bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Emergency Access to Human Immunodeficiency Virus Prophylaxis for Patients Evaluated After Sexual Assault
Authors: Saadatzadeh Tirajeh , Salas Natalie M. , Walraven Carla , Sarangarm Preeyaporn , Crandall Cameron S. , Crook Joy , Sarangarm Dusadee , Yaple Charles , Stafford Amanda , Wilson Christopher G. , Page Kimberly , Carvour Martha L. 
Published: March 2020

ABSTRACT

Introduction:
Patients evaluated after sexual assault may benefit from nonoccupational postexposure prophylaxis (nPEP) to prevent infection with HIV, yet multiple barriers may prohibit nPEP delivery. The IN-STEP (Integrating nPEP after Sexual Trauma in Emergency Practice) project was designed to improve access to HIV screening and prevention for patients evaluated in the emergency department (ED) of our academic hospital after a sexual assault.

Methods:
The IN-STEP team identified and addressed four key areas for improvement: (1) training of ED providers to perform nPEP assessments; (2) access to HIV testing in the ED; (3) provision of nPEP medications, using a patient-centered approach; and (4) continuity of care between the ED and follow-up sites in the community. Improvements were implemented using parallel plan-do-study-act cycles corresponding to these four key areas.

Results:
IN-STEP resulted in significant systems improvements in HIV screening, prevention, and continuity of care. This program not only improved the care of patients affected by sexual assault but also those evaluated for HIV due to other indications.

Conclusions:
Involvement of a multidisciplinary leadership team, clear delineation of a patient-centered project focus, and coordination across four parallel areas for improvement were useful for completing this complex effort.
Developing a screening tool to identify harmful sibling aggression in a primary care setting
Authors: Hudson Gregory R. , Bowie Bonnie H. 
Published: March 2020

ABSTRACT

Background:
Despite the possibility of adversely affecting the mental health of children, sibling aggression, the most common form of family violence, is often dismissed as normal or less harmful than other types of violence. Currently, there is no easily administered screening method for sibling aggression.

Purpose:
The goal of this project was to develop and test a brief sibling aggression screening tool for use in pediatric primary care.

Methods:
The project was implemented in four phases: phase I reviewed the literature for adolescent and child aggression screening tools and to create a draft for expert content analysis. Phase II used a focus group of family mental health providers to modify draft items for the screening tool (N = 5). In phase III, the first draft of a screening tool was critiqued by individual pediatric providers (N = 8) for clarity and feasibility of use in pediatric primary care. In phase IV, the screening tool was piloted by one provider in pediatric clinical practice, who used the tool with six children over 3 weeks.

Results:
All providers in phase II (N = 13) identified sibling aggression as an underassessed area of pediatric care. All providers in phase III found the revised questions to be clearly stated and child friendly; 75% (N = 6) agreed they could incorporate the questions into their current assessment, 25% disagreed citing limited time and resources. Pilot testing with six children demonstrated feasibility for use in pediatric primary care.

Implications for practice:
Utilization of a brief screening tool to assess for sibling aggression may help providers to identify and therapeutically respond to the most common type of childhood violence.
ABCA3 mutations in adult pulmonary fibrosis patients: a case series and review of literature
Authors: Klay Dymph , Platenburg Mark G.J.P. , van Rijswijk Rein H.N.A.J. , Grutters Jan C. , van Moorsel Coline H.M. 
Published: March 2020

Purpose of review
The current review aims to recognize the variability in clinical presentation of adult patients with bi-allelic ABCA3 mutations, create more depth in ABCA3 mutations reported and highlight the influence of environmental factors on disease course.

Recent findings
Mutations in ABCA3 are predominantly linked to neonatal and pediatric interstitial lung disease (ILD) with a minority surviving beyond puberty. Here, we present three patients with ABCA3 mutations who present with disease at the age of 19, 61 and 77. Moreover, we identified c.4451G>C (p.R1484P), c.1675G>A (p.G559R) and c.4745C>G (p.T1582S) as three novel ABCA3 mutations. In addition, we identified six additional patients with ABCA3 mutations in literature who reached an age above 18. Furthermore, we discuss the influence of infections, drugs and smoking on disease course.

Summary
Although extremely rare, patients with bi-allelic mutations in ABCA3 may present at adulthood. Late onset of disease may be influenced by type of mutation or environmental factors.
Analysis on plausible factors related to the prognosis of stage IV esophageal cancer
Authors: Li Chenghui , Wang Zhiqiu , Duan Aixiong , Jiang Qian 
Published: March 2020

Abstract
To investigate factors related to poor prognosis of patients with stage IV esophageal cancer and to provide some bases on which proper therapeutic schemes could be formulated for stage IV esophageal cancer patients with performance status (PS) score between 0 and 2.
Clinical data of 60 patients with stage IV esophageal cancer were retrospectively analyzed, and the relationships of clinical characteristics and therapeutic methods with patients’ prognosis were explored. Univariate analysis on factors possibly affecting the prognosis of patients with stage IV esophageal cancer was performed using Log-rank test, and independent risk factors for the prognosis were estimated in multivariate Cox regression analysis through embracing variables which showed statistical significance in univariate analyses.
According to univariate analysis results, nutritional status, anemia, therapeutic method, esophageal stent, and visceral metastasis were main influencing factors for the prognosis of stage IV esophageal cancer (P < .05). While in multivariate Cox regression analysis, visceral metastasis was revealed to be an independent risk factor for poor prognosis in patients with stage IV esophageal cancer.
Visceral metastasis is an independent risk factor for poor prognosis in patients with stage IV esophageal cancer. Optimizing therapeutic modes according to with or without combined visceral metastasis possesses certain clinical significance in prolonging survival time and in improving the quality of life among patients with stage IV esophageal cancer.
Expression of SREBP2 and cholesterol metabolism related genes in TCGA glioma cohorts
Authors: Li Dali , Li Shenglan , Xue Allen Z. , Smith Callahan Laura A. , Liu Ying 
Published: March 2020

Abstract
Diffuse gliomas are the most common primary brain tumors. The Cancer Genome Atlas (TCGA) database provides correlative evidence between altered molecular pathways and gliomas. Dysregulated cholesterol homeostasis emerges as a potential indicator of the pathogenesis of gliomas.
Mining large cohorts from the TCGA together with database from the Chinese Glioma Genome Atlas (CGGA) for confirmation, we compared gene expression of cholesterol synthesis master regulator SREBP2 and its regulatory networks in low grade glioma (LGG) and glioblastoma (GBM).
Our analysis shows that expression of SREBP2 and related genes is lower in GBM than in LGG, indicating that cholesterol metabolism processes, including de novo synthesis, cholesterol uptakes, and cholesterol conversion and efflux, are suppressed in GBM.
Overall, our data suggests that SREBP2 transcript could serve as a potential prognosis marker or therapeutic target in diffuse glioma including GBM.
The effectiveness and safety of acupuncture in the treatment of lumbar disc herniation
Authors: Deng Rong , Huang ZiLing , Li Xun , Pei XingHong , Li ChengXi , Zhao JianXin 
Published: March 2020

Abstract

Background:
Lumbar disc herniation (LDH) is a common disease that seriously affects patients’ quality of life. Although several articles have reported that acupuncture can improve the symptoms of LDH, different guidelines do not evaluate the efficacy of acupuncture consistently, new randomized controlled trials have been published in recent years.
The purpose of this study is to evaluate the efficacy and safety of acupuncture for LDH.

Method:
Electronic resource databases, trial registration platform, and different types of grey literature will be systematically searched for eligible studies by 2 authors independently. The type of trial will be limited to randomized controlled trials on acupuncture treatment for LDH. Search strategy will be a combination of terms associated with LDH (eg, low back pain or sciatica) and study of design (eg, randomized controlled trials or clinical trial). Data from homogeneous studies will be combined in a fixed-effects model, and the evidence level will be measured by grading of recommendations assessment, development, and evaluation.

Results:
This study will provide high-quality evidence to evaluate the relief of pain intensity and improvement of dysfunction of acupuncture in patients with LDH, and to evaluate the safety of acupuncture.

Conclusion:
This study will provide strong evidence for evaluating whether acupuncture therapy is effective and safe for LDH patients.

PROSPERO registration number:
CRD 42019137399.
Effect of continuous positive airway pressure (CPAP) on mild-moderate obstructive sleep apnea (OSA) related dreaminess
Authors: Xue Pei , Zhou Junying , Lei Fei , Tan Lu , Li Xiao , Tang Xiangdong 
Published: March 2020

Abstract

Introduction:
Dreaminess is one of the common symptoms of sleep disorders and often leads to complaint of poor sleep quality and morning fatigue. Literatures on the relationship between obstructive sleep apnea (OSA) and dreams have been reported with contradictory results. In this case report, we identified a moderate OSA related dreaminess that was successfully treated by continuous positive airway pressure (CPAP).

Patient concerns:
We present a case of a 47-year-old woman who was bothered by all-night dreaminess for over 20 years.

Diagnosis:
An overnight polysomnography (PSG) examination showed the apnea-hypopnea index (AHI) was 21.7 events/hour and the rapid eye movement (REM)-AHI was 46.3 events/hour. The patient was diagnosed with moderate OSA.

Interventions:
The patient received auto CPAP therapy.

Outcomes:
The symptoms of dreaminess and daytime functioning significantly improved after CPAP treatment. During the 4-month follow up, 3 CPAP titrations showed that OSA events and OSA related REM interruption almost disappeared. On the night of PSG diagnosis, only 1 non-rapid eye movement sleep 3 (N3) episode occurred before the first REM episode. Nevertheless, N3 episodes were observed before the majority of REM episodes on all three nights of CPAP titration.

Conclusion:
This case suggests that specific REM related OSA could be the main reason for dreaminess symptoms and could be successfully treated by CPAP. The identification of OSA, especially for mild-moderate OSA, has not received enough attention in the management of complaints of dissatisfactory sleep issues. We believe this case has educational value in clinical practice.
Impact of mobile phone text messaging intervention on adherence among patients with diabetes in a rural setting
Authors: Owolabi Eyitayo Omolara , Goon Daniel Ter , Ajayi Anthony Idowu 
Published: March 2020

Abstract

Background:
Nonadherence to prescribed therapy is a significant challenge at the primary healthcare level of South Africa. There are documented evidence of the potential impact of mobile health technology in improving adherence and compliance to treatment. This study assessed the effect of unidirectional text messaging on adherence to dietary and activity regimens among adults living with diabetes in a rural setting of Eastern Cape, South Africa.

Methods:
This was a 2-arm, multicenter, parallel, randomized controlled trial, involving a total of 216 patients with diabetes with uncontrolled glycemic status randomly assigned into the intervention (n = 108) and the control group (n = 108). Participants in the intervention arm received daily educational text messages on diabetes and reminders for 6 months, while the control arm continued with standard care only. A validated, self-developed adherence scale was used to assess participants’ adherence to diets and physical activity. Descriptive statistics and linear regression were used to assess changes in adherence and the effect of the intervention on adherence to therapy.

Results:
On a scale of 8, the mean medication adherence level for the intervention group was 6.90 (SD ± 1.34) while that of the control group was 6.87 (SD ± 1.32) with no statistical difference (P = .88). The adjusted mean change in the medication adherence level was 0.02 (−0.33 to 0.43) with no significant difference (P = .79). There was however a low level of adherence to dietary recommendations (1.52 ± 1.62), and physical activity (1.48 ± 1.58) at baseline, and both groups demonstrated a nonsignificant increase in dietary (P = .98) and physical activity adherence (P = .99) from baseline to the follow-up period.

Conclusion:
There is a moderate level of adherence to medication and a low level of adherence to dietary and physical activity recommendation in this setting. The text messaging intervention did not bring about any significant improvement in medication, dietary and physical activity adherence levels. There is a need to design effective strategies for improving adherence to recommended lifestyle changes in this setting.
Clinical effects of Shou-Wu Jiang-Qi Decoction combined acupuncture on the treatment of Polycystic Ovarian Syndrome with kidney deficiency, phlegm and blood stasisness
Authors: Xu Wenting , Tang Mengyu , Wang Jiahui , Wang Lihong 
Published: March 2020

Abstract

Background:
Polycystic ovary syndrome (PCOS) is a female endocrine disease with a high incidence. At present, drug treatment is still the main therapeutic strategy for PCOS. Traditional Chinese medicine has a long history in the treatment of menstrual disorders. Shouwu Jiangqi Decoction (SWJQD) is a traditional herbal medicine prescribed in a clinical setting as a remedy for PCOS. Acupuncture also plays an important role in regulating the menstrual cycle and treating PCOS. This study aims to examine the efficacy and safety of the combination of SWJQD and acupuncture in the treatment of PCOS.

Methods:
This randomized controlled trial will be conducted with a total of 81 participants diagnosed with PCOS. The participants will be randomly divided into 3 treatment groups: group A will receive SWJQD combined with acupuncture; group B, SWJQD combined with sham acupuncture; and group C, metformin. Each treatment will last 3 months. The primary outcomes include the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index and the Oral Glucose Tolerance Test. The secondary outcome measures include sex hormone levels, body mass index, ovulation rate, clinical pregnancy rate, and complete genome sequencing data. Adverse events will be recorded during the intervention and follow-up.

Results:
This study will investigate whether the combination of SWJQD and acupuncture can alleviate the clinical symptoms and improve insulin resistance in patients with PCOS. The results of this study are expected to provide clinical evidence for the application of the combination of SWJQD and acupuncture in patients with PCOS.

Trial registration:
Chinese Clinical Trial Registry: ChiCTR1900028106, ChiMCT1900002826 (registered on December 12, 2019).
Physical Exercise following bariatric surgery in women with Morbid obesity
Authors: Soriano-Maldonado Alberto , Martínez-Forte Sonia , Ferrer-Márquez Manuel , Martínez-Rosales Elena , Hernández-Martínez Alba , Carretero-Ruiz Alejandro , Villa-González Emilio , Barranco-Ruiz Yaira , Rodríguez-Pérez Manuel A. , Torrente-Sánchez María José , Carmona-Rodríguez Lorena , Soriano-Maldonado Pablo , Vargas-Hitos José A. , Casimiro-Andújar Antonio J. , Artero Enrique G. , Fernández-Alonso Ana M. 
Published: March 2020

Abstract

Background:
Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life.

Methods:
This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured.

Discussion:
This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery.

Trial registration number:
ISRCTN registry (ISRCTN27697878).
Sex-specific association of hyperuricemia with cardiometabolic abnormalities in a military cohort
Authors: Lin Yu-Kai , Lin Yen-Po , Lee Jiunn-Tay , Lin Chin-Sheng , Wu Tsung-Jui , Tsai Kun-Zhe , Su Fang-Ying , Kwon Younghoon , Hoshide Satoshi , Lin Gen-Min 
Published: March 2020

Abstract
Hyperuricemia has been associated with metabolic syndrome, and the association with various cardiometabolic risk factors may be affected by sex.
We made a cross-sectional examination in a military cohort of 6738 men and 766 women, aged 18 to 50 years of Taiwan in 2013 to 2014. Hyperuricemia were defined as serum uric acid levels ≥7.0 mg/dL for men and ≥5.7 mg/dL for women, respectively. Multivariable logistic regression analyses were used to determine the associations between hyperuricemia and various metabolic abnormalities.
In the overall population, hyperuricemia was associated with high blood pressure (odds ratio [OR]: 1.59, and 95% confidence intervals: 1.42–1.77), low high-density lipoprotein (OR: 1.75, 1.56–1.97), high triglycerides (OR: 2.14, 1.90–2.42), high low-density lipoprotein (OR: 1.71, 1.51–1.93), high fasting plasma glucose (OR: 1.29, 1.13–1.48), and central obesity (OR: 2.85, 2.55–3.18) after adjusting for age and serum creatinine concentrations. However, the associations with atherogenic lipid profiles including high triglycerides and high low-density lipoprotein were merely significant in men but not in women. In addition, there was a tendency for a sex difference in the association of hyperuricemia and raised blood pressure ≥130/85 mm Hg, which was greater in women than that in men (OR: 2.92, 1.37–6.25 and 1.54, 1.37–1.72, respectively; P for interaction = .059).
Our findings suggest that the association between hyperuricemia and various cardiometabolic abnormalities in young adults may differ by sex, possibly due to a regulation of sex hormones and uneven effects of uric acid at the same levels between sexes on lipid metabolisms and arterial stiffness.
Nationwide cohort study of outcomes of acute myocardial infarction in patients with liver cirrhosis
Authors: Wu Victor Chien-Chia , Chen Shao-Wei , Chou An-Hsun , Wu Michael , Ting Pei-Chi , Chang Shang-Hung , Wang Chao-Yung , Lin Ming-Shyan , Hung Kuo-Chun , Hsieh I-Chang , Chu Pao-Hsien , Wu Cheng-Shyong , Lin Yu-Sheng 
Published: March 2020

Abstract
Liver cirrhotic predisposes patients to coagulopathy and bleeding. Little is known about outcomes of acute myocardial infarction (AMI) in cirrhotic patients.
Data from Taiwan National Health Insurance Research Database during 2001 to 2013 were retrieved for patients admitted with cirrhosis and AMI. We excluded patients with missing information, <20 years old, previous AMI, previous coronary intervention, and liver transplant. Patients were separated into cirrhotic and non-cirrhotic. Primary outcomes included all-cause mortality, recurrent myocardial infarction (MI), major cardiac and cerebrovascular events (MACCE: recurrent MI, revascularization, ischemic stroke, and heart failure), and liver outcomes (hepatic encephalopathy, ascites tapping, spontaneous peritonitis, and esophageal varices bleeding).
A total of 3217 cirrhotic patients and 6434 non-cirrhotic patients were analyzed, with a mean follow up of 2.8 ± 3.3 years. In cirrhotic patients with AMI, subsequent coronary and cerebrovascular events were lower in comparison to non-cirrhotic patients, with higher all-cause mortality observed from adverse liver related outcomes and bleeding. There were significantly lower cumulative incidence of both recurrent MI and MACCE in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (hazard ratio [HR] 0.82, confidence interval [CI] 0.71–0.94, P = .006 and HR 0.86, 95% CI 0.79–0.92, P < .001, respectively). There was significantly higher cumulative incidence of liver related outcome in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 2.27, 95% CI 2.06–2.51, P < .001). And there was significantly higher all-cause mortality in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 1.30, 95% CI 1.23–1.38, P < .001).
In cirrhotic cohort with AMI, a decreased in coronary and cerebrovascular events were observed. However, these patients also had higher all-cause mortality due to adverse liver outcomes and bleeding.