bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chinese herbal medicines for mild cognitive impairment
Authors: Gu Si-Chun , Zhang Li-Min , Wang Chun-Xu , Qu Yan-Jie , Ma Jing-Yi , Zhen Rong-Rong , Gu Chao , Yuan Can-Xing 
Published: October 2021

Abstract

Background:
Mild cognitive impairment (MCI), as a common neurodegenerative aging disease representing an intermediate stage between normal cognitive functioning and dementia, poses an excessive burden on health care. The clinical benefit of Chinese herbal medicines (CHMs) for MCI remains inconclusive. This study is aimed at evaluating the efficacy and acceptability of CHMs through meta-analysis and trial sequential analysis (TSA).

Methods:
We applied extensive strategies on preliminary literature screening to identify relevant randomized controlled trials which meticulously compare any of CHMs interventions with placebo groups as monotherapy for MCI. The primary outcome of this study is the change of global cognitive function, and the secondary outcomes include assessments of activities of daily living, mood, and adverse events. Data synthesis, risk of bias assessment, sensitivity and subgroup analyses, and TSA will be conducted with application of Review Manager, Stata, and TSA software. The quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. INPLASY registration number: INPLASY202190006 (https://inplasy.com/inplasy-2021-9-0006/).

Results:
This study will confirm the clinical efficacy and safety of CHMs when used in the treatment of patients with MCI.

Conclusion:
This study will provide reliable evidence and references for the selection of CHMs in therapy and future clinical research of MCI.
Lead time on confirmatory test after abnormal Pap test in the COVID-19 era
Authors: Kim Miseon , Lee Nara , Won Seyeon , Kim Ju-Hyun , Kim Mi Kyoung , Kim Mi-La , Jung Yong Wook , Yun Bo Seong , Seong Seok Ju 
Published: October 2021

Abstract
During the COVID-19 pandemic, there are concerns about medical delay, including confirmatory tests after screening for various cancers. We evaluated the lead time to a confirmatory test after an abnormal screening Papanicolaou (Pap) test in women before the COVID-19 period and during the COVID-19 period.
The medical records of 1144 women who underwent colposcopy at a single institution located in Seoul after abnormal Pap results from January 2019 to December 2020 were reviewed. The lead time to colposcopy from the Pap test between 2019 and 2020 was compared; the adverse factors for a long lead time to colposcopy were also evaluated.
Age, residence, institution, and the Pap results did not differ between women who underwent colposcopy in 2019 (n = 621) and 2020 (n = 523). The time to colposcopy from the Pap test was also not different. A higher number of women were diagnosed with high-grade dysplasia in 2020 and underwent excision procedures; however, the difference was not statistically significant. Instead, patients’ residence, institution of the Pap test, and results of the Pap test were associated with a long lead time to colposcopy of >6 weeks.
The lead time to colposcopy from the abnormal Pap test was not delayed in the COVID-19 era compared to before. However, regional factors could affect a long lead time.
Role of erector spinae plane block in controlling functional abdominal pain
Authors: Chung Kyudon , Choi Seung Tae , Jun Eun Hwa , Choi Se Gyu , Kim Eung Don 
Published: October 2021

Abstract

Rationale:
Functional abdominal pain is an intractable medical condition that often reduces quality of life. Celiac plexus block is a representative intervention for managing intractable abdominal pain. However, celiac plexus block can be technically difficult to perform and carries the risk of potential complications. During erector spinae plane block (ESPB), the injectate can enter the paravertebral space and reach the sympathetic chain. If local anesthetics spread to the sympathetic chain that supplies fibers to the splanchnic nerve, abdominal pain theoretically could be reduced.

Patient concerns:
Three patients suffered from abdominal pain of unknown cause, and no medical abnormalities were found in various examinations.

Diagnosis:
As a result of collaboration with related medical departments, the abdominal symptoms of the patients were suspected to be functional abdominal pain.

Interventions:
We successfully controlled symptoms by performing ESPB at the lower thoracic level in 3 patients with functional abdominal pain.

Outcomes:
After the procedure, the patients’ abdominal pain improved significantly over several months.

Lessons:
We suggest that lower thoracic ESPB could be an option for management of functional abdominal pain.
Mixed neuroendocrine non-neuroendocrine neoplasm of the gallbladder complicated by a pancreaticobiliary maljunction of a non-dilated biliary duct
Authors: Wagatsuma Kohei , Akita Kotaro , Motoya Masayo , Kimura Yasutoshi , Sugita Shintaro , Hirano Takehiro , Kawakami Yujiro , Numata Yasunao , Ishigami Keisuke , Masaki Yoshiharu , Murota Ayako , Shitani Masahiro , Akutsu Noriyuki , Sasaki Shigeru , Nakase Hiroshi 
Published: October 2021

Abstract

Rationale:
Mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is a rare tumor. MiNEN of the gallbladder (GB) with pancreaticobiliary maljunction (PMJ) is extremely rare. The origin of MiNEN of the GB remains unknown; the biliary tract normally lacks neuroendocrine cells. MiNEN of the GB has a poor prognosis; because of its rarity, no treatment or management guidelines have been established yet.

Patient concerns:
A 47-year-old male presenting with right hypochondrial pain and malaise for 3 months was referred to our hospital for further management.

Diagnosis:
The neuron-specific enolase level was increased. Contrast-enhanced computed tomography revealed a mass of 70 mm in size with unclear boundaries in the liver. The GB was surrounded by this mass, narrowing the lumen of the GB. Many swollen lymph nodes were observed in the hepatoduodenal ligament. Endoscopic retrograde cholangiopancreatography revealed a PMJ with a non-dilated biliary duct. A percutaneous biopsy was performed on the liver mass, and the pathological findings were neuroendocrine carcinoma (NEC) (small cell type). We diagnosed a NEC of the GB, T3N1M0, stage IIIB (Union for International Cancer Control, 7th edition).

Interventions:
Because of advanced lymph node metastasis, we considered this tumor difficult to cure solely by surgical intervention. After initial chemotherapy consisting of cisplatin and irinotecan, a marked reduction in both tumor and lymph node sizes enabled conversion surgery. The pathological diagnosis of the resected tumor was MiNEN consisting of NEC and adenocarcinoma. The primary lesion was the adenocarcinoma occupying the luminal side of the GB. As a postsurgical treatment, the patient received additional irradiation therapy to the common hepatic duct and liver stump because of positive surgical margins.

Outcomes:
At 13 months postoperatively, computed tomography findings revealed the appearance of a hypervascular liver tumor, and laboratory data showed increased serum neuron-specific enolase levels. Chemotherapy was unsuccessful, leading to the death of the patient 36 months from the date of diagnosis.

Lessons:
There are several reports on the development of MiNEN of the GB. In our case, a PMJ-related adenocarcinoma of the GB transdifferentiated into NEC. Further accumulation of cases is necessary to establish a treatment strategy for MiNEN of the GB.
The traditional and modifiable risk factors of coronary artery disease – a community-based cross-sectional study among 2 populations
Authors: Dain Chacko Pearl , Ganapathi Sanjay , Geevar Zachariah , Harikrishnan Sivadasanpillai , Ammu Jayanthi Viswanathan , Chacko Manas 
Published: October 2021

Abstract
A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors.
The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health.
PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38–8.38]) and significant (P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44–5.4) and non-significant (P = .503) in the multivariate regression analysis.
In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.
Application evaluation of virtual reality technology in dental implant training: a new dental implant training system
Authors: Zhou Yong , Chen Wanlu , Zhao Xiaoxian , He Bingwei , Huang Wenxiu , Wu Dong , Chen Jiang 
Published: October 2021

Abstract
To evaluate the application of virtual reality technology in a dental implant training system.
A 3-dimensional model of mandible was established by Mimics17.0 software based on the Digital Imaging and Communications in Medicine data obtained from cone beam computed tomography scanning of the patient in mandibular. Thirty physicians were divided into 2 groups. The virtual reality dental implant training system was used for group A, while conventional theoretical knowledge training and clinical demonstration were performed in group B. All young physicians have a 1-month study. After training, all the physicians in groups A and B would conduct a questionnaire survey according to the training situation, which was compared between the 2 groups. The success rate of the operation was also evaluated and compared.
The median scores in the 5 dimensions of postoperative assessment of group A was 9/9/9/8/8, and of group B was 6/7/6/7/7. The scores of the 5 dimensions were significantly higher than those of group B (P < .05), indicating that group A has a better grasp of the simulator. After the training of simulated mandibular implants in group A, the deviations in the 4 dimensions of mesiodistal, buccal and tongue, depth, and angle were significantly lower than those of group B (P < .05). Group A has smaller deviations in each of the 4 dimensions than those in group B, indicating group A has a higher operation success rate.
We independently develop a set of virtual surgery system for dental implant training, which can be used for teaching and training, with good operability and predictability, to achieve a breakthrough in dental implant surgery training.
Diagnostic accuracy of electronic surveillance tool for catheter-associated urinary tract infections in tertiary care hospitals
Authors: Shen Yuehua , Cui Hongmei 
Published: October 2021

Abstract

Background:
Automated systems have been developed to reduce labor-intensive manual recordings during nosocomial infection surveillance. The diagnostic accuracies of these systems have differed in various settings.

Methods:
We designed this meta-analysis to evaluate the diagnostic accuracy of an electronic surveillance tool for catheter-associated urinary tract infections (CAUTIs) in tertiary care hospitals. We systematically searched databases such as Medline, Scopus, Cochrane library and Embase (from inception until November 2019) for relevant studies. We assessed the quality of trials using the diagnostic accuracy studies-2 tool, and performed a meta-analysis to obtain a pooled sensitivity and specificity for electronic surveillance. We included 6 studies with 16,492 patients in the analysis.

Results:
We found a pooled sensitivity of electronic diagnostic surveillance for CAUTIs of 97.5% (95% confidence interval [CI], 67.6–99.9%) and a pooled specificity of 92.6% (95% CI, 55.2–99.2%). The diagnostic odds ratio was 494 (95% CI, 89–2747). The positive likelihood ratio was 13.1 (95% CI, 1.63–105.8) and the negative likelihood ratio 0.02 (95% CI, 0.001–0.40). A bivariate box plot indicated the possibility of heterogeneity between the included studies.

Conclusion:
Our review suggests that electronic surveillance is useful for diagnosing CAUTIs among hospitalized patients in tertiary care hospitals due to its high sensitivity and specificity.
Derivation and validation of a clinical prediction model for risks of venous thromboembolism in diabetic and general populations
Authors: Lin Cheng-Chieh , Chen Ching-Chu , Li Chia-Ing , Liu Chiu-Shong , Lin Wen-Yuan , Lin Chih-Hsueh , Yang Shing-Yu , Li Tsai-Chung 
Published: October 2021

Abstract
Most studies on the prediction of venous thromboembolism (VTE) focused on hospitalized, surgery, and cancer patients or women receiving hormonal contraceptives or menopausal hormone therapy. No study considered diabetic and general populations to establish a VTE prediction model, especially in Asia. We developed a predictive model for VTE among type 2 diabetic patients and the general population.
This study considered 2 nationwide retrospective cohort studies consisting of 52,427 diabetic participants and 508,664 participants from the general population aged 30 to 85 years during 2001 to 2004 in Taiwan. All participants were followed up until VTE event, death, or December 2011. The outcome event was VTE, including deep venous thrombosis and pulmonary embolism. Candidate predictors consisted of socio-demographic factors, diabetes-related factors and biomarkers, comorbidities, and medicine use. Our study followed the procedures proposed by the Framingham Heart Study to develop prediction models by using a Cox regression model. The predictive accuracy and performance characteristics were assessed using the area under curve of receiver operating characteristics curve and calibration of a risk score were performed by Hosmer–Lemeshow goodness-of-fit test.
The common factors for persons with type 2 diabetes and general population included age, hospitalization status 1 year before the baseline, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, and anti-diabetes medications; the specific factors for persons with type 2 diabetes consisted of body mass index, glycosylated hemoglobin A1C, and creatinine; and the factors for general population included gender, peripheral vascular disease, cancer, hypertension medication, cardiovascular medication, and non-steroidal anti-inflammatory drug. The area under curve of 3-, 5-, and 8-year VTE prediction models were 0.74, 0.71, and 0.69 in the diabetic population and 0.77, 0.76, and 0.75 in the general population, respectively.
The new clinical prediction models can help identify a high risk of VTE and provide medical intervention in diabetic and general populations.
A review of split liver transplantation with full right/left hemi-liver grafts for 2 adult recipients
Authors: Chan Kun-Ming , Hung Hao-Chien , Lee Jin-Chiao , Wu Tsung-Han , Wang Yu-Chao , Cheng Chih-Hsien , Lee Chen-Fang , Wu Ting-Jung , Chou Hong-Shiue , Lee Wei-Chen 
Published: October 2021

Abstract
Liver transplantation has become a routine operation in many transplantation centers worldwide. However, liver graft availability fails to meet patient demands. Split liver transplantation (SPLT), which divides a deceased donor liver into 2 partial liver grafts, is a promising strategy for increasing graft availability for transplantation and ameliorating organ shortage to a certain degree. However, the transplantation community has not yet reached a consensus on SPLT because of the variable results. Specifically, SPLT for 2 adult recipients using full right/left hemi-liver grafts is clinically more challenging in terms of surgical technique and potential postoperative complications. Therefore, this review summarizes the current status of SPLT, focusing on the transplantation of adult recipients. Furthermore, the initiation of the SPLT program, donor allocation, surgical aspects, recipient outcomes, and obstacles to developing this procedure will be thoroughly discussed. This information might help provide an optimal strategy for implementing SPLT for 2 adult recipients among current transplantation societies. Meanwhile, potential obstacles to SPLT might be overcome in the near future with growing knowledge, experience, and refinement of surgical techniques. Ultimately, the widespread diffusion of SPLT may increase graft availability and mitigate organ donation shortages.
The effect of magnetic therapy and moderate aerobic exercise on osteoporotic patients
Authors: Eid Marwa M. , El-Gendy Amira M. , Abdelbasset Walid Kamal , Elkholi Safaa Mostafa , Abdel-fattah Mostafa S. 
Published: October 2021

Abstract

Background:
Osteoporosis is a frequent musculoskeletal condition with significant complications that would be a global health problem and one of the major causes of mortality and morbidity.

Objectives:
The current study aimed to ascertain the impact of pulsed magnetic therapy, aerobic exercise, and a combination of both modalities on osteoporotic female patients postthyroidectomy.

Methods:
Between May 2018 and September 2019, 45 female patients with osteoporosis were included in the randomized clinical study, their age ranged from 40 to 50 years, had thyroidectomy for at least 6 months ago, and had an inactive lifestyle for at least the previous 6 months. Patients were assigned randomly into 3 equal groups. Group A (magnetic therapy group): received routine medical treatment (bisphosphonates, calcium, and vitamin D) in addition to pulsed magnetic therapy on the hip region for 12 weeks (3 sessions/week). Group B (exercise group): received routine medical treatment plus moderate-intensity aerobic exercise for 12 weeks (3 sessions/week). Group C (combined magnetic therapy and exercise therapy group): received routine medical treatment plus pulsed magnetic therapy and moderate-intensity aerobic exercise for 12 weeks (3 sessions/week). The 3 groups were assessed for bone mineral density (BMD) at baseline by dual-energy x-ray absorptiometry and after 12 weeks of treatment.

Results:
The results showed that within-group analysis a statistically significant increase was reveled (P < .05) for BMD in the 3 studied groups. Comparing the results among the 3 tested groups revealed a significant increase (P < .05) in posttesting mean values of BMD in group (C) compared to group (A) and group (B). No significant statistical difference in BMD means values between the 2 groups (A) and (B) after testing was detected.

Conclusion:
Combination of both pulsed magnetic therapy and moderate-intensity aerobic exercise showed significant improvement in BMD at the hip region than using any of the 2 modalities alone.
Comparison of prognosis predictive value of 4 disease severity scoring systems in patients with acute respiratory failure in intensive care unit
Authors: Huang Wen-Cheng , Xie Hong-Jian , Fan Hong-Tao , Yan Mei-Hao , Hong Yuan-Cheng 
Published: October 2021

Abstract
Various disease severity scoring systems were currently used in critically ill patients with acute respiratory failure, while their performances were not well investigated.
The study aimed to investigate the difference in prognosis predictive value of 4 different disease severity scoring systems in patients with acute respiratory failure.
With a retrospective cohort study design, adult patients admitted to intensive care unit (ICU) with acute respiratory failure were screened and relevant data were extracted from an open-access American intensive care database to calculate the following disease severity scores on ICU admission: acute physiology score (APS) III, Sequential Organ Failure Assessment score (SOFA), quick SOFA (qSOFA), and Oxford Acute Severity of Illness Score (OASIS). Hospital mortality was chosen as the primary outcome. Multivariable logistic regression analyses were performed to analyze the association of each scoring system with the outcome. Receiver operating characteristic curve analyses were conducted to evaluate the prognosis predictive performance of each scoring system.
A total of 4828 patients with acute respiratory failure were enrolled with a hospital mortality rate of 16.78%. APS III (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.02–1.03), SOFA (OR 1.15, 95% CI 1.12–1.18), qSOFA (OR 1.26, 95% CI 1.11–1.42), and OASIS (OR 1.06, 95% CI 1.05–1.08) were all significantly associated with hospital mortality after adjustment for age and comorbidities. Receiver operating characteristic analyses showed that APS III had the highest area under the curve (AUC) (0.703, 95% CI 0.683–0.722), and SOFA and OASIS shared similar predictive performance (area under the curve 0.653 [95% CI 0.631–0.675] and 0.664 [95% CI 0.644–0.685], respectively), while qSOFA had the worst predictive performance for predicting hospital mortality (0.553, 95% CI 0.535–0.572).
These results suggested the prognosis predictive value varied among the 4 different disease severity scores for patients admitted to ICU with acute respiratory failure.