bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traditional Chinese medicine for symptoms of upper respiratory tract of COVID-19
Authors: Liang Fangqi , Dong Lei , Zhou Li , Shi Yu , Tian Li 
Published: July 2020

Abstract

Background:
Assessing the effectiveness and safety of traditional Chinese medicine (TCM) for symptoms of upper respiratory tract of coronavirus disease 2019 is the main purpose of this systematic review protocol.

Methods:
The following electronic databases will be searched from inception to Sep 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, TCM, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database (VIP database), and Wan-Fang Database. Search dates: from inception dates to June 2020. Language: English. Publication period: from inception dates to June 2020. The primary outcome is the time and rate of appearance of main symptoms (including coughing, pharyngalgia, and nasal obstruction). The secondary outcome is the length of hospital stay. Two independent reviewers will conduct the study selection, data extraction and assessment. RevMan V.5.3 will be used for the assessment of risk of bias and data synthesis.

Results:
The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:
The conclusion of our study will provide an evidence to judge whether TCM is effective and safe for the patients with symptoms of upper respiratory tract of coronavirus disease 2019.

Ethics and dissemination:
This protocol will not evaluate individual patient information or affect patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports.

PROSPERO registration number:
CRD42020187422.
Acute monocular nasal hemianopia following a mild traumatic brain injury
Authors: Lin Hsin-Le , Yen Ju-Chuan 
Published: July 2020

Abstract

Introduction:
Monocular hemianopia is a visual field defect with an uncommon pattern. The etiology of monocular temporal hemianopia has been well-evaluated and has been suggested to result from an optic nerve or chiasmal lesion. However, the etiology of monocular nasal hemianopia remains unclear.

Patient concerns:
Here, we present the case of a 41-year-old male who was punched on the head with fists during a fight and then suffered from painless blurred vision in the left eye after mild traumatic brain injury. An ophthalmic examination revealed a conjunctival chemosis, periorbital hematoma, and a relative afferent pupillary defect in the left eye. Automated perimetry indicated there was a left side nasal hemianopia along the vertical meridian.

Diagnosis:
Examination of the fundus showed there was a normal appearing retina and disc bilaterally. Fluorescein angiography revealed no delayed filling of the vessels. Computed tomography and magnetic resonance imaging showed unremarkable findings of the visual pathways, orbit, and brain. A diagnosis of left traumatic optic neuropathy was made.

Interventions:
Systemic steroid pulse therapy (1 gram of intravenous methylprednisolone per day) was given to the patient for 3 days.

Outcomes:
An ophthalmologic examination after treatment indicated there was no obvious improvement in the relative afferent pupillary defect, best corrected visual acuity, and color sense. A second set of automated perimetry results showedno changes after 3 months.

Conclusion:
Monocular nasal hemianopia caused by traumatic optic neuropathy is uncommon. In this case, monocular nasal hemianopia was likely due to ischemic changes from impairment of the prechiasmal arterial anastomotic network or indirect injury to the lateral prechiasmal nerve fiber.
Association between Vitamin B12 levels and cognitive function in the elderly Korean population
Authors: Soh Yunsoo , Lee Do Hun , Won Chang Won 
Published: July 2020

Abstract
Vitamin B12 (B12), also known as cobalamin, is a water-soluble vitamin. It is a cofactor in DNA synthesis and is involved in the metabolism of every cell of the human body, including the central nervous system. Those with a deficiency of B12 can present with peripheral neuropathy, pernicious anemia, or a cognitive disorder. Previous studies have revealed that a deficiency of B12 is associated with cognitive decline or Alzheimer disease.
The data of 2991 people were evaluated from 2 years of the Korean Frailty and Aging Cohort Study, a nationwide multicenter survey. To assess cognitive function, a short form of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was used. Of the CERAD-K tests, we included the Mini-Mental State Examination in the Korean version of the CERAD assessment packet (MMSE-KC), the word list: memory/recall/recognition, digit span (forward, backward), trail making test-A, and the frontal assessment battery. B12 concentrations were classified into clinically relevant categories, insufficient (<350 pg/mL) and sufficient (≥350 pg/mL). A linear regression analysis was used to evaluate the relationship between cognitive function and B12 levels.
The mean age of the 2991 participants was 76.4 ± 3.9 years old. Overall, 414 (13.8%) were classified as B12 insufficient, and 2577 (86.2%) as B12 sufficient. The sufficient B12 group performed better in the MMSE-KC, Wordlist: memory, Wordlist: recognition, TMT-A test, digit span, and FAB tests. This was statistically significant (P < .05). However, in the multivariable linear regression analysis, after adjusting for age, sex, education period, marriage, smoking and drinking habits, and comorbidities, the association between the B12 group and cognitive function was not statistically significant.
Although our study does not show that B12 insufficiency is a direct risk factor to cognitive decline, B12 levels could be a contributing factor to cognitive function. Our results suggest that cognition was affected by the B12 levels, along with demographic and sociological variables.
Factors associated with delayed diagnosis of infective endocarditis
Authors: Nishiguchi Sho , Nishino Koichi , Kitagawa Izumi , Tokuda Yasuharu 
Published: July 2020

Abstract
Patients with infective endocarditis (IE), have high mortality and morbidity, however, its early diagnosis is difficult. Few studies have examined the delayed diagnosis of IE. We aimed to investigate the factors associated with the diagnostic delay of IE.
A retrospective cohort study was conducted for consecutive patients diagnosed with IE in an acute care teaching hospital in Japan from April 2006 to March 2018. Time-to-diagnosis was analyzed using a multivariate Cox hazard model for determining factors associated with days required for IE diagnosis. Factors analyzed in the model included age, gender, activities of daily living, Charlson comorbidity index, presence of internal device, chief complaint, inappropriate antibiotics use, shaking chill, fever >38°C, hypoxemia, serum C-reactive protein (CRP) < 10 mg/dL, Staphylococcus aureus as causative pathogen, findings on first echocardiography, resident as a first contact physician, primary care physician as a first contact doctor, and transport measures to the clinic/hospital.
There were 145 IE patients with a mean age of 70 years and 90 were male (62.1%). The median time to the diagnosis of definite IE was 13 days and median time to consider the diagnosis of IE from first clinic/hospital visit was 6 days. The time to consider IE diagnosis was significantly delayed in patients who had inappropriate prior antibiotic use (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.01 to 2.57; P = .045), in patients without fever >38°C (HR, 1.80; 95% CI, 1.11 to 2.90; P = .016), in patients with serum CRP level < 10 mg/dL (HR, 1.53; 95% CI, 1.01 to 2.33; P = .046), and in patients who did not use an ambulance for hospital arrival (HR, 3.18; 95% CI, 1.72 to 5.85; P < .001).
Delay in considering IE diagnosis is associated with inappropriate prior antibiotics use, absence of high fever, absence of high CRP level, and use of a hospital arrival vehicle other than an ambulance. For earlier IE diagnosis, inappropriate use of antibiotics should be avoided and IE should not be excluded by relatively low level of temperature or serum CRP.
Orthopaedic Nurses' Perceptions of Preoperative Education for Total Knee Replacement
Authors: Causey-Upton Renee , Howell Dana M. , Kitzman Patrick H. , Custer Melba G. , Dressler Emily V. 
Published: July 2020

BACKGROUND:
Limited descriptions of preoperative education programs for total knee replacement (TKR) surgery are provided in the literature, and the most effective program design is currently unknown.

PURPOSE:
The purpose of this qualitative study is to describe orthopaedic nurses' perceptions of preoperative education prior to TKR surgery.

METHODS:
Ten participants completed phone interviews and transcripts were analyzed qualitatively for themes among participants.

RESULTS:
Participants believed that preoperative education was a significant component impacting patient outcomes following surgery. Interprofessional preoperative education was valued, but pragmatic factors were identified as barriers to the inclusion of other disciplines within these programs. Education programs were constantly evolving on the basis of evidence-based practice and changes to orthopaedic protocols. Pragmatic factors influenced all aspects of program design, such as the timing and length of education sessions.

CONCLUSIONS:
Results from this study provide descriptions of factors that influence program design and can be used to restructure education programs for improved patient outcomes.
Clinical and Psychosocial Factors Over Time Following an Acute Low Back Pain Episode
Authors: Salt Elizabeth , Wiggins Amanda T. , Hooker Quenten , Rayens Mary Kay 
Published: July 2020

BACKGROUND:
Low back pain (LBP) is a prevalent condition with overwhelming healthcare costs and high disability rates. Characterization of clinical and psychosocial variables over time in patients experiencing an episode of acute LBP and the identification of factors that differ between those who develop chronic LBP and those who do not could aid in the development of improved targeted treatment.

PURPOSE:
The purpose of this study was to evaluate the trajectory of depression, pain catastrophizing, life purpose, pain sensitivity, and disability in persons presenting with an acute/subacute episode of LBP, evaluating whether there are changes over time and differences in these variables between those who developed chronic LBP and those who did not.

METHODS:
Prospective analysis (baseline, 2.5 months, 6 months, and weekly diaries) of 42 patients experiencing an acute LBP episode was performed. Descriptive statistics, repeated-measures mixed modeling, and Fisher's least significant differences method were used during data analysis.

RESULTS:
Depressive symptoms vary over time. There was no difference over time in pain catastrophizing, life purpose, pain sensitivity, or disability. Those who met the criteria for chronic LBP at 6 months had increased pain catastrophizing scores and higher disability scores compared with those who do not meet the criteria for chronic LBP. Depressive symptoms, life purpose, and pain sensitivity were not different between those who met the criteria for chronic LBP and those who did not.

CONCLUSION:
Findings from this study characterize factors potentially contributory to the development of chronic LBP over time. Those participants who developed chronic LBP had higher pain catastrophizing scores averaged across all time points in this study, suggesting it could be an interesting factor to target to improve LBP chronicity.
Angiomyolipoma of the Hard Palate
Authors: Akçay Hüseyin , Adak Berat Metin 
Published: July 2020

Abstract
Angiomyolipoma (AML) is a tumor which commonly affects the kidney. Few authors have been reported AML in the oral cavity. In this clinical report, an AML of the hard palate will be presented in a 48-year-old patient. The AML contains mature adipose tissue, thick-walled blood vessels, and irregular bundle of smooth muscle. The AML is sometimes associated with tuberous sclerosis. Although the renal AMLs are often invasive, they involve regional nodes and may recur, extrarenal AMLs are commonly well demarcated, show no recurrence and may simply be removed. The AML usually behaves in a benign fashion.
Good Platelets Gone Bad: The Effects of Trauma Patient Plasma on Healthy Platelet Aggregation
Authors: Fields Alexander T. , Matthay Zachary A. , Nunez-Garcia Brenda , Matthay Ellicott C. , Bainton Roland J. , Callcut Rachael A. , Kornblith Lucy Z. 
Published: July 2020

ABSTRACT

Background:
Altered postinjury platelet behavior is recognized in the pathophysiology of trauma-induced coagulopathy (TIC), but the mechanisms remain largely undefined. Studies suggest that soluble factors released by injury may inhibit signaling pathways and induce structural changes in circulating platelets. Given this, we sought to examine the impact of treating healthy platelets with plasma from injured patients. We hypothesized that healthy platelets treated ex-vivo with plasma from injured patients with shock would impair platelet aggregation, while treatment with plasma from injured patients with significant injury burden, but without shock, would enhance platelet aggregation.

Methods:
Plasma samples were isolated from injured patients (pretransfusion) and healthy donors at a Level I trauma center and stored at −80°C. Plasma samples from four separate patients in each of the following stratified clinical groups were used: mild injury/no shock (injury severity score [ISS] 2–15, base excess [BE]>−6), mild injury/with shock (ISS 2–15, BE≤−6), severe injury/no shock (ISS>25, BE>−6), severe injury/with shock (ISS>25, BE≤−6), minimal injury (ISS 0/1, BE>−6), and healthy. Platelets were isolated from three healthy adult males and were treated with plasma for 30 min. Aggregation was stimulated with a thrombin receptor agonist and measured via multiple-electrode platelet aggregometry. Data were normalized to HEPES Tyrode's (HT) buffer-only treated platelets. Associations of plasma treatment groups with platelet aggregation measures were tested with Mann–Whitney U tests.

Results:
Platelets treated with plasma from patients with shock (regardless of degree of injury) had significantly impaired thrombin-stimulated aggregation compared with platelets treated with plasma from patients without shock (P = 0.002). Conversely, platelets treated with plasma from patients with severe injury, but without shock, had amplified thrombin-stimulated aggregation (P = 0.030).

Conclusion:
Shock-mediated soluble factors impair platelet aggregation, and tissue injury-mediated soluble factors amplify platelet aggregation. Future characterization of these soluble factors will support development of novel treatments of TIC.
Reducing bruising and pain through enhancement of subcutaneous anticoagulant injection techniques: a best practice implementation project
Authors: Neo Nicholas W.S. , Seow Paola Y.Q. , Tho Poh Chi 
Published: July 2020

ABSTRACT

Introduction:
Subcutaneous delivery of anticoagulant therapy is a common treatment modality across multiple medical disciplines. However, postinjection complications of bruising and pain continues to be a problem that has the propensity to affect patients physically and psychologically. A review of literature revealed a set of recommended injection techniques that have shown to improve these clinical outcomes.

Objectives:
The project aims to utilize an evidence implementation framework to introduce evidence-based injection technique, for the reduction of postinjection complications.

Methods:
A best practice implementation project was administered across three adult- cardiology and cardio-thoracic general wards in Singapore from March 2018 to February 2019. The Joanna Briggs Institute (JBI)'s framework of evidence implementation was utilized to enable change. A baseline audit was carried out to ascertain existing injection practices. Guided by the latest evidence, a new subcutaneous injection workflow was created and disseminated. Follow-up audits were held at 1 and 8-month postimplementation to assess compliance to the new subcutaneous injection workflow and the sustainment of change. Data were consolidated and analysed with the aid of JBI Practical Application of Clinical Evidence System. Barriers to change were also identified and addressed with the aid of JBI's Getting Research into Practice tool.

Results:
A large variation of subcutaneous injection techniques was observed at the baseline audit. At 1-month postimplementation, overall compliance with the new subcutaneous injection workflow was assessed to be 73.3%. Criteria 2 and 3 of the JBI Practical Application of Clinical Evidence System audit criteria improved from the baseline values (9.1–80%; 0–93.3%). At 8-month postimplementation, compliance rate remained high (83%) following strategies to reinforce and sustain change. Participants complied to Criteria 1 at all stages of the project. Correspondingly, the incidence of bruising reduced from baseline, with a relative risk reduction of 52% (1 month) and 29% (8 months). Median pain also decreased from the baseline, with an improvement from 2.0 (1.0–3.0) to 0.0 (0.0–1.0).

Conclusion:
Introduction and sustainment of change requires careful planning and execution. JBI's framework of evidence implementation is an effective model to guide this process. This project also highlighted the value of continuous learning, clinical update and practice standardization. This is especially important in the current climate of nursing mobility worldwide and the associated practice variations based on nursing education and experience.
Assessing the quality of the evidence underlying recommendations in type 2 diabetes’ commonly used clinical practice guidelines
Authors: Enchev-Hristov Enrik , Esteve-Serra Mariona , Reyes-Céspedes Luz Maria , Barahona-San Millán Rebeca , Recasens-Sala Mònica , Sojo-Vega Lidia , Costa-Lima Elisabet , Fernández-Real José Manuel , Ricart-Engel Wifredo , Fernández-Balsells Mercè 
Published: July 2020

ABSTRACT

Aim:
In a world of data overload, clinical practice recommendations are needed to help practitioners and patients to take evidence-based decisions. However, in the field of type 2 diabetes mellitus (T2DM) recommendations on glycemic goals and treatment choice are controversial in spite of being supported by a common body of evidence. We hypothesize that internal and external validity of this body of evidence might not be as sound as expected. The aim of the current study is to appraise the studies supporting recommendations developed by influential medical societies dealing with glycemic goals and the choice of pharmacological treatment in adults with T2DM.

Methods:
Clinical practice recommendations and their references were extracted out of eight documents developed by influential scientific societies between 2016 and 2019. Internal and external validity of each study was then appraised with standard tools and in duplicate.

Results:
A total of 114 recommendations and their underlying 233 citations were extracted. Out of these 233 citations 81 (35%) corresponded to randomized controlled trials (RCT) and 45 (20%) to systematic reviews. After systematical appraisal only four RCT (5%) and eight systematic reviews (17%) were considered to be unflawed. Indirectness (lack of generalizability) was the most common caveat identified in RCTs. Out of the 114 recommendations analyzed (32 dealing with glycemic goals and 82 with treatment choice), only 21 (18.4%) were supported by at least one high-quality study.

Conclusion:
Only one in five recommendations regarding glycemic goals or pharmacological treatment choice in T2DM is based on at least one high-quality study. Clinical practice recommendations dealing with areas of uncertainty should be formulated more transparently to enable real evidence-based decisions.
Time between Symptom Onset, Hospitalisation and Recovery or Death: a Statistical Analysis of Different Time-Delay Distributions in Belgian COVID-19 Patients
Authors: Faes C. , Abrams S. , Van Beckhoven D. , Meyfroidt G. , Vlieghe E. , Hens N. 
Published: July 2020

AbstractBackgroundThere are different patterns in the COVID-19 outbreak in the general population and amongst nursing home patients. Different age-groups are also impacted differently. However, it remains unclear whether the time from symptom onset to diagnosis and hospitalization or the length of stay in the hospital is different for different age groups, gender, residence place or whether it is time dependent.MethodsSciensano, the Belgian Scientific Institute of Public Health, collected information on hospitalized patients with COVID-19 hospital admissions from 114 participating hospitals in Belgium. Between March 14, 2020 and June 12, 2020, a total of 14,618 COVID-19 patients were registered. The time of symptom onset, time of COVID-19 diagnosis, time of hospitalization, time of recovery or death, and length of stay in intensive care are recorded. The distributions of these different event times for different age groups are estimated accounting for interval censoring and right truncation in the observed data.ResultsThe truncated and interval-censored Weibull regression model is the best model for the time between symptom onset and diagnosis/hospitalization best, whereas the length of stay in hospital is best described by a truncated and interval-censored lognormal regression model.ConclusionsThe time between symptom onset and hospitalization and between symptom onset and diagnosis are very similar, with median length between symptom onset and hospitalization ranging between 3 and 10.4 days, depending on the age of the patient and whether or not the patient lives in a nursing home. Patients coming from a nursing home facility have a slightly prolonged time between symptom onset and hospitalization (i.e., 2 days). The longest delay time is observed in the age group 20-60 years old. The time from symptom onset to diagnosis follows the same trend, but on average is one day longer as compared to the time to hospitalization. The median length of stay in hospital varies between 3 and 10.4 days, with the length of stay increasing with age. However, a difference is observed between patients that recover and patients that die. While the hospital length of stay for patients that recover increases with age, we observe the longest time between hospitalization and death in the age group 20-60. And, while the hospital length of stay for patients that recover is shorter for patients living in a nursing home, the time from hospitalization to death is longer for these patients. But, over the course of the first wave, the length of stay has decreased, with a decrease in median length of stay of around 2 days.