bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cross-Sectional Examination of 10-Year Atherosclerotic Cardiovascular Disease Risk Among US Firefighters by Age and Weight Status
Authors: Hollerbach Brittany S. , Mathias Kevin C. , Stewart Donald , Jack Kepra , Smith Denise L. 
Published: October 2020

Objective:
Examine atherosclerotic cardiovascular disease (ASCVD) risk scores by age and weight status in career firefighters.

Methods:
Medical examinations for firefighters more than or equal to 40 years (n = 644) were examined. ASCVD 10-year risk scores were calculated from sex- and race-specific equations and were reported by three age (40 to 44.9, 45 to 49.9, more than or equal to 50 years) and weight (normal, overweight, obese) categories.

Results:
Mean risk scores were 1.8%, 3.5%, and 6.2% for firefighters 40 to 44.9, 45 to 49.9, and more than or equal to 50 years, respectively. The association of weight status with increased ASCVD risk was higher (P < 0.01) among older firefighters, where risk was 0.8% (95% confidence interval [CI]: 0.6 to 1.1) and 2.3% (95% CI: 2.0 to 2.6) among normal versus obese 40 to 44.9 year olds, and 4.1% (95% CI: 3.1 to 5.3) and 7.8% (95% CI: 6.7 to 8.9) among normal versus obese more than or equal to 50 year olds.

Conclusions:
While firefighters cannot avoid aging, physicians should counsel firefighters with weight-maintenance or weight-loss advice to prevent and manage elevated ASCVD risk.
Advancing the Safety, Health, and Well-Being of Commercial Driving Teams Who Sleep in Moving Semi-Trucks
Authors: Olson Ryan , Johnson Peter , Shea Steven A. , Marino Miguel , Rimby Jarred , Womak Kelsey , Wang Fangfang , Springer Rachel , Donovan Courtney , Rice Sean P.M. 
Published: October 2020

Objective:
To test the feasibility, acceptability, and potential effectiveness of engineering and behavioral interventions to improve the sleep, health, and well-being of team truck drivers (dyads) who sleep in moving semi-trucks.

Methods:
Drivers (n = 16) were exposed to Condition A: a new innerspring mattress, and Condition B: a novel therapeutic mattress. A subsample of drivers (n = 8) were also exposed to Condition C: use of their preferred mattress (all chose to keep B), switching to an active suspension driver's seat, and completing a behavioral sleep-health program. Primary outcomes were sleep duration, sleep quality, and fatigue. Behavioral program targets included physical activity and sleep hygiene.

Results:
Self-reported sleep and fatigue improved with mattress A, and improved further with mattress B which altered vibration exposures and was universally preferred and kept by all drivers. Condition C improved additional targets and produced larger effect sizes for most outcomes.

Conclusions:
Results support these interventions as promising for advancing team truck drivers’ sleep, health, and well-being.
Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review
Authors: Bonde Jesper , Bottari Fabio , Iacobone Anna D. , Cocuzza Clementina E. , Sandri Maria-Teresa , Bogliatto Fabrizio , Khan Khalid S. , Ejegod Ditte M. , Gary Devin S. , Andrews Jeffrey C. 
Published: October 2020

Objective
The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results.

Materials and Methods
MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093).

Results
Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds.

Conclusions
There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
Validation of the Binocular Vision Dysfunction Questionnaire (BVDQ)
Authors: Feinberg Debby L. , Rosner Mark S. , Rosner Arthur J. 
Published: October 2020

Objective:
Among patients presenting with dizziness, visual dysfunction must be considered, including vertical heterophoria (VH), a frequently under-identified form of binocular vision dysfunction where there is vertical discrepancy between the lines of sight of the eyes when at physiologic rest. Current self-rated screening measures do not account for complex VH symptomatology including dizziness/ambulation difficulties, nausea, headache, anxiety, neck pain, and reading impairment. VH must be differentiated from vestibular/otolithic etiologies, as their treatment frequently provides inadequate relief, yet treatment of the VH can reduce/eliminate symptoms. The objective of this study is to create a valid measurement tool (binocular vision dysfunction questionnaire) to assist in identifying VH among dizzy patients to aid in appropriate referral.

Study Design:
Retrospective case series.

Setting:
Tertiary referral center.

Patients:
One hundred twenty-six patients presenting to an optometric binocular vision subspecialist diagnosed with VH.

Intervention:
Psychometric study. The measurement tool's internal consistency and test–retest reliability was assessed. Confirmatory and exploratory factor analyses were performed. Validity was estimated through correlations with a visual analog scale and validated instruments for headaches, dizziness, and anxiety.

Main Outcome Measures/Results:
Excellent reliability demonstrated including Cronbach's alpha of 0.91 and high test–retest reliability. Statistical correlations with established measurements established sound convergent/content validity. Analysis of participants who underwent treatment indicated change in BVDQ score correlates with perception of change in symptom burden.

Conclusions:
Results suggest the BVDQ is a valid, reliable screening tool to assist otologists in identifying VH among their dizzy patients. The BVDQ may also be useful for measuring changes with various treatments, and in identifying diverse symptoms associated with BVD/VH
Incidental cerebral aneurysms detected by a computer-assisted detection system based on artificial intelligence
Authors: Shimada Yuki , Tanimoto Tetsuya , Nishimori Masataka , Choppin Antoine , Meir Arie , Ozaki Akihiko , Higuchi Asaka , Kosaka Makoto , Shimahara Yuki , Kitamura Naoyuki 
Published: October 2020

Abstract

Rationale:
Computer-assisted detection (CAD) systems based on artificial intelligence (AI) using convolutional neural network (CNN) have been successfully used for the diagnosis of unruptured cerebral aneurysms in experimental situations. However, it is yet unclear whether CAD systems can detect cerebral aneurysms effectively in real-life clinical situations. This paper describes the diagnostic efficacy of CAD systems for cerebral aneurysms and the types of cerebral aneurysms that they can detect.

Patient Concerns:
From March 7, 2017 to August 26, 2018 we performed brain magnetic resonance imaging (MRI) scans for 1623 subjects, to rule out intracranial diseases. We retrospectively reviewed the medical records including the history and images for each patient.

Diagnoses, interventions and outcomes:
Among them, we encountered 5 cases in whom the cerebral aneurysms had been overlooked in the first and second round of imaging, and were detected for the first time by CAD. All missed aneurysms were less than 2 mm in diameter. Of the 5 aneurysms, 2 were internal carotid artery (ICA) paraclinoid aneurysms, 2 were Internal carotid-posterior communicating artery (IC-PC) aneurysms and 1 was a distal middle cerebral artery (MCA) aneurysm.

Lessons:
Our CAD system can detect very small aneurysms masked by the surrounding arteries and difficult for radiologists to detect. In the future, CAD systems might pave the way to substitute the workload of diagnostic radiologists and reduce the cost of human labor.
Musashi1 expression is negatively correlated with numb expression in brain metastases
Authors: Dong Yalan , Li Jianfeng , Liu Rongju , Zhao Zhenxiang , Wang Shuaibin , Cui Kai 
Published: October 2020

Abstract
The expression of tumor stem cell markers musashi1 (msi1) and numb in brain metastases were detected to explore their roles in the development of brain metastases.
A total of 51 cases of brain metastasis, 29 cases of primary tumor and 15 cases of normal brain tissue were selected. Immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR) were used to detect msi1 and numb expression at the protein and mRNA levels. Correlation between msi1 and numb in brain metastases were evaluated.
Immunohistochemistry and RT-PCR showed that no significant difference in the expression of msi1 and numb between brain metastases and primary tumors was observed (P > .05); the expression of msi1 and numb in brain metastases was significantly higher than that in normal brain tissues (P < .05); and the expression of msi1 and numb in primary tumors was significantly higher than that in normal brain tissues (P < .05). In general, the expression of msi1 gene was negatively correlated with the expression of numb at mRNA level by Pearson correlation analysis (r = −0.345, P < .05). Additionally, the expression of msi1 and numb in brain metastases was not related to gender, age, and tissue origin (P > .05).
Msi1 is highly expressed in brain metastases and primary tumors, while numb is lowly expressed in brain metastases and primary tumors; msi1 and numb are negatively correlated in brain metastases, suggesting that msi1 and numb may have regulatory mechanisms in the development of brain metastases.
Comparison of dexmedetomidine with midazolam for dental surgery
Authors: Zhang Yibo , Li Chao , Shi Jingjing , Gong Yanming , Zeng Tao , Lin Min , Zhang Xi 
Published: October 2020

Abstract

Introduction:
Dexmedetomidine and midazolam have become important approaches for the sedation of dental surgery. However, the comparison of these 2 drugs for the sedation of dental surgery has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of dexmedetomidine versus midazolam for dental surgery.

Methods:
PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of dexmedetomidine versus midazolam on dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model.

Results:
Five RCTs and 420 patients are included in the meta-analysis. Compared with midazolam intervention for dental surgery, dexmedetomidine intervention has similar lowest SpO2, lowest heart rate and lowest systolic blood pressure, duration of surgery, and total volume of local anesthetic, but is associated with stable and reduced lowest diastolic blood pressure.

Conclusions:
Similar benefits of dexmedetomidine and midazolam intervention are observed for the sedation of dental surgery in terms of SpO2, heart rate, systolic blood pressure, and the volume of local anesthetic, but dexmedetomidine may result in more stable diastolic blood pressure.
Lymphodepletion chemotherapy revitalizes chimeric antigen receptor T cells contributing to regression of relapsed B-cell lymphoma
Authors: Liang Zuyu , Zhang Hao , Shao Mi , Cui Qu , Wu Zhao , Xiao Lei , Huang He , Hu Yongxian 
Published: October 2020

Abstract

Introduction:
Chimeric antigen receptor T cells (CAR-T) targeting CD19 have shown great potential for treatment of B-cell malignancies. For those patients who can not achieve complete remission (CR) or suffer from relapse after CAR-T therapy, further therapeutic strategies still remain elusive. Whether existing CAR-T cells can revitalize in vivo and eradicate tumor cells is still unknown.

Patient concerns:
We report a case of diffused large B-cell lymphoma patient who had achieved CR after CD19 targeted CAR-T therapy but relapsed after 5 months.

Diagnosis:
Five months after CAR-T cell infusion, the patient was confirmed a relapse by follow-up PET/CT scan and a mass biopsy. Flow cytometry showed a dramatically decreased percentage of CAR-T cells in peripheral blood (PB).

Interventions:
A second anti-CD19 CAR-T therapy was planned with deliberation. Firstly, the patient received lymphodepletion chemotherapy with fludarabine (25 mg/m2, d1–d3) and cyclophosphamide (500 mg/m2 d2–d3).

Outcomes:
After fludarabine and cyclophosphamide (FC) lymphodepletion chemotherapy, pre-existing CAR-T cells were revitalized and the patient developed grade 2 cytokine release syndrome (CRS) contributing to the regression of relapsed B-cell lymphoma.

Conclusions:
This case suggested that FC chemotherapy could revitalize CAR-T cells contributing to the regression of relapsed B-cell lymphoma. Nevertheless, further researches are required in the future as this report described only a single case.
Effectiveness and safety of different traditional Chinese medicine therapies for allergic rhinitis
Authors: Yu Ting , Yan ShiFan , Chi ZhenHai , Cheng Pan , Li HaiYan , Qin SiYu , Li MingHui , Chen RiXin , Jiao Lin 
Published: October 2020

Abstract

Introduction:
Traditional Chinese medicine has been widely used in the treatment of allergic rhinitis. However, currently randomized controlled trials (RCTs) and meta-analysis only compare 1 or 2 types of traditional Chinese medicine therapies, and the comprehensive ranking of efficacy and safety of multiple traditional Chinese medicine therapies for the treatment of allergic rhinitis has not been completed. Therefore, the purpose of this network meta-analysis is to evaluate the efficacy and safety of different traditional Chinese medicine therapies for the treatment of allergic rhinitis.

Methods and analysis:
Three English databases of PubMed, Embase, Cochrane Library, and 2 Chinese databases of CNKI and Wanfang were searched from their inceptions to September 1, 2020. At the same time, in order to prevent omissions, we also compared the previous meta-analysis to determine the final included trials. The main evaluation outcome was the total Clinical Score (total nasal symptom score [TNSS]), the secondary evaluation outcome was the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and adverse events. The Cochrane Collaboration's Tool was used to evaluate the methodological quality of articles, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument was used to evaluate the quality of evidence. Network meta-analysis was completed by using Stata Statistical Software (Version 14.0, Stata Corporation, College Station, TX).

Results:
This study will compare and rank the different traditional Chinese medicine therapies for allergic rhinitis.

Conclusion:
This study is the first time to use network meta-analysis (NMA) to compare the efficacy and safety of traditional Chinese medicine for the treatment of allergic rhinitis, which will provide ideas and methods for the clinical treatment for allergic rhinitis.

INPLASY registration number:
No. INPLASY202080119
Comfort and safety of bronchoscopy performed under sedation and local anesthesia in elderly patients
Authors: Noda Naotaka , Hara Makiko , Ise Shinji , Ose Mizuko , Tatsuta Miyoko , Nagaoka Aiko , Izumi Miiru , Wakamatsu Kentaro , Kawasaki Masayuki 
Published: October 2020

Abstract
Although sedation for bronchoscopy improves patient comfort, there is a risk of oversedation in elderly patients. Only a few studies have evaluated the efficacy and safety of sedation for bronchoscopy in elderly patients.
This study retrospectively analyzed records of 210 patients who underwent transbronchial brushing and/or biopsy under midazolam sedation at National Hospital Organization Omuta National Hospital between June 2017 and October 2019. Patients were administered 1 mg midazolam following 10 mL 4% lidocaine inhalation. When sedation was insufficient, 0.5 mg midazolam was administered additionally. Diagnostic yield, incidence of complications, amount of oxygen supplementation, decreases in percutaneous oxygen saturation (SpO2), changes in blood pressure, and degree of comfort were analyzed.
Patients were divided into the elderly (n = 102) and non-elderly (n = 108) groups. No significant differences were observed in diagnostic yield and procedure time between the 2 groups, and no severe adverse events were noted in the elderly group. The degree of comfort during bronchoscopy was significantly higher in the elderly group. In patients administered < 2 mg midazolam, the amount of oxygen supplementation and decreases in SpO2 were significantly smaller in the elderly group compared to the non-elderly group.
The risk of adverse events related to midazolam sedation in bronchoscopy does not increase with age, and sedation improves comfort during flexible bronchoscopy in elderly patients. Moreover, a total dose of midazolam <2 mg is safe for elderly patients undergoing bronchoscopy.
Efficacy and safety of spironolactone for the treatment of patients with acute heart failure
Authors: Feng Yan-lin , Lu Min 
Published: October 2020

Abstract

Background:
This study will investigate the efficacy and safety of spironolactone for the treatment of acute heart failure (AHF).

Methods:
The following electronic databases will be retrieved in PUBMED, EMBASE, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, and VIP database from inception through present. Two researchers will independently screen and assess the obtained literatures and extract outcome data. All study methodological quality will be assessed using Cochrane risk of bias tool, and all statistical analysis will be performed by RevMan 5.3 software. Additionally, we will undertake a narrative synthesis if it is possible.

Results:
This study will sum-marize most recent evidence to investigate the efficacy and safety of spironolactone for the treatment of AHF.

Conclusion:
This study will seek to assess the efficacy and safety of spironolactone for treating AHF.

Systematic review registration:
INPLASY202070053.
Is the proximal adductor canal block a better choice than the distal adductor canal block for primary total knee arthroplasty?
Authors: Zhang Lu-kai , Chen Cheng , Du Wei-bin , Zhou Hua-ten , Quan Ren-fu , Liu Jun-sheng 
Published: October 2020

Abstract

Background:
Total knee arthroplasty is accompanied by moderate to severe postoperative pain. Postoperative pain hampers the functional recovery and lowers patient satisfaction with the surgery. Recently, the adductor canal block (ACB) has been widely used in total knee arthroplasty. However, there is no definite answer as to the location of a continuous block within the ACBs.

Method:
Randomized controlled trials about relevant studies were searched in PubMed (1996 to Oct 2019), Embase (1996 to Oct 2019), and Cochrane Library (CENTRAL, Oct 2019).

Results:
Five studies involving 348 patients met the inclusion criteria. Pooled data indicated that the proximal ACB was as effective as the distal ACB in terms of total opioid consumption (P = .54), average visual analog scale (VAS) score (P = .35), worst VAS score (P = .19), block success rate (P = .86), and time of catheter insertion (P = .54).

Conclusions:
Compared with the distal ACB, the proximal ACB showed similar analgesic efficacy for total opioid consumption, average VAS score, worst VAS score, block success rate, and time of catheter insertion. However, because of the limited number of involved studies, more high-quality studies are needed to further identify the optimal location of the ACB.
Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma
Authors: Han Jie , Fan Yu-chen , Wang Kai 
Published: October 2020

Abstract

Background:
Several randomized control trials (RCTs) were conducted to compare microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) over the years. The purpose of this study was to compare the efficacy of RFA and MWA for early stage HCC.

Methods:
Studies were systematically searched on Emabse, Ovid Medline, PubMed, and Cochrane Library until March 20, 2020. Continuous variables and dichotomous variables were compared using weighted mean difference (WMD) and odds ratio (OR), respectively. For the comparison of overall survival (OS) and disease-free survival (DFS), the hazard ratio (HR) and 95% confidence interval (CI) were extracted from univariate analysis or survival plots.

Results:
A total of 26 studies (5 RCTs and 21 cohorts) with 4396 patients (2393 patients in RFA and 2003 patients in MWA) were included in our study. Of these patients, 47% received treatment under general anesthesia in the MWA group and 84% in the RFA group (OR = 0.529, P < .001). The median ablation time was reduced in the MWA group (12 minutes) compared with RFA group (29 minutes) (WMD = –15.674, P < .001). In total, 17.6% patients exhibited progression during follow-up in the MWA group compared with 19.5% in the RFA group (OR = 0.877, P = .225). No statistically significant differences were observed between MWA and RFA groups in terms of OS and DFS (HR = 0.891 and 1.014, P = .222 and .852, respectively).

Conclusions:
MWA exhibited similar therapeutic effects as RFA in the treatment of early stage HCC. Given the shorter ablation time, MWA can be performed under local anesthesia.
Dexmedetomidine-remifentanil vs propofol-remifentanil for monitored anesthesia care during hysteroscopy
Authors: Park Seongjoo , Choi Soo-Lyoen , Nahm Francis Sahngun , Ryu Jung-Hee , Do Sang-Hwan 
Published: October 2020

Abstract

Background:
Although dexmedetomidine has been used as either the anesthetic agent for light sedation or as an adjunct to other sedatives, no study has investigated the usefulness of dexmedetomidine as the main sedative agent for invasive and painful procedures. The purpose of this study was to compare the safety of dexmedetomidine-remifentanil and propofol-remifentanil during monitored anesthesia care (MAC) for hysteroscopy.

Methods:
Female patients undergoing hysteroscopy were randomly assigned to either the dexmedetomidine (group D) or the propofol group (group P). The study drug (0.6 ml/kg; dexmedetomidine 2 μg/ml or propofol 4 mg/ml) was loaded for 10 minutes followed by 0.1 to 0.5 ml/kg/hour to maintain a bispectral index of 60 to 80 during the procedure. In both groups, remifentanil was infused using a target-controlled-infusion system with a target concentration of 2 ng/ml and titrated during the procedure. The incidence rates of intraoperative respiratory depression in both groups were compared. Postoperative pain and patients satisfaction were also compared.

Results:
A total of 69 female patients were included in this study. Dexmedetomidine significantly decrease the incidence of respiratory depression compared with propofol (15/34 [44.1%] vs 5/35 [14.3%], P = .006, group P and D, respectively). Postoperative pain and patients satisfaction score did not differ between the groups.

Conclusion:
The combination of dexmedetomidine-remifentanil can reduce the incidence of respiratory depression without increasing hemodynamic complications compared with propofol-remifentanil for MAC during hysteroscopy.