bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality of Enlisted Men Who Served on Nuclear-Powered Submarines in the United States Navy
Authors: Friedman-Jimenez George , Kato Ikuko , Factor-Litvak Pam , Shore Roy 
Published: August 2021

Objective:
To describe the long-term mortality experience of a cohort of enlisted men who served on nuclear-powered submarines in the United States Navy and breathed recirculated filtered air for extended periods of time.

Methods:
In this historical cohort study we estimated standardized mortality ratios (SMRs) and used within-cohort Poisson regression analyses to address healthy worker biases.

Results:
Three thousand two hundred sixty three deaths occurred among 85,498 men during 1,926,875 person-years of follow-up from 1969 to 1995. SMRs were reduced for most cause-of-death categories, prostate cancer had a twofold elevation. In within-cohort comparisons, prostate cancer mortality did not increase with duration of submarine service, but ischemic heart disease mortality increased 26% per 5 years of submarine service.

Conclusions:
Long periods of submarine service do not increase mortality in most cause-of-death categories. Increased mortality from ischemic heart disease likely reflects the effects of tobacco smoke.
Effect of Rehabilitative Ultrasound Imaging (RUSI) Biofeedback on Improving Pelvic Floor Muscle Function in Individuals With Stress Urinary Incontinence: A Systematic Review
Authors: LaCross Jenny , Proulx Laurel , Brizzolara Kelli , Humphrey John 
Published: August 2021

Background:
Pelvic floor muscle training is a common intervention for the treatment of stress urinary incontinence (SUI). One method utilized to augment muscle training is biofeedback. Rehabilitative ultrasound imaging (RUSI) is a noninvasive biofeedback tool.

Objectives:
The purpose of this review was to determine the effect of RUSI on pelvic floor muscle function, quality of life, volume of urinary leakage, and severity of urinary leakage in females and males with urinary incontinence and, when possible, compare these results to those of other biofeedback interventions.

Study Design:
Systematic review.

Methods:
PubMed, CINAHL, Science Direct, Scopus, Web of Science, and MEDLINE were searched for titles from peer-reviewed journals and conference proceedings from January 2010 to May 2020. An updated search was performed in January 2021. Inclusion criteria included studies with participants 18 years or older with urinary incontinence. The primary experimental intervention was transabdominal or transperineal RUSI.

Results:
Nine studies were included in this review. The ability to correctly contract the pelvic floor was achieved by more than 95% of participants following RUSI biofeedback training. Although outcomes were not consistently reported, RUSI intervention resulted in a decrease in incontinence severity and number of incontinence episodes per week, as well as improved pelvic floor strength, self-rating of improvement, task-specific self-efficacy, and quality of life.

Conclusion:
The results of this review provide moderate evidence to support the use of RUSI biofeedback via a transabdominal or transperineal approach in males and females with SUI to improve motor performance of the pelvic floor.
Clinical characteristics and early prognosis of patients with SARS-CoV-2 infection undergoing joint arthroplasty during the COVID-19 pandemic
Authors: Jin Xin , Chen Mengcun , Wang Jinlong , Yang Shuhua , Xu Weihua , Liu Xianzhe 
Published: August 2021

Abstract
The present study reported early clinical outcomes and perioperative precautions for medical staffs during joint arthroplasty procedures in SARS-CoV-2-infected patients.
The medical records of 8 patients with SARS-CoV-2 infection who underwent joint arthroplasty from January 19 to September 24, 2020 were retrospectively reviewed and analyzed. Perioperative precautions and follow-up (time length varies from 6 month to 13 months, 11 months in average) for SARS-CoV-2 infection of medical staffs were reported.
All patients recovered well from both the primary disease and SARS-CoV-2 infection. Significant improved Visual analogue scale was observed with no major complications or recurrence of the COVID-19 at discharge. There was no evidence indicating SARS-CoV-2 infection in any health providers.
Elective joint arthroplasties for patients in recovery period of SARS-CoV-2 infection could be continued under comprehensive preoperative evaluation and appropriate medical protection. For patients with currently confirmed or highly suspected COVID-19, the operation should be carried out only if it was essential.
Effect of Ma Yinglong Shexiang hemorrhoids cream combined with pearl powder on the pain and complications of severe pressure ulcer patients
Authors: Niu Dongling 
Published: August 2021

Abstract

Objective:
The aim of this study was to investigate the effect of Ma Yinglong Shexiang Hemorrhoids Cream combined with pearl powder on pain and complications in patients with severe pressure ulcers.

Methods:
One hundred seventeen patients with severe pressure ulcers hospitalized and treated in our hospital (January 2019--December 2019) were divided into Ma Yinglong Musk Hemorrhoid Cream Group (MY Group), Pearl Powder Group (PP Group), and combination with Ma Yinglong Musk Hemorrhoid Cream and Pearl Powder Group (MP group), 39 patients in each group. There was no significant difference in the general data of patients in MY group, PP group, and MP group. By analyzing the differences in clinical efficacy, secondary effects, scar incidence, pain, and clinical indicators of patients in the MY group, PP group, and MP group, the effects of Mayinglong Shexiang Hemorrhoid Cream combined with pearl powder in the treatment of pain and complications in patients with severe pressure ulcers were explored.

Results:
After treatment, compared with the MY group and the PP group, the MP group had a higher clinical efficacy than the MY group and the PP group. Compared with MY group and PP group, the healing time, dressing change times, and dressing change time of MP group were better than MY group (P < .05). After treatment, the VAS score and incidence of secondary effects of the MP group was significantly lower than that of the MY group and PP group (P < .05). The incidence and area of scar formation in the MP group were lower than those in the MY group and the PP group (P < .05).

Conclusion:
Compared with Ma Yinglong Musk Hemorrhoid Cream or Pearl Powder, combination of Ma Yinglong Musk Hemorrhoid Cream and Pearl Powder are more effective in treating severe pressure ulcer patients, and can significantly reduce the pain in the affected area and reduce the occurrence of complications.
Multidimensional analyses of the effect of exercise on women with depression
Authors: Yan Lin-Bo , Zhang Jing-Zhi , Zhou Qian , Peng Feng-Lin 
Published: August 2021

Abstract

Background:
The proportion of women is higher than men in depression. This is mainly due to women's physiological regulation is different from men, especially in puberty, menstruation, pregnancy, menopause, among others. Therefore, treating depressive women is still a health challenge. Besides, recent studies of exercise therapy have a more outstanding performance in treating depression, especially in contrast to drug therapy and psychotherapy. Its main advantages are convenience, quickness, no side effects, real-time, and long-term effectiveness.

Objective:
The aim of this study was to systematically review the clinical efficacy of exercise on women with depressive symptoms.

Methods:
Searching PubMed, The Cochrane Library, and Embase databases to collect randomized controlled trials about exercise in the treatment of depressive women. After literature screening, data extraction, and literature quality evaluation, the meta-analysis of acquirement data was performed with RevMan5.3 software.

Results:
A total of 2294 patients were included in 25 different articles totally. Meta-analysis shows that compared with the control group, exercise could relieve female depression (standard mean difference [95% confidence interval, CI] = −0.64 [−0.89 to −0.39], Z = 4.99, P < .001). Subgroup analysis shows that different types of exercise have significant effects in improving depression symptoms. Exercise therapy has better effect on depressive patients induced by physiology or disease than ordinary depressive patients.

Conclusion:
Exercise can significantly improve depressive symptoms in women.
Effect of aspirin use on survival benefits of breast cancer patients
Authors: Liu Jiamin , Zheng Fengxian , Yang Meng , Wu Xiaoyong , Liu Aimin 
Published: August 2021

Abstract

Objective:
The purpose of this study is to investigate whether aspirin improves the prognosis of breast cancer patients by meta analysis.

Methods:
Searched PubMed, EMBASE, and other databases for literature on the relationship between aspirin use and breast cancer prognosis, with the deadline of October 2019. The related results of all-cause death, breast cancer-specific death, and breast cancer recurrence/metastasis were extracted to combine the effect amount. The sensitivity analysis and published bias analysis were carried out for the included data. Stata12.0 software was used to complete all statistical analysis.

Results:
A total of 13 papers were included in the study, including 142,644 breast cancer patients. The results of meta-analysis showed that patients who took aspirin were associated with lower breast cancer-specific death (HR = 0.69, 95% CI = 0.61–0.76), all-cause death (HR = 0.78, 95% CI = 0.71–0.84), and risk of recurrence/metastasis (HR = 0.91, 95% CI: 0.82–1.00).

Conclusions:
Aspirin use may improve all-cause mortality, specific mortality, and risk of recurrence/metastasis in patients with breast cancer.
Elevated homocysteine levels in patients with heart failure
Authors: Jin Nake , Huang Lei , Hong Jun , Zhao Xuechen , Chen Yujiao , Hu Jianan , Cong Xin , Xie Yuquan , Pu Jun 
Published: August 2021

Abstract

Background:
Elevated homocysteine (Hcy) levels showed increasing significance as the predisposing factor for the pathogenesis of atherosclerotic sequelae, including cardiovascular mortality, coronary artery disease, and stroke. There is increasing evidence linking plasma Hcy levels and heart failure (HF). The association between the elevated level of plasma Hcy and HF was examined by meta-analysis and systematic review in this study.

Methods:
The PubMed and ScienceDirect databases until April 2020 were utilized to collect previous literature on plasma Hcy levels and the potential relation to HF. The pooled effects were evaluated depending on standardized mean differences (SMDs) with 95% confidence intervals (CIs), and the calculation was performed using Stata 12 software. Potential sources of heterogeneity were assessed with subgroup analysis and sensitivity analysis.

Results:
A total of 12 research projects including 5506 subjects were selected. For pooled effect, the results confirmed that patients with HF had higher Hcy levels than the control subjects (SMD,1.148 and 95%CI, [0.715, 1.581]). Based on the classification of New York Heart Association (NYHA), the Hcy levels for the group of NYHA I or II (SMD, 1.484 and 95% CI, [0.442, 2.527]) and the group of NYHA III or IV (SMD, 3.361 and 95% CI, [1.902, 4.820]) were significantly increased compared to controls, while the increase was more intensive for the group of NYHA III or IV. Subgroup analyses revealed similar results.

Conclusion:
Our meta-analysis identified that plasma Hcy levels were significantly elevated in HF patients compared to control subjects, which is positively related to the advancement of NYHA class.
A prognostic scoring system for operated acute epidural hematoma based on gray–white matter ratio
Authors: Luo Yunxing , He Xiwu , Yang Mingfei , Du Chaonan , Jin Xiaoqing 
Published: August 2021

Abstract
To determine the prognostic risk factors of patients with acute epidural hematoma (AEDH), a scoring system was established based on gray–white matter ratio (GWR) and internal verification was performed.
All patients with AEDH who underwent surgical treatment in Qinghai Provincial People's Hospital from January 2013 to June 2019 were continuously collected. The clinical and imaging data of the patients were collected. According to Glasgow Outcome Scale at 3 months after operation, the patients were divided into poor and good prognosis groups, respectively. The GWR value of the nonhematoma side was measured at the inner capsule area. Univariate and multivariate analyses were used. Independent predictors significantly related to the prognosis of AEDH were screened out and a nomogram was established based on these factors.
A total of 170 cases were included in this study, the Glasgow Coma Score (severe and moderate), cerebral hernia, midline shift, preoperative GWR, postoperative GWR, hematoma thickness/midline shift, time from coma to surgery, and decompression of bone flap were the independent risk factors for predicting the poor prognosis of AEDH. Moreover, the prediction ability of nomogram was higher than any other independent predictive factors.
The nomogram model established represents the most effective factor to predict the prognosis of operated AEDH. The scoring system is characterized by high accuracy, simplicity and feasibility, with a wide range of clinical application prospects.
Long non-coding RNA as a potential biomarker for prognosis of glioma
Authors: Xie Teng , Li Bin , Liu Huaming , Zhang Chunwei , Wang Yanhua , Chen Zhijun , Yan Junping 
Published: August 2021

Abstract

Background:
The molecular mechanism of Glioma is still unclear, and there are few early diagnostic markers. Therefore, it is urgent to figure out effective preventive measures, active diagnostic methods and rapid treatment measures. In recent years, relevant studies have revealed that long non-coding RNA (lncRNA) is associated with the prognosis of Glioma. However, these results have not been supported by any evidence. Therefore, this study carried out a meta-analysis method to analyze the relationship between lncRNA and the prognosis of Glioma. In addition, bioinformatics analysis was conducted to investigate the mechanism and related pathways of lncRNAs in Glioma.

Methods:
We performed a systematic search in electronic databases, including China National Knowledge Infrastructure, Chinese Biomedical literature Database, Chinese Scientific and Journal Database, Wan Fang database, PubMed, EMBASE, Cochrane Library and Web of Science, to investigate the potential association between lncRNA expression and prognostic significance and clinical features in glioma patients. Hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to estimate the prognosis value of lncRNA by Stata16.0 software. The online tool AnnoLnc was applied to screen the co-expressed gene related to each lncRNA, David was used for gene ontology (GO) analysis and enrichment analysis of the signal pathway, and through Starbase, the possible competitive endogenous RNA network of lncRNAs was constructed.

Results:
The results of this meta-analysis would be submitted to peer-reviewed journals for publication.

Conclusion:
This study will provide evidence-based medical evidence for lncRNA, so as to predict the prognosis of Glioma and bioinformatics analysis will provide ideas for the mechanism study on Glioma.
The obesity paradox and orthopedic surgery
Authors: Hennrikus Matthew , Hennrikus William P. , Lehman Erik , Skolka Michael , Hennrikus Eileen 
Published: August 2021

Abstract
The Obesity Paradox describes the counterintuitive finding that although obesity contributes to the development of chronic conditions such as chronic kidney disease and cardiovascular disease, obesity seems to improve mortality in patients with these diseases. This paradox has also been sited in the critical care literature in regard to acute kidney injury, obesity and mortality. This study's objective is to examine the impact of obesity and post-surgical acute kidney injury on hospital length of stay and 2-year mortality after orthopedic surgery.
We reviewed the electronic medical records of all adult elective orthopedic surgery patients over 2 years in a large academic hospital. The 1783 patients who met inclusion criteria were divided into obese (body mass index, BMI ≥ 30, n = 1123) and non-obese groups (BMI <30, n = 660). Demographics, medications, comorbidities, and perioperative variables were included in multivariable logistic regression analyses with acute kidney injury, length of hospital stay, and two-year mortality as primary outcomes. Outcomes were analyzed for the entire group, the obese cohort and the non-obese cohort.
Acute kidney injury developed in 5% of the post-surgical orthopedic patients. Obesity increased the likelihood of developing acute kidney injury post orthopedic surgery (odds ratio [OR] = 1.82; 95% Confidence interval [CI] 1.05–3.15, P = .034). Acute kidney injury increased length of stay by 1.3 days and increased the odds of two-year mortality (OR = 2.08; 95% CI 1.03–4.22, P = .041). However, obese patients had a decreased likelihood of two-year mortality (OR = 0.53; 95% CI 0.33–0.84, P = .009).
In adult orthopedic surgery patients, obesity increased the risk of acute kidney injury. Patients who developed an acute kidney injury had longer hospital stays and higher two-year mortality. Paradoxically, obesity decreased two-year mortality.
Association of gastroesophageal reflux disease with increased risk of chronic otitis media with effusion in adults
Authors: Yeo Cha Dong , Kim Jong Seung , Lee Eun Jung 
Published: August 2021

Abstract
This study aimed to evaluate the risk of developing chronic otitis media with effusion (OME) in individuals with gastroesophageal reflux disease (GERD).
A retrospective propensity score-matched cohort study was performed using data from the Korea National Health Insurance Service. The GERD group (n = 3532) included certain individuals who had been diagnosed with GERD between January 2002 and December 2005. A comparison control group (n = 14,128) was calculated by 1:4 propensity score matching considering age, sex, and comorbidities and year of enrollment. Each patient was monitored until 2013. Survival analysis, the Log-rank test, and Cox proportional hazard regression models were used to calculate the incidence, survival rate, and hazard ratio (HR) of chronic OME for each group.
Among the 17,660 individuals included in the study population (53.2% men), the overall incidence of chronic OME during the 11-year follow-up was 1.84-fold higher in the GERD group than in the non-GERD group (1.8 vs 3.0 per 1000 person-year; adjusted HR 1.84; 95% confidence interval [CI], 1.46–2.31). Moreover, the adjusted HRs of developing chronic OME (allergic rhinitis, 1.69 [95% CI, 1.37–2.10]; asthma, 1.29 [95% CI, 1.02–1.64]; chronic rhinosinusitis, 1.61 [95% CI, 1.26–2.05]) were greater in study population with comorbidities.
From long-term follow-up, the prevalence of chronic OME in adults was 1.84 times higher in the GERD group compared with the non-GERD group. Specifically, it found that allergic rhinitis, asthma, or chronic rhinosinusitis showed increase the risk of developing chronic OME than those without these conditions.
Evaluation of the distance from the anterior cervicovaginal junction to the anterior peritoneal reflection for anterior colpotomy during vaginal hysterectomy in Korean women
Authors: Lee Ji Hye , Chae Su Hyun , Lee A. Jin , Min Yoon Jung , So Kyeong A. , Lee Sun Joo , Kim Tae Jin , Shim Seung-Hyuk 
Published: August 2021

Abstract
This study aimed to know the distance of the cervicovaginal junction (CVJ) to the anterior peritoneal reflection (APR) as measured in surgical specimens, and assess the distance between the CVJ and APR to ensure safe anterior colpotomy for vaginal hysterectomy among Korean women.
Patients who underwent vaginal hysterectomy were included in the analysis. According to the presence of pelvic organ prolapse or menopausal status, the distance from the CVJ to the APR was assessed preoperatively through transvaginal ultrasonography (TV-US), as well as intraoperatively using surgical specimens. The intraclass correlation coefficient was used to determine the reliability between 2 measurements.
In total, 171 patients were included. The median distance from the CVJ to the APR measured on TV-US was 19.8 (3.3–41.3) mm. Meanwhile, the median distance from the CVJ to the APR measured using the surgical specimen was 26.0 (12.0–55.0) mm. The intraclass correlation coefficient for the absolute agreement between 2 measurements was 0.353 (95% confidence interval: 0.002–0.570; P < .001), which is indicative of poor reliability. The median distance from the CVJ to the APR measured using the surgical specimen did not differ significantly between the 2 groups according to pelvic organ prolapse (26.0 [12.0–55.0] vs 27.5 [17.0–55.0] mm, P = .076] and menopausal status (27.0 [15.0–55.0] vs 26.0 [12.0–55.0] mm, P = .237).
TV-US does not an accurately measure the dissection plane length from the CVJ to the APR during anterior colpotomy. During vaginal hysterectomy, the median distance from the CVJ to the APR measured using the surgical specimen was 26 (12.0–55.0) mm, which can help decrease surgical complications.
A novel immune signature to predict the prognosis of patients with hepatocellular carcinoma
Authors: Li Qinghe , Fan Bin , Ding Jun , Xiang Xiaoxi , Zhang Jian 
Published: August 2021

Abstract
Aberrant immunity has been associated with the initiation and progression of cancers such as hepatocellular carcinoma (HCC). Here, we aim to develop a signature based on immune-related genes (IRGs) to predict the prognosis of HCC patients. The gene expression profiles of 891 HCC samples were derived from 4 publicly accessible datasets. A total of 1534 IRGs from Immunology Database and Analysis Portal website were obtained as candidate genes for prognostic assessment. Using least absolute shrinkage and selection operator (LASSO) regression analysis, 12 IRGs were selected as prognostic biomarkers and were then aggregated to generate an IRG score for each HCC sample. In the training dataset (n = 365), patients with high IRG scores showed a remarkably poorer overall survival than those with low IRG scores (log-rank P < .001). Similar results were documented in 3 independent testing datasets (n = 226, 221, 79, respectively). Multivariate Cox regression and stratified analyses indicated that the IRG score was an independent and robust signature to predict the overall survival in HCC patients. Patients with high IRG scores tended to be in advanced TNM stages, with increased risks of tumor recurrence and metastasis. More importantly, the IRG score was strongly associated with certain immune cell counts, gene expression of immune checkpoints, estimated immune score, and mutation of critical genes in HCC. In conclusion, the proposed IRG score can predict the prognosis and reflect the tumor immune microenvironment of HCC patients, which may facilitate the individualized treatment and provide potential immunotherapeutic targets.