bluuebunny/crossref_metadata_2025_split huggingface dataset:
Key Insights From the Development and Implementation of a Novel Virtual Interview Process for Medical School Admissions During the COVID-19 Pandemic
Authors: Garden Evan , Loebel Emma , Sanky Charles , Chudow Jacquelyn , Fallar Robert , Parkas Valerie 
Published: May 2021

Problem
During the COVID-19 pandemic, medical schools have offered a virtual application process. Minimal literature is available to guide best practices.

Approach
The Icahn School of Medicine at Mount Sinai (ISMMS) implemented a completely virtual interview (VI) process in April/May 2020. Large-group sessions for applicants, interviews with applicants, and ISMMS Admissions Committee meetings occurred via Zoom (Zoom Video Communications, Inc., San Jose, California). Large-group sessions and committee meetings occurred via communal conference calls, while one-on-one, semistructured interviews occurred in individual breakout rooms. ISMMS offered live, virtual question-and-answer sessions with students and faculty, plus digital resources describing program features. After the interview day, applicants and interviewers were invited to complete anonymous surveys regarding their experiences with and perspectives of VI.

Outcomes
Of 125 applicants and 20 interviewers, 99 (79%) and 18 (90%), respectively, completed at least part of the survey. Of the applicants, 85/95 (89%) agreed VI met or exceeded expectations, with many praising the day’s organization and convenience, and 71/95 (75%) agreed they received a sufficient sense of the student body. A minority (n = 39/95 [41%]) felt limited in their ability to learn about the institution (commonly related to their inability to tour campus), and a majority (n =74/91 [81%]) would have preferred an in-person interview. Most interviewers felt comfortable assessing applicants’ verbal communication skills (n = 13/16 [81%]), and most (n = 12/17 [71%]) felt VI should be an option for future applicants.

Next Steps
VI, likely to be a temporary-but-universal fixture of upcoming application cycles, may benefit applicants and interviewers alike by saving resources and diversifying those involved. Next steps are developing programming that will permit applicants to virtually explore the institution and connect more with current students. Future research should evaluate potential bias in VI to ensure an equitable application process for all.
Cardiovascular disease (CVD) risk scores, age, or years since menopause to predict cardiovascular disease in the Women's Health Initiative
Authors: Wild Robert A. , Hovey Kathleen M. , Andrews Christopher , Robinson Jennifer G. , Kaunitz Andrew M. , Manson JoAnn E. , Crandall Carolyn J. , Paragallo Rachel , Shufelt Chrisandra , Merz C. Noel Bairey 
Published: May 2021

Abstract

Objective:
To assess the utility of cardiovascular disease (CVD) risk scores compared to age or years since menopause for prediction of CVD events in the WHI clinical trials.

Methods:
Briefly, in the randomized clinical trial 27,347 postmenopausal women age 50 to 79 years entered from 1993 to 1998. Women with a uterus (16,608) were randomized to receive daily oral conjugated equine estrogen (CEE) (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) (5.7 years or placebo), while women with a hysterectomy (10,739) were randomized to receive daily oral CEE (0.625 mg) alone or placebo (7.2 y). CVD risk scores were assessed at baseline and CVD events were adjudicated throughout the follow-up period to the end of the main study phase and to the end of cumulative follow-up. The median follow-up time after the start of the randomized clinical trial to the end of the main study phase was 8.2 years. The median follow-up time to the end of cumulative follow-up was 17.6 years. We compared The American Heart Association/American College of Cardiology (AHA/ACC) and Framingham Heart Study risk scores to age or years since menopause all obtained at baseline to predict subsequent CVD events. The absolute event rates, hazard ratios, and C-statistics (Uno Concordance from Cox proportional models) were compared.

Results:
Overall, the hazard ratios for CVD events were highest with calculated CVD scores calculated at trial onset both at the end of the main study (ranging from 2.02 to 10.8 for Q2-Q5, compared to Q1) and at cumulative follow-up (ranging from 1.76 to 8.86 for Q2-Q5, compared to Q1). While older age and years since menopause at baseline were also associated with higher CVD event rates, better risk prediction was accomplished by using CVD risk scores. The Framingham Heart Study BMI score had the highest C-statistic at the end of the main study (0.711) and after 17.6 years through the end of follow-up (0.689).

Conclusions:
CVD risk scores can help identify postmenopausal women at higher risk for CVD beyond age or time since menopause. Risk scoring that better estimates vascular aging may facilitate CVD risk prevention. When performed prior to initiation of menopausal hormone therapy, scores can better inform HT risk/benefit discussions.

Video Summary:

http://links.lww.com/MENO/A717.
Early-onset climacterium is not associated with impaired vitamin D status: a population-based study
Authors: Lumme Johanna E. , Savukoski Susanna M. , Suvanto Eila T.J. , Pesonen Paula R.O. , Auvinen Juha P. , Sebert Sylvain , Hyppönen Elina , Järvelin Marjo-Riitta , Puukka Katri S. , Herzig Karl-Heinz , Oura Petteri , Ojaniemi Marja , Niinimäki Maarit 
Published: May 2021

Abstract

Objective:
To investigate vitamin D status in women with the onset of the climacteric phase by age 46 as both early menopause and inadequate vitamin D status may increase the risk of adverse health outcomes.

Methods:
A cross-sectional study included 2,544, 46-year-old women from a birth cohort. Women were divided into the following two groups according to their menstrual history and follicle-stimulating hormone (FSH) concentration: 1) climacteric (FSH ≥25 IU/L and amenorrhea ≥4 mo, n = 351) and 2) preclimacteric women (FSH <25 IU/L and having regular/irregular menstrual cycles, n = 2,193). Serum 25-hydroxyvitamin D (25(OH)D) concentrations were compared between the groups. A linear regression model was performed to investigate which factors are associated with 25(OH)D status.

Results:
Mean serum 25(OH)D concentrations were higher in climacteric compared with preclimacteric women (68.1 ± 19.8 nmol/L vs 65.2 ± 19.3 nmol/L, P = 0.01). However, in the linear regression model, climacteric status was not associated with 25(OH)D status (multivariable adjusted mean difference 4.5 nmol/L, 95% confidence interval −1.4 to 10.4, P = 0.137). A total of 76 of the climacteric women were using systemic estrogen hormone therapy (HT). In a subanalysis, including only climacteric women, the use of HT was associated with higher 25(OH)D status (multivariable adjusted mean difference 5.9 nmol/L, 95% confidence interval 1.3-10.5, P = 0.013).

Conclusions:
The onset of the climacteric phase by age 46 was not associated with inadequate 25(OH)D concentrations, whereas HT use was associated with higher 25(OH)D status in women with early-onset climacterium.
Risk factors, demographic profiles, and management of uncomplicated recurrent urinary tract infections: a single institution study
Authors: Ingram Amanda , Posid Tasha , Pandit Aroh , Rose Justin , Amin Sabrina , Bellows Fara 
Published: May 2021

Abstract

Objective:
Recurrent urinary tract infections (rUTI) are a common urologic chief complaint. Although rUTIs are a significant burden on the healthcare system, until recently there were no published guidelines to delineate optimal management of this condition. The objective of this study was to describe the demographic profile of rUTI patients and summarize practice patterns at a single tertiary health center, as well as to assess whether our real-life practice patterns parallel the recently published guidelines.

Methods:
We conducted a retrospective record review of female patients presenting for diagnosis of uncomplicated rUTI/cystitis between October 2010 and September 2018. Analyses were conducted to investigate (a) whether pre- versus postmenopausal women differed in their risk factors for rUTI, (b) whether providers adjust their practice patterns when treating pre- versus postmenopausal women with rUTIs, and (c) whether certain treatment regimens led to lower rates of rUTI than others.

Results:
Of the 125 cases included in the final analysis, pre- versus postmenopausal women did differ in their risk factors for rUTI, specifically age, Charlson Comorbidity Index score, and comorbidities. Although common treatments were found across menopausal status, providers did adjust their practice patterns when treating pre- versus postmenopausal women, including the use of postcoital suppression, conservative measures, cranberry juice/extract, and probiotics for premenopausal women and daily suppression and vaginal estrogens for postmenopausal women. rUTI after treatment (<40%) was highest after the use of conservative measures for all women and rates of rUTI after treatment generally did not differ as a function of menopausal status, but rather by treatment option.

Conclusions:
This single institution report sheds light on practice patterns at a major academic center, specifically as it compares to the new American Urological Association guidelines and the use of estrogen cream for postmenopausal women.
Temporal Trends in COVID-19 Incidence in Two Healthcare Worker Cohorts
Authors: McNicholas James E. , Kosnik Robert , Blanc Paul D. , Taylor Brian R. , Guntur Sandeep 
Published: May 2021

Background:
Health care workers (HCWs) experience increased occupational risk of contracting COVID-19, with temporal trends that might inform surveillance.

Methods:
We analyzed data from a Veterans Affairs hospital-based COVID-19 worker telephone hotline collected over 40 weeks (2020). We calculated the proportion of COVID-19+ cases among persons-under-investigation (PUIs) for illness compared to rates from a nearby large university-based health care institution.

Results:
We observed 740 PUIs, 65 (8.8%) COVID-19+. Time trends were similar at the study and comparison hospitals; only for the first of 10 four-week observation periods was the ratio for observed to expected COVID-19+ significant (P < 0.001).

Discussion:
These data suggest that employee health COVID-19+ to PUI ratios could be utilized as a barometer of community trends. Pooling experience among heath care facilities may yield insights into occupational infectious disease outbreaks.
The effects of whole-body muscle stimulation on body composition and strength parameters
Authors: Rodrigues-Santana Luiz , Adsuar José Carmelo , Louro Hugo , Pérez-Gómez Jorge , Hernández-Mocholí Miguel Angel , Carlos-Vivas Jorge , Gomez-Campos Rossana , Campos Luis Felipe Castelli Correia de 
Published: May 2021

Abstract

Background:
This study will analyze the effect of Whole Body Electromyostimulation (WB-EMS) in strength and body composition outcomes in adult population.

Methods:
This study will search the following electronic databases up to July 21, 2020: PubMed, WOS, Scopus, SPORTDiscus y EMBASE. There will be no language limitation. Two authors will independently identify titles/abstracts and full text all potential studies, and will collect data from eligible studies. Additionally, study quality will be assessed by PEDro Scale risk of bias. We will conduct meta-analysis if enough trials are included.

Results:
This study will explore the effects of WB-EMS in strength and body composition outcomes.

Conclusion:
The findings of this study may summarize the effectiveness of WB-EMS in increasing strength and improving body composition in adult population.

INPLASY registration number:
INPLASY202120050
The genotype analysis of the hepatitis C virus in Heilongjiang Province, China
Authors: Cheng Xue-Di , Xu Hua-Feng , Wei Feng , Jiang Li-Xin , Zhou Hai-Zhou 
Published: May 2021

Abstract
Introduction: Hepatitis C virus (HCV) infection is a major public health issue. HCV genotype identification is clinically important to tailor the dosage and duration of treatment, and recombination in intra-patient populations of HCV may lead to the generation of escape mutants, as previously observed for other RNA viruses. Up to now, there is no study assessing HCV genotypes and subtypes in Heilongjiang Province, China.
Methods: To determine genotype and phylogenetic analysis of HCV in Heilongjiang Province is crucial. In this study, we amplified 3 genome regions (5’UTR, E1, and NS5B) of 30 HCV patients in Heilongjiang Province, amplified products were analyzed by bioinformatics.
Results: We found that 23 specimens had concordant subtypes in the 3 gene regions (2a and 1b), 7 HCV patients were considered the recombinants, the recombination pattern of the 7 HCV patients in the 5’UTR, E1, and NS5B region as followed: 1b/2a/1b, 2a/2a/1b, 1b/2a/2a, 1b/2a/1b, 1b/2a/1b, 1b/2a/1b, 2a/2a/1b.
Conclusions: The findings in the present study showed that a higher recombination rate (23%) than other researches, and the recombination of 2a/1b in the 5’UTR, E1, and NS5B region was only found in the present study up to now.
Predictors of patient safety culture in hospitals in Venezuela
Authors: Chirinos Muñoz Mónica Susana , Orrego Carola , Montoya Cesar , Suñol Rosa 
Published: May 2021

Abstract
An organization's culture with regard to patient safety is important because it defines the beliefs and practices of the organization, and consequently its efficiency and productivity.
Knowing the level of this and the factors that influence or not their dynamic represents a challenge, due to the degree of complexity and specificity of the elements involved.
The aim of this study was to analyze predictors of patient safety culture in public and private hospitals and examining the factors that contribute to it, constructing a new and specific theoretical and methodological model.
This study was carried out by reviewing medical records, detecting healthcare professionals directly involved in caring (N = 588), for patients in 2 public hospitals and 2 private hospitals in Venezuela (N = 566), conducting an “Analysis of Patient Safety Culture” questionnaire. The results were subsequently analyzed, derived 3 predictors factors and using a Patient Safety Culture Index (PSCI) for specific determination to evaluate patient safety culture level.
The analysis showed that all hospitals had a “moderately unfavorable” PSCI (public = 52.96, private = 52.67, sig = 0.90). The PSCI was calculated by assessing the weight of the following factors in the index: occupational factors (factor loading = 32.03), communication factors (factor loading = 11.83), and organizational factors (factor loading = 9.10). Traumatology presented the lowest PSCI of all the care units, falling into the “unfavorable” category (36.48), and Laboratory the highest (70.02) (sig = 0.174), falling into the “moderately favorable” category. When analyzing professional groups, nurses had the highest PSCI, with a “moderately unfavorable” rating (PSCI = 61.1) and medical residents the lowest, falling into the “unfavorable” category (35.2). Adverse event reporting is determined by “management expectations and actions” (sig = 0.048) and “direct interaction with the patient” (sig = 0.049).
The use of this theoretical and methodological approach in other contexts may provide a more objective system for identifying more specific needs and factors that influence in patient safety culture, and consequently, opportunities for improvement when constructing a patient safety culture in healthcare institutions. Efforts need to be made to improve safety culture in the hospitals studied, irrespective of whether they are public or private.
The safety and feasibility of comprehensive nutrition care in pregnant women with gestational diabetes mellitus
Authors: Long Mei , Zhang Xiangchun 
Published: May 2021

Abstract

Background:
The argument on the efficacy of medical nutritional therapy and comprehensive nutritional care remains to be resolved. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the efficacy between medical nutritional therapy and comprehensive nutritional care for patients with gestational diabetes mellitus (GDM).

Methods:
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases “gestational diabetes mellitus,” “comprehensive nutrition care,” and “medical nutritional therapy” for all cohort studies published up to May 20, 2021. There is no restriction in the dates of publication or language in the search for the current review. The studies on cohort study focusing on comparing medical nutritional therapy and comprehensive nutrition care for GDM patients will be included in our meta-analysis. The outcomes include blood glucose levels, complications, weight change, and incidence of cesarean section. Where disagreement in the collection of data occurrs, this will be resolved through discussion.

Results:
We hypothesized that these 2 methods would provide similar therapeutic benefits.

OSF registration number:
10.17605/OSF.IO/SC8HJ.
Efficacy and safety of electroacupuncture in treatment of cervical spondylosis
Authors: Zhou YaZhou , Wang WenGang , Tian Ke , Huang Hui , Jia Mengrui 
Published: May 2021

Abstract

Background:
Cervical Spondylotic radiculopathy (CSR) is the most common spinal degenerative disease. Its clinical manifestations are pain and numbness in the neck and arm and limitation of neck movement, which greatly affects the life and work of patients. Acupuncture and electroacupuncture are commonly used in China, the efficacy of acupuncture has been confirmed. Existing evidence shows that electroacupuncture seems to be better than acupuncture, but there is a lack of clinical research to directly compare the two.

Methods:
This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR. Approved by the Clinical Research Ethics Committee of our hospital, the patients are randomly divided into an experimental group (electroacupuncture group) or control group (acupuncture group). The patients are followed up for 30 days after 4 weeks of treatment. Observation indexes included VAS score, Neck Disability Index, Yasuhisa Tanaka 20 Score Scale, adverse reactions and so on. Finally, the data will be analyzed by SPSS 18.0 software.

Discussion:
This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR. The results of this study will help to guide patients with CSR to choose appropriate treatment.

Trial registration:
OSF Registration number: DOI 10.17605/OSF.IO/9MKPN
The role of E255K/V-inclusive mutations in a Philadelphia-positive acute lymphoblastic leukemia with mutation evolution during sequential TKIs therapies
Authors: Zhao Miaomiao , Gui Xiya , Wu Qiuling , Xia Linghui , Wang Yadan 
Published: May 2021

Abstract

Rationale:
Until recently, the survival rate in patients with Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) was approximately 30%. Tyrosine kinase inhibitors (TKIs), which are a new class of drugs that target BCR-ABL fusion protein, have shown to be effective in treating Ph+ ALL in adults. However, the resistance mechanisms that promote the disease recurrence have altered the initial success of these revolutionary agents.

Patient concerns:
A 71-year-old Chinese female patient who suffered from severe shoulder and back pain for 1 week.

Diagnosis:
The patient was diagnosed with Ph+ ALL (B–cell) because of the following items. Complete blood count showed extremely abnormal white blood cell count (26.26×109/l), hemoglobin concentration (65 g/l) and platelet count (14×109/l). And because that Bone marrow aspirate showed 72.5% lymphoblasts and 59.30% lymphoblasts were confirmed by flow cytometry (FCM). At mean time, Real-time fluorescent quantitative PCR analysis confirmed that the P190 BCR/ABL fusion gene expression was 5.9%. Karyotype analysis indicated the following: 45, XX, −7, t (922) (q34; q11) [cp3].

Interventions:
The patient was treated with chemotherapy and different TKIs including imatinib, dasatinib, ponatinib, and bosutinib.

Outcomes:
The patient achieved complete remissions with different TKIs after diagnose but relapsed afterward and died of infection.

Lessons:
Multidrug-resistant mutations within the BCR-ABL1 kinase domain are an emerging clinical problem for patients receiving sequential TKIs therapy. Acquisition of E255K/V-inclusive mutations is usually associated with ponatinib resistance, thus it is necessary to screen out new real pan-inhibitor compounds for all BCR/ABL mutations and figure out the potential efficacy of asciminib-based drug combinations in the future.
Lupus acute cardiomyopathy is highly responsive to intravenous immunoglobulin treatment
Authors: Meridor Katya , Shoenfeld Yehuda , Tayer-Shifman Oshrat , Levy Yair 
Published: May 2021

Abstract

Introduction:
Intravenous immunoglobulin (IVIg) is currently used with considerable success for the treatment of many autoimmune diseases, including systemic lupus erythematosus (SLE). Among its various indications, IVIg has also been found to be beneficial in myocarditis, whether or not it is associated with an autoimmune disease. Nevertheless, data regarding IVIg treatment for myocarditis/cardiomyopathy in patients with SLE are sparse. The objective of this case series was to describe our experience with IVIg as a treatment for lupus myocarditis and to review the literature for IVIg for this indication.

Patient concerns:
We report 5 female patients with SLE, who presented with signs of acute heart failure including pulmonary congestion and arrhythmias.

Diagnosis:
Echocardiography demonstrated new reduced left ventricular ejection fraction of 20% to 30%. Two patients underwent coronary artery angiography, which demonstrated normal coronary arteries, supporting the diagnosis of myocarditis or nonischemic cardiomyopathy.

Interventions:
High-dose IVIg treatment was initiated in all 5 patients.

Outcomes:
Following the treatment, clinical and echocardiographic improvement in cardiac function occurred within a few days to 1 month. This dramatic improvement persisted for several years.

Conclusion:
Based on our case series, we believe that IVIg has an important role in the management of lupus acute cardiomyopathy. This safe, well-tolerated optional treatment should be considered, especially in severe cases.
Risk factors of enteral feeding intolerance in severe acute pancreatitis patients
Authors: Fan Hongyun , Yang Chunchun , Duan Zhiying , Huo Xiaohui , Yang Yang 
Published: May 2021

Abstract

Background:
Patients with severe acute pancreatitis (SAP) have gastrointestinal dysfunction, and enteral nutrition intolerance is easy to occur during the implementation of enteral nutrition, which leads to the suspension or termination of enteral nutrition. Enteral nutrition cannot tolerate the influence of many factors. At present, there is a lack of analysis on the influencing factors of enteral nutrition intolerance in patients with SAP. Therefore, this study analyzed the factors of enteral nutrition intolerance in patients with SAP by meta-analysis, to provide a basis for the protection of enteral nutrition in patients with SAP.

Methods:
Databases (PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang) were searched using index words to find relevant studies published before March 2021. Meta-analyses of relative risk were performed for the identification of risk factors.

Results:
We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.

Conclusion:
This study systematically reviewed the existing evidence and determined the incidence and predictors of enteral nutrition intolerance in patients with SAP.