bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of the CDKAL1 polymorphism rs10946398 with type 2 diabetes mellitus in adults
Authors: Liu Xuekui , Liang Jun , Geng Houfa , Xu Wei , Teng Fei , Yang Manqing 
Published: July 2020

Abstract
Previous studies had reported that the CDKAL1 (cyclin-dependent kinase 5 (CDK5) regulatory subunit-associated protein 1-like 1) rs10946398 C/A polymorphism associated with type 2 diabetes mellitus (T2DM) in various ethnic groups, however, inconsistent results have been obtained in studies of different populations.
We performed a meta-analysis of 13 studies for rs10946398 of CDKAL1 on genetic susceptibility for T2DM.
The results showed that CDKAL1 rs10946398 C/A polymorphism associated with T2DM under allelic (odds risk (OR): 1.17, 95% CI: 1.07–1.28, P = .0007), homozygous (OR: 1.39, 95% CI: 1.15–1.69, P = .0008), and dominant models (OR: 1.26, 95% CI: 1.09–1.46, P = .001).
We found that rs10946398 C/A polymorphism was associated with T2DM, and this association was significantly in population of western country (Europe and United States) and Asian populations.
Effectiveness of a single lead AliveCor electrocardiogram application for the screening of atrial fibrillation
Authors: Hall Angela , Mitchell Andrew Robert John , Wood Lisa , Holland Carol 
Published: July 2020

Abstract

Background:
Increasing prevalence of atrial fibrillation has a significant impact on health, society, and healthcare resource utilization, due to increased morbidity, mortality, risk of stroke, and reduction in quality of life. Early diagnosis allows for treatment initiation, a reduction in complications and associated costs, and so innovation to improve screening and enable easy access are needed Developments in digital technology have significantly contributed to the availability of screening tools. The single-lead electrocardiogram AliveCor (Mountainview, CA) device offers the opportunity to provide heart rhythm screening and has been used extensively in clinical practice and research studies.

Methods:
This review investigates the feasibility, validity, and utility of the AliveCor device as a tool for atrial fibrillation detection in clinical practice and in wider research. Databases searched included PUBMED, CINAHL, MEDLINE, and World of Science, plus grey literature search. Search terms related to atrial fibrillation, screening, and AliveCor with adults >18 years. Feasibility metrics were applied including process, resource, management, and scientific outcomes. Studies not written in the English language were excluded. Validity of AliveCor was explored by extracting sensitivity and specificity data from eligible studies and overall effectiveness analyzed by incorporating the above, with wider issues surrounding screening approaches, cost effectiveness and appropriateness of AliveCor as a screening tool.

Results:
The AliveCor device screening was reviewed in 11 studies matching inclusion criteria. Atrial fibrillation detection rates ranged from 0.8% to 36% and this largely correlated to the study population, where wider age inclusion and mass/population screening represented lower atrial fibrillation detection. Recruitment from higher-risk groups (older age, targeted localities, chronic disease) identified higher numbers with atrial fibrillation. Feasibility metrics demonstrated AliveCor as an effective tool of choice in terms of process, resources, and management. Duration of screening time had an impact on rates of atrial fibrillation detection. There was however significant heterogeneity between studies reviewed.

Conclusion:
The AliveCor device offers a convenient, valid, and feasible means of monitoring for atrial fibrillation. Further analysis of electrocardiograms produced by AliveCor may be necessary in some circumstances. The AliveCor electrocardiogram device can be successfully implemented into both opportunistic and systematic screening strategies for atrial fibrillation.
Efficacy and safety of Lianhua Qingwen combined with conventional antiviral Western Medicine in the treatment of coronavirus disease (covid-19) in 2019
Authors: Zhang Xiaolin , Cao Di , Liu Junnan , Zhang Qi , Liu Mingjun 
Published: July 2020

Abstract

Background:
The novel coronavirus pneumonia (COVID-19) has spread to >200 countries and regions. There is no effective antiviral drug for COVID-19. Traditional Chinese medicine, such as Lianhua Qingwen, has achieved some curative effect in many countries, but its effect is not clear. We aim to assess the efficacy and safety of Lianhua Qingwen combined with Conventional antiviral Western Medicine in Clinical treatment of COVID-19 or asymptomatic infection.

Methods:
The following electronic bibliographic databases will be searched to identify relevant studies: CNKI, CBM, VIP and Wanfang databases, PubMed, EMBASE, MEDLINE, Cochrane central, and clinical trial registration centers, such as China Clinical Trial Registration Center (ChiCTR), Netherlands National Trial Registration Center (NTR) and clinical trials.gov. In addition, Manual retrieval of articles, conference papers, ongoing experiments, internal reports, among others, to supplement electronic retrieval. Select all eligible studies published before May 8, 2020.
According to the Cochrane Handbook “bias risk” assessment tool, bias risk is independently assessed. The independent Newcastle Ottawa scale was used to conduct methodological quality assessment of nonrandomized trials. STATA15.1 and RevMan5.3 software were used to analyze meta outcomes of different intervention measures for the treatment of new crown pneumonia and the control group (conventional antiviral western medicine treatment) clinical efficacy.

Results:
This study will provide a relatively high-quality synthesis of current evidence of Lianhua Qingwen combined with Conventional antiviral Western Medicine in the treatment of COVID-19 from several aspects including the Clinical effective rate, CT improvement rate, severe conversion rate, antipyretic time, disappearance rate of fever symptoms, disappearance rate of cough symptoms, disappearance rate of asthenia symptoms, and adverse drug events.

Conclusion:
The conclusion of this review will provide evidence to judge whether Lianhua Qingwen combined with Conventional antiviral Western Medicine is an effective and safe intervention for COVID-19.

Ethics and dissemination:
This systemic review will evaluate the efficacy and safety of Lianhua Qingwen combined with Conventional antiviral Western Medicine in the treatment of COVID-19. Since all the data included are published, the systematic review does not need ethical approval.

INPLASY registration number:
INPLASY202060067
Dexamethasone for preventing postoperative nausea and vomiting after mastectomy
Authors: Xu LeiLai , Xie XiaoHong , Gu XiDong 
Published: July 2020

Abstract

Background:
Postoperative nausea and vomiting (PONV) is a common complication after mastectomy. Although many researches have been studied the prophylactic effect of antiemetics, none of the results are effective. To overcome this problem, dexamethasone was used to relieve the occurrence of PONV. Since concerns about steroid-related morbidity still remain, We carried out a meta-analysis to evaluate the impact of prophylactic dexamethasone on PONV, post-operative pain undergoing mastectomy.

Methods:
Literature search was conducted through PubMed, Web of Science, EMBASE, MEDLINE, and Cochrane library database till June 2019 to identify eligible studies. Meanwhile, we also consulted some Chinese periodicals, such as China Academic Journals, Wanfang and Weipu. The research was reported according to the preferred reporting items for systematic reviews and meta-analysis guidelines. Randomized controlled trials were included in our meta-analysis. Meanwhile, the assessment of the risk of bias was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions version. The pooled data are processed by software RevMan 5.3.

Results:
Four studies with 490 patients were enrolled to this meta-analysis. Our study demonstrated that the dexamethasone group was significantly more effective than the placebo group in term of PONV (risk ratio [RR] = 0.46, 95% confidence intervals [CI]: 0.30–0.70, P = .0003), nausea (RR = 0.26, 95% CI: 0.10–0.68, P = .006) and vomiting (RR = 0.15, 95% CI: 0.04∼0.55, P = .004). The visual analog scale score was significantly diminished at 1 hour (weighted mean difference = -1.40, 95% CI: -1.53 to -1.26, P < .00001) in the dexamethasone group, while, no statistically significant difference was observed between the two groups in terms of visual analog scale at 24 hours (weighted mean difference = -0.56, 95% CI: -1.24 to 0.13, P = 0.11).

Conclusion:
Not only does Dexamethasone reduce the incidence of PONV but also decreases postoperative pain. However, we still need larger samples and higher quality studies to determine the relationship between symptoms and administration time to reach the conclusion.

Trial registration number:
PROSPERO CRD 42018118575
Mechanical thrombectomy for a 12-year-old boy with acute ischemic stroke
Authors: Huang Yuchai , Wang Zhen , Li Changluo , Ding Ning 
Published: July 2020

Abstract

Rationale:
Acute ischemic stroke (AIS) is one of the most severe diseases that endanger human health. It is very common among middle-aged and elderly people, but it is rare in children. The treatment varies among children and adults, since the cause for AIS in children differs from that in adults. In adults with AIS, endovascular therapy has been recommended, but guidelines for endovascular therapy in children with AIS have not been established yet. In China, few relevant evidence is present so far in clinical research of mechanical thrombectomy in the treatment for children with AIS.

Patient concerns:
A 12-year-old boy without any special physical collision and trauma was admitted to emergency department of Changsha central hospital due to hemiplegia of left limbs for 3 hours.

Diagnoses:
He was diagnosed with AIS after magnetic resonance imaging (MRI) examination and magnetic resonance angiography (MRA) examination. Cerebral infarction in the right parietal, temporal, insular, and frontal lobes was revealed by the MRI test. The MRA test detected occlusions in right internal carotid artery, A1 segment of right anterior cerebral artery, right middle cerebral artery, and distal branch.

Interventions:
Mechanic thrombectomy and antiplatelet aggregation therapy with clopidogrel helped the patient to recover, along with active rehabilitation training.

Outcomes:
A significant improvement in muscle strength of his left limbs was proved. He walked by himself and had 2 of Modified Rankin Scale (MRS). At 1-year follow-up visit, he recovered well except feeling a bit pain of left lower limb when walking, with finally MRS of 1.

Conclusions:
Mechanical thrombectomy can be performed safely for children with AIS, but needs a further research with large samples.
Can the severity of central lumbar stenosis affect the results of nerve conduction study?
Authors: Jang Seung Wha , Lee Dong Gyu 
Published: July 2020

Abstract
To evaluate the effect of the severity of spinal stenosis on the peripheral nerves of lower extremities by nerve conduction study (NCS).
One hundred fifteen patients with lumbar spinal stenosis were recruited retrospectively in this study. The grading system for lumbar stenosis was used based on the degree of separation of the cauda equina. The degree of cauda equina damage caused by lumbar central stenosis was assessed by NCS of peripheral nerves. Multiple regression analysis was used to estimate which factors affect peripheral nerve injury, according to the presence of DM, total grading of lumbar central stenosis, and age.
Only age was associated with low amplitude in the tibial and peroneal motor NCS in the multiple regression analysis. The severity of the compression of the cauda equina, caused by spinal stenosis, did not statistically significantly affect the NCS values of nerves on the lower extremities.
In conclusion, the cauda equina is resilient against degenerative lumbar central stenosis. Unlike changes caused by peripheral nerve entrapment, lumbar central stenosis did not affect the findings of NCS on the peripheral nerve of lower extremities.
The Impact of Preoperative Education on Patients Undergoing Elective Total Hip and Knee Arthroplasty
Authors: Giardina Julie L. , Embrey Katrina , Morris Kathy , Taggart Helen M. 
Published: July 2020

BACKGROUND:
Preoperative education has been found to be responsible for patients having a realistic expectation of surgery as well as high level of satisfaction with their recovery. The Joint Academy offers preoperative educational classes for all patients undergoing elective knee and hip replacements.

PURPOSE:
The purpose of this descriptive study was to determine whether the education provided by The Joint Academy has an impact on anxiety, expectation, and preparedness in patients who undergo elective total knee or hip arthroplasty.

METHODS:
All patients who had total joint or hip arthroplasty over a 2-month period were invited to participate in this descriptive correlational study.

RESULTS:
Of the 49 study participants, 28 attended The Joint Academy. Those who attended The Joint Academy were more likely to hold surgical expectations that better correlated with actual experience (p = .425). There was no statistically significant difference between the groups for nervousness (p = .171) or feeling prepared for the surgery (p = .425).

CONCLUSION:
Offering education before knee or hip arthroplasty provides patients with an understanding of the expectations related to surgery.
Periocular Facial Scald Burns in Children
Authors: Ahmed Omar Z. , Clay Carson E. , Spiliopoulos Konstantinos , Taylormoore Jonathan , Karwoski Bethany A. , Burd Randall S. 
Published: July 2020

Objectives
Criteria that predict the need for ocular injury treatment in children who suffer periocular facial scald burns are not known. The purpose of this study was to evaluate the incidence and management of ocular injuries among children sustaining facial scald burns and to determine predictors of injuries requiring additional treatment.

Methods
Children treated at a burn center with periocular facial scald burns were analyzed. Patient and injury profiles were compared between those evaluated and not evaluated by an ophthalmologist. Factors associated with an ocular injury requiring treatment were determined, and treatment differences before and after ophthalmology consultation were evaluated.

Results
Seventy-three children with facial scald burns were identified, none with a full-thickness injury. Thirteen children had ocular findings on examination including corneal abrasion, conjunctivitis, scleral burn, and chemosis of the conjunctiva. Twenty-three patients received erythromycin ointment, only 8 of whom had a documented ocular injury. Children seen by an ophthalmologist (n = 24) more often had a positive finding on examination (37.5% vs 8.2%, P = 0.007) and received treatment (66.7% vs 14.3%, P < 0.001). Only 4 patients had modification in their treatment plan after consultation, 3 of whom were started on treatment despite not having a positive finding on examination.

Conclusions
Ocular injury after periocular facial scald burns is an infrequent finding. Among children with partial-thickness periocular facial scald burns, initial evaluation and treatment without ophthalmology consultation are appropriate. Ophthalmic antibiotic ointment is an appropriate initial treatment in most symptomatic patients, with ophthalmologic consultation being limited to children without symptomatic improvement.
Sense of Purpose in Life and Likelihood of Future Illicit Drug Use or Prescription Medication Misuse
Authors: Kim Eric S. , Ryff Carol , Hassett Afton , Brummett Chad , Yeh Charlotte , Strecher Victor 
Published: July 2020

ABSTRACT

Objective
In the United States, 28.6 million people used illicit drugs or misused prescription drugs in the last 30 days. Thus, identifying factors linked with lower likelihood of future drug misuse is an important target for research and practice. Sense of purpose in life has been linked with better behavioral and physical health outcomes. Furthermore, a higher sense of purpose may reduce the likelihood of drug misuse because it has been linked with several protective factors including enhanced ability to handle stress, higher pain tolerance, and lower impulsivity. However, the association between sense of purpose and drug misuse has been understudied. Thus, we tested whether people with a higher sense of purpose at baseline had a lower likelihood of future drug misuse 9 to 10 years later.

Methods
This study included 3535 middle-aged adults from the Midlife in the United States Study who were not misusing drugs at baseline. Using multiple logistic regression models, we assessed whether baseline purpose in life was associated with risk of misusing drugs 9 to 10 years later.

Results
Among respondents not misusing drugs at baseline, people in the highest quartile of purpose (versus lowest quartile) had a substantially lower likelihood of future drug misuse in a model adjusting for demographic variables (odds ratio = 0.50, 95% confidence interval = 0.31–0.83). Associations remained evident after additionally adjusting for psychological distress, baseline health, and health behaviors.

Conclusions
A growing knowledge base suggests that a sense of purpose can be increased. Additional research is needed to evaluate sense of purpose as a novel target in the prevention and reduction of drug misuse.
Body Composition Changes in Response to Moderate- or High-Intensity Exercise Among Older Adults With or Without HIV Infection
Authors: Jankowski Catherine M. , Mawhinney Samantha , Wilson Melissa P. , Campbell Thomas B. , Kohrt Wendy M. , Schwartz Robert S. , Brown Todd T. , Erlandson Kristine M. 
Published: July 2020

Background:People with HIV (PWH) are at an increased risk for adiposity and sarcopenia, despite effective antiretroviral therapy. Our objective was to compare the effects of prescribed exercise on body composition in older PWH and uninfected controls.Setting:Academic medical center.Methods:Sedentary PWH (n = 27) and uninfected controls (n = 28) aged 50–75 years completed 24 weeks of cardiovascular and resistance exercise. Participants completed 12 weeks of moderate-intensity exercise and then were randomized to moderate- or high-intensity exercise for 12 additional weeks. Total lean (LEAN) and fat mass (FAT), and visceral adipose tissue area (VAT) were measured using dual-energy x-ray absorptiometry at baseline and 24 weeks; baseline and intervention differences were compared by HIV serostatus using multivariable regression analyses adjusted for baseline values, age, and exercise adherence.Results:At baseline, PWH had significantly lower FAT (P= 0.003), but no significant differences in LEAN or VAT compared with controls (P> 0.20). Changes over 24 weeks were not significantly different by HIV serostatus, although controls tended to gain more LEAN (0.8 kg; range, 0–1.6 kg; P = 0.04] than PWH (0.6 kg; range, −0.2 to 1.4 kg;P= 0.12) and lose less FAT and VAT (controls: (−0.9 kg; range, −1.8 to 0.0 kg and −10.3 cm2; range, −19.6, 1.0) cm2; bothP= 0.03 vs PWH: −2.0 kg; range, −2.9 to −1.1 kg and −17.7 cm2; range, −27.1 to −8.2 cm2; bothP< 0.001). Exercise intensity differences were not apparent for LEAN, FAT, or VAT.Conclusions:Exercise reduced total and visceral fat in older PWH and controls. Minimal gains in lean mass suggest that greater emphasis on resistance exercise may be needed to more effectively increase muscle in PWH.
Repeat Pregnancies Among US Women Living With HIV in the SMARTT Study: Temporal Changes in HIV Disease Status and Predictors of Preterm Birth
Authors: O'Brien Brigid E. , Williams Paige L. , Huo Yanling , Kacanek Deborah , Chadwick Ellen G. , Powis Kathleen M. , Correia Katharine , Haddad Lisa B. , Yee Lynn M. , Chakhtoura Nahida , Dola Chi , Van Dyke Russell B. ,   for the Pediatric HIV/AIDS Cohort Study (PHACS)
Published: July 2020

Background:
Birth rates among women living with HIV (WLHIV) have increased recently, with many experiencing multiple pregnancies. Yet, viral suppression is often not sustained between pregnancies. In addition, protease inhibitors (PIs) have been associated with preterm birth, but associations between integrase strand transfer inhibitors (INSTIs) and preterm birth are less well characterized.

Methods:
We studied WLHIV with ≥2 live-born infants enrolled into the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring for Antiretroviral Treatment Toxicities (SMARTT) study between 2007 and 2018, comparing CD4 counts and viral loads (VLs) between 2 consecutive SMARTT pregnancies. We evaluated associations of covariates with CD4 and viral suppression and the association of PI/INSTI use during pregnancy with odds of preterm birth.

Results:
There were 736 women who had ≥2 live-born children enrolled in SMARTT (1695 pregnancies). Median CD4 counts remained stable over repeat pregnancies. Although >80% of women achieved VL suppression during pregnancy, more than half had a detectable VL early in their subsequent pregnancy. In adjusted models including all singleton pregnancies, an increased odds of preterm birth was observed for women with first trimester PI initiation (adjusted odds ratio: 1.97; 95% confidence interval: 1.27 to 3.07) compared with those not receiving PIs during pregnancy and for first trimester INSTI initiation (adjusted odds ratio: 2.39; 95% confidence interval: 1.04 to 5.46) compared with those never using INSTIs during pregnancy.

Conclusions:
Most WLHIV achieved VL suppression by late pregnancy but many were viremic early in subsequent pregnancies. First trimester initiation of PIs or INSTIs was associated with a higher risk of preterm birth.
Screening for Hydroxychloroquine Retinal Toxicity in Indian Patients
Authors: Dadhaniya Nikunjkumar V. , Sood Isha , Patil Abhishek , Mallaiah Uma , Upadhyaya Sundeep , Handa Rohini , Gupta Sirinder J. 
Published: July 2020

Objective
Several studies have reported hydroxychloroquine (HCQ) retinal toxicity in East Asian patients. However, at present, there are limited data from Indian patients. The aim of this study was to investigate the prevalence and pattern of HCQ retinal toxicity in Indian population and to see if screening protocol for retinal toxicity in Indian patients should be any different to others.

Methods
This was a cross-sectional study involving adult patients with autoimmune rheumatic diseases who had received HCQ for at least 5 years or a cumulative dose of at least 500 g. Retinal toxicity was evaluated using fundus examination, visual fields 10-2 and 30-2 protocol, and spectral domain optical coherence tomography.

Results
Of 110 patients screened, retinal toxicity was found in 7 patients (6.36%). A parafoveal pattern was found in 4 patients, whereas a mixed parafoveal and perifoveal pattern was found in 3 patients. None of the patients had isolated perifoveal pattern. Except for the one patient, all the patients with retinal toxicity had more than 10 years (mean, 13 ± 4.89 years; range, 5–20 years) of HCQ usage with a mean cumulative dose of 1573.7 ± 771.5 g. The mean daily dose was 5 ± 1.6 mg/kg per day.

Conclusions
Hydroxychloroquine retinal toxicity is more common than previously recognized in patients who have used the drug for more than 5 years. The toxicity manifests as a parafoveal or a mixed parafoveal and perifoveal pattern in Indian patients.