bluuebunny/crossref_metadata_2025_split huggingface dataset:
A core outcome set for genitourinary symptoms associated with menopause: the COMMA (Core Outcomes in Menopause) global initiative
Authors: Lensen Sarah , Bell Robin J. , Carpenter Janet S. , Christmas Monica , Davis Susan R. , Giblin Karen , Goldstein Steven R. , Hillard Tim , Hunter Myra S. , Iliodromiti Stamatina , Jaisamrarn Unnop , Khandelwal Sunila , Kiesel Ludwig , Kim Bobae V. , Lumsden Mary Ann , Maki Pauline M. , Mitchell Caroline M. , Nappi Rossella E. , Niederberger Craig , Panay Nick , Roberts Helen , Shifren Jan , Simon James A. , Stute Petra , Vincent Amanda , Wolfman Wendy , Hickey Martha 
Published: May 2021

Abstract

Objective:
Genitourinary symptoms, such as vaginal dryness and pain with sex, are commonly experienced by postmenopausal women. Comparing treatments for these genitourinary symptoms are restricted by the use of different outcome measures in clinical trials and the omission of outcomes, which may be relevant to women. The aim of this project was to develop a Core Outcome Set (COS) to be reported in clinical trials of treatments for genitourinary symptoms associated with menopause.

Methods:
We performed a systematic review of randomized controlled trials of treatments for genitourinary symptoms associated with menopause and extracted their outcomes. This list was refined and entered into a two-round modified Delphi survey, which was open to clinicians, researchers, and postmenopausal women from November 2019 to March 2020. Outcomes were scored on a nine-point scale from “not important” to “critically important.” The final COS was determined following two international consensus meetings.

Results:
A total of 26 unique outcomes were included in the Delphi process, which was completed by 227 participants of whom 58% were postmenopausal women, 34% clinicians, and 8% researchers. Predefined thresholds were applied to the Delphi scores to categorize outcomes by importance, which informed the e consensus meetings, attended by 43 participants from 21 countries. The final COS includes eight outcomes: (1) pain with sex, (2) vulvovaginal dryness, (3) vulvovaginal discomfort or irritation, (4) discomfort or pain when urinating, (5) change in most bothersome symptom, (6) distress, bother or interference of genitourinary symptoms, (7) satisfaction with treatment, (8) side effects of treatment.

Conclusion:
These eight core outcomes reflect the joint priorities of postmenopausal women, clinicians, and researchers internationally. Standardized collection and reporting of these outcomes in clinical trials will facilitate the comparison of different treatments for genitourinary symptoms, advance clinical practice, and ultimately improve outcomes for symptomatic women.

Video Summary:

http://links.lww.com/MENO/A765.
Trends in cause-related comorbidities in hospitalized patients with secondary hypertension in China from 2013 to 2016: a retrospective analysis of hospital quality monitoring system data
Authors: Zhang Long , Li Jianping , Li Nanfang , Sun Ningling , Xie Liangdi , Han Qinghua , Li Yong , Lu Xin Zheng , Sun Pengfei , Li Yuxi , Shi Ying , Wang Haibo , Zhang Yan , Chen Hu , Huo Yong 
Published: May 2021

Background:
Secondary hypertension has emerged as a major public health problem in China. Early diagnosis and treatment can significantly improve the clinical outcomes. However, data on the current cause composition in China are seldom reported.

Objective:
To describe the trends in cause-related comorbidities in hospitalized patients with secondary hypertension in China from 2013 to 2016.

Methods:
This was a retrospective analysis based on the national Hospital Quality Monitoring System (HQMS) database, which collects information from the front pages of in-hospital medical records. Hospitalized patients with secondary hypertension from 746 tertiary hospitals that consistently uploaded data to the HQMS from 2013 to 2016 were enrolled. All diagnoses were identified using International Classification of Diseases version 10 (ICD-10) diagnostic codes. Descriptive analyses were used to determine the proportions of secondary hypertension causes and changing trends over 4 years.

Result:
The study collected data on 402 371 hospitalized patients with secondary hypertension from the HQMS during 2013–2016. Secondary hypertension caused by renal parenchymal disease ranked first and accounted for more than 50%. Obstructive sleep apnea syndrome (OSAS) followed closely with a rate of approximately 25%. Primary aldosteronism presented the highest proportion among all causes of endocrine hypertension. Regarding longitudinal changes over time, the rates of renal hypertension showed a significant downward trend from 2013 to 2016 (P < 0.001). In contrast, OSAS, endocrine hypertension, renal vascular disease, and aorta diseases maintained a significant upward trend from 2013 to 2016 (P < 0.001). The rates of these diseases in women with common secondary hypertension was higher than that of men, except in patients with OSAS (P < 0.001). In addition, renal parenchymal diseases and renal vascular diseases gradually decreased with age, whereas OSAS and aortic diseases gradually increased with age. The proportion of endocrine hypertension in the middle-aged group was higher than the other two age groups.

Conclusion:
The study provides important information on the changing trends of cause rate of secondary hypertension modified by age and sex in China during 2013–2016. Renal parenchymal disease is still the most common cause of secondary hypertension with a decreasing trend, followed by OSAS with an increasing trend.
Evaluating Ineffective Treatments: A Proposed Model for Discussing Futility in Psychiatric Illness
Authors: Coulter Andrew , Schuermeyer Isabel , Sola Christopher 
Published: May 2021

Abstract

Background
Treatment futility and terminality discussions arise rarely in psychiatric practice, frequently instilling apprehension, as there is little written that defines these terms in relation to mental illness. It therefore remains uncertain how to deal with cases that are refractory to multimodal interventions and that demonstrate limited improvement or even a worsening trajectory. Any viable solution needs to respect patient autonomy and maintain both beneficence and nonmaleficence, while taking into account the strained resources of the mental health care system as a whole.

Objective
This article reviews historical conflicts surrounding the notion of futility in psychiatric disorders, and proposes and elaborates a set of six criteria that psychiatrists can use in working through these difficult cases. Given the potential controversy involving futility in psychiatry, it proves helpful to understand its similarity to the notion of futility in standard medical contexts. This article also works through some of the common concerns or objections regarding the application of futility in psychiatric contexts.

Conclusions
Futility in psychiatric illness is a concept that the psychiatric community needs to understand and address, given the limited treatment options available to our field, as well as the limitations of health care resources. The proposed framework allows for ethically appropriate treatment decisions for treatment-resistant patients—respecting their individual wishes while ensuring appropriate care.
FAMILIAL EXUDATIVE VITREOTINOPATHY–LIKE FEATURES IN STICKLER TYPE IV ASSOCIATED WITH NOVEL VARIANTS IN COL9A1
Authors: Alsubaie Hamad F. , Magliyah Moustafa S. , AlRaddadi Osama , AlZaid Abdulrahman , Nowilaty Sawsan R. 
Published: May 2021

Background/Purpose:
To report a case of Stickler Type IV with familial exudative vitreoretinopathy phenotype.

Methods:
Retrospective case report.

Results:
A 24-year-old woman presented with right eye exotropia and decreased vision. She had no facial or typical retinal features of Stickler syndrome but complained of right-sided hearing loss and right-sided neck pain. Examination of the right eye showed a chronic combined exudative and traction retinal detachment with temporal retinal dragging associated with far temporal retinal exudations and fibrovascular proliferations. The left eye had an attached retina with large areas of peripheral temporal retinal nonperfusion on fluorescein angiography, sharply demarcated by end circulation vascular pruning and mild peripheral vascular leakage, consistent with familial exudative vitreoretinopathy phenotype. Genetic analysis identified two heterozygous c.1052C>A and c.1349A>G variants in COL9A1, but did not disclose any mutation in genes classically associated with familial exudative vitreoretinopathy.

Conclusion:
Familial exudative vitreoretinopathy–like retinal vascular features can be the presenting sign in patients with Stickler syndrome Type IV.
Challenges in management of the Boston Keratoprosthesis Type 1
Authors: Koo Ellen H. , Hannush Sadeer B. 
Published: May 2021

Purpose of review
The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain.

Recent findings
The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to identify diagnoses and indications that can lead to more favorable results with the Boston Keratoprosthesis Type I device.

Summary
The Boston Keratoprosthesis Type I device continues to play a vital role in visual rehabilitation for eyes with very low chance of realistic allograft survival -- such as in eyes where corneal grafting is considered high-risk: eyes with corneal limbal stem cell failure, extensive deep corneal stromal neovascularization, and multiple allograft failures. This review article summarizes the perioperative and postoperative challenges, as well as other considerations associated with the device.
Association Between the “COVID-19 Occupational Vulnerability Index” and COVID-19 Severity and Sequelae Among Hospital Employees
Authors: Navarro-Font Xavier , Kales Stefanos N. , Vicente-Herrero Ma Teófila , Rueda-Garrido Juan Carlos , del Campo Ma Teresa , Reinoso-Barbero Luis , Fernandez-Montero Alejandro 
Published: May 2021

Objectives:
In addition to personal and health related factors, healthcare workers have an increased risk due to their work. We assessed the association of the score of the Occupational Vulnerability Index with the risk of suffering a severe COVID-19 and sequelae.

Methods:
Retrospective observational study carried out in healthcare workers. Among 119 employees infected, the COVID-19 Occupational Vulnerability Index (composed of 29 items regarding personal health, working conditions, and ability to comply with preventive measures) was calculated and correlated with COVID-19 severity/sequelae.

Results:
Workers with higher scores (six to seven points) had a significantly increased risk of developing severe disease (OR = 9.73; 95% CI, 1.53 to 35.56) and clinical sequelae (OR = 5.22; 95% CI, 1.80 to 15.16) than those with lower scores (0 to 3).

Conclusion:
The “COVID-19 Occupational Vulnerability Index” may predict the risk of severe COVID-19 disease and clinical sequelae among healthcare workers.
Carb-conscious: the role of carbohydrate intake in recovery from exercise
Authors: Gonzalez Javier T. , Wallis Gareth A. 
Published: May 2021

Purpose of review
The present review summarized evidence on the role of carbohydrates in recovery from exercise within the context of acute and chronic effects on metabolism and performance.

Recent findings
Recent studies demonstrate that, in contrast to recovery of muscle glycogen stores, the recovery of liver glycogen stores can be accelerated by the co-ingestion of fructose with glucose-based carbohydrates. Three recent studies suggest this can extend time-to-exhaustion during endurance exercise tests. However, periodically restricting carbohydrate intakes during recovery from some training sessions to slow the recovery of liver and muscle glycogen stores may, over time, result in a modest increase in the ability to oxidize fat during exercise in a fasted state. Whether this periodized strategy translates into a performance advantage in the fed state remains to be clearly demonstrated.

Summary
To maximize recovery of glycogen stores and the capacity to perform in subsequent endurance exercise, athletes should consider ingesting at least 1.2 g carbohydrate per kilogram body mass per hour – for the first few hours of recovery – as a mixture of fructose and glucose-based carbohydrates. However, if a goal is increased capacity for fat oxidation, athletes should consider restricting carbohydrate intakes during recovery from some key training sessions.

Video abstract

http://links.lww.com/COCN/A15
Robotic bronchoscopy for peripheral pulmonary lesions: a convergence of technologies
Authors: Lin Julie , Ost David E. 
Published: May 2021

Purpose of review
Robotic bronchoscopy is the newest advanced diagnostic bronchoscopy technology for biopsying peripheral pulmonary lesions; sensitivity for malignancy is currently suboptimal using modalities, such as radial endobronchial ultrasound or electromagnetic navigational bronchoscopy. We review the pitfalls of prior methods and the technological advancements with robotic bronchoscopy.

Recent findings
The contributors to reduced diagnostic sensitivity with current approaches include limitations in: navigation to the target, confirmation once the target is reached, and tissue acquisition. CT to body divergence with virtual reality methods, such as with electromagnetic navigation, potential false-positive confirmation with radial endobronchial ultrasound because of intraprocedural induced atelectasis, and lack of bronchoscopic and instrument maneuverability are all limitations to improving sensitivity. Robotic bronchoscopy enhances navigation through target pathway selection, allows for further reach in the distal airways, and improves tissue acquisition with more flexible and maneuverable biopsy instruments but lacks a high-fidelity target confirmation system.

Summary
Robotic bronchoscopy shows promise in biopsying peripheral lesions. Current published studies focus on diagnostic yield with robotic bronchoscopy. Future studies with long-term follow-up will be needed to assess diagnostic sensitivity for lung cancer and if robotic bronchoscopy is superior to other advanced diagnostic bronchoscopic techniques for peripheral pulmonary lesions.
Trans-esophageal echocardiography guided closure of ventricular septal defect with 2 occluders from different incisions simultaneously
Authors: Yang Hui , Mu Jie , Zhao Yuyi , Chen Zizhu , Song Haibo , Liu Jin 
Published: May 2021

Abstract

Introduction:
Ventricular septal defect (VSD) accounts for up to 40% of all congenital cardiac malformations. Transthoracic closure of VSDs has been well described in literature. In the current report, we described a procedure to successfully close a VSD with 2 occluders from different incisions simultaneously under the guidance of trans-esophageal echocardiography (TEE), to save the patient from undergoing another surgery.

Patient concerns:
A 52-year-old man was referred to our clinic for repeating palpitations for 6 months without chest pain and polypnea after activity.

Diagnosis:
The diagnosis of VSD was established due to the findings of a juxtatricuspid VSD with a left-to-right shunt at ventricular level and mild mitral regurgitation by TTE.

Interventions:
A transcatheter VSD closure was firstly performed but failed to repair the VSD. After the failure of transcatheter VSD closure, the patient received transthoracic closure of VSD operated by a cardiac surgeon. The VSD was closed with 2 occluders from different incisions (median thoracic skin incision and subxiphoid incision) simultaneously under the TEE guidance.

Outcomes:
The patient was extubated in intensive care unit and was discharged 4 days after the operation. During the follow up, there were no significant clinical nor laboratory side-effects of the procedure found as compared to the patient's condition before the procedure.

Conclusion:
VSD can be closed with 2 occluders from different incisions simultaneously under the TEE guidance to save the patient from undergoing repeated surgeries. Meanwhile, TEE plays a significant role in cardiac surgery.
The worldwide coronavirus disease 2019 outbreak
Authors: Mu Lin , Zhang Caijuan , Pei Yun , Wang Jingyu 
Published: May 2021

Abstract
To describe and advise on management protocols and infection-protection experience of the radiology department in makeshift hospitals in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak.
Based on the literature review and the experience in the frontline, we retrospectively reviewed the configuration of the radiology department, human resource, personal protection, examination procedures for patients confirmed with COVID-19 in Wuhan fangcang shelter hospital.
From February 11, 2020 to March 10, 2020, 2730 and 510 CT examinations were performed in the Hanjiang shelter hospital and Hanyang Sports School shelter hospital, respectively, including initial examinations and re-examinations. The maximum number of daily CT examinations reached 289. The CT scanned a patient approximately once every 13 mins.
Fangcang shelter radiology department could be powerful components of both global and national responses to the COVID-19 pandemic.
Efficacy of Jihwangeumja (Dihuang Yinzi) on cognitive function and activities of daily living in patients with Alzheimer disease
Authors: Lee Jae Yeong , Kim Ju Yeon , Lee Ji-Yoon , Jung Jin-Hyeong , Jung In Chul 
Published: May 2021

Abstract

Background:
This systematic review protocol describes the methods proposed to evaluate the efficacy and safety of Jihwangeumja in patients with Alzheimer disease.

Methods:
The following databases, PubMed, EMBASE, CENTRAL, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, National Digital Science Library, Korean Information Service System, and Korean Medical Database will be searched for relevant publications without language or publication status restrictions. Search terms will be based on “Alzheimer” for participants and “Jihwangeumja” or “Dihuang Yinzi” for interventions. Two researchers will independently extract the study data from the included studies and only randomized controlled trials will be included. The risk of bias will also be assessed independently by 2 researchers using the Cochrane risk of bias tool. We will use RevMan software random-effects and fixed-effect models for the assessment of heterogeneity and data synthesis. Any changes in the plan for documenting significant protocol amendments will require the researchers to have a revision agreement and register the international prospective register of systematic review modification.

Results:
The treatment effect and safety will be measured by meta-analysis and the quality of the included studies will be reviewed.

Conclusion:
This systematic review will provide evidence regarding the efficacy and safety of Jihwangeumja.

Ethics and dissemination:
Ethical approval is not required because individual patient data will not be included in this paper. The study findings will be disseminated through conference presentations.

OSF Registration
DOI: 10.17605/OSF.IO/HXA58.
Nonpharmacological treatments for Tourette syndrome and tic disorders
Authors: Suh Hyo-Weon , Kwon Chan-Young , Hong Sunggyu , Lee Hyun Woo , Lee Misun , Kim Jong Woo , Chung Sun-Yong 
Published: May 2021

Abstract

Background:
A tic is a sudden, rapid, recurrent, nonrhythmic motor movement, or vocalization. Tic disorders are diagnosed based on the presence of motor or vocal tics, duration of tic symptoms, and age at onset. Current clinical practice guidelines strongly recommend behavioral therapies because they are more effective and safer than medications. To determine the most effective nonpharmacological intervention for tic disorders and Tourette syndrome, we will conduct a systematic review and network meta-analysis.

Methods:
We will search the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycARTICLES, AMED, 3 Chinese databases (China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data), 3 Korean databases (Korean Medical Database, Korean studies Information Service System, and ScienceON), and a Japanese database (CiNii). There will be no language or date restrictions. The primary outcome will be the tic severity scale, the Yale Global Tic Severity Scale. The secondary outcomes will include the effective rate defined by the trial authors, dropout rate, and adverse events. Methodological quality will be assessed using the Cochrane risk of bias tool.

Results:
Results of this review and network meta-analysis will be published in a peer-reviewed journal.

Conclusions:
This systematic review will assess the effectiveness of nonpharmacological interventions for treating tic disorders. A systematic review or meta-analysis will provide an unbiased overview of the existing evidence.
Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients
Authors: Roh Jiyeon , Ahn Hyo Yeong , Kim Insu , Son Ju Hyeong , Seol Hee Yun , Kim Mi Hyun , Lee Min Ki , Eom Jung Seop 
Published: May 2021

Abstract
The British Thoracic Society guidelines recommend observation for patients with asymptomatic malignant pleural effusion (MPE). However, asymptomatic MPE can become symptomatic. This study examined the clinical course of asymptomatic MPE in patients with non-small cell lung cancer (NSCLC), including the incidence and timing of symptom development of asymptomatic MPE and the associated factors.
Retrospective data of 4822 NSCLC patients between January 2012 and December 2017 were reviewed. Symptom development of asymptomatic MPE was defined as the development of symptoms requiring additional treatment, such as insertion of a chest tube, within 1 year in patients who lacked MPE symptoms at the time of diagnosis. Clinical information, pathological parameters, and radiological characteristics were reviewed. Patient data up to 1 year from the initial diagnosis were reviewed.
Of 113 patients with asymptomatic MPE, 46 (41%) became symptomatic within 1 year despite appropriate anticancer treatment. The median time to symptom development was 4 months, and 38 patients (83%) developed symptoms within 6 months. Multivariate logistic regression showed that female sex (odds ratio [OR], 0.256; 95% confidence interval [CI], 0.101–0.649; P = .004) and the depth of pleural effusion on initial computed tomography (CT) (OR, 0.957; 95% CI, 0.932–0.982; P = .001) were independently associated with symptom development of asymptomatic MPE.
A fraction of 41% of patients with asymptomatic MPE became symptomatic within 1 year. Female sex and larger MPE on initial CT were independently associated with symptom development of asymptomatic MPE.