bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sero-epidemiology study of hepatitis B virus surface antibodies from 2017 to 2019 among Chinese young adults in Hunan Province
Authors: Xie Ming , Quan Hongjiao , Zeng Yuan , Yuan Shuqian , Liu Yinyue , Yang Yide 
Published: August 2021

Abstract

Background:
Data on the epidemiology characteristics of hepatitis B surface antibodies (anti-HBs) are lacking among central southern undeveloped areas of China, especially for young adults. This study aims to demonstrate the sero-epidemiology characteristics of HBsAb among young adults.

Aims:
The aim of this study is to demonstrate the epidemiological characteristics in prevalence of serum anti-HBs in college students of a university in Hunan Province, China.

Methods:
Data were derived from the health records (including serum HBsAb data) among freshmen of a university from 2017 to 2019 in Hunan Province, China.

Results:
A total of 13,426 freshmen with complete data who were born in Hunan Province were collected. The 3-year total prevalence of anti-HBs in freshmen was 44.75% with no statistically significant sex difference, the prevalence of anti-HBs is 46.93%, 53.13%, and 34.79% for 2017, 2018, and 2019, respectively. There are significant geographic differences of prevalence of anti-HBs in freshmen from different areas. The lowest prevalence of anti-HBs was 31.80% in freshmen from Xiangtan, and the highest prevalence of anti-HBs was 53.10% in freshmen from Yongzhou.

Conclusion:
The prevalence of serum anti-HBs among the freshmen in Hunan from 2017 to 2019 is much lower than the average national level, and the prevalence in 2019 is significantly lower than that in 2017 and 2019. There are significant differences in different time and areas of the prevalence of anti-HBs. There is a necessity to carry out area-specific intensive immunization plan in a timely manner among young population in Hunan Province, China.
A survey of PM2.5 preventive behavioral intention and related factors among community elderly in Northern Taiwan
Authors: Weng Yu-Ling , Liang Chin-Chia , Tseng Chie-Chien , Lee Shih-Yi , Yeh Gwo-Liang 
Published: August 2021

Abstract
Population aging and air pollution are global concerns. The purpose of this study is to explore the relationship among particulate matter with a diameter of 2.5 μm or less (PM2.5) knowledge, PM2.5 preventive attitude, and PM2.5 preventive behavioral intention in the elderly.
A cross-sectional survey design was applied in this study, including usage intention and snowball sampling. A total of 617 elderly people aged over 65 participated, and the collected data were quantitatively analyzed.
The results showed that the mean score of PM2.5 knowledge of the elderly was 10.34 (79.53%) with the standard deviation (SD) of 3.42, the mean score of PM2.5 preventive attitude was 4.58 (91.60%) with SD of 0.49, and the mean score of PM2.5 preventive behavioral intention was 4.72 (94.40%) with SD of 0.40. Elderly people's characteristics regarding PM2.5 knowledge and PM2.5 preventive attitude explained 22% (adjusted R
2 = 0.22, F = 30.44, P < .001) of the variance in PM2.5 preventive behavioral intention.
It is concluded that we found no difference in PM2.5 knowledge, PM2.5 preventive attitude, or PM2.5 preventive behavioral intention among the elderly with or without chronic diseases. In our opinion, health education regarding the threat of PM2.5 to the health of the elderly should be strengthened, to enhance their knowledge, preventive attitude, and preventive behavioral intention of PM2.5.
Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer
Authors: Lee Eung Kyum , Kim Jin , Park Dong-Hyuk , Lee Chang Kyu , Kim Sun Bean , Sohn Jang Wook , Yoon Young Kyung 
Published: August 2021

Abstract

Rationale:
Nocardiosis is an uncommon and potentially life-threatening infection that usually affects immunocompromised hosts. No clinical guidelines have been established for managing this rare disease, and the optimal treatment modality remains unclear. Nocardia farcinica, a relatively infrequent pathogen of nocardiosis, causes a clinically aggressive infection. In addition to our patient data, our search of the literature for patients who presented with empyema caused by N. farcinica will provide fundamental information for optimal treatment modalities.

Patient concerns:
A 64-year-old man was diagnosed with empyema, 4 days following surgery for sigmoid colon cancer. Brain lesions were evaluated only after N. farcinica was isolated and identified as the causative pathogen through repeated culture tests.

Diagnoses:

N. farcinica was isolated from the pleural effusion and confirmed as the pathogen through 16S rRNA sequencing.

Interventions:
The patient was successfully treated with tube thoracotomy, neurosurgical evacuation, and a combination of trimethoprim/sulfamethoxazole plus imipenem. Long-term antibiotic therapy was required to prevent recurrence.

Outcomes:
Pyothorax showed a good clinical response to antimicrobial therapy and drainage of pleural effusion, whereas brain abscess did not respond to medical therapy and required surgery. The patient eventually recovered and continued chemotherapy as treatment for sigmoid colon cancer.

Lessons:
Although extremely rare, this report demonstrates the importance of considering Nocardia infection as the differential diagnosis in immunocompromised patients who present with empyema. In particular, because of the N. farcinica infection's tendency to spread and the resistance of the organism to antibiotics, aggressive evaluation of metastatic lesions and standardized support from microbiological laboratories are important. Surgery may be required in some patients with brain abscesses to improve the chance of survival.
Sinus pause during nerve integrity monitoring tube insertion following anesthetic induction with a low-dose neuromuscular blocking agent
Authors: Byun Sung-Hye , Jeon Jae-Min 
Published: August 2021

Abstract

Rationale:
Nerve integrity monitoring (NIM) tubes are commonly used in thyroid surgery to prevent recurrent laryngeal nerve injury. To achieve the optimal electromyographic signal for NIM as intraoperative neural monitoring (IONM), the neuromuscular blocking agent (NMBA) dose should be low. The use of a low-dose NMBA increases the anesthetic and analgesic agent dose required to attenuate the laryngeal reflex during intubation. In addition, since the NMBA onset time is delayed, depending on the situation, anesthesia may become excessively deep or shallow before intubation.

Patient's concern:
A 51-year-old woman scheduled for thyroid lobectomy received 0.3 mg/kg of rocuronium. Three minutes later, when the NIM tube was inserted through the vocal cord, the patient's heart rate (HR) was undetectable for 2 seconds.

Diagnosis:
We suspected that the use of a high-dose anesthetic agent and remifentanil or the laryngocardiac reflex induced the sinus pause.

Interventions:
To maintain the anesthetic depth, we administered 6 vol% of desflurane. Because the patient's systolic blood pressure was 70 mmHg and HR was 30 beats/min, we discontinued the remifentanil infusion and administered 8 mg of ephedrine.

Outcomes:
The patient's vital signs recovered to normal levels. Subsequently, there were no episodes of bradycardia or arrhythmia.

Conclusion:
Sinus pause or severe bradycardia may occur due to the laryngocardiac reflex or the administration of a high-dose anesthetic and analgesic agent during tracheal intubation in patients who received a low-dose NMBA for IONM induction using an NIM tube. Anesthesiologists should be aware of these risks and take precautions to maintain adequate anesthesia, be prepared to administer vasoactive drugs to increase the blood pressure and HR if needed, and, if possible, intravenously administer lidocaine to attenuate the laryngeal reflex during intubation.
Bilateral Trichosporon asahii keratitis after ptosis correction
Authors: Shin Jeongah , Son Woo Young , Cho Kyong Jin , Rho Chang Rae 
Published: August 2021

Abstract

Rationale:
Fungal keratitis (FK) is a severe vision-threatening disease that can lead to corneal perforation or endophthalmitis despite proper treatment. It is important to diagnose the disease promptly due to its indolent nature and disproportionate disease symptoms. Trichosporon asahii is reported rarely as the causative organism of FK. We report a case of highly unusual bilateral T asahii keratitis following ptosis surgery.

Patient concerns:
An 86-year-old female underwent bilateral levator resection surgery for ptosis. Postoperatively, the patient complained of gradually worsening bilateral ocular pain and a decrease in visual acuity associated with a chronic non-healing epithelial defect.

Diagnoses:
Both eyes of the patient were evaluated using best-corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, and corneal culture. Multifocal deep stromal infiltrates were found in both corneas. Cultures from both corneal ulcers revealed growth of T asahii. Optical coherence tomographic examination showed bilateral macular edema.

Interventions:
The patient was treated with revisional ptosis surgery, an antifungal agent for the corneal ulcer, and intravitreal injection of steroid for macular edema.

Outcomes:
Both eyes recovered well. Her best-corrected visual acuity improved from 20/200 to 20/40 in the right eye and from 20/100 to 20/40 in the left eye.

Lessons:
FK can develop in the cornea when certain risk factors are present, including recent lid surgery, chronic keratitis, and steroid eye drop use. Identification and correction of risk factors can be beneficial in the treatment of FK.
Impact of chronic kidney disease on the prognosis of transcatheter aortic valve replacement in patients with aortic stenosis
Authors: Wang Jialu , Liu Shidong , Han Xiangxiang , Wan Zunhui , Chen Yang , Chen Hao , Song Bing 
Published: August 2021

Abstract

Background:
The prognosis of patients with aortic stenosis, in conjunction with chronic kidney disease (CKD), after transcatheter aortic valve replacement (TAVR) remains unclear. This study assessed the impact of CKD, and different stages of CKD, on prognosis of patients undergoing TAVR.

Methods:
The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement guidelines. As of June 2021, we performed a comprehensive literature search on studies related to CKD and TAVR, using databases such as PubMed, Embase, Cochrane Library, and Web of Science. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Then, Stata 15.0 software was used for meta-analysis.

Results and Conclusion:
The purpose of this study was to evaluate the effect of CKD and different stages of CKD on the prognosis of patients with TAVR. It is hoped to provide a comprehensive reference for clinical practice and related clinical trials in the future.
Efficacy and safety of acupuncture for senile insomnia
Authors: Wu Jiuru , Shi Yan , Wang Xichen , Dong Xiukun , Liu Xinyu , Wang Guojian , Hu Yinghua 
Published: August 2021

Abstract

Background:
Senile insomnia seriously affects the quality of life of the elderly. With the increase of the proportion of insomnia in the elderly, compared with the elderly with normal sleep quality, the elderly with long-term insomnia are more likely to have dizziness, fatigue, and decreased immunity. Acupuncture has shown good effects in the treatment of insomnia. At present, there is a lack of systematic review on acupuncture in the treatment of senile insomnia. We conduct this study to evaluate the efficacy and safety of acupuncture in the treatment of senile insomnia.

Methods:
We will search Chinese and English databases: China National Knowledge Infrastructure, Chinese Scientific and Journal Database, Wan Fang database (Wanfang), Chinese Biomedical Literature Database, PubMed, EMBASE, Cochrane library to identify articles of randomized clinical trials of acupuncture for senile insomnia. All above electronic databases will be searched from inception to September 1, 2021. RevMan 5.3 software will be used to conduct this systematic review.

Results:
The study will prove the efficacy and safety of acupuncture for senile insomnia.

Conclusion:
We plan to submit this systematic review to a peer-reviewed journal.

INPLASY registration number:
INPLASY202160106.
Risk factors for acute kidney injury in critically ill patients with torso injury
Authors: Sul Young Hoon , Lee Jin Young , Kim Se Heon , Ye Jin Bong , Lee Jin Suk , Yoon Su Young , Choi Jung Hee 
Published: August 2021

Abstract
Acute kidney injury (AKI) is common in trauma patients and associated with poor outcomes. Identifying AKI risk factors in trauma patients is important for risk stratification and provision of optimal intensive care unit (ICU) treatment. This study identified AKI risk factors in patients admitted to critical care after sustaining torso injuries.
We performed a retrospective chart review involving 380 patients who sustained torso injuries from January 2016 to December 2019. Patients were included if they were aged >15 years, admitted to an ICU, survived for >48 hours, and had thoracic and/or abdominal injuries and no end-stage renal disease. AKI was defined according to the Kidney Disease Improving Global Outcomes definition and staging system. Clinical and laboratory variables were compared between the AKI and non-AKI groups (n = 72 and 308, respectively). AKI risk factors were assessed using multivariate logistic regression analysis.
AKI occurred in 72 (18.9%) patients and was associated with higher mortality than non-AKI patients (26% vs 4%, P < .001). Multivariate logistic regression analysis identified bowel injury, cumulative fluid balance >2.5 L for 24 hours, lactate levels, and vasopressor use (adjusted odds ratio: 2.953, 2.058, 1.170, and 2.910; 95% confidence interval: 1.410–6.181, 1.017–4.164, 1.019–1.343, and 1.414–5.987; P = .004, .045, .026, and .004, respectively) as independent risk factors for AKI.
AKI in patients admitted to the ICU with torso injury had a substantial mortality. Recognizing risk factors at an early stage could aid risk stratification and provision of optimal ICU care.
Values of ultrasound for diagnosis and management of insulin-induced lipohypertrophy
Authors: Wang Wei , Huang Rong , Chen Yang , Tu Mei 
Published: August 2021

Abstract
The aim of this study was to explore the values of ultrasound for diagnosis and management of insulin-induced lipohypertrophy and further analyzing the impact of body mass index and subcutaneous fat thickness on ultrasound manifestations of lipohypertrophy.
In this 3-month, prospective cohort study, a total of 162 patients with diabetes who used insulin therapy more than 1 year with unknown lipohypertrophy status were enrolled into this study. Demographic information, assessment of glycemic control and insulin injection technique were evaluated. Physical and ultrasound examination were separately performed to detect lipohypertrophy by a team of diabetes educator nurses or ultrasonographer in a blinded fashion. Patients with lipohypertrophy received insulin injection technique education based on ultrasound examination and Chinese guideline.
Ultrasound examination detected 41.1% more patients (74.1% vs 52.5%; P < .001) with lipohypertrophy and 61.2% more lesions (216 vs 134; P < .001) than physical examination. Glycosylated hemoglobin A1c and fasting blood glucose were significantly decreased in patients with lipohypertrophy or subclinical lipohypertrophy (lipohypertrophy without visual and palpation changes) after receiving insulin injection technique education based on ultrasound examination and Chinese guideline than baseline at 3 months (P < .001). The proportion of lesions with ultrasound manifestation 2 (distortion of surrounding connective tissue) in obese and STF (>15 mm) groups were no more than 50% and showed a decreased trend with increased subcutaneous fat thickness and body mass index (P < .001).
Lipohypertrophy has characteristic ultrasound manifestations which can detect more accurate results than palpation alone and provide detailed information to promote effective education on lipohypertrophy management, thereby improving glycemic control.
Mediating effects of meaning in life on the relationship between general self-efficacy and nursing professional commitment in nursing students
Authors: Cheng Linan , Chen Qian , Zhang Fengying 
Published: August 2021

Abstract
Meaning in life (MiL) is regarded as a valuable indicator of positive functioning in terms of an understanding of one's purpose in life, well-being, and professional commitment. As such, it is important to improve MiL for the stability of nursing staff. General self-efficacy is a significant predictor of both MiL and nursing professional commitment. Nursing professional commitment is key for both the stability of nursing staff and the provision of excellent health care. Few scholars have investigated the relationship between general self-efficacy and nursing professional commitment. In particular, a possible mediating effect of MiL has not been fully explored in nursing students.
We aimed to examine the association between general self-efficacy and MiL among nursing students and to determine whether MiL mediates the relationship between general self-efficacy and nursing professional commitment for Chinese nursing students.
A cross-sectional descriptive design was used. Between June and September 2019, 710 Chinese nursing students from 2 colleges completed the Meaning in Life Scale (MiLS), General Self-Efficacy Scale (GSES), and Nursing Professional Commitment Scale (NPCS). Data were analyzed using structural equation modeling (SEM) and SPSS (version 23.0, IBM Corp, Armonk, NY).
The mean MiL score was above the moderate level (M = 52.55, SD = 9.79). However, the mean scores of self-efficacy and nursing professional commitment were relatively low. Self-efficacy was positively related to MiL (B = 0.46, P < .01), and MiL was positively related to nursing professional commitment (B = 0.37, P < .01). However, self-efficacy was not related to nursing professional commitment (B = 0.12, P = .01). We therefore suggest that MiL has a complete mediating role between self-efficacy and nursing professional commitment among Chinese nursing students.
In this study, we confirmed the complete mediation of nursing professional commitment by MiL in nursing students, thus providing scientific evidence that could be beneficial for the development of interventions to increase nursing professional commitment.
Dissociative symptoms with intravenous ketamine in treatment-resistant depression exploratory observational study
Authors: Włodarczyk Adam , Cubała Wiesław J. , Gałuszko-Węgielnik Maria , Szarmach Joanna 
Published: August 2021

Abstract
There is evidence for ketamine use in treatment-resistant depression (TRD). Several safety and tolerability concerns arise regarding adverse drug reactions and specific subpopulations. This paper aims to investigate the relationship between dissociative and psychometric measures in course of intravenous ketamine treatment in TRD inpatients with major depressive disorder and bipolar disorder.
This study result represents safety data in a population of 49 inpatients with major depressive disorder and bipolar disorder subjects receiving eight 0.5 mg/kg of ketamine intravenous infusions, with a duration of 40 min each, as an add-on treatment to standard-of-care pharmacotherapy, registered in the naturalistic observational protocol of the tertiary reference unit for mood disorders (NCT04226963). The safety psychometrics assessed dissociation and psychomimetic symptomatology with the Clinician-Administered Dissociative States Scale (CADSS) the Brief Psychiatric Rating Scale (BPRS).
The significant differences in CADSS scores between measurements in course of the treatment were observed (P = .003). No significant differences between BPRS measurements were made after infusions. In each case, both BPRS and CADSS values dropped to the “absent” level within 1 hour from the infusion. Neither CADSS nor BPRS scores were associated with the treatment outcome.
The study demonstrates a good safety profile of intravenous ketamine as an add-on intervention to current psychotropic medication in TRD. The abatement of dissociation was observed in time with no sequelae nor harm. The study provides no support for the association between dissociation and treatment outcome.
This study may be underpowered due to the small sample size. The protocol was defined as a study on acute depressive symptomatology without blinding.
Efficacy of Xpert MTB/RIF Ultra in diagnosing tuberculosis meningitis
Authors: Shen Yanqin , Yu Guocan , Zhao Wuchen , Lang Yazhen 
Published: August 2021

Abstract

Background:
This study aimed to assess whether Xpert MTB/RIF Ultra (Xpert Ultra) can effectively diagnose tuberculosis meningitis (TBM) and to simultaneously compare its effectiveness with Xpert in diagnosing TBM in the same population.

Methods:
On August 12, 2020, Wanfang Database, China National Knowledge Infrastructure, Embase, Cochrane Library, and PubMed were searched for studies evaluating the diagnostic accuracy of Xpert Ultra for TBM. Then, we assessed the efficacy of Xpert Ultra against a composite reference standard and culture. If applicable, we also examined the diagnostic efficacy of Xpert in the same population. Heterogeneity was then explored by meta-regression, subgroup, and sensitivity analyses.

Results:
Six studies containing 601 specimens reported the diagnostic efficacy of Xpert Ultra for TBM, with a composite reference standard. No study had compared the efficacy between Xpert Ultra and culture. The pooled sensitivity of Xpert Ultra was 64% (95% confidence interval [CI]: 45–80), and the I
2 value was 86% (95% CI: 76–96); its specificity for TBM was consistently 100%. In the same population, 5 studies compared the diagnostic efficacy between Xpert Ultra and Xpert for TBM. The pooled sensitivity of Xpert Ultra and Xpert was 68% (95% CI: 46–84; I
2 = 87%) and 37% (95% CI: 25–50; I
2 = 72%), respectively. The studies were significantly heterogeneous in terms of sensitivity but not heterogeneous in specificity.

Conclusions:
Xpert Ultra was more sensitive than Xpert, but both were specific (100%). Therefore, Xpert Ultra had an excellent diagnostic efficacy for TBM, and it could be the preferred initial test for TBM.
A case study of overfeeding 3 different diets
Authors: Feltham Sam , Westman Eric C. 
Published: August 2021

Purpose of review
Quality or quantity of food has been at the heart of the diet debate for decades and will seemingly continue for many to come unless tightly controlled studies are conducted. To our knowledge, there has never been an overfeeding study comparing the effects of multiple diets.

Recent findings
This study reports a case study of an individual who ate 5800 Calories per day of 3 different diets for 21 days at a time. The 3 different diets were low-carb, low-fat, and very-low-fat vegan. The weight gain over 21 days was 1.3 kg for low-carb, 7.1 kg for low-fat, and 4.7 kg for very-low-fat vegan.

Summary
In this n-of-1 study, consuming 5800 Calories/day of 3 different diets for 21 days did not lead to the same amount of weight gain. Further research should be conducted on how the human body gains weight with an emphasis on how different foods affect physiology. If these findings are replicated, there would be many ramifications for obesity treatment and healthcare guidelines.