bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rehabilitation Program Using Short Prostheses after Bilateral Transfemoral Amputation: A Case Report
Authors: Strelec Juliana , Akeju Oluropo A. , Gras Laura Z. 
Published: August 2020

ABSTRACT

Introduction
Individuals with bilateral lower-limb (LL) amputations require more energy when using bilateral prostheses compared with those who have unilateral LL amputations. A short prosthesis is often used to determine whether someone will be functional using a more advanced prosthesis long term.

Patient Information
This case report describes physical therapy interventions for a 72-year-old male subject in subacute rehabilitation after a bilateral transfemoral amputation secondary to peripheral artery disease (PAD). At initial examination, the patient was dependent for all transfers and unable to sit unsupported.

Intervention
The interventions were done in three phases. Phase 1 focused on trunk strengthening, postural control, sitting and standing balance, and standing tolerance using short prostheses on a tilt table. Phase 2 progressed to dynamic standing activities using a tilt table and LiteGait with the goal to increase standing tolerance. Phase 3 focused on transfers and gait with assistance from the LiteGait and a platform walker.

Outcomes
After 8 weeks of rehabilitation, the patient achieved all short-term goals (STGs) and made 75% progress toward meeting his long-term goals. His Functional Balance Grades Scale (FBGS) score increased from poor to fair, whereas his Functional Independence Measure (FIM) scores for transfers and ambulation increased from 3 to 4 and 0 to 1, respectively.

Discussion
There is limited information in the literature on progressing exercise programs in individuals with bilateral transfemoral amputation. Physical therapists may wish to consider the interventions described in this case report when designing programs for individuals with bilateral transfemoral amputation.
A Two-Dimensional Mathematical Model to Simulate the Effects of Knee Center Misalignment in Lower-Limb Orthoses
Authors: Bapat Ganesh M. , Sujatha S. 
Published: August 2020

ABSTRACT

Introduction
Pistoning is relative sliding motion between an affected limb and its corresponding externally fit assistive device (like an orthosis). Pistoning causes skin problems, pain, and discomfort to the orthosis user. Misalignment of an orthotic joint with respect to the anatomical joint is one of the causes of pistoning motion, and the current knowledge pertaining to the effects of orthotic knee center (OKC) misalignments in lower-limb orthoses is limited. This work quantifies the effects of OKC misalignment in terms of relative motion between the limb and the orthosis and predicts locations of resultant pressure point on the limb.

Method
A two-dimensional link segment model that simulates relative motion between the limb and orthosis was developed. The OKC was systematically misaligned in the anterior-posterior (A-P), proximal-distal (P-D) directions, and their combination to simulate orthosis/thigh strap sliding and identify pressure points on the thigh. Simulations were performed for stand-to-sit activity and walking with a knee-ankle-foot orthosis.

Results
It was found that OKC misalignment causes increased A-P and P-D relative motions with an increase in misalignment distance for the stand-to-sit activity. The A-P and P-D relative motions are of greater concern for activities involving increased knee flexion such as sitting, squatting, and kneeling as compared with walking with an orthosis. Although the A-P and P-D relative motions during walking are of small magnitude, they occur with reversals in the direction and are repetitive in nature, which may cause skin problems and discomfort due to recurring pressure points.

Conclusions
The model provides a means to study the consequences of misalignment and insights for orthosis modification for improved comfort. A software simulation tool based on the presented model can serve as an educational and training tool in prosthetics and orthotics courses for creating awareness about the importance of proper alignment of orthotic knee joints. Study of misalignments of this nature will also guide fabrication and fitting of lower-limb orthoses/exoskeletons.
Risk Factors Associated With Postendoscopic Mucosal Resection Bleeding in Patients With Cirrhosis
Authors: Hasan Badar , Colak Yasar , Rashid Mamoon Ur , Van Amy , Sarvepalli Deepika , Khalid Rumman A. , Yim Yunjoo , Rahman Asad Ur , Charles Giovanni , Castro Fernando J. , Zervos Xaralambos B. , AlKhalloufi Kawtar 
Published: August 2020

Background and Aim:
There is limited data regarding the safety of endoscopic mucosal resection (EMR) in the cirrhotic population. Our study aimed to evaluate the safety of colonoscopic EMR in cirrhosis.

Materials and Methods:
This was a retrospective review of cirrhotics who underwent colonic EMR at 8 Cleveland Clinic Centers between January 1, 2006, and December 31, 2018. Patient data including polyp details and complications occurring within 30 days of the procedure were noted. Univariable and multivariable logistic regression analyses were conducted to find risk factors for post-EMR bleeding.

Results:
A total of 238 patients who underwent EMR were included. There were 145 males (60.9%) and the mean age was 61.9±8.6 years. Immediate and delayed bleeding, and postpolypectomy syndrome rates were 9.2%, 5.8%, and 1.3%, respectively. Significant risk factors for postpolypectomy bleeding were: increased age (P=0.001), procedure duration >37 minutes (P=0.001), antiplatelet use within 5 days (P=0.023), and lesion diameter >15 mm (P=0.004). Multivariable analysis revealed independent predictors of procedure-related bleeding: age above 65 years [odds ratio (OR) 2.14, P=0.044], antiplatelet use within 5 days (OR 2.42, P=0.047), right colon polyp (OR 3.51, P=0.001), and lesion diameter >15 mm (OR 3.22, P=0.003).

Conclusions:
EMR in cirrhotics has an acceptable bleeding risk. Age above 65 years, right colon polyp, polyp size >15 mm, and use of antiplatelets within 5 days are independent risk factors for bleeding.
Diagnostic performance of a whole-body dynamic 68GA-DOTATOC PET/CT acquisition to differentiate physiological uptake of pancreatic uncinate process from pancreatic neuroendocrine tumor
Authors: Thuillier Philippe , Bourhis David , Karakatsanis Nicolas , Schick Ulrike , Metges Jean Philippe , Salaun Pierre-Yves , Kerlan Véronique , Abgral Ronan 
Published: August 2020

Abstract
To evaluate the diagnostic performance of net influx rate (Ki) values from a whole-body dynamic (WBD) 68Ga-DOTATOC-PET/CT acquisition to differentiate pancreatic neuroendocrine tumors (pNETs) from physiological uptake of pancreatic uncinate process (UP).
Patients who were benefited from a WBD acquisition for the assessment of a known well-differentiated neuroendocrine tumor (NET)/suspicion of disease in the prospective GAPET-NET cohort were screened. Only patients with a confirmed pNET/UP as our gold standard were included. The positron emission tomography (PET) procedure consisted in a single-bed dynamic acquisition centered on the heart, followed by a whole-body dynamic acquisition and then a static acquisition. Dynamic (Ki calculated according to Patlak method), static (SUVmax, SUVmean, SUVpeak) parameters, and tumor-to-liver and tumor-to-spleen ratio (TLRKi and TSRKi (according to hepatic/splenic Ki)), tumor SUVmax to liver SUVmax (TM/LM), tumor SUVmax to liver SUVmean (TM/Lm), tumor SUVmax to spleen SUVmax (TM/SM), and tumor SUVmax to spleen SUVmean (TM/Sm) (according to hepatic/splenic SUVmax and SUVmean respectively) were calculated. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate their diagnostic performance to distinguish UP from pNET.
One hundred five patients benefited from a WBD between July 2018 and July 2019. Eighteen (17.1%) had an UP and 26 (24.8%) a pNET. For parameters alone, the Ki and SUVpeak had the best sensitivity (88.5%) while the Ki, SUVmax, and SUVmean had the best specificity (94.4%). The best diagnostic accuracy was obtained with Ki (90.9%). For ratios, the TLRKi and the TSRKi had the best sensitivity (95.7%) while the TM/SM and TM/Sm the best specificity (100%). TLRKi had the best diagnostic accuracy (95.1%) and the best area under the curve (AUC) (0.990).
Our study is the first one to evaluate the interest of a WBD acquisition to differentiate UP from pNETs and shows excellent diagnostic performances of the Ki approach.
HER2-positive pure mucinous breast carcinoma
Authors: Zhao Xingjuan , Yang Xuan , Gao Runfang , Zhai Liqin , Yang Lizhu , Yu Keda 
Published: August 2020

Abstract

Introduction:
Pure mucinous carcinoma is a rare type of breast carcinoma, but it usually has a favorable prognosis. Tumors of pure mucinous carcinoma are typically positive for both estrogen receptor (ER) and progesterone receptor (PR), and they do not commonly overexpress human epidermal growth factor receptor 2 (HER2). However, when tumors have HER2 overexpression and are progesterone receptor negative, the prognosis is worse.

Patient concerns:
A 59-year-old female reported a slow growth mass of 3 years, which was radiologically diagnosed as fibroadenoma at another institution. The patient came to our institution for treatment and follow-up. She had no salient past history.

Diagnosis:
Excisional biopsy revealed a pure mucinous breast carcinoma that was ER (100%, moderate-strong intensity), PR(−), 5% Ki-67 (+), and HER2(3+) by immunohistochemistry. The HER2 gene was found to be amplified by fluorescence in situ hybridization (FISH). The clinical staging was T2N0M0, with pathological grade I, subtype luminal B.

Interventions:
After a modified radical mastectomy, she received four 21-day cycles of intravenous docetaxel (75 mg/m2), intravenous cyclophosphamide (600 mg/m2), and intravenous trastuzumab (8 mg/kg) (loading dose) on day 1 followed by 6 mg/kg every 3 weeks to complete a full year of treatment. She then received 2.5 mg of letrozole daily for 5 years.

Outcomes:
After following up for 2 years, the patient's outcome was survival without recurrence. Cardiac ultrasounds were performed every 3 months and there was no change in the left ventricular ejection fraction (LEVF).

Conclusion:
It is essential to correctly diagnose the ER(+), PR(−) HER2(+) subtype in mucinous carcinoma. This type should be treated with chemotherapy and anti-HER2 therapy, as well as aromatase inhibitor endocrine therapy.
Chinese medicine for coronavirus disease 2019 as complementary therapy
Authors: Zhou Min , Liang Qijun , Pei QiuLan , Xu Fan , Wen Hang 
Published: August 2020

Abstract

Background:
The aim of this systematic review and meta-analysis is to assess effectiveness and safety of Chinese medicine (CM) as complementary therapy in treating coronavirus disease 2019 (COVID-19).

Methods:
The following databases will be searched: PubMed, Cochrane, Embase, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang database from October 1, 2019 to March 1, 2020. Randomized trials and quasi-randomized or prospective controlled clinical trials of CM that reported data on COVID-19 patients will be included. Study selection, data extraction, quality assessment, and assessment of risk bias will be performed by 2 reviewers independently. Odds ratios and correlative 95% confidence intervals will be calculated to present the association between the CM and CWM using Review Manager version 5.3 when there is sufficient available data.

Results:
The results will be disseminated through a peer-reviewed journal publication.

Conclusion:
This systematic review findings will summarize up-to-date evidence for that CM is more effective and safe as adjunctive treatment for patients with COVID-19.

Ethics and dissemination:
Ethics approval and patient consent are not required as this study is a systematic review based on published articles.

PROSPERO registration number:
CRD42020185382.
Multi-center study for acupuncture combined with Chinese medicine in the treatment of chronic spontaneous urticaria based on the theory of taking shu-stream points when the disease is aggravated
Authors: Qin Yuesi , Guo Jing , Song Pan , Hou Tianshu , He Yan , Han Ming , Yu Qianying , Lin Wenxia , Chen Mingling , Su Hong 
Published: August 2020

Abstract
Chronic spontaneous urticaria (CSU) is a common dermatologic disease that seriously affects patient quality of life. The choice of therapy to control the disease and prevent its recurrence has always presented a difficult clinical issue. Previous studies have shown that traditional Chinese medicine is a safe and effective treatment for CSU. Recently, the temporal rhythms of CSU, a disease characterized by intermittent flares of active disease and periods of little or no disease, have attracted the attention of traditional Chinese medicine researchers. We designed a multicenter, randomized, controlled study to evaluate the efficacy and safety of combining a Chinese herbal formulation with acupuncture using shu-stream acupoints applied on the corresponding time meridians during disease exacerbations. We plan to recruit 111 outpatients with CSU aged 18 to 65 years. Participants will be randomized to 1 of the 3 groups: group A, which will be given basic acupuncture and the herbal formulation dangui yinzi; group B, which will be given danggui yinzi and shu-stream acupuncture; and a control group, which will be given danggui yinzi alone. Patients will be treated for 4 weeks and followed for 8 additional weeks. Investigators will evaluate the following parameters: the symptoms and side effects of treatment, quality of life (using the chronic urticaria quality of life questionnaire), and overall patient condition. Each week, patients will also complete the measurement of 7-day urticarial activity score. This is the first use of a combination of shu-stream acupoints and Chinese herbal medicine in the treatment of CSU. If successful, it will prove to be a simple, inexpensive, treatment strategy for solving a difficult clinical problem.
A protocol of systematic review and meta-analysis of narrow band imaging endoscopy in detection of early gastric cancer
Authors: Zhang Li , Liu Xiao-yu , Zhong Gang , Xin Zhi , Sun Xiang-Yu , Wang Zhen-Yu 
Published: August 2020

Abstract

Background:
Early gastric cancer is the fifth common malignancy and the third leading cause of cancer death throughout the world. However, it is not clear how endoscopic screening for early gastric cancer affects incidence or mortality. We performed a systematic review and meta-analysis to evaluate the relationship between endoscopic screening for the mortality and incidence of early gastric cancer.

Materials and methods:
This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for cohort and case-control studies in cases without early gastric cancer until March 31, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the Eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The relative risk and 95% confidence intervals were used as effect estimate. I-square test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review.

Results:
The results will be published in a peer-reviewed journal.

Conclusion:
The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also provide helpful evidence of whether endoscopic screening would reduce the mortality and incidence of early gastric cancer.

PROSPERO registration number:
CRD42020171053
Selective serotonin reuptake inhibitors-associated apathy syndrome
Authors: Padala Prasad R. , Padala Kalpana P. , Majagi Anusha S. , Garner Kimberly K. , Dennis Richard A. , Sullivan Dennis H. 
Published: August 2020

Abstract
Selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, are associated with loss of motivation, anergy, and lack of curiosity often referred collectively as apathy. However, this association has not been systematically assessed using a specific rating scale for measuring apathy syndrome. Our objective was to study the association between SSRI use and apathy syndrome.
We conducted a retrospective chart review of 125 patients enrolled in an outpatient psychiatry clinic. The prevalence of apathy syndrome and its clinical significance (based on standardized assessment) were compared between patients treated and not treated with SSRIs. Apathy was assessed using the Apathy Evaluation Scale-clinician version with a score ranging 18–72 with higher score for worse apathy. A score of greater than 30 is considered clinically significant apathy.
Among 119 patients, the mean apathy scores were significantly higher in those treated with SSRIs compared to those not treated with SSRIs (42.5 ± 9.2 vs 31.3 ± 6, P < .0001). The SSRI group also had a significantly higher percentage of patients with clinically significant apathy (92% vs 61%, P < .0001). Use of all SSRIs was associated with the presence of apathy. Apathy was seen in all mental health diagnostic categories with highest Apathy evaluation scale-clinician version scores in those with dementia.
SSRI use may be associated with higher rates of apathy syndrome. Clinicians should specifically inquire about iatrogenic apathy syndrome when evaluating patients on an SSRI if there is suspicion of loss of motivation. Limitations of this study included retrospective nature of this study, and that majority of the sample was males. Prospective studies are needed to elucidate information regarding the prevalence, etiology, and treatment response for SSRI-associated apathy syndrome.
Laparoscopic versus open herniorrhaphy for children with inguinal hernia
Authors: Liu Guoqing , Zhang Wenxian , Zhou Jianfeng , Sun Bin , Jiang Bin , Wang Hao 
Published: August 2020

Abstract

Purpose:
The aim of this study was to compare the effectiveness between laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in children with inguinal hernia.

Methods:
PubMed, EmBase, and the Cochrane library were searched to select trials from their inception till April 2019. The summary of relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were employed to evaluate the treatment effectiveness between LH and OH.

Results:
Six randomized controlled trials (RCTs) including a total of 594 children were selected. No significant differences were observed between LH and OH regarding the risk of postoperative complications. However, LH significantly reduced the risk of major postoperative complications when compared with OH. Moreover, LH showed association with a shorter operative time in bilateral inguinal hernia when compared with OH, whereas no significant difference between groups for unilateral inguinal hernia. Finally, children who received LH showed association with longer time to discharge than those who received OH, whereas no significant difference was observed between the groups for time to resume full activity.

Conclusions:
These findings suggested that children who received LH had protection against major postoperative complications than those who received OH. Moreover, children who received LH had shorter operative time, and longer time to discharge.
Analysis of the correlation between periodontal disease and metabolic syndrome among coal mine workers
Authors: Zhao Jian , Zhu Xiang-yu , Ren Yan , Li Jin-yuan 
Published: August 2020

Abstract
Metabolic syndrome (MetS) refers to the pathological state of metabolic disorders in the body's proteins, fats, carbohydrates and other substances. MetS is a systemic metabolic disease. Periodontal disease is also a part of systemic inflammatory diseases. Among Chinese patients with middle-aged and elderly MetS, the periodontal morbidity is very high, which is due to the involvement of inflammatory mediators in the pathogenesis of MetS and periodontal disease. The latter may also be a risk factor for the former's morbidity and promotion of disease progression. At present, there are not many investigations and studies on periodontal examination data and periodontal disease prevalence of patients with MetS. Coal mine workers, especially coal mine underground workers, have different work natures and different working environments. See related report.
We will collect the clinical diagnosis and treatment information of the enrolled patients. We will focus on checking the incidence of periodontal disease and recording. Establish a database, check every 10 medical records, and make corrections in time to ensure data accuracy. We will popularize oral hygiene knowledge for the included patients and guide them to brush their teeth correctly and how to use dental floss. We will perform periodontal examination on the patients’ teeth by site and record the plaque index, gingival sulcus bleeding index, periodontal pocket exploration depth and other indicators. We will repeat the above inspection items and record in the second and fourth weeks of the experiment.
This study will explore the correlation between periodontal disease and MetS of coal mine workers. We aim to clarify the role and mechanism of MetS in the occurrence and development of periodontal diseases, guide the prevention of periodontal diseases, and thus reduce the prevalence of periodontal diseases.

Trial registration:
ClinicalTrials.gov, ChiCTR2000034177, Registered on 27 June 2020
Ankylosing spondylitis complicating Turner syndrome
Authors: Chen Fang-Fei , Zhang Xue-Han , Jiao Yang 
Published: August 2020

Abstract

Rationale:
Turner syndrome (TS) is an anomaly caused by loss of part of or all the X chromosomes. Ankylosing spondylitis (AS) is an HLA-B27-associated autoimmune disease with a male predominance. It is widely accepted that TS patients are at higher risk of autoimmune diseases, but AS in TS patients has only rarely been reported.

Patient concerns:
A 13-year-old TS patient presented with intermittent pain in both hip joints, and a 27-year-old TS patient presented with thoracic kyphosis and a history of AS.

Diagnoses:
Both patients were diagnosed with AS according to their symptoms, laboratory results, and imaging.

Interventions:
The first patient was treated with tocilizumab for 8 months, whereas the second patient was treated with diclofenac initially with subsequent surgery for thoracic kyphosis.

Outcomes:
Treatment relieved the symptoms of both patients and laboratory parameters improved.

Lessons:
Even though AS has a male predominance, clinicians should be aware that AS and TS may co-exist and that the clinical features are atypical in TS patients with AS.