stage IIA and 6 with Masaoka stage IIB; furthermore, 5 of the patients were diagnosed with myasthenia gravis (MG). INTRABEAM radiation (8–10 Gy, low energy) was delivered to the postoperative tumor bed of each patient during surgery. The intra- and postoperative complications were observed and evaluated, and the improvement in symptoms was assessed. An additional 23 patients with stage II thymoma undergoing radical surgery from April to August 2016 were chosen as the control group.
One month after the operation, only 1 patient in the IORT group had cough, increased levels of leucocytes and neutrophils, and pulmonary inflammation on chest computed tomography. Reactive inflammation and pleural effusion in the 2 groups were similar (P > .05). There was no significant difference between the 2 groups in the improvement of myasthenia gravis (P > .05). Postoperative chest computed tomography and routine blood examination at 3 and 12 months showed that all the patients recovered, with normal hemogram levels and no pulmonary fibrosis around the radiation field. In addition, ultrasonic cardiography and electrocardiography demonstrated no significant difference before or after surgery within the IORT group. At the end of the follow-up, all the patients were alive, no relapse or remote metastasis was observed in the IORT group, and 2 inpatients in the control group had experienced relapse at 24 and 26 months. There was a significant difference in disease-free survival between the 2 groups (P = .00).
It is safe to administer low-energy INTRABEAM IORT at a dose of approximately 10 Gy in patients with stage II invasive thymoma. INTRABEAM IORT does not significantly increase operation- or radiation-related complications and has no significant effect on vital organs such as the lungs and heart. Its long-term efficacy is worth expecting.
Exploring smoking cessation behaviors of outpatients in outpatient clinics
Authors: Hsu Ching-Yi , Liao Hung-En , Huang Li-Chun 
Published: June 2020

Abstract
To examine the knowledge, attitudes, and behaviors of smokers towards smoking prevention and provide high-quality smoking cessation services and education on tobacco prevention and establish a smoke-free care network.
This study is a cross-sectional survey. The research tool is a questionnaire composed of 4 sub-scales, namely, “tobacco harm awareness,” “tobacco prevention attitude,” “quitting smoking self-efficacy scale,” and “intentional behavior to quit smoking.”
A positive correlation was identified between cessation-specific knowledge, attitude to quit smoking, and intentional behavior to quit smoking among outpatients. Following the regression analysis, 2 factors (cessation-specific knowledge and attitude toward quitting the smoking habit) were considered in the model and its total variance explained reached 53.2%.
Regular smoking cessation classes should be conducted to increase the awareness of smoking hazards and improve the positive attitude toward smoking cessation to avoid smoking hazards.