bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Intensive Care Unit Diary as an Integrated Tool in an Italian General Intensive Care Unit
Authors: Iannuzzi Luigi , Villa Silvia , Vimercati Simona , Villa Marta , Pisetti Carmen Francesca , Viganò Giulia , Fumagalli Roberto , Rona Roberto , Lucchini Alberto 
Published: May 2021

Purpose
The aim of this study was to investigate the implementation of an intensive care unit (ICU) diary in an Italian general ICU.

Methods
A mixed-methods pilot study was performed, enrolling all patients who received an ICU diary in an Italian ICU during the study period.

Results
Study results are presented in 2 sections: (1) diary evaluation and content themes and (2) follow-up program results. Sixty-six patients were assessed for eligibility. Diary administration was possible in 31 patients (47%). The overall diary entries, in 31 analyzed diaries, were 1331, with a median of 25 entries (interquartile range, 16–57 entries) for each diary. Participants' relatives and friends wrote a median of 1.2 (0.3–1.6), and nurses wrote 1.1 (0.8–1.2). Other ICU staff wrote a total of 24 entries (2%). Follow-up results revealed low incidence of delirium detected in only 1 patient at the 7-day visit (3%). The median value of PTSS-10 (Post Traumatic Stress Symptoms) score was 12 (3.5–12) at the 7-day visit, 6 (1.5–12) at 3 months' telephone interview, and 12 (1.5–17) at 6 months' visit.

Conclusions
To our knowledge, this is the first Italian report about the introduction of an ICU diary. The diaries were easily implemented in our clinical practice as a “low-cost” initiative. In our study, nurses and participants' relatives and friends wrote a similar number of entries in each analyzed diary. This project could be effective in reducing survivors' delirium and post-traumatic stress disorder and in implementing mutual understanding between clinical staff and relatives during ICU stay.
Evaluation of a Novel Absorbable Mesh in a Porcine Model of Abdominal Wall Repair
Authors: Mlodinow Alexei S. , Yerneni Ketan , Hasse Michelle E. , Cruikshank Todd , Kuzycz Markian J. , Ellis Marco F. 
Published: May 2021

Background:
Bioabsorbable meshes have seen increasing clinical use to reinforce soft tissue, and exist on a spectrum of strength loss versus absorption: several retain their strength for months, but remain in situ for years. Others lose strength fully by 6 weeks. An intermediate profile, with some strength for 3 -4 months, but consistent absorption in less than a year, may be an optimal balance of near-term support and long-term safety. In this large animal study, we evaluate such a mesh (DuraSorb, SIA), assessing its utility in a porcine model of abdominal wall repair.

Methods:
Two full-thickness defects were created in the abdominal walls of nine Yucatan swine via midline approach and repaired preperitoneally with either DuraSorb or long-lasting control mesh (TIGR, Novus Scientific). At 30 days, 3 months, and 1 year, the implantations were assessed by clinical pathology, post-necropsy histopathology, and burst strength testing.

Results:
No device-associated complications were found in vivo, at necropsy, or histologically. DuraSorb was well-integrated and vascularized by 30 days. DuraSorb demonstrated minimal/mild inflammation and fibroplasia, and lower inflammatory scores when compared with TIGR at all time points (P < 0.05). Burst strength of the repair sites was higher than adjacent abdominal wall at all time points (P < 0.05).

Conclusions:
DuraSorb provided durable long-term support, minimal inflammation, and consistent absorption in this porcine model of abdominal wall repair, as compared to a long-term control. Clinical data is needed, but these results suggest that this mesh provides adequate structural support while potentially reducing long-term device reactions.
Defining Heterogeneous Cognitive Trajectories in Bipolar Disorder: A Perspective
Authors: Millett Caitlin E. , Burdick Katherine E. 
Published: May 2021

Abstract
Bipolar disorder (BD) is a highly disabling mental illness that affects approximately 1% of the global population. Cognitive capacity is a strong predictor of “everyday” functional outcome in BD and should thus be considered a key treatment target. Interventions to improve cognition have been largely unsuccessful, likely due to the substantial heterogeneity inherent to the illness. It is known that 40%–60% of people with BD have cognitive impairment, yet impairment is not “one size fits all”; in fact, the literature supports discrete cognitive subtypes in BD (e.g., intact, globally impaired, and selectively impaired). Gaining a better understanding of these cognitive subtypes, their longitudinal trajectories, and their biological underpinnings will be essential for improving patient outcomes. The prevailing hypothesis for the development of cognitive impairment in BD postulates a stepwise cumulative effect of repeated mood episodes causing wear-and-tear on the brain. However, a paucity of data supports this idea at the group level. We propose that studying heterogeneity longitudinally will allow for clearer delineation of the natural history of cognitive trajectories in BD. In sum, parsing heterogeneity in BD will allow us to identify causal mechanisms and optimize treatment at the level of the individual.
Corynebacterium Minutissimum
Authors: Vanaparthy Rachana , Greene John 
Published: May 2021

Abstract

Corynebacterium minutissimum has previously been considered a contaminant but is now increasingly being recognized as a cause of a variety of infections. Corynebacterium minutissimum is the most common causative agent of erythrasma. It has been associated with various extracutaneous manifestations, including cellulitis, meningitis, endocarditis, endophthalmitis, costochondral abscess, and peritonitis. The increasing use of intravenous access devices and a rising number of immunocompromised patients are potential contributions to this disease presentation. We report 3 cases of C. minutissimum infection in immunocompromised patients at the H. Lee Moffitt Cancer Center and Research Institute and review the literature. In such rare diseases, proper infection control guidelines, prompt prophylaxis, and treatment with antibiotics will maximize benefits in these patients.
Breast Infections With Mycobacterium goodii After Reduction Mammaplasty
Authors: Al Zoubi Moamen , Spier Addie B. 
Published: May 2021

Abstract

Mycobacterium goodii was identified in 1999 as a rapidly growing nontuberculous mycobacteria species related to the Mycobacterium smegmatis group isolated from human wound infections. Infection with this organism is exceptionally rare after breast surgery in the absence of a prosthetic implant.
The authors present a case of breast infections with M. goodii after a reduction mammaplasty.
Exploration of Geriatric Care Competencies in Registered Nurses in Hospitals
Authors: HU Fang-Wen , LEE Huan-Fang , LI Yueh-Ping 
Published: May 2021

ABSTRACT

Background
Older adults occupy one third of acute care hospital beds, and the regular duties of many nurses include caring for older patients. A working knowledge of geriatric care competencies is necessary for nurses to provide high-quality care to older patients and their families. It is unclear how nurses who work in acute care hospitals self-evaluate their geriatric care competencies and how these self-evaluated abilities differ from the objective abilities of these nurses.

Purposes
This study was designed to explore the geriatric care competencies of nurses in hospitals and to identify the factors associated with these competencies.

Methods
This was a cross-sectional study. Nurses who were employed and directly caring for patients aged 65 years and older in any of the adult wards of a medical center located in southern Taiwan were recruited as participants. A structured questionnaire was developed based on a review of the relevant literature and validated using expert consensus. This questionnaire included a demographic datasheet, knowledge of geriatric care scale, attitude of geriatric care scale, self-evaluation of geriatric care competency, and geriatric care competency test. Descriptive and inferential statistics were used to analyze the geriatric care competencies of the participants and related factors.

Results
One hundred seventy nurses were enrolled as participants. The average self-evaluation score for geriatric care competency was 67.74 (SD = 0.84). However, the average percentage of correct answers given on the geriatric care competency test was much lower (17.6%). The self-evaluation score was found to be significantly associated with job satisfaction and having received continuing education in geriatric care. In addition, age was shown to significantly affect the percentage of correct answers given on the geriatric care competency test.

Conclusions/Implications for Practice
A significant gap was found between the self-perceived and actual competencies of nurses in terms of providing geriatric care. Appropriate policies are necessary to improve the geriatric care competencies of nurses working in hospitals and to oversee the implementation of effective educational methods in Taiwan.
Gastric adenocarcinoma of fundic gland (chief cell predominant type) coexisting with well differentiated intestinal adenocarcinoma
Authors: Liu Lifeng , Han Lin , Ma Qingzhu , Zhang Jinliang 
Published: May 2021

Abstract

Rationale:
Gastric adenocarcinoma of fundic gland (chief cell predominant type) (GA-FG-CCP) is a new, rare variant of gastric adenocarcinoma, which is characterized by mild nuclear atypia and specific immunohistochemical markers.

Patient concerns:
An 84-year-old Chinese man was referred to our hospital for endoscopic resection of a gastric lesion.

Interventions:
We performed endoscopic submucosal dissection, and successfully removed the lesion.

Diagnosis:
Esophago gastroduodenoscopy showed a slightly elevated lesion with a diameter of 22 mm in the posterior wall of cardia. Magnifying endoscopy with narrow band imaging revealed an abnormal microsurface and microvessels on the tumor surface. Endoscopic ultrasonography revealed a hypoechoic mass located in the first layer. The pathological diagnosis of the biopsy specimens indicated that the tumor was high grade intraepithelial neoplasia. The pathological diagnosis differed between the superficial and deeper part of the lesion. The superficial part was composed of a tubular structure with prominent atypia and was diagnosed as well differentiated intestinal adenocarcinoma. The deeper part was composed of a well-differentiated tubular adenocarcinoma mimicking the fundic gland cells, mainly the chief cells. The tumor cells showed mild nuclear atypia and was positive for pepsinogen-I (PG-I) and mucin-6 (MUC6). This deeper part was diagnosed as GA-FG-CCP.

Outcomes:
The tumor was successfully removed. This patient had no discomfort during the follow-up period (10 months).

Lessons:
We present a rare case of GA-FG-CCP coexisted with well-differentiated tubular adenocarcinoma. GA-FG-CCP exists in the deep mucosal layer and the muscularis mucosa, which could not be found under endoscopy, but could be discerned in pathology with mild nuclear atypia and special biomarkers.
Cervical spine lateral radiograph versus whole spine lateral radiograph
Authors: Lee Dong-Ho , Park Sehan , Kim Dong Gyun , Hwang Chang Ju , Lee Choon Sung , Hwang Eui Seung , Cho Jae Hwan 
Published: May 2021

Abstract
This study is aimed to compare whole-spine lateral radiograph (WLR) and cervical lateral radiograph (CLR) in terms of T1 slope visibility and cervical sagittal parameters and to identify the superior imaging modality for assessment of cervical sagittal parameters.
We retrospectively reviewed the radiographic data of 60 consecutive adult patients (male-to-female ratio, 38:22; mean age, 55.6 ± 1.3 years) who presented with only neck pain (without radiculopathy or myelopathy). All the patients underwent standing CLR and WLR. The following parameters were measured and analyzed:
The visibility of the T1 slope was significantly lower with WLR than with CLR (28.3% vs 83.3%, P  = .049). The mean CAC2–C7 on WLR was significantly less lordotic than that on CLR (11.2 ± 9.2° vs 14.3 ± 11.3°; P = .01). The mean cSVA was translated more posteriorly on WLR than on CLR (9.9 ± 18.9 mm vs 15.0 ± 13.4 mm, P = .04). However, no significant differences in T1 slope, C7 slope, and CAC0–C2 were found between CLR and WLR.
This study shows that standing CLR could provide better visualization of the upper endplate of T1. Furthermore, WLR taken in hands on clavicle position distorted radiographic measurements such as CAC2-C7 and cSVA. Therefore, CLR performed in the standing position seems to allow more-accurate measurements of cervical sagittal parameters.
A comparison between Qigong exercise and cycle ergometer exercise for the rehabilitation of chronic obstructive pulmonary disease
Authors: Dong Xiaosheng , Wang Xiangyu , Jia Ningxin , Chen Xianhai , Ding Meng 
Published: May 2021

Abstract

Background:
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that is associated with significant morbidity and mortality. Exercise training confers health benefits to people with COPD. The purpose of this study was to compare differences in the rehabilitation of COPD between Qigong exercise (QE) and aerobic exercise using a cycle ergometer (CE).

Methods:
This study was a randomized single-blind controlled trial. Twenty six participants were recruited and randomized to either the Qigong group or the cycle ergometer group. Both interventions lasted 12 weeks and comprised a 30 minutes supervised training session performed twice a week, that is, 24 sessions in total. The primary outcome measure was the endurance capacity measured by the six-minute walk test (6MWT). The secondary outcome measures were the results of the St. George's Hospital Respiratory Questionnaire (SGRQ) and the COPD assessment test (CAT).

Results:
Participants in the group that performed aerobic exercise using a cycle ergometer had significantly improved 6MWT (P = .005), SGRQ (P = .029), and CAT (P = .018) results. Participants in the Qigong exercise group had significant changes in 6MWT (P = .033). However, the differences in 6MWT and SGRQ were not statistically significant between the 2 groups. The changes in CAT scores before and after the intervention were significantly different between the 2 groups (P = .020). There were no reports of adverse events during the course of the trial.

Conclusions:
There was no difference in the primary outcome between groups. In particular, QE and cycle ergometer exercise had similar rehabilitation effects on the improvement of the cardiopulmonary endurance and quality of life of chronic obstructive pulmonary disease patients. In addition, cycle ergometer exercise may lead to a better trend of improvement in the quality of life and can improve the severity of the clinical symptoms of chronic obstructive pulmonary disease.

Trial registration:
ChiCTR-TRC-14004404.
Diagnostic yield, safety, and advantages of ultra-low dose chest CT compared to chest radiography in early stage suspected SARS-CoV-2 pneumonia
Authors: Argentieri Gianluca , Bellesi Luca , Pagnamenta Alberto , Vanini Gianluca , Presilla Stefano , Del Grande Filippo , Marando Marco , Gianella Pietro 
Published: May 2021

Abstract
To determine the role of ultra-low dose chest computed tomography (uld CT) compared to chest radiographs in patients with laboratory-confirmed early stage SARS-CoV-2 pneumonia.
Chest radiographs and uld CT of 12 consecutive suspected SARS-CoV-2 patients performed up to 48 hours from hospital admission were reviewed by 2 radiologists. Dosimetry and descriptive statistics of both modalities were analyzed.
On uld CT, parenchymal abnormalities compatible with SARS-CoV-2 pneumonia were detected in 10/12 (83%) patients whereas on chest X-ray in, respectively, 8/12 (66%) and 5/12 (41%) patients for reader 1 and 2. The average increment of diagnostic performance of uld CT compared to chest X-ray was 29%. The average effective dose was, respectively, of 0.219 and 0.073 mSv.
Uld CT detects substantially more lung injuries in symptomatic patients with suspected early stage SARS-CoV-2 pneumonia compared to chest radiographs, with a significantly better inter-reader agreement, at the cost of a slightly higher equivalent radiation dose.
The efficacy and safety of beta-blockers versus cyanoacrylate injection for gastric variceal bleeding
Authors: Sun Yubao , Li Sheng , Li Feng 
Published: May 2021

Abstract

Background:
The benefit of beta-blockers for secondary prophylaxis of gastric variceal bleeding has limited evidence. Therefore, a systematic review and meta-analysis was conducted to systematically analyze and compare the effect of beta-blockers versus cyanoacrylate injection for patients with gastric variceal bleeding.

Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines will be followed to conduct the present meta-analysis. From the inception to June 2021, the Web of Science, EMBASE, PubMed, and Cochrane Library electronic databases will be searched using the key phrases “beta-blockers,” “cyanoacrylate,” and “gastric variceal bleeding” for all relevant English-language trials. Study included in our meta-analysis has to meet the following criteria: observational or randomized controlled trial focusing on assessing the effectiveness of beta-blockers and cyanoacrylate injection for gastric variceal bleeding; the following outcome measures are reported: bleeding from gastric variceal, overall mortality, bleed related mortality, and complications.

Results:
This study expects to provide credible and scientific evidence for the efficacy and safety of beta-blockers versus cyanoacrylate injection for patients with gastric variceal bleeding.

Registration number:
10.17605/OSF.IO/CPV9T.
First open-label, single-arm, prospective study of real-world use of FIX replacement therapy in a predominantly pediatric hemophilia B population in China
Authors: Yang Renchi , Wu Runhui , Sun Jing , Sun Feifei , Rupon Jeremy , Huard Francois , Korth-Bradley Joan M. , Xu Lihong , Luo Binyu , Liu Yingxue Cathy , Rendo Pablo 
Published: May 2021

Abstract

Background:
Nonacog alfa (recombinant factor IX [FIX]) is approved in China for the control and prevention of bleeding events in patients with hemophilia B. This was the first study to assess prophylaxis and on-demand therapy with recombinant FIX replacement in a real-world setting in China. This study aimed to evaluate the safety and efficacy of nonacog alfa in Chinese patients with hemophilia B.

Methods:
In this open-label, multicenter study (clinicaltrials.gov identifier NCT02336178), patients received on-demand or prophylactic treatment with intravenous nonacog alfa for approximately 6 months or 50 exposure days, whichever occurred first. The primary safety outcome was medically important events (i.e., development of FIX inhibitors, allergic reactions, and thrombotic events). Key secondary efficacy outcomes included the annualized bleeding rate for on-demand treatment and prophylaxis, response to on-demand treatment, the number of infusions per bleeding event, and the number of breakthrough bleeding events within 48 hours of prophylaxis.

Results:
Seventy male patients (mean [standard deviation] age 7.8 [7.2] years) were enrolled (on-demand, n = 37; prophylaxis, n = 57 [24 patients were included in both groups]). Thirty-eight (54%) patients had up to 50 FIX exposure days before the study. The only medically important event was a transient low-titer FIX inhibitor (incidence 1.4%, 95% confidence interval, 0–7.7). The mean annualized bleeding rate was 26.3 for on-demand treatment and 6.5 for prophylaxis. A mean (standard deviation) of 1.5 (1.7) nonacog alfa infusions were given per bleeding episode; 78.8% of episodes resolved with 1 infusion. Response was “excellent” or “good” for 88% of the on-demand infusions. Twenty-three bleeding events (n = 11 patients) occurred within 48 hours of 2032 prophylaxis doses (1.13%).

Conclusion:
In the real-world setting, nonacog alfa is safe and effective for on-demand treatment and for prophylaxis for patients with hemophilia B in China.
KIF4A as a novel prognostic biomarker in cholangiocarcinoma
Authors: Zhang Deng Yong , Ma Shuo Shuo , Sun Wan-liang , Lv Xue Chen Huang , Lu Zheng 
Published: May 2021

Abstract
Cholangiocarcinoma (CCA) is one of the most common malignant tumors. Although gene-targeted therapies have significantly improved the outcome of many cancers, the results are still not satisfactory for patients with CCA. Owing to the lack of an effective biomarker for guiding clinical treatment and monitoring prognosis in patients with CCA, the purpose of this study was to identify a new biomarker that could help predict the outcome of patients with CCA using bioinformatics tools.
Gene expression data were collected from three publicly available datasets, comprising 263 patients with CCA and 22 healthy controls. Differentially expressed genes were obtained using the limma package (FDR < 0.05, |Log2FC|>1), and the respective protein–protein interaction revealed five relevant genes in the STRING dataset (TOP2A, BUB1, RRM2, TYMS, and KIF4A). The immunohistochemistry and PCR were used to analyze the difference in KIF4A expression in CCA.
Kinesin Family Member 4A (KIF4A) was the only gene significantly associated with overall patient survival (P .035), with higher KIF4A expression being associated with poor survival rates. Moreover, KIF4A was significantly correlated with the infiltration of activated memory T cells (P = .0198) and activated mast cells (P = .008) in the tumor microenvironment. Increase in KIF4A expression affected the infiltration degree of the immune cells, which may be involved in the regulation of immune tolerance by CCA cells. The results indicated that the expression of KIF4A in CCA was higher than that in paracancerous tissues.
Taken together, these findings suggest that KIF4A could be a potential new biomarker in CCA for predicting the response of patients to targeted immunotherapies.
Argon plasma coagulation with atezolizumab and chemoradiation in lung pleomorphic cancer showed a remarkable response
Authors: Harada Masanori , Morikawa Keisuke , Kagoo Namio , Ito Yutaro , Kubota Tsutomu , Ichijo Koshiro , Mochizuki Eisuke , Uehara Masahiro , Matsuura Shun , Yasuda Kazuyo , Tsukui Masaru , Koshimizu Naoki 
Published: May 2021

Abstract

Rationale:
Lung pleomorphic carcinoma (LPC) is generally resistant to chemotherapy or radiotherapy. However, a combination of immune checkpoint inhibitors and radiotherapy has a remarkable efficacy against LPC.

Patient Concerns and Diagnoses:
Here, we report the case of a 50-year old man diagnosed with progressive LPC. The tumor invaded the carina and predominantly obstructed the right main bronchus; therefore, a combination of palliative chemoradiotherapy and atezolizumab was initiated. However the trachea was gradually obstructed.

Intervention and Outcome:
Argon plasma coagulation (APC) was performed to prevent tumor invasion. After three APC sessions, the tumor showed a necrotic change and was easily excised using biopsy forceps.

Lessons:
A combination of chemoradiotherapy, atezolizumab, and APC showed a good efficacy, and the patient had a good response to atezolizumab maintenance therapy. Multidisciplinary treatments, such as a combination of immune checkpoint inhibitors and APC, could have synergistic efficacy in lung cancer.