bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture for blunt chest trauma
Authors: Kao Pei-Yu , Ben-Arie Eyal , Lu Ting-Yu , Ho Wen-Chao , Lee Yu-Chen , Lin Yu-Sen , Chen Chien-Kuang , Chen Jian-Xun , Huang Tzu-Min , Chen Fang-Pey 
Published: May 2021

Abstract

Introduction:
Blunt chest trauma (BCT) accounts for up to 65% of polytrauma patients. In patients with 0 to 2 rib fractures, treatment interventions are typically limited to oral analgesics and breathing exercises. Patients suffering from BCT experience symptoms of severe pain, poor sleep, and inability to perform simple daily life activities for an extended period of time thereafter. In this trial, we aim to investigate the efficacy of acupuncture as a functional and reliable treatment option for blunt chest trauma patients.

Methods:
The study is designed as a double-blind randomized control trial. We will include 72 patients divided into 2 groups; the acupuncture group (Acu) and placebo group (Con). The acupuncture group will receive true acupuncture using a uniquely designed press tack needle. The control group will receive placebo acupuncture treatment through the use of a similarly designed press tack needle without the needle element. The acupoints selected for both groups are GB 34, GB 36, LI 4, LU 7, ST 36, and TH 5. Both groups will receive 1 treatment only following the initial visit to the medical facility and upon diagnosis of BCT. Patient outcome measurements include: Numerical Rating Scale, Face Rating Scale, respiratory function flowmeter, Verran Snyder-Halpern sleep scale, and the total amount of allopathic medication used. Follow-up time will be scheduled at 4 days, 2 weeks, and lastly 3 months.

Expected outcome:
The results of this study can potentially provide a simple and cost-effective analgesic solution to blunt chest trauma patients. This novel study design can serve as supporting evidence for future double-blind studies within the field of acupuncture.

Other information:
The study will be conducted in the thoracic surgical department and acupuncture department in China Medical University Hospital, Taichung, Taiwan. The study will be conducted on blunt chest trauma patients and is anticipated to have minimum risk of adverse events. Enrollment of the patients and data collection will start from March 2020. Study completion time is expected in March 2022.

Protocol Registration:
(CMUH109-REC1-002), (NCT04318496).
The efficacy and safety of moxibustion for chronic fatigue syndrome
Authors: Xue Kaiyang , Wang Yanping , Wang Xianzhu , Chen Pingnan , Xiao Caihong , Fu Jing , Cui Jin 
Published: May 2021

Abstract

Background:
The pathogenesis of chronic fatigue syndrome (CFS) is not clear. The main purpose of treatment is to improve autoimmune function and relieve fatigue symptoms. Moxibustion is often used to treat diseases caused by low autoimmunity, especially in relieving fatigue symptoms. It is a superior therapy for CFS in traditional Chinese medicine. At present, there is a lack of the high level clinical evidence to support the moxibustion in the treatment of CFS, so this study will systematically review and analyze the currently available randomized controlled trials to evaluate the efficacy and safety of moxibustion in the treatment of CFS.

Methods:
We will systematically search PubMed, EMBASE, Cochrane library, Sinomed, CNKI, VIP, and Wanfang Database, ClinicalTrials.gov and Chinese Clinical Trial Registry will also be searched. The time range for the search will be from database activation to March 31, 2021. The randomized controlled trials (RCTs) associated with moxibustion for CFS will be included, regardless of language.
We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the bias risk of a single RCT. The main outcome index of the study is Fatigue Assessment Instrument (FAI), secondary outcome indexes will include Fatigue Scale -14 (FS-14), Fatigue Severity Scale (FSS), Pittsburgh sleep quality index (PSQI), natural killer (NK) cells, interleukin- 2 (IL-2), T lymphocyte subsets (CD4
+, CD8
+), cure rate, total efficiency and adverse reactions. The random effect model meta was used to analyze the effect data of a single RCT. Heterogeneity will be measured by Cochran Q test and I-squared statistics. We will use 2 subgroup analyses to explore the source of heterogeneity. RCTs with high bias risk was excluded and adjustment effect model was used for sensitivity analysis to test the robustness of the meta-analysis results. The publication bias included in RCTs will be assessed by funnel plot and Egger test.

Results:
This study will objectively and comprehensively evaluate the efficacy and safety of randomized controlled trials of moxibustion in the treatment of chronic fatigue syndrome, and the results will be submitted to peer-reviewed journals for publication.

Conclusion:
This systematic review will provide clinicians with the latest high-quality evidence for the use of moxibustion in the treatment of chronic fatigue syndrome.

INPLASY registration number:
INPLASY202140063.
The genotype and phenotype of chromosome 18p deletion syndrome
Authors: Jin Qiujie , Qiang Rong , Cai Bo , Wang Xiaobin , Cai Na , Zhen Shuai , Zhai Wen 
Published: May 2021

Abstract

Rationale:
The chromosome 18p deletion syndrome is a syndrome with a deletion of all or a portion of the short arm of the chromosome 18. The phenotypes of the chromosome 18p deletion syndrome vary widely among individuals due to differences in size and breakpoints and the involved genes on the deletions. Given the varied and untypical clinical presentation of this syndrome, the prenatal diagnosis of the syndrome still presents as a challenge.

Patient concerns:
We described 4 China cases with different chromosomal breakpoints. In case 1, a woman who with mild phenotypes gave birth to a severely deformed fetus. Three other cases were for prenatal diagnosis. Their phenotypes are the increased nuchal translucency (INT) and the noninvasive prenatal testing (NIPT) indicated deletions on the chromosome 18p and severe hydronephrosis respectively.

Diagnosis:
The 4 cases were diagnosed with chromosome 18p deletion syndrome through karyotype analysis and array-based comparative genomic hybridization (array-CGH).

Interventions:
Karyotype analysis and array-based comparative genomic hybridization were used to analyze the abnormal chromosome.

Outcomes:
Case 1 and case 2 revealed 11.51 and 12.39 Mb deletions in 18p11.32p11.21. Case 3 revealed 7.1 Mb deletions in 18p11.3218p11.23. Case 4 revealed 9.9 Mb deletions in 18p11.3218p11.22.

Lessons:
In our report, we are the first to report that mother and progeny who have the same chromosomal breakpoint have different phenotypes, significantly. In addition, we found a new phenotype of chromosome 18p deletion syndrome in fetus, which can enrich the phenotypes of this syndrome in the prenatal diagnosis. Finally, we demonstrate that the individuals with different chromosomal breakpoints of 18p deletion syndrome have different phenotypes. On the other hand, the individuals with the same chromosomal breakpoints of 18p deletion syndrome may also have remarkably different phenotypes.
Adverse events experienced with intrahospital transfer of critically ill patients
Authors: Temsah Mohamad-Hani , Al-Sohime Fahad , Alhaboob Ali , Al-Eyadhy Ayman , Aljamaan Fadi , Hasan Gamal , Ali Salma , Ashri Ahmed , Nahass Assalh Ali , Al-Barrak Rana , Temsah Omar , Alhasan Khalid , Jamal Amr A. 
Published: May 2021

Abstract
Research that focuses on transfers to and from the intensive care unit (ICU) could highlight important patients’ safety issues. This study aims to describe healthcare workers’ (HCWs) practices involved in patient transfers to or from the ICU.
This cross-sectional study was conducted among HCWs during the Saudi Critical Care Society's annual International Conference, April 2017. Responses were assessed using Likert scales and frequencies. Bivariate analysis was used to evaluate the significance of different indicators.
Overall, 312 HCWs participated in this study. Regarding transfer to ICUs, the most frequently reported complications were deterioration in respiratory status (51.4%), followed by deterioration in hemodynamic status (46.5%), and missing clinical information (35.5%). Regarding transfers from ICUs to the general ward, the most commonly reported complications were changes in respiratory status (55.6%), followed by incomplete clinical information (37.9%), and change in hemodynamic conditions (29%). The most-used models for communicating transfers were written documents in electronic health records (69.3%) and verbal communication (62.8%). One-fourth of the respondents were not aware of the Situation, Background, Assessment, Recommendation (SBAR) method of patients’ handover. Pearson's test of correlation showed that the HCW's perceived satisfaction with their hospital transfer guidelines showed significant negative correlation with their reported transfer-related complications (r = −0.27, P < .010).
Hemodynamic and respiratory status deterioration is representing significant adverse events among patients transferred to or from the ICU. Factors controlling the perceived satisfaction of HCWs involved in patients, transfer to and from the ICU need to be addressed, focusing on their compliance to the hospital-wide transfer and handover policies. Quality improvement initiatives could improve patient safety to transfer patients to and from the ICU and minimize the associated adverse events.
Collapsing focal segmental glomerulosclerosis in a patient with oral cavity cancer
Authors: Choi Sae Byeol , Kim Kyoung Min , Park Moon Hyang , Kang Kyung Pyo 
Published: May 2021

Abstract

Rationale:
Focal segmental glomerulosclerosis (FSGS) is one of the most common glomerular diseases, leading to end-stage renal disease. Among the 5 variants of FSGS, the collapsing variant is rare and has the worst prognosis. Solid and hematologic malignancies are associated with glomerular diseases, such as membranous nephropathy, minimal change disease, and FSGS. However, squamous cell carcinoma of the oral cavity is rarely associated with nephrotic syndrome, especially FSGS.

Patient concerns:
A 55-year-old woman diagnosed with oral cavity cancer presented with generalized edema with heavy proteinuria and renal dysfunction after neoadjuvant chemotherapy and wide surgical excision.

Diagnosis:
Renal biopsy shows segmental or global collapse of glomerular capillaries with marked hyperplasia and swelling of overlying epithelial cells, suggesting a collapsing variant of FSGS.

Interventions:
After the renal biopsy, we prescribed oral prednisolone at a dose of 1 mg/kg/day. Despite immunosuppressive treatment, renal function deteriorated, and hemodialysis was started.

Outcomes:
After 23 sessions of hemodialysis and high-dose oral glucocorticoid treatment, renal function gradually improved, and oral glucocorticoid therapy was discontinued after 8 months. Currently, this patient is in a cancer-free state and has normal renal function without proteinuria.

Lessons:
Unusual collapsing FSGS might be associated with neoadjuvant chemotherapy and wide surgical excision in patients with oral cavity cancer. Proper diagnostic workup, such as renal biopsy and high-dose glucocorticoid therapy, might have helped recover from nephrotic syndrome and acute renal injury in cancer patients.
Adults Followed by Pediatric Subspecialists
Authors: Rudloff James , Gittelman Mike , Pomerantz Wendy J. 
Published: May 2021

Background
Adults are being seen with increasing frequency in pediatric emergency departments (PEDs), but the drivers behind this increase are unknown. Our primary aim was to compare adults seen in the PED followed by pediatric subspecialists to those who are not.

Methods
A retrospective study of patients 21 years or older presenting to the PED of a tertiary care children's hospital was performed from January 2011 through December 2018. Data included patient demographics, PED length of stay, disposition, and any subspecialty clinic encounters at the children's hospital in the prior year.

Results
A total of 10,034 adult encounters were seen in the PED over the study period; 5852 (58.3%) adult PED encounters had preceding pediatric subspecialty clinic visit(s) within a year prior. Pediatric subspecialty adult PED encounters increased by 38.9%, compared with 10.6% for other adults (P = 0.01). Encounters for pediatric subspecialty adults were significantly longer and more likely to result in admission to the children's hospital. The most common pediatric subspecialists caring for adult patients seen in the PED were hematology/oncology (1655 encounters), neurology (1572 encounters), cardiology (1217 encounters), and gastroenterology (1173 encounters).

Conclusions
Pediatric subspecialty adults are presenting to the PED at a greater rate, and they require more time and resources compared with other presenting adults. As frontline providers, PEDs, physicians, and staff must be prepared to address this growing subset of patients driving the increase in adults presenting to the PED.
Maintenance of Certification Pediatrics: Pediatric Emergency Medicine (PEM)
Authors: Iyer Maya S. , Bachur Richard , Wang Vincent , Hsu Deborah , Mistry Rakesh D. , Nagler Joshua , Mick Nathan , Althouse Linda , Du Ying , Leslie Laurel K. 
Published: May 2021

Abstract
Starting in 2022, the American Board of Pediatrics will launch the Maintenance of Certification Assessment for Pediatrics: Pediatric Emergency Medicine (MOCA-Peds: PEM) longitudinal assessment, which will provide an at-home alternative to the point-in-time examination. This longitudinal assessment will help engage PEM physicians participating in continuing certification in a more flexible and continuous lifelong, self-directed learning process while still providing a summative assessment of their knowledge. This commentary provides background information on MOCA-Peds and an introduction to MOCA-Peds: PEM and how it gives the PEM physician another option to participate in continuing certification.
Diagnostic Performance of Shear Wave Elastography in the Noninvasive Evaluation of Liver Inflammation of Chronic Hepatitis B Patients
Authors: Ren Xinping , Zhang Lu , Xia Shujun , Zhou Jianqiao , Lin Yanyan , Zhijie Chen , Li Ruokun , Zhan Weiwei 
Published: May 2021

Abstract
In the current study, we sought to delineate the elastographic characteristics and further compare the diagnostic performance of various shear wave elastography modalities in hepatitis B virus patients whose liver fibrosis stage was less than F2 by liver biopsy. We retrospectively studied the clinical and imaging data of chronic hepatitis B virus patients who underwent liver biopsy at our hospital between January 2017 and October 2017. Totally, 102 patients were eligible for the study. The mean Young modulus of sound touch elastography (STE) and sound touch quantify (STQ) gradually increased as inflammation grade of the liver rose from G0 to G3. Spearman rank correlation analysis revealed that the mean Young modulus of STE and STQ significantly correlated with hepatic inflammation grade (r = 0.341, P < 0.05). The area under the receiver operating characteristic curve (AUC) was the highest for the mean Young modulus of STE (AUC = 0.740; P = 0.015) followed by that of STQ (AUC = 0.684; P = 0.063) for G ≥ 2 hepatic inflammation and the AUC was the highest for the mean Young modulus of STE (AUC = 0.920; P = 0.000) followed by that of STQ (AUC = 0.910; P = 0.000) for G ≥ 3 hepatic inflammation. The current study demonstrated that the mean Young modulus of STE and STQ could serve as a useful diagnostic marker for hepatic inflammation of hepatitis B virus patients with no apparent liver fibrosis.
Single-Use Negative Pressure Wound Therapy Devices
Authors: Crumley Carolyn 
Published: May 2021

PURPOSE:
The purpose of this technologic analysis was to evaluate single-use negative pressure wound therapy (sNPWT) devices.

APPROACH:
Published literature regarding negative pressure wound therapy, particularly focusing on single-use or disposal devices, was reviewed. Varied features of devices currently available in the United States were drawn from use instructions published by individual manufacturers. Safety information regarding sNPWT was derived from the Manufacturer and User Facility Device Experience (MAUDE) Database.

CONCLUSIONS:
Single-use or disposable negative pressure wound therapy devices provide a safe and effective alternative to traditional negative pressure wound therapy. These devices promote healing of select open wounds and reduce complication rates in closed surgical incisions, when used in accordance with manufacturer guidelines. They may be used in any setting, but they are designed for use in home care and may be applied as a primary treatment option or following a course of traditional negative pressure wound therapy.
Network alignment and similarity reveal atlas-based topological differences in structural connectomes
Authors: Frigo Matteo , Cruciani Emilio , Coudert David , Deriche Rachid , Natale Emanuele , Deslauriers-Gauthier Samuel 
Published: May 2021

ABSTRACTThe interactions between different brain regions can be modeled as a graph, called connectome, whose nodes correspond to parcels from a predefined brain atlas. The edges of the graph encode the strength of the axonal connectivity between regions of the atlas which can be estimated via diffusion Magnetic Resonance Imaging (MRI) tractography. Herein, we aim at providing a novel perspective on the problem of choosing a suitable atlas for structural connectivity studies by assessing how robustly an atlas captures the network topology across different subjects in a homogeneous cohort. We measure this robustness by assessing the alignability of the connectomes, namely the possibility to retrieve graph matchings that provide highly similar graphs. We introduce two novel concepts. First, the graph Jaccard index (GJI), a graph similarity measure based on the well-established Jaccard index between sets; the GJI exhibits natural mathematical properties that are not satisfied by previous approaches. Second, we devise WL-align, a new technique for aligning connectomes obtained by adapting the Weisfeiler-Lehman (WL) graph-isomorphism test. We validated the GJI and WL-align on data from the Human Connectome Project database, inferring a strategy for choosing a suitable parcellation for structural connectivity studies. Code and data are publicly available.AUTHOR SUMMARYAn important part of our current understanding of the structure of the human brain relies on the concept of brain network, which is obtained by looking at how different brain regions are connected with each other. In this paper we present a strategy for choosing a suitable parcellation of the brain for structural connectivity studies by making use of the concepts of network alignment and similarity. To do so, we design a novel similarity measure between weighted networks called graph Jaccard index, and a new network alignment technique called WL-align. By assessing the possibility to retrieve graph matchings that provide highly similar graphs, we show that morphology- and structure-based atlases define brain networks which are more topologically robust across a wide range of resolutions.
Phylodynamic insights on the early spread of the COVID-19 pandemic and the efficacy of intervention measures
Authors: Gao Jiansi , May Michael R. , Rannala Bruce , Moore Brian R. 
Published: May 2021

We performed phylodynamic analyses of all available SARS-CoV-2 genomes from the early phase of the COVID-19 pandemic—combined with a novel dataset on contemporary global air-travel volume—to assess the efficacy of public-health measures on viral geographic spread. Globally, viral dispersal rates are significantly correlated with air-travel volume, and widespread international air-travel bans imposed against China by early February coincide with a significant reduction in geographic viral spread. In North America, the efficacy of this travel ban was temporary, possibly due to the lack of both containment measures against other infected regions and domestic mitigation measures. By contrast, in China, domestic mitigation measures were correlated with a long-term reduction in viral spread, despite repeated international introductions. Our study supports a role for both targeted international containment and domestic mitigation measures as critical components of a more comprehensive public-health strategy to mitigate future outbreaks caused by the emergence of novel SARS-CoV-2 variants.One sentence summaryPhylodynamic analyses reveal that variation in rates of early geographic spread of COVID-19 are correlated with intervention measures.
Persistent malaria transmission from asymptomatic children despite highly effective malaria control in eastern Uganda
Authors: Andolina Chiara , Rek John , Briggs Jessica , Okoth Joseph , Musiime Alex , Ramjith Jordache , Teyssier Noam , Conrad Melissa , Nankabirwa Joaniter I. , Lanke Kjerstin , Rodriguez-Barraquer Isabel , Meerstein-Kessel Lisette , Arinaitwe Emmanuel , Olwoch Peter , Rosenthal Philip J. , Kamya Moses R. , Dorsey Grant , Greenhouse Bryan , Drakeley Chris , Staedke Sarah G. , Bousema Teun 
Published: May 2021

SummaryBackgroundPersistent asymptomaticPlasmodium falciparuminfections are common in malaria-endemic settings, but their contribution to transmission is poorly understood.MethodsA cohort of children and adults from Tororo, Uganda was closely followed for 24 months by continuous passive surveillance and routine assessments.P. falciparumparasite density, gametocyte density and genetic composition were determined molecularly; mosquito membrane feeding assays were performed on samples from participants with symptomatic and asymptomatic infections.FindingsFrom October 2017 to October 2019, we followed all 531 residents from 80 households. Parasite prevalence was 5·8% by microscopy and 17·3% by PCR at enrolment and declined thereafter. We conducted 538 mosquito feeding experiments on samples from 107 individuals. Mosquito infection rates were strongly associated with gametocyte densities of participants. Considering both transmissibility of infections and their relative frequency, the estimated human infectious reservoir was primarily asymptomatic microscopy-detected infections (83·8%), followed by asymptomatic submicroscopic (15·6%) and symptomatic (0·6%) infections. Over half of the infectious reservoir was children aged 5-15 years (56·8%); individuals <5 years (27·5%) and>16 years (15·7%) contributed less. Four children were responsible for 62·6% (279/446) of infected mosquitos and were infectious at multiple timepoints.InterpretationIndividuals with asymptomatic infections were important drivers of malaria transmission. School-aged children were responsible for over half of all mosquito infections, with a small minority of asymptomatic children highly infectious. Demographically targeted interventions, aimed at school-aged children, could further reduce transmission in areas under effective vector control.FundingNational institute of Health, Bill & Melinda Gates Foundation, European Research Council.