bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine interventions to reduce blood pressure in a chronic disease population: A meta-analysis
Authors: Gao Wenyan , Lv Xiaoling , Xu Xiaogang , Zhang Zhongshan , Yan Jing , Mao Genxiang , Xing Wenmin 
Published: October 2020

Introduction Elevated blood pressure (BP) is a leading risk factor for many chronic diseases. Many investigations conducted using telemedicine (TM)-based interventions have the potential to control BP. The purpose of this study was to assess the efficacy of TM-based interventions in reducing BP. Methods Studies were selected from PubMed, PMC, Web of Science, Embase, Google Scholar, Cochrane Library, the Chinese National Knowledge Infrastructure (CNKI) and the Chinese Biomedical Literature Database (CBM) according to the inclusion and exclusion criteria. The mean and standard deviation changes in systolic BP (SBP) and diastolic BP (DBP) were analysed using standard mean difference (SMD) and 95% confidence intervals (CI) with a random-effects model or fixed-effects model to assess the efficiency of controlling BP. Subgroup analysis, influence analysis and publication bias analysis were also conducted. Results Sixteen randomised clinical trials were included in this meta-analysis. A TM-based lifestyle intervention significantly reduced daytime SBP (SMD = −0.18, 95% CI −0.27 to −0.10; p < 0.001) and DBP (SMD = −0.18, 95% CI −0.27 to −0.09; p < 0.001). The results of subgroup analysis indicated that this reduction in BP was reliable when BP interventions lasted for 6 months or longer in populations with cardiovascular disease and hypertension. Moreover, the detection data should be delivered by a device system to ensure accuracy. Discussion A TM-based intervention could reduce daytime SBP and DBP in populations with hypertension and cardiovascular disease. This review provides intuitive evidence of a reduction in BP using TM-based interventions.
The genetic polymorphisms of angiotensin converting enzyme insertion/deletion and glioma susceptibility: A meta-analysis
Authors: Sun Meili , Fang Yuying , Ma Shuzhen , Gao Ximei , Sun Yuping 
Published: October 2020

Objective: The previous studies on angiotensin converting enzyme (ACE) insertion/deletion (I/D) genetic polymorphism and glioma risk were inconsistent. Therefore, we performed a meta-analysis to assess the association between ACE I/D polymorphisms and glioma risk. Methods and Results: In total, four populations (1110 cases and 1335 controls) on ACE I/D polymorphism were included. Overall, the meta-analysis demonstrated no significant association between ACE I/D polymorphism and glioma risk. In addition, the analysis of the association of ACE I/D polymorphism and clinical grade also showed no significant association. Conclusion: Our meta-analysis didn’t find a significant association between ACE I/D polymorphism glioma risk. However, further studies with larger sample size and more ethnic groups are required to confirm the results.
Clinical-Pathologic Analysis of Breast Cancer With PIK3CA Mutations in Chinese Women
Authors: Lian Jing , Xu En-Wei , Xi Yan-Feng , Wang Hui-Wen , Bu Peng , Wang Jin-fen , Wang Li-Xia 
Published: October 2020

Purpose: Mutations of PIK3CA have recently been shown to play an important role in the pathogenesis and progression of breast neoplasms. The prevalence of PIK3CA in Chinese breast cancer patients may be underestimated. Therefore, we investigated the distribution of somatic PIK3CA mutation in Chinese breast cancer patients and explored their role in tumor phenotypes. Methods: Mutational analysis of PIK3CA was done in 113 primary breast cancers of Chinese women used Amplification refractory mutation system (ARMS). The relationship of PIK3CA mutations with several clinicopathologic characteristics was analyzed. Results: PIK3CA gene mutation was identified in 43(38.05%) cases and has a more significant difference between exon 9 and 20. HER2 gene amplification was 32.6% in 43 cases of PIK3CA mutation, but 37.1% in 70 cases of non-mutation (χ2 = 0.245, P > 0.05). There was no significant correlation of the age distribution, lymph node status, histological tumor grading, ER and/or PR and P53 between 2 groups (P > 0.05). Conclusion: A high frequency of somatic PIK3CA mutation was detected in Chinese breast cancer patients, especially in exon 20. The relationship between PIK3CA gene mutation and clinical pathological features of breast cancer needs to be further studied in a large series of patients. PIK3CA mutations seem to have the potential to be used in target treatment and as an indicator of prognosis.
The First Unprovoked Seizure in Typically Developing Children: A Real-Life Setting in Southern Brazil
Authors: de Rezende Machado Mayara , Bruck Isac , de Paola Luciano , Cat Mônica Nunes Lima , Antoniuk Sérgio Antonio , Silvado Carlos Eduardo Soares 
Published: October 2020

Aim To describe the first unprovoked seizure in typically developing children, its clinical characteristics, recurrence rate, and possible risk factors in a real-life setting in Southern Brazil. Method In this retrospective cohort study, medical records of typically developing children aged 28 days to 14 years who had a first unprovoked seizure in a single tertiary care center were reviewed, in a 10-year period (2006-2016). Results Seventy-four children were included, 41 males and 33 females. The most frequent age group of the first seizure was 5 to 10 years and seizure main type was focal (50%). Most seizures occurred while children were awake (70%). All patients underwent an electroencephalogram (EEG), which was normal in 44.6%. Neuroimaging was performed in 81%, in 2 cases the etiology was considered structural, the remaining was classified as unknown. Median follow-up period was 32.5 months. Seizure recurrence rate was 56.7% and age younger than 5 years was a possible risk factor. Interpretation In the subpopulation of Brazilian typically developing children with a first unprovoked epileptic seizure there is a high recurrence rate. An abnormal EEG was a common finding, although it was not associated with a higher risk of seizure recurrence. A possible risk factor was age younger than 5 years, which may suggest a more rigorous follow-up of these patients.
Clinical academic careers for general practice nurses: a rapid evidence assessment
Authors: Bradbury Andrew , Shortland Sue , Jones Sarahjane , Hewett Fraser , and Karen Storey  
Published: October 2020

Background Clinical academics are health professionals who provide direct patient care alongside engaging in health research. Despite the generally agreed consensus that such roles enhance evidence-based care, availability and uptake has been sporadic in non-medical professions. With no data readily available regarding general practice nurses undertaking clinical academic roles, there is a need to understand the barriers and enabling factors that impact general practice nurses considering or pursuing a clinical academic career. Aims This review aims to address the question ‘What are the barriers and enablers relevant to general practice nurses in the UK pursuing clinical academic careers?’ by providing an overview of the relevant existing literature and drawing out the implications for policy and practice. Methods Literature published in the past 10 years was systematically searched. Using agreed inclusion criteria, papers were first screened on titles and abstracts, with papers included at this stage reviewed as full texts. Results Thirteen papers met the criteria for inclusion. The extraction and synthesis of findings allowed for the development of three themes: roles and responsibilities; embarking on a clinical academic career; and organisational research culture. Conclusions Findings suggest that infrastructure developments are required across higher education institutions and general practice organisations to bring about a cultural change to equip and empower general practice nurses to consider and pursue clinical academic careers.
Association between estimated pulse wave velocity and the risk of stroke in middle-aged men
Authors: Jae Sae Young , Heffernan Kevin S , Kurl Sudhir , Kunutsor Setor K , Laukkanen Jari A 
Published: October 2020

Background Increased aortic stiffness, assessed as carotid-femoral pulse wave velocity (cfPWV), contributes to cerebrovascular damage and is predictive of cerebrovascular events. Aims and methods We sought to examine the association between estimated pulse wave velocity (ePWV), a proxy of carotid-femoral pulse wave velocity, and stroke and its subtypes (ischemic and hemorrhagic) in a prospective cohort of 2666 men (aged mean 53.1, range 42–61 years) enrolled in the Kuopio Ischemic Heart Disease cohort study. Results During a median 28-year follow-up, 471 incident stroke (397 ischemic and 94 hemorrhagic) events occurred. After adjusting for several established and emerging risk factors including age and pulse pressure, comparing the p versus bottom quartiles of ePWV, there was an increased risk of stroke (hazard ratio [HR] 2.37, 95% Confidence Interval [CI]: 1.57–3.58), ischemic stroke (HR 2.23, 95% CI, 1.42–3.50), and hemorrhagic stroke (HR 3.57, 95% CI, 1.45–8.76). Conclusion These findings demonstrate that ePWV is independently associated with the risk of stroke in middle-aged men.
Psychological Interventions for Persistent Orofacial Pain
Authors: Barker Sarah , Urbanek Monika , Penlington Chris 
Published: October 2020

Persistent pain has been defined as pain lasting beyond the normal time of healing (up to six months), often in the absence of observable tissue pathology. It includes a range of conditions which are likely to present in the dental setting including temporomandibular disorders, burning mouth syndrome, persistent dentoalveolar pain, trigeminal nerve injury, trigeminal neuralgia and atypical facial pain. This article reviews psychological interventions for pain. This includes interventions that have been researched in a range of persistent pain settings, including but not limited to those that have been directly applied to persistent orofacial pain (POFP). All current psychological interventions for persistent pain are underpinned by a biopsychosocial understanding of the complex and multifactorial nature of pain. The main currently applied interventions are described, along with their rationale and selected relevant research. To date, psychological treatments which have been shown to persistent pain demonstrate small but consistent improvements in pain, disability and quality of life compared to standard care. A stepped care approach to service provision is outlined, with practical ideas for administering routine psychological measures to help stratify patients towards the appropriate care pathway.
Duration of Surgery and Learning Curve Affect Rotator Cuff Repair Retear Rates: A Post Hoc Analysis of 1600 Cases
Authors: Elkins Ashleigh R. , Lam Patrick H. , Murrell George A.C. 
Published: October 2020

Background: Arthroscopic rotator cuff repair can be quite complex and time consuming, particularly early in the surgeon’s learning curve. Hypothesis: Patients who have undergone rotator cuff repair with shorter operative times will be less likely to have a rotator cuff retear at 6 months postoperatively. Study Design: Case-control study; Level of evidence, 3. Methods: This study was an analysis of data from 1600 consecutive patients (670 partial-thickness and 930 full-thickness tears) who had rotator cuff repair performed by a single surgeon utilizing an arthroscopic, single-row, knotless inverted mattress suture anchor technique. All patients underwent ultrasound at 6 months postoperatively to determine repair integrity. Moving average analysis was performed for the variables of operative time and case number to evaluate the surgeon’s learning curve. Results: For early cases, the mean operative time was approximately 35 minutes. After approximately 450 cases, the operative time plateaued at approximately 20 minutes. The mean operative time for the cohort (±SEM) was 22 ± 0.3 minutes, and the mean retear rate was 13%. Increased operative time was associated with a retear ( r = 0.18; P < .001). Multiple logistic regression analysis revealed that the variables with the most independent effect on retears were larger tear size (Wald statistic = 36; P < .001), lower case number (ie, less surgeon experience) (Wald statistic = 28; P < .001), older patient age (Wald statistic = 23; P < .001), full-thickness tears (Wald statistic = 13; P < .001), and lower surgeon-rated repair quality (Wald statistic = 8; P = .004). Operative time was not a significant independent factor contributing to retears. Conclusion: Operative time and rotator cuff retear rates decreased as surgical team experience increased. The hypothesis of this study, however, was not supported. The reduced retear rate was not related to a reduction in operative time per se but rather to improved surgical team experience and patient factors, such as improved healing with smaller tears in younger patients.
Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews
Authors: Darzi Andrea J. , Repp Allen B. , Spencer Frederick A. , Morsi Rami Z. , Charide Rana , Etxeandia-Ikobaltzeta Itziar , Bauer Kenneth A. , Burnett Allison E. , Cushman Mary , Dentali Francesco , Kahn Susan R. , Rezende Suely M. , Zakai Neil A. , Agarwal Arnav , Karam Samer G. , Lotfi Tamara , Wiercioch Wojtek , Waziry Reem , Iorio Alfonso , Akl Elie A. , Schünemann Holger J. 
Published: October 2020

Abstract
Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical patients have been developed. To inform the 2018 American Society of Hematology (ASH) guidelines on VTE, we conducted an overview of systematic reviews to identify and summarize evidence related to RAMs for VTE and bleeding in medical inpatients. We searched Epistemonikos, the Cochrane Database, Medline, and Embase from 2005 through June 2017 and then updated the search in January 2020 to identify systematic reviews that included RAMs for VTE and bleeding in medical inpatients. We conducted study selection, data abstraction and quality assessment (using the Risk of Bias in Systematic Reviews [ROBIS] tool) independently and in duplicate. We described the characteristics of the reviews and their included studies, and compared the identified RAMs using narrative synthesis. Of 15 348 citations, we included 2 systematic reviews, of which 1 had low risk of bias. The reviews included 19 unique studies reporting on 15 RAMs. Seven of the RAMs were derived using individual patient data in which risk factors were included based on their predictive ability in a regression analysis. The other 8 RAMs were empirically developed using consensus approaches, risk factors identified from a literature review, and clinical expertise. The RAMs that have been externally validated include the Caprini, Geneva, IMPROVE, Kucher, and Padua RAMs. The Padua, Geneva, and Kucher RAMs have been evaluated in impact studies that reported an increase in appropriate VTE prophylaxis rates. Our findings informed the ASH guidelines. They also aim to guide health care practitioners in their decision-making processes regarding appropriate individual prophylactic management.
Augmenting emergency granulopoiesis with CpG conditioned mesenchymal stromal cells in murine neutropenic sepsis
Authors: Ng Julie , Guo Fei , Marneth Anna E. , Ghanta Sailaja , Kwon Min-Young , Keegan Joshua , Liu Xiaoli , Wright Kyle T. , Kamaz Baransel , Cahill Laura A. , Mullally Ann , Perrella Mark A. , Lederer James A. 
Published: October 2020

AbstractPatients with immune deficiencies from cancers and associated treatments represent a growing population within the intensive care unit with increased risk of morbidity and mortality from sepsis. Mesenchymal stromal cells (MSCs) are an integral part of the hematopoietic niche and express toll-like receptors, making them candidate cells to sense and translate pathogenic signals into an innate immune response. In this study, we demonstrate that MSCs administered therapeutically in a murine model of radiation-associated neutropenia have dual actions to confer a survival benefit in Pseudomonas aeruginosa pneumo-sepsis that is not from improved bacterial clearance. First, MSCs augment the neutrophil response to infection, an effect that is enhanced when MSCs are preconditioned with CpG oligodeoxynucleotide, a toll-like receptor 9 agonist. Using cytometry by time of flight, we identified proliferating neutrophils (Ly6GlowKi-67+) as the main expanded cell population within the bone marrow. Further analysis revealed that CpG-MSCs expand a lineage restricted progenitor population (Lin−Sca1+C-kit+CD150−CD48+) in the bone marrow, which corresponded to a doubling in the myeloid proliferation and differentiation potential in response to infection compared with control. Despite increased neutrophils, no reduction in organ bacterial count was observed between experimental groups. However, the second effect exerted by CpG-MSCs is to attenuate organ damage, particularly in the lungs. Neutrophils obtained from irradiated mice and cocultured with CpG-MSCs had decreased neutrophil extracellular trap formation, which was associated with decreased citrullinated H3 staining in the lungs of mice given CpG-MSCs in vivo. Thus, this preclinical study provides evidence for the therapeutic potential of MSCs in neutropenic sepsis.
Evaluation of disease severity in bronchiectasis using impulse oscillometry
Authors: Yamamoto Yuji , Miki Keisuke , Tsujino Kazuyuki , Kuge Tomoki , Matsuki Takanori , Fukushima Kiyoharu , Oshitani Yohei , Kagawa Hiroyuki , Yoshimura Kenji , Miki Mari , Kida Hiroshi 
Published: October 2020

Although the diagnostic value of impulse oscillometry (IOS) in bronchiectasis for the differential diagnosis of healthy subjects has been researched, the usefulness of each IOS parameter for predicting disease severity in bronchiectasis has not been thoroughly investigated. In addition, the usefulness of IOS in patients with nontuberculous mycobacteria (NTM) infection has not been reported. This study aimed to determine the predictive significance of respiratory impedance and detect the other most significant IOS parameters for predicting disease severity in bronchiectasis patients and to validate the usefulness of IOS in patients with NTM infection.A total of 206 patients with bronchiectasis who attended clinics at the National Hospital Organization Osaka Toneyama Medical Center were included. Chest high-resolution computed tomography, spirometry and IOS were performed. Hospital admissions, mortality and disease severity indices for bronchiectasis (Bronchiectasis Severity Index (BSI), FACED, and E-FACED scores) were calculated to assess disease severity. The patients were divided into subgroups with and without NTM infection, and subgroup analyses were performed.Respiratory reactance, especially resonant frequency (fres), correlated with both BSI and FACED score better than respiratory resistance. Inspiratory but not expiratory impedance was strongly correlated with BSI, FACED and E-FACED scores. Inspiratoryfreswas the most useful predictor, increasing as the disease became more severe. The usefulness of IOS was almost equivalent in patients both with and without NTM infection.Inspiratory reactance measured by IOS is useful for estimating disease severity in bronchiectasis. Inspiratoryfresbest predicts disease severity in bronchiectasis patients both with and without NTM infection.
A comprehensive analysis of the microbiota composition and gene expression in colorectal cancer
Authors: Zhang Qian , Zhao Huan , Wu Dedong , Cao Dayong , Ma Wang 
Published: October 2020

Abstract
Background
The dysregulation of gut microbiota is pivotal in colorectal carcinogenesis. Meanwhile, altered gut microbiome may affect the development of intestinal diseases through interaction with the host genes. However, the synergy between the altered gut microbiota composition and differential expression of specific genes in colorectal cancer (CRC) remains elusive. Thus, we integrated the data from 16S rRNA gene sequences and RNA sequences to investigate the potential relationship between genes and gut microbes in patients with CRC.

Results
Compared with normal samples, the presence of Proteobacteria and Fusobacteria increased considerably in CRC samples; conversely, the abundance of Firmicutes and Spirochaetes decreased markedly. In particular, the genera Fusobacterium, Catenibacterium, and Shewanella were only detected in tumor samples. Meanwhile, a closely interaction between Butyricimonas and Clostridium was observed in the microbiome network. Furthermore, a total of 246 (differentially expressed genes) DEGs were identified between tumor and normal tissues. Both DEGs and microbiota were involved in bile secretion and steroid hormone biosynthesis pathways. Finally, genes like cytochrome P450 family 3 subfamily A member 4 (CYP3A4) and ATP binding cassette subfamily G member 2 (ABCG2) enriched in these two pathways were connected with the prognosis of CRC, and CRC patients with low expression level of CYP3A4 and ABCG2 had longer survival time.

Conclusion
Identifying the complicated interaction between gut microbiota and the DEGs contributed to further understand the pathogenesis of CRC, and these findings might enable better diagnosis and treatment of CRC patients.
Anesthesia departments’ readiness for the COVID-19 pandemic; a nationwide cross-sectional study in Israel
Authors: Cohen Barak , Baar Yuval , Fein Shai , Matot Idit 
Published: October 2020

Abstract
Background
The Coronavirus infectious disease 2019 (COVID-19) brings anesthesiologists and intensive care physicians to the mainstay of clinical workload and healthcare managements’ focus. There are approximately 900 anesthesiologists in Israel, working in non-private hospitals. This nationwide cross-sectional study evaluated the readiness and involvement of anesthesia departments in Israel in management of the COVID-19 pandemic. The impact on anesthesiologists’ health, workload, and clinical practices were also evaluated.

Methods
An online questionnaire was distributed to all of anesthesia department chairs in Israel on April 14th. Each response was identifiable on the hospital level only. Informed consent was waived since no patient data were collected.

Results
Response rate was 100%. A decrease of at least 40% in operating-room activity was reported by two-thirds of the departments. Anesthesiologists are leading the treatment of COVID-19 patients in 19/28 (68%) Israeli hospitals. Israel Society of Anesthesiologists’ recommendations regarding intubation of COVID-19 patients were strictly followed (intubations performed by the most experienced available physician, by rapid-sequence induction utilizing video-laryngoscopy, while minimizing the number of people in the room - about 90% compliance for each). Anesthesiologists in most departments use standard personal protective equipment when caring for COVID-19 patients, including N95 masks, face shields, and water-proof gowns. Only one anesthesiologist across Israel was diagnosed with COVID-19 (unknown source of transmission). All department chairs reported emerging opportunities that advance the anesthesia profession: implementation of new technologies and improvement in caregivers’ clinical capabilities (68% each), purchase of new equipment (96%), and increase in research activity (36%).

Conclusions
This nationwide cross-sectional study had a complete response rate and therefore well-represents the anesthesia practice in Israel. We found that Israeli anesthesia departments are generally highly involved in the health system efforts to cope with the COVID-19 pandemic. Anesthesia and airway management are performed in a remarkably comparable manner and with proper protection of caregivers. Ambulatory anesthesia activity has dramatically decreased, but many departments find opportunities for improvement even in these challenging times.