bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain control and related factors in hospitalized patients
Authors: Lin Li-Ying , Hung Tzu-Ching , Lai Yen-Ho 
Published: August 2021

Abstract
Pain is a common health problem for hospitalized patients. It is necessary to understand the factors that affect patients’ pain to provide individual and complete pain management. This study explored the severity and incidence of pain in hospitalized patients on the admission day, during the hospitalization, and the discharge day, and explored the predictive factors that affect the patient's pain on the discharge day.
This was a retrospective study that reviewed the medical records of 73,814 hospitalized patients from January 2016 to April 2018. The number of pain assessments was 471,339.
The incidence of pain on the discharge day of patients was significantly higher than that on the admission day. The factors that affect and predict the pain of patients on discharge day include the degree of pain on the day of admission, emotional distress on the day of discharge, disease category, gender, age, and length of stay in hospital. It shows that the higher the degree of pain on the day of admission, the higher the degree of emotional distress on the day of discharge, female patients, younger patients, longer hospitalization days, and surgical and gynecological patients have significantly higher pain levels on the day of discharge (P < .05).
This study found that the incidence of pain on the discharge day of patients was 46.5%. Previous pain level, disease category, emotional distress, gender, age, and length of hospital stay were important factors affecting patient pain on the discharge day. The influencing factors of patient pain should be fully assessed to provide individual and complete pain management, and improve patient quality of life after discharge.
The changes of Lp-PLA2 in patients with gestational diabetes and its clinical significance
Authors: Wang Guo-Hua , Jin Jun , Liu Ya-Qiong , Yang Fu-Yan , Shi Dan , Zhang Yi , Zhao Yi-Mei , Wang Yang 
Published: August 2021

Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and associated with adverse pregnancy outcomes. The aim of this study was to investigate the changes of lipoprotein-associated phospholipaseA2 (Lp-PLA2) level and its correlation with biochemical indexes in patients with GDM.
This observational cross-sectional study was performed among 52 GDM and 48 healthy pregnant women. Automatic biochemical analyzer was employed to test the biochemical indexes, including fasting plasma glucose (FPG), Hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). The lipoprotein-associated phospholipaseA2 (Lp-PLA2) level was evaluated by enzyme-linked immunosorbent assay, and homeostatic model assessment for insulin resistance (HOMA-IR) was calculated.
The levels of FPG, HbA1c, HOMA-IR, TG, TC and LDL-C were significantly increased while high-density lipoprotein cholesterol (HDL-C) level was significantly decreased in the GDM group when compared with those in the control group. Lp-PLA2 level in maternal blood in the GDM group was significantly higher than that in the control group (199.125 ± 23.494 vs165.825 ± 15.576 ng/mL, P < .05) and logistic regression analysis further confirmed the association of Lp-PLA2 levels with GDM. Furthermore, Lp-PLA2 positively correlated with HOMA-IR, TC, and LDL-C.
Our results confirmed the association of Lp-PLA2 with GDM. This broadens our knowledge on the pathophysiology of GDM and provides insights into the development of new targets for the prevention and treatment of GDM.
Efficacy of carboprost tromethamine combined with leonurus japonicus for prevention of postpartum hemorrhage in high-risk pregnant women
Authors: Zong Fang , Cao Yanmin 
Published: August 2021

Abstract

Background:
No well-designed and systematic evaluation of the efficacy and safety of leonurus japonicus injection (LJI) in combination with carboprost tromethamine has been found. Therefore, we undertook a meta-analysis to assess the efficacy and safety of carboprost tromethamine combined with LJI for the prevention of postpartum hemorrhage in high-risk pregnant women to provide new evidence-based medical evidence for clinical treatment.

Methods:
This systematic review and meta-analysis would be performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The following databases including EMBASE, MEDICINE, Wanfang, China National Knowledge Infrastructure database, and Cochrane central controlled trial registries were searched by 2 reviewers from inception to July 2021. Mesh and keyword search terms were “motherwort,” “Yimucao,” “leonurus japonicas,” “carboprost tromethamine,” and “postpartum hemorrhage.” Any cohort studies that assessed the efficacy and safety of carboprost tromethamine combined with LJI for the prevention of postpartum hemorrhage would be included. P < .05 was set as the level of significance.

Results:
The review would add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

OSF registration number:
10.17605/OSF.IO/2WC53.
Successful treatment of restless leg syndrome with the traditional herbal medicines Dangguijakyak-san and Shihogyeji-tang
Authors: Seo Yuna , Jin Chul , Jang Bo-Hyoung , Jeon Jin Pyeong , Lee Ye-Seul , Yang Seung-Bo , Jung Woo-Sang , Moon Sang-Kwan , Cho Ki-Ho , Kwon Seungwon 
Published: August 2021

Abstract

Rationale:
Dopamine replacement is currently the standard treatment for restless leg syndrome (RLS); however, various adverse effects are associated with long-term therapy, and the benefits disappear upon discontinuation. To overcome these limitations, interest in traditional East Asian medicine has increased.

Patient concerns:
A 72-year-old Asian woman originally admitted for an intracerebral hemorrhage presented with complaints of an unpleasant sensation throughout the body that appeared at night.

Diagnoses:
The patient was diagnosed with chronic persistent RLS based on the 2012 Revised International Restless Leg Syndrome Study Group Diagnostic Criteria.

Interventions:
The patient was treated with extracts of the traditional herbal medicines Dangguijakyak-san (DS) and Shihogyeji-tang (ST). After 47 days of therapy, all herbal medicines were discontinued, and symptoms had not returned by the last follow-up 244 days after the initial treatment.

Outcomes:
One week after initiating herbal treatment with DS and ST, the RLS symptoms began to improve, and the total hours of sleep had increased from 2 to 9 hours by day 21, with a Korean version of the international restless legs scale score of 11 points. On day 36, ST was discontinued, given the continued improvement of symptoms. On day 47, symptoms had disappeared (Korean version of the international restless legs scale score: 0), and sleep disturbances caused by RLS had completely resolved. After day 47, DS was also discontinued. There were no adverse effects associated with the administration of DS and ST, and the symptoms had not recurred by the last follow-up on day 244.

Lessons:
In this case, RLS related symptoms, which had been present for approximately 60 years, were improved using only the traditional herbal medicines DS and ST (without dopamine replacement), and no symptoms recurred for 244 days. This case suggests that if replacement therapy is difficult or not desired, herbal medicinal therapies may be an effective alternative. This also suggests that the effect of herbal medicine on RLS might be semi-permanent. Further investigations, including clinical trials, are needed to confirm these effects.
A rapid response of lung squamous cell carcinoma following treatment with sintilimab combined with recombinant humane endostatin injection and nab-paclitaxel in an elderly patient
Authors: Fang Yueyu , Sun Hui , Chen Yi , Jiang Nanyuan , Ji Lianhua , Shi Junfeng 
Published: August 2021

Abstract

Rationale:
At present, the prognosis of patients with giant lung squamous cell carcinoma (LSCC) is poor, and there is no safe and effective treatment for elderly patients with large LSCC.

Patient concerns:
Here, we reported a 77-year-old man admitted to the hospital with cough for 3 months and significant chest pain. Computed tomography (CT) imaging showed a large mass in the left lung with pleural effusion.

Diagnoses:
Chest CT scan revealed a 12.5 cm × 7.3 cm mass in the left upper lobe adjacent to the pulmonary vein, with left pleural effusion. Pulmonary tumor markers were significantly elevated, and CT-guided percutaneous lung mass biopsy specimens showed LSCC.

Interventions:
After diagnosis, the patient was treated with sintilimab combined with endostar and nab-paclitaxel. After 2 cycles of treatment, the lung mass in the patient shrank rapidly and the clinical symptoms were relieved.

Outcomes:
The patient's tumor dramatically shrank, and the pleural effusion was decreased after 4 cycles of treatment without any adverse effects. Meanwhile, the high-level tumor marker resumed normal.

Lessons:
Sintilimab combined with endostar and nab-paclitaxel may be a good treatment option for lung squamous cell cancer, especially for that in elderly patients.
Clinical characteristics, prescription patterns, and persistence associated with sacubitril/valsartan adoption
Authors: Chen Wenwen , Liu Yanyan , Tang Longlong , Li Zhenshan , Liu Yanlin , Dang Heqin 
Published: August 2021

Abstract
Sacubitril/valsartan (sac/val) was launched in China in 2018; however, the adoption of sac/val in real-world clinical practice has yet to be described.
This study aimed to analyze real-world treatment patterns of sac/val using data from 3 tertiary hospitals in China.
A non-interventional, retrospective cohort study of patients with Heart failure (HF) prescribed sac/val from 3 tertiary hospitals in China between January 1, 2018 and June 30, 2020 was conducted. The analysis included sac/val dose titration patterns and persistence during 6 months post-index.
A total of 267 patients were included, with a mean age of 63.9 ± 13.1 years. At index, 27% of patients were prescribed sac/val 12/13 mg b.i.d., 63.7% were prescribed 24/26 mg b.i.d., 4.5% were prescribed the target dose of 49/51 mg b.i.d., and 4.8% were not prescribed according to the recommended dose. During the 6 months post-index, 8.3% of patients had only 1 dose titration record. Good therapeutic persistence was observed across sac/val doses, and only 15.7% of patients discontinued sac/val during the 6 months post-index.
In China, the majority of patients prescribed sac/val are not initiated on the recommended dose nor up-titrated according to drug instruction. Notably, good persistence with sac/val is observed in the real-world cohort study.
A strong reconstruction option for tissue loss on hand and wrist due to firearm injury in the Syrian war
Authors: Ucak Murat 
Published: August 2021

Abstract
All of the injuries were the open injuries with bone or tendon structures in the hand and wrist region as a result of the firearm injury (FI) in the Syria. In the study, we assessed the outcomes of the posterior interosseous flap (PIF) on hand and wrist that we used for the Syrian injured people including civilians and soldiers in this War. PIF was applied to 77 patients who composed of 43 female and 34 male that all patients were evaluated for tissue loss resulting from gunshot wounds and injured in the War between 2014 and 2020 years with tissue loss in hand and wrist as a result of FI. The flap survival rate was 100% for all the patients. The dimensions of flaps ranged from 4.1 cm × 2.2 cm to 9cm × 5.4 cm with 0.51 ± 0.12 cm thickness. The mean pedicle length was 6.33 ± 1.08 cm. The surgery for PIF took 68.8 ± 22.1 minutes, while blood loss was 60 ± 24 mL. We observed no palsy conditions including the posterior interosseous nerve. The donor sites were treated by primary intention in the patients. We found the superiority of PIF with the postoperative follow-up comfort, ease of fracture healing, easy and fast, easy-to-apply method and no second additional session requirement in FI patients. We did not detect flap necrosis in any patient or observe a flap-related complication. As a result of the present study, it strongly supports the thesis that PIF is the best option in these cases.
Adherence to antihypertensive medications among adult hypertensive patients attending chronic follow-up units of Dessie Referral Hospital, Northeastern Ethiopia
Authors: Andualem Atsedemariam , Liknaw Tiliksew , Edmealem Afework , Gedefaw Mihretie 
Published: August 2021

Abstract
Hypertension is the leading cause of increased morbidity and mortality rates worldwide. Despite adherence to therapies is the important determinant of treatment success to reduce apparent resistant hypertension, maintaining good adherence to antihypertensive medications remained the most serious challenge. Thus, this study aimed to assess adherence to antihypertensive medications among adult hypertensive patients in Dessie Referral Hospital.
A cross-sectional study design was conducted among hypertensive patients during May and June 2020. The study participants were selected using a systematic random sampling technique. The collected data were entered into EpiData version 4.4 and exported to SPSS version 25.0 software for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression at a 95% confidence interval (CI). A variable that has a P-value < .05 was declared as statistically significant. Hosmer–Lemeshow test was used to test goodness-of-fit and multicollinearity was tested.
The overall good adherence to antihypertensive medications was 51.9%; 95% CI: (46.8–58.3%) and poor adherence was 48.1%. Factors associated with good adherence were: sex—female adjusted odd ratio (AOR) = 1.31; 95% CI (1.06–2.52), occupational status-employed AOR = 2.24; 95% CI (1.33–3.72), good knowledge of the disease AOR = 2.20; 95% CI (1.34–3.72) and good self-efficacy AOR = 1.38; 95% CI (1.20–2.13).
This study revealed that almost half of the hypertensive patients in Dessie Referral Hospital had good antihypertensive medication adherence. Sex, occupational status, knowledge, and self-efficacy were factors associated with good adherence. Therefore, health education should be given to patients on the importance of complying with medication and patients should be monitored by health extension workers.
Decreased activities of daily living at discharge predict mortality and readmission in elderly patients after cardiac and aortic surgery
Authors: Sato Masaaki , Mutai Hitoshi , Yamamoto Shuhei , Tsukakoshi Daichi , Takeda Shuhei , Oguchi Natsuko , Ichimura Hajime , Ikegami Shota , Wada Yuko , Seto Tatsuichiro , Horiuchi Hiroshi 
Published: August 2021

Abstract
Recently, activities of daily living (ADL) were identified as a prognostic factor among elderly patients with heart disease; however, a specific association between ADL and prognosis after cardiac and aortic surgery is not well established. We aimed to clarify the impact of ADL capacity at discharge on prognosis in elderly patients after cardiac and aortic surgery.
This retrospective cohort study included 171 elderly patients who underwent open operation for cardiovascular disease in a single center (median age: 74 years; men: 70%). We used the Barthel Index (BI) as an indicator for ADL. Patients were classified into 2 groups according to the BI at discharge, indicating a high (BI ≥ 85) or low (BI < 85) ADL status. All-cause mortality and unplanned readmission events were observed after discharge.
Thirteen all-cause mortality and 44 all-cause unplanned readmission events occurred during the median follow-up of 365 days. Using Kaplan–Meier analysis, a low ADL status was determined to be significantly associated with all-cause mortality and unplanned readmission. In the multivariable Cox proportional hazard models, a low ADL status was an independent predictor of all-cause mortality and unplanned readmission after adjusting for age, sex, length of hospital stay, and other variables (including preoperative status, surgical parameter, and postoperative course).
A low ADL status at discharge predicted all-cause mortality and unplanned readmission in elderly patients after cardiac and aortic surgery. A comprehensive approach from the time of admission to postdischarge to improve ADL capacity in elderly patients undergoing cardiac and aortic surgery may improve patient outcomes.
Transient deterioration of albumin–bilirubin scores in early post-dose period of molecular targeted therapies in advanced hepatocellular carcinoma with 50% or higher liver occupation
Authors: Muto Hisanori , Kuzuya Teiji , Ito Takanori , Ishizu Yoji , Honda Takashi , Ishikawa Tetsuya , Ishigami Masatoshi , Fujishiro Mitsuhiro 
Published: August 2021

Abstract
Real-world clinical cases of molecularly targeted agent (MTA) administration to patients with advanced hepatocellular carcinoma (HCC) with ≥50% liver occupation have been reported, but treatment outcomes have rarely been described. We have encountered several cases in which albumin–bilirubin (ALBI) scores deteriorated markedly and C-reactive protein (CRP) levels elevated in the early post-dose period. The present study therefore investigated early clinical changes in ALBI score and CRP levels after initiating MTA in advanced HCC patients with ≥50% liver occupation, focusing on antitumor response at 6 weeks.
This retrospective study included 46 HCC patients with liver occupation ≥50% and 191 patients with <50%, Child-Pugh score ≤7, and Eastern Cooperative Oncology Group Performance Status scores of 0 or 1, who were treated with sorafenib or lenvatinib as first-line systemic therapy at our hospital between June 2011 and January 2020. We analyzed their medical records up to March 2020 and investigated the outcomes and changes in CRP and ALBI scores classified according to antitumor response at 6 weeks.
Overall survival was significantly longer in patients with partial response (PR) + stable disease (SD) (13.7 months) than in patients with progressive disease (PD) (1.7 months, P < .001) in the ≥50% group. Patients with antitumor response of PR + SD at 6 weeks in the ≥50% group showed more marked deterioration of ALBI score at 2 weeks than those in the <50% group. These significant differences between groups had again disappeared at 4 and 6 weeks. Focusing on patients with PD at 6 weeks, ALBI score deteriorated over time in both groups. Regarding CRP, on 6-week PR + SD patients, a significant increase in CRP levels at 1 and 2 weeks was evident in the >50% group compared to the <50% group. These significant differences between groups had again disappeared at 4 and 6 weeks. In PD patients, no difference between groups in CRP elevation occurred at 1 and 2 weeks.
In MTA treatment for patients with ≥50% liver occupation, to obtain an antitumor response of PR + SD, adequate management might be important considering transient deteriorated ALBI scores and elevated CRP levels.
Added value of deep learning-based computer-aided diagnosis and shear wave elastography to b-mode ultrasound for evaluation of breast masses detected by screening ultrasound
Authors: Kim Min Young , Kim Soo-Yeon , Kim Yeon Soo , Kim Eun Sil , Chang Jung Min 
Published: August 2021

Abstract
Low specificity and operator dependency are the main problems of breast ultrasound (US) screening. We investigated the added value of deep learning-based computer-aided diagnosis (S-Detect) and shear wave elastography (SWE) to B-mode US for evaluation of breast masses detected by screening US.
Between February 2018 and June 2019, B-mode US, S-Detect, and SWE were prospectively obtained for 156 screening US-detected breast masses in 146 women before undergoing US-guided biopsy. S-Detect was applied for the representative B-mode US image, and quantitative elasticity was measured for SWE. Breast Imaging Reporting and Data System final assessment category was assigned for the datasets of B-mode US alone, B-mode US plus S-Detect, and B-mode US plus SWE by 3 radiologists with varied experience in breast imaging. Area under the receiver operator characteristics curve (AUC), sensitivity, and specificity for the 3 datasets were compared using Delong's method and McNemar test.
Of 156 masses, 10 (6%) were malignant and 146 (94%) were benign. Compared to B-mode US alone, the addition of S-Detect increased the specificity from 8%–9% to 31%–71% and the AUC from 0.541–0.545 to 0.658–0.803 in all radiologists (All P < .001). The addition of SWE to B-mode US also increased the specificity from 8%–9% to 41%–75% and the AUC from 0.541–0.545 to 0.709–0.823 in all radiologists (All P < .001). There was no significant loss in sensitivity when either S-Detect or SWE were added to B-mode US.
Adding S-Detect or SWE to B-mode US improved the specificity and AUC without loss of sensitivity.
The efficacy and safety of fire needle for cervical spondylotic radiculopathy
Authors: Xue Kaiyang , Liu Hong , Shi Qiumei , Wang Xianzhu , He Yanqin , Cui Jin , Fu Jing 
Published: August 2021

Abstract

Background:
Cervical spondylotic radiculopathy (CSR) is one of the most common types of cervical spondylosis, and its treatments are mainly for relieving radicular pain and improving dysfunction. The existing randomized controlled trials (RCTs) suggest that fire needle may be a potential therapy in the treatment of CSR, but there is no evidence-based medical evidence to date. Therefore, this study will systematically evaluate the efficacy and safety of fire needle in the treatment of CSR.

Methods:

We will search for 7 electronic databases (PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Sinomed, and Wanfang Database) and 2 trial registration platforms (ClinicalTrials.gov and Chinese Clinic Trials.gov) to collect eligible studies. The RCTs related to fire needle for CSR and published up to June 30, 2021 will be included, regardless of language. We will consider the visual analogue scale as the primary outcome and the secondary outcome will include cervical range of motion, assessment of muscle strength, neck disability index, the MOS item short from health survey, activities of daily living, total efficiency, and adverse reactions. We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the quality and bias risk of every RCT, and all analyses will be conducted through RevMan software V5.3 (Copenhagen: Nordic Cochrane Center, Cochrane, Collaborative Organization, 2014).

Results:
This systematic review and meta-analysis will provide a convincing synthesis of existing evidences on the efficacy and safety of fire needle for CSR, and the results will be submitted to a peer-reviewed journal for publication.

Conclusion:
The results of this study will provide high-quality evidence of fire needle in the treatment of CSR for clinical decision-making.

INPLASY registration number:
INPLASY202170041.