bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic effect and safety of Tuina on sciatica
Authors: Yan Huixin , An Yun , Zhang Tao , Zhao Jiangna , Yan Juntao 
Published: December 2021

Abstract

Background:
Sciatica is one of the common pain symptoms in the human body, also known as radiating leg pain. Sciatica is increasingly occurring due to poor posture and lack of physical exercise all over the world. At present, many studies have indicated that Tuina can improve the clinical symptoms and functional status of sciatica. However, there is currently no relevant systematic review to evaluate and report this clinical scientific issue. Consequently, this study will conduct a meta-analysis on the effectiveness and safety of Tuina therapy for sciatica.

Methods and analysis:
Randomized controlled trials (RCTs) related to Tuina treatment of sciatica will be retrieved from the Chinese and English databases and Clinical Trial Register. These databases include China National Knowledge Infrastructure, Wan Fang Database, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, PubMed, Embase, Web of Science, Cochrane Library, and Medline, etc. We will consider articles published in English or Chinese between database initiation and October 2021. Our team will use Review Manager Software 5.3 software provided by the Cochrane Collaborative Network to conduct this systematic review and meta-analysis.

Results:
This study provides a comprehensive evaluation of the effectiveness and safety of Tuina therapy for sciatica.

Conclusion:
The conclusion of our study will provide scientific evidence and reference to determine whether Tuina is an effective and safe intervention for patients with sciatica.

Registration number:
INPLASY2021100034.
Electric wire as a urethral foreign body
Authors: Song Qiqi , Zhang Jingwen , Jiao Ronghong 
Published: December 2021

Abstract

Rationale:
Most self-insertion of urethral foreign bodies is the result of exotic impulses, psychometric problems, sexual curiosity, or sexual practice while intoxicated. Ultrasound has been proven to be an effective tool for determining the presence, location, and characteristics of the urethral foreign body.

Patient concerns:
A 48-year-old man presented with a mass in the urethra for 2 years. Physical examination suggested swelling and ulcer in the scrotum. The white blood cell count was elevated (12.60 × 109/L). Urinalysis showed an increased white cell count (484.60/μL) and urine occult blood (±).

Diagnosis:
Ultrasound examination of the genitourinary system identified an 8.3 cm linear hyperechoic object and hyperechoic spots in the urethra. Computed tomography revealed an extremely hyperdense lesion in the penis. Intraoperative findings showed electric wire bending and winding surrounded by fibrous tissues with urethral rupture.

Interventions:
The patient was treated with urethrotomy as the endoscopic treatment failed. and the electric wire was removed successfully.

Outcomes:
The patient was followed up for 45 days without discomfort. Ultrasound examination of the genitourinary system suggested that the wound was almost healed, but with a small urethral effusion, with a maximum depth of approximately 1.9 mm.

Lessons:
A foreign body was inserted into the patient's urethra for 2 years without any medical treatment. Urethral perforation was found during surgery. In such cases, ultrasound examination can determine the location, shape, and size of the urethral foreign body and play an important role in the diagnosis of foreign bodies.
The efficacy of the traditional Korean herbal medicine Tongsayobang for the treatment of irritable bowel syndrome
Authors: Han Gajin , Ko Seok-Jae , Kim Keumji , Jun Hyejin , Park Jae-Woo 
Published: December 2021

Abstract

Background:
Irritable bowel syndrome (IBS) is a functional bowel disorder with symptoms of recurrent abdominal pain associated with a change in stool frequency or appearance that decreases patient quality of life. Conventional Western medicine has limited efficacy in treating IBS. Tongsayobang (TSYB) is a traditional Korean medicine that has been used to treat lower intestinal problems. This study provides a procedure for conducting a systematic review of the efficacy and safety of TSYB for IBS.

Methods and analysis:
The main electronic databases will be searched up to May 2021 for randomized controlled trials and quasi-randomized controlled trials evaluating the effect of TSYB or modified TSYB on patients with IBS. The primary outcome will be the overall efficacy rate. The secondary outcome will be data such as IBS-related quality of life, global symptom scores, and adverse events. This study will adopt the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and will involve a meta-analysis, if possible. The methodological quality of the included studies will be assessed using the Risk of Bias tool from the Cochrane Handbook, version 6.1.0.

Ethics and dissemination:
Ethical approval is not required because this study does not include any participants’ personal information.

OSF registration number:
DOI 10.17605/OSF.IO/M32BK (https://osf.io/m32bk)
The clinical and neuroradiological features of patients of coexisting atraumatic convexity subarachnoid hemorrhage and large artery atherosclerosis stroke
Authors: Chai Jingyan , Nie Hongbing , Wu Xiangbin , Guan Yanqin , Dai Tingmin , Shen Yaoyao 
Published: December 2021

Abstract
Atraumatic convexity subarachnoid hemorrhage (c-SAH) concomitant with large artery atherosclerosis (LAA) stroke has been rarely discussed in the literature. Our aim in this study is to characterize the clinical and neuroradiological features of patients with LAA stroke and c-SAH.
A retrospective study from a single institution was performed between January 2016 and June 2020. Only patients diagnosed with c-SAH and LAA stoke were included in this study. The clinical presentation and neuroimaging finding were summarized by our experienced neurologists.
In total, 12 patients (8 men, 4 women), ranging in age from 45 to 75 years, were identified. All of them had cardiovascular risk factors and hypertension was the commonest (50%). Almost all patients presented hemiparesis (91.7%). Other clinical presentations included, dysarthria (41.7%), hemianesthesia (33.3%), facial palsy (33.3%), aphasia (16.7%), and cognitive impairment (8.3%). Internal border-zone (IBZ) infarction and cortical border-zone (CBZ) infarction occurred in 12 and 3 patients, respectively. c-SAH might occurred in different cortical sulcis. Percentages of frontal lobe, parietal lobe and fronto-parietal lobe were 41.7% (n = 5), 25% (n = 3) and 25% (n = 3), respectively. All ischemic lesions were ipsilateral to the sites of c-SAH. High-grade atherosclerotic stenosis of large artery was detected in all patients. The M1 segment of middle cerebral artery (MCA) is the second most common atherosclerotic artery after internal carotid artery (ICA).
Our data suggest that LAA stroke is always ipsilateral to the site of c-SAH. Severe atherosclerotic changes can also been seen in the M1 segment of MCA apart from extracranial ICA. Moreover, border zone infarction may be a specific form of infarct when c-SAH is confronted with LAA stroke.
Serum copper, ceruloplasmin, and their relations to metabolic factors in nonalcoholic fatty liver disease: a cross-sectional study
Authors: Arefhosseini Sara , Pouretedal Zohre , Tutunchi Helda , Ebrahimi-Mameghani Mehrangiz 
Published: December 2021

Objective
Nonalcoholic fatty liver disease (NAFLD) characterized by excessive intrahepatic fat accumulation is increasing worldwide. This study aimed to investigate serum copper (Cu) and ceruloplasmin (Cer) levels and their relations to metabolic factors in NAFLD.

Methods
This cross-sectional study was conducted on 141 subjects with NAFLD diagnosed using abdominal ultrasonography. Personal information, anthropometric measures, glucose and lipid profile, and serum levels of liver enzymes were assessed. Fasting serum levels of Cu and Cer were determined using colorimetry and nephelometry assay, respectively. Odds ratios (ORs) were used to examine the associations of serum Cu and Cer levels with NAFLD risk.

Results
The results on 85 patients with NAFLD and 56 apparently healthy participants showed that all NAFLD cases and 53.6% of the healthy subjects were overweight or obese. More than half of the patients (58.8%) showed mild NAFLD. Age, weight, BMI, lipid profile, uric acid, and ferritin were significantly higher in NAFLD patients than the healthy cases. No significant differences were found in the concentrations of Cu and Cer between the groups. Only 7.4% of the healthy subjects and 2.4% of the patients were Cu deficient (<70 µg/dl). No association was found between the risk of NAFLD and serum Cu [OR: 0.994; 95% confidence interval (CI): 0.981–1.006] and Cer levels (OR: 0.414; 95% CI: 0.001–123.604) after adjusting for the confounders.

Conclusion
Our findings revealed no association between Cu deficiency and NAFLD risk. Further human studies with larger sample sizes are required to investigate how Cu and Cer status may affect NAFLD.
MicroRNA-34a Alleviates Gemcitabine Resistance in Pancreatic Cancer by Repression of Cancer Stem Cell Renewal
Authors: Pan Yue , Li Kun , Tao Xufeng , Zhao Yongxin , Chen Qing , Li Ning , Liu Jianzhou , Go Vay Liang W. , Guo Junchao , Gao Ge , Xiao Gary Guishan 
Published: December 2021

Objectives
This study aimed to enhance the sensitivity of pancreatic ductal adenocarcinoma cells by microRNA-34a (miR-34a)–mediated targeting of Notch 1.

Methods
Cell viability was determined by using an MTT (3-(4,5)-dimethylthiahiazo(−2)-3,5-diphenytetrazoliumromide) assay. The expression levels of miR-34a and relevant mRNAs were determined using quantitative polymerase chain reaction. Protein levels were measured by Western blotting. Cellular stemness was assessed by cell invasiveness and sphere formation assays. A transplanted tumor model was established for in vivo experiments.

Results
MicroRNA-34a enhanced gemcitabine sensitivity both in vivo and in vitro. MicroRNA-34a suppressed the stemness and proliferation of pancreatic cancer stem cells. MicroRNA-34a directly associated with Notch 1, which lies upstream of epithelial-mesenchymal transition signaling pathways.

Conclusions
MicroRNA-34a sensitized pancreatic cancer cells to gemcitabine treatment by inhibiting Notch 1 signaling in pancreatic cancer stem cells, indicating that miR-34a has the potential to be developed as a novel therapeutic agent for the treatment of gemcitabine-resistant pancreatic ductal adenocarcinoma cells.
International Survey on Severe Acute Respiratory Syndrome Coronavirus 2 and Acute Pancreatitis Co-occurrence in Children
Authors: Slae Mordechai , Wilschanski Michael , Sanjines Elvi , Abu-El-Haija Maisam , Sellers Zachary M. 
Published: December 2021

Objectives
It is unknown to what extent coronavirus 2019 (COVID-19) may co-occur with acute pancreatitis (AP) in children and how their clinical course may differ from children with AP alone.

Methods
An online survey was sent to pediatric gastroenterologists to report on COVID-19 and AP cases from December 11, 2020, to February 26, 2021.

Results
From 72 respondents (20 countries, 5 continents), 22 cases of positive COVID-19 infection and AP were reported. Patients were predominantly White or Hispanic/Latinx (73%), female (68%), and adolescents (68%). For 86% of patients, this was their first episode of AP. Sixty-eight percent of positive COVID-19 tests were polymerase chain reaction based. There was significant morbidity; 60% required intensive care, 45% had multiorgan involvement, and 24% developed shock. Eleven percent had pancreatic necrosis. Abnormal clotting and systemic inflammatory laboratories were common (31%–92% and 93%, respectively). Median length of symptomatic pancreatitis recovery was 1.8× longer than AP without COVID-19.

Conclusions
Coronavirus 2019 infection and AP co-occur primarily in children without a prior history of pancreatitis. Given the increased need for intensive care, multiorgan involvement, and potentially higher risk for pancreatic necrosis, pediatric providers should have a high level of suspicion for AP in children with COVID-19 infection.
Elevated Blood Pressure in Women of Childbearing Age in the United States
Authors: Logsdon M. Cynthia , Blair Leeanna , Gunaratnam Bakeerathan 
Published: December 2021

Abstract

Purpose:
Elevated blood pressure is frequently associated with adverse health issues among women during and after childbirth in the United States. The purpose of this study was to describe incidence of and determine predictors of prehypertension and hypertension among women of childbearing age in the United States.

Study Design and Methods:
Using secondary data analysis, existing data from the National Health and Nutrition Examination Survey (NHANES; 2013-2018) were used to address study aims. Inclusion criteria were women in the age range commonly considered to be of childbearing age, 15 to 44 years of age. Simple random sampling was to select subjects from the 2,932 women in the NHANES dataset who met inclusion criteria. We calculated a sample size as adequate for the statistical group comparison to be significant with a power of 95% to detect a difference among groups. An ordinal logistic regression model was created to discriminate predictors of normotensive blood pressure, prehypertension, and hypertension.

Results:
The sample (n = 393) included 300 women with normal blood pressure, 46 women with prehypertension, and 47 with hypertension. Older women (within childbearing age range), women with high body mass index, and African American women are highly likely to have prehypertension and hypertension.

Clinical Implications:
Contrary to previous research, poverty income ratio was not associated with prehypertension and hypertension. Future research should test interventions that include promoting heathy lifestyles and address elevated body mass index. Interventions should be tailored to be culturally appropriate for African American women and older women within this age range.
Burnout and Turnover among NICU Nurses
Authors: Thomas Anisa O. , Bakas Tamilyn , Miller Elaine , Johnson Kimberly , Tubbs-Cooley Heather L. 
Published: December 2021

Abstract

Introduction:
In 2019, the national average turnover rate of registered nurses in the United States was approximately 17.8%. Each percentage increase in turnover costs a hospital, on average, $270,800. Although burnout is a known contributor to nurses' turnover intention, few studies have examined the relationship between nurse burnout and turnover, and there is little data on this relationship in neonatal intensive care environments. The purpose of this study was to examine the relationship between nurse burnout and turnover among neonatal intensive care unit (NICU) nurses.

Study Design:
A secondary analysis of data collected from an observational study involving 136 nurses in a 52-bed NICU from 2013 to 2014.

Methods:
Multivariate logistic regression models were used to test for associations between measures of burnout and turnover.

Results:
16.9% of nurses turned over during the 11 months of the original study. Most nurses reported high (46%) to moderate (37%) levels of emotional exhaustion. Final models did not indicate a relationship between burnout and turnover.

Clinical Nursing Implications:
Although burnout has been associated with turnover intent among nurses, we did not observe an association between burnout and turnover among NICU nurses. Despite no direct relationship between burnout and turnover in the NICU, burnout may have other negative consequences. Nurse leaders should continue to prioritize reducing burnout among nursing staff to improve the well-being of the NICU nurse workforce.
Trigger Point Injection as a Rare Cause of Ischemic Stroke
Authors: Tanoğlu Ceyda , Duman İlki Canan , Ersoy Alevtina , Yaşar Hasan 
Published: December 2021

Introduction:
Myofascial pain syndrome is a painful local or regional disease caused by myofascial trigger points. Trigger point injection (TPI) is a frequently used method for the treatment of myofascial pain. Major complications associated with TPI have rarely been reported in the literature.

Case Report:
A 24-year-old woman, without medical history of any disease, was diagnosed with myofascial syndrome based on the presence of long-standing neck and right arm pain, and TPI with lidocaine was applied to the right trapezius region. During the procedure, blurred vision and loss of strength in the left arm occurred. Magnetic resonance and computed tomography imaging of the brain revealed findings that were consistent with an ischemic stroke in the right capsular interna and right occipital region.

Conclusion:
The reported patient is the first in the literature who suffered from ischemic stroke after TPI. The use of ultrasound for injections into the neck muscles could avoid serious complications.
Randomized Controlled Trials for Neuromyelitis Optica Spectrum Disorder
Authors: Cabal-Herrera Ana M. , Mateen Farrah J. 
Published: December 2021

Background:
Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing inflammatory disease that primarily affects the optic nerves and the spinal cord. Randomized controlled trials (RCTs) assessing treatments for NMOSD have only been performed in the past decade, and to date, there are 3 drugs approved by the US Food and Drug Administration (FDA) for antiaquaporin-4 immunoglobulin G seropositive NMOSD. This review assesses the characteristics and challenges of RCTs when evaluating treatments for NMOSD.

Review Summary:
We conducted a review using the terms (“neuromyelitis optica” OR “NMO” OR “NMOSD”) AND “clinical trial” in any language on March 28, 2021. Seven RCTs were included, and the trials’ architecture was analyzed and synthesized. Overall, 794 subjects were randomized [monoclonal antibody intervention group, n= 493 (62.1%), placebo, n=196 (24.7%), and active control, n=105 (13.2%)]; 709 (89.3%) were females; and 658 (82.9%) were aquaporin-4 (AQP4) antibody seropositive. The primary outcome was time to relapse in 6/7 of the trials, and annualized relapse rate in the remaining one. Four RCTs used placebo in their design. Among the seven published RCTs, the trial design differed by the criteria used to define NMOSD relapse, selection of subjects, proportion of AQP4 immunoglobulin G seronegative patients, and baseline characteristics indicating NMO disease severity.

Conclusions:
Ethical considerations for the use of placebo should change in light of the approval of 3 therapies for seropositive NMOSD. Remaining challenges for clinical trials in NMOSD include the assessment of long-term safety and efficacy, standardization of trial design and endpoints, and head-to-head study designs.
Large Middle Cerebral Artery Ischemic Stroke in a Therapeutically Anticoagulated Patient With Severe SARS-CoV-2 Infection
Authors: Choudhry Humdoon , Klingensmith Jessica , Border Dalton Lloyd , Myers My , Mercado Edgar 
Published: December 2021

Introduction:
Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with hypercoagulability which can predispose infected patients to both arterial and venous thromboembolic complications. Despite therapeutic anticoagulation, there remains a risk of ischemic strokes, which may lead to adverse patient outcomes. Only a few cases are described in the literature regarding SARS-CoV-2 positive patients developing thrombotic ischemic strokes despite therapeutic anticoagulation.

Case Report:
The following is a case discussion regarding a 71-year-old female with past medical history of hypertension, diabetes mellitus type 2, hyperlipidemia, and hypothyroidism who was admitted with severe SARS-CoV-2 infection to the intensive care unit and later developed acute left upper extremity weakness on the 5th day of her admission. Initial National Institutes of Health stroke scale (NIHSS) was 15. Subsequent brain imaging was significant for right middle cerebral artery ischemic stroke. The patient was therapeutically anticoagulated with 1.5 mg/kg subcutaneous dose of Enoxaparin since day 1 of her admission. D-dimer upon admission was 1.84 mg/L (<0.59) and fibrinogen 783.1 mg/dL (200 to 450). Other than past medical comorbidities, our patient had no other known stroke risk factors. Unfortunately, despite early transcatheter thrombectomy, the patient remained comatose and eventually expired after withdrawal of ventilatory support and compassionate extubation.

Conclusion:
Because of the severity of inflammation and coagulopathic sequelae of coronavirus disease 2019, anticoagulation failure may occur and lead to adverse patient outcomes. Our case report is one of the few discussions in the current literature regarding large vessel thromboembolic ischemic strokes despite therapeutic anticoagulation.
Temporal Trends in Glioblastoma Survival
Authors: Neth Bryan J. , Carabenciov Ivan D. , Ruff Michael W. , Johnson Derek R. 
Published: December 2021

Background:
Survival of patients with glioblastoma (GBM) increased in the 2000s, most prominently after the addition of temozolomide to the standard-of-care treatment protocol. The reason for subsequent improvements in survival in the late 2000s and early 2010s was less clear, with explanations including the introduction of bevacizumab, better surgical methods, and advances in supportive care. It is uncertain whether the trend of improving population-level survival has continued.

Materials and Methods:
Data from the Surveillance, Epidemiology, and End Results (SEER) Program was analyzed comparing survival of adult GBM patients diagnosed in consecutive 3-year periods from 2000 to 2017. Kaplan-Meier survival analysis and Cox proportional hazards models were used.

Results:
A total of 38,352 patients diagnosed with GBM between 2000 and 2017 met inclusion criteria. Median survival and percent survival to 12 and 24 months all progressively increased between 2000 and 2011. There were no significant differences in survival comparing 2009-2011 with 2012-2014 or 2015-2017. During the 2015-2017 period, median survival was 11 months, with 12 and 24-month survival proportions of 45.7% (95% confidence interval, 44.5-47.0) and 19.0% (95% confidence interval, 18.6-21.2), respectively.

Conclusions:
After a period of progressive improvement in GBM survival between 2000 and 2011, survival plateaued. Subsequent advances since 2011 have not yet been translated to improved survival on the population-level as of 2017.