bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective analysis of 12,400 SARS-CoV-2 RNA tests in patients with COVID-19 in Wuhan
Authors: Wang Jingwei , Bao Anyu , Gu Jian , He Xiaoyun , Wu Zegang , Qiao Bin , Chen Zhen , Xiong Liang , Zhang Yan , Zheng Hongyun , Li Feng , Zhao Zhijun , Mei Siqing , Tong Yongqing 
Published: May 2021

Abstract
The outbreak and widely spread of coronavirus disease 2019 (COVID-19) has become a global public health concern. COVID-19 has caused an unprecedented and profound impact on the whole world, and the prevention and control of COVID-19 is a global public health challenge remains to be solved. The retrospective analysis of the large scale tests of SARS-CoV-2 RNA may indicate some important information of this pandemic. We selected 12400 SARS-CoV-2 tests detected in Wuhan in the first semester of 2020 and made a systematic analysis of them, in order to find some beneficial clue for the consistent prevention and control of COVID-19.
SARS-CoV-2 RNA was detected in suspected COVID-19 patients with real-time fluorescence quantitative PCR (RT-qPCR). The patients’ features including gender, age, type of specimen, source of patients, and the dynamic changes of the clinical symptoms were recorded and statistically analyzed. Quantitative and qualitive statistical analysis were carried out after laboratory detection.
The positive rate of SARS-CoV-2 was 33.02% in 12,400 suspected patients’ specimens in Wuhan at the first months of COVID-19 epidemics. SARS-CoV-2 RT-qPCR test of nasopharyngeal swabs might produce 4.79% (594/12400) presumptive results. The positive rate of SARS-CoV-2 RNA was significantly different between gender, age, type of specimen, source of patients, respectively (P < .05). The median window period from the occurrence of clinical symptom or close contact with COVID-19 patient to the first detection of positive PCR was 2 days (interquartile range, 1–4 days). The median interval time from the first SARS-CoV-2 positive to the turning negative was 14 days (interquartile range, 8–19.25 days).
This study reveals the comprehensive characteristics of the SARS-CoV-2 RNA detection from multiple perspectives, and it provides important clues and may also supply useful suggestions for future work of the prevention and treatment of COVID-19.
Application of 3D printing technology combined with PBL teaching model in teaching clinical nursing in congenital heart surgery
Authors: Tan Hui , Huang Erjia , Deng Xicheng , Ouyang Shayuan 
Published: May 2021

Abstract
We aimed to explore the application of three-dimensional (3D) printing technology with problem-based learning (PBL) teaching model in clinical nursing education of congenital heart surgery, and to further improve the teaching quality of clinical nursing in congenital heart surgery. In this study, a total of 132 trainees of clinical nursing in congenital heart surgery from a grade-A tertiary hospital in 2019 were selected and randomly divided into 3D printing group or traditional group. The 3D printing group was taught with 3D printed heart models combined with PBL teaching technique, while the traditional group used conventional teaching aids combined with PBL technique for teaching. After the teaching process, the 2 groups of nursing students were assessed and surveyed separately to evaluate the results. Compared to the traditional group, the theoretical scores, clinical nursing thinking ability, self-evaluation for comprehensive ability, and teaching satisfaction from the questionnaires filled by the 3D printing group were all higher than the traditional group. The difference was found to be statistically significant (P < .05). Our study has shown the 3D printing technology combined with the PBL teaching technique in the clinical nursing teaching of congenital heart surgery achieved good results.
Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery
Authors: Zheng Yongshun , Yang Jiazhao , Zhang Fan , Lu Jinsen , Qian Yeben 
Published: May 2021

Abstract

Background:
Several studies have reported that medical robot-assisted method (RA) might be superior to conventional freehand method (FH) in orthopedic surgery. Yet the results are still controversial, especially in terms of femoral neck fractures surgery. Here, 2 methods were assessed based on current evidence.

Methods:
Electronic databases including Cochrane Library, PubMed, Web of Science. and EMBASE were selected to retrieved to identify eligible studies between freehand and RAs in femoral neck fractures, with 2 reviewers independently reviewing included studies as well as collecting data.

Results:
A total of 5 studies with 331 patients were included. Results indicated that 2 surgical methods were equivalent in terms of surgical duration, Harris score, fracture healing time, fracture healing proportion and complications, while RA showed clinical benefits in radiation exposure, intraoperative bleeding, total drilling times, and screw parallelism.

Conclusions:
Current literature revealed significantly difference between 2 techniques and suggested that RA might be beneficial for patients than freehand method.
Epidemiological characteristics of hand, foot, and mouth disease in China
Authors: Chen Bo , Yang Ying , Xu Xufeng , Zhao Haixia , Li Yi , Yin Shi , Chen Yong-Quan 
Published: May 2021

Abstract

Background:
To study the epidemic features of hand-foot-mouth disease (HFMD) in mainland China through systematic review and meta-analysis so as to provide evidence for the future prevention and control of HFMD.

Methods:
Articles on the epidemic features of HFMD in mainland China, written in English or Chinese and released between January 1, 2015 and January 1, 2020, were searched from English literature databases including Embase, Web of Science, PubMed, Cochrane library, Google academic, and Chinese literature databases including China national knowledge infrastructure (CNKI), Wanfang, and China Biology Medicine (CBM). Papers were selected according to the inclusion and exclusion criteria, and quality scoring was performed. Meta-analysis, sensitivity analysis, and identification of publication bias were finished through STATA version 12.0 software.

Results:
A total of 23 articles were included in this study, the total number of cases was 377,083, of which the total number of male cases was 231,798 and the total number of female cases was 145,285, the sex ratio was about 1.6:1, and the incidence of HFMD in China was 1.61‰ (95% confidence interval [CI]: 1.21‰–1.94‰). The results of the subgroup analysis showed that the incidence of HFMD in mainland China was the highest in South China, in 2014, in 1-year-old group and in other types of enteroviruses, respectively, with the rate of 3.48‰ (95% CI: 1.22‰–5.73‰), 1.81‰ (95% CI: 1.06‰–2.57‰), 15.20‰ (95% CI: 5.00‰–25.30‰), and 1.83‰ (95% CI: 1.32‰–2.33‰), respectively. The differences among the above 4 subgroups were statistically significant (P < .05). There were no publication bias in this study, and the sensitivity analysis results suggested that the meta-analysis results were robust.

Conclusion:
There were differences in the distribution of region, time, population, and etiology of HFMD in mainland China. Health departments should adopt key strategies and measures for key populations in key areas to prevent and control the development of HFMD, and improve the ability of pathogen detection and typing in laboratories.
Mucous membrane pemphigoid in a patient with chronic hepatitis B virus infection
Authors: Chou Christine Yi-Ting , Lin Chi-Wei , Chen Gwo-Shing , Huang Ru-Yi 
Published: May 2021

Abstract

Rationale:
Mucous membrane pemphigoid (MMP) is a rare, autoimmune bullous disease that affects mucosal surfaces and skin. Early and aggressive treatment initiation may be warranted due to the risks of serious complications. However, it can be challenging to make an initial diagnosis. Viral infection such as hepatitis B virus (HBV) infection has been found to be associated with the formation of autoimmune bullous diseases.

Patient concerns:
The patient was a 43-year-old male with gingivitis and recurrent swelling over the neck, cheeks, lips, and eyelids. The patient presented at oral medicine, otolaryngology, plastic surgery, and ophthalmology sequentially, and was later referred to the rheumatology, dermatology, and family medicine departments. Recurrent hemorrhagic bullae on oral mucosa and skin scarring occurred 2 years after the onset of the initial symptoms.

Diagnosis:
Skin biopsy with direct immunofluorescence was performed under the suspicion of MMP. Lesional hematoxylin and eosin stain and perilesional direct immunofluorescence were consistent with MMP.

Interventions:
Systemic Prednisolone and topical corticosteroid were used to control the disease.

Outcomes:
A flare-up of hepatitis B developed as a result of systemic prednisolone use. The disease went through relapses and remissions. The patient is on low-dose prednisolone (5 mg/day) with a monthly outpatient visit in the family medicine department.

Lessons:
It would be useful for medical practitioners in different specialties to be alert of the heterogeneous presentations of MMP. Chronic HBV infection might be a risk factor for MMP. In patients with chronic HBV infection, treatment of MMP must be closely monitored for the risk of reactivation of HBV.
Racial/ethnic and socioeconomic variations in hospital length of stay
Authors: Ghosh Arnab K. , Geisler Benjamin P. , Ibrahim Said 
Published: May 2021

Abstract
Disparities by race/ethnicity and socioeconomic status (SES) exist in rehospitalization rates and inpatient mortality rates. Few studies have examined how length of stay (LOS, a measure of hospital efficiency/quality) differs by race/ethnicity and SES.
This study's objective was to determine whether differences in risk-adjusted LOS exist by race/ethnicity and SES
Using a retrospective cohort of 1,432,683 medical and surgical discharges, we compared risk-adjusted LOS, in days, by race/ ethnicity and SES (median household income by patient ZIP code in quartiles), using generalized linear models controlling for demographic and clinical factors, and differences between hospitals and between diagnoses.
White patients were on average older than both Black and Hispanic patients, had more chronic conditions, and had a higher inpatient mortality risk. In adjusted analyses, Black patients had a significantly longer LOS than White patients (0.25-day difference when discharged to home and 0.23-day difference when discharged to non-home destinations, both P<.001); there was no difference between Hispanic and White patients. Wealthier patients had a shorter LOS than poorer patients (0.16-day difference when discharged to home and 0.06-day difference when discharged to nonhome destinations, both P<.001). These differences by race/ethnicity reversed for Medicaid patients.
Disparities in LOS exist based on a patient's race/ethnicity and SES. Black and poorer patients, but not Hispanic patients, have longer LOS compared to White and wealthier patients. In aggregate, these differences may be related to trust and implicit bias and have implications for use of LOS as a quality metric. Future research should examine the drivers of these disparities.
Diagnostic accuracy of novel folate receptor-mediated staining solution detection (FRD) for CIN2+
Authors: Li Yuan-xing , Luo Hai-xia , Wang Wei , Wang Zhe , Zhao Wei-hong , Hao Min 
Published: May 2021

Abstract

Background:
Early detection and diagnosis of high-grade cervical intraepithelial neoplasia grade 2 or higher (CIN2+) is critical for a good prognosis and appropriate treatment. The chief aim of our study was to evaluate the diagnostic performance of folate receptor-mediated staining solution detection (FRD) for CIN2+.

Methods:
We conducted a systematic review and meta-analysis by searching the PubMed and EMBASE databases for studies published until May 2020, which assessed the diagnostic accuracy of FRD, human papilloma virus (HPV) testing, and ThinPrep cytology test (TCT) for the detection of CIN2+. Bivariate models were used to compare the diagnostic performance of FRD, HPV, and TCT.

Results:
Six studies involving 2817 patients were included in this meta-analysis. The pooled specificity of FRD was higher than that of HPV and TCT for detecting CIN2+ (0.65, 0.12, and 0.39, respectively). The summary area under the receiver operating characteristic curve values using FRD, HPV, and TCT for detecting CIN2+ were 0.79, 0.95, and 0.77, respectively, indicating that FRD was superior to TCT. The diagnostic odds ratios of FRD, HPV, and TCT were 6 (95% CI: 5–7), 3 (95% CI: 2–5), and 3 (95% CI: 2–4), respectively, demonstrating that FRD had good diagnostic accuracy.

Conclusion:
FRD showed good diagnostic accuracy and higher specificity than HPV and TCT for detecting CIN2+. Based on our results, we propose that FRD could be a candidate for cervical screening, especially in underdeveloped countries.
Predictors of pain severity among community-dwelling older adults with pain in the United States
Authors: Axon David R. , Le Darlena 
Published: May 2021

Abstract
The purpose of this study was to determine predictors of pain severity among older United States (US) adults with pain.
This cross-sectional, retrospective study utilized 2017 Medical Expenditure Panel Survey data. Eligible participants were alive for the calendar year, aged ≥50 years, and reported pain in the past 4 weeks. Hierarchical logistic regression models, adjusting for the survey design, were used to identify significant predictors of pain severity (i.e., extreme/quite a bit or moderate/little pain).
An estimated 14,250,534 adults aged ≥50 with pain reported extreme/quite a bit of pain. Many variables were associated with extreme/quite a bit of pain, including: age 50 to 64 vs ≥65 years (adjusted odds ratio [AOR] = 1.49, 95% confidence interval [95% CI] = 1.22–1.82); males vs females (AOR = 0.80, 95% CI = 0.67–0.95); white race vs others (AOR = 0.75, 95% CI = 0.61–0.92); married vs other marital status (AOR = 1.31, 95% CI = 1.08–1.57); income <200% vs ≥200% federal poverty level (AOR = 1.30, 95% CI = 1.06–1.60); employed vs unemployed (AOR = 0.47, 95% CI = 0.37–0.60); limitation vs no limitation (AOR = 2.64, 95% CI = 2.09–3.33); 0, 1, 3, or 4 vs ≥5 chronic conditions (AOR ranged from 0.39 for 0 conditions to 0.77 for 4 conditions); excellent/very good or good vs fair/poor perceived physical health status (AOR ranged from 0.28 for excellent/very good to 0.40 for good); smokers vs non-smokers (AOR = 1.56, 95% CI = 1.27–1.93); exercise versus no exercise (AOR = 0.74, 95% CI = 0.62–0.88); and South vs West census region (AOR = 1.34, 95% CI = 1.04–1.74).
This study found several characteristics could predict pain severity among older US adults who reported extreme/quite a bit of pain. These characteristics may guide specific areas of focus to improve patients’ pain management.
Tuina plus acupuncture for post-stroke depression
Authors: Meng Meng , Hu Guanyu , Yang Kang , Wang Heran , Han Yiran , Pan Ting , Lou Huijuan , Zhang Ye , Wang Yufeng , Cong Deyu 
Published: May 2021

Abstract

Background:
Post-stroke depression (PSD) is the most common mental health issue, affecting approximately 33% of stroke survivors. Tuina and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of Tuina and acupuncture in PSD treatment.

Methods:
The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and April 2021. Clinical randomized controlled trials related to Tuina combined with acupuncture for post-stroke depression will be included in the study. Language is limited to Chinese and English. Research selection, data extraction, and research quality assessment were independently completed by 2 researchers. Data were synthesized using a fixed effect model or random effect model, depending on the heterogeneity test. The Hamilton depression rating scale (HDRS) and effective rate were the primary outcomes. The post-stroke depression rating scale (PSDRS), patient health questionnaire-9 (PHQ-9), and the incidence of adverse events will also be assessed as secondary outcomes. RevMan V.5.4 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. Data synthesis uses the risk ratio and the standardized or weighted average difference of continuous data to represent the results.

Results:
This study provides a high-quality synthesis to assess the effectiveness and safety of Tuina for post-stroke depression.

Conclusion:
This systematic review will provide evidence to determine whether Tuina plus acupuncture is an effective and safe intervention for patients with post-stroke depression.

Ethics and dissemination:
The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

Systematic review registration:
INPLASY202140098
Clinicopathologic features and treatment outcomes of patients with fibrillary glomerulonephritis
Authors: Marinaki Smaragdi , Tsiakas Stathis , Liapis George , Skalioti Chrysanthi , Kapsia Eleni , Lionaki Sophia , Boletis John 
Published: May 2021

Abstract
Fibrillary glomerulonephritis (FGN) is a diverse glomerular disease with poor renal prognosis. The optimal therapeutic approach remains undetermined, as treatment outcomes vary across different studies.
We retrospectively reviewed the medical data of 10 patients diagnosed with biopsy-proven FGN at our center between 2004 and 2019. Clinical and histological features, as well as therapeutic regimens and treatment response, are reported.
The patients were predominantly men (2.5/1 men-female ratio) with a mean age at diagnosis of 46.5 years (IQR: 41.5-59.5). The median proteinuria and creatinine levels at presentation were 2.55 g/day (IQR: 0.4-8.9) and 1.35 mg/dl (IQR: 0.94–1.88), respectively. Four out of 10 patients presented with nephrotic syndrome, 5 patients with nephritic syndrome and 1 with isolated microscopic hematuria. Light microscopy showed mesangial proliferative (n = 7), membranoproliferative-like (n = 2), and diffuse sclerosing patterns (n = 1). Rituximab was used in 7/10 patients, either as monotherapy (n = 3) or combined with cyclophosphamide and corticosteroids (n = 4). Patients who were treated with immunosuppression had higher median levels of creatinine (1.40 mg/dl) and proteinuria (3.5 g/d) compared to those who received supportive treatment alone (0.94 mg/dl and 0.6 g/d, respectively). After a median follow-up of 30 months (IQR:18–66.5), 4 out of 7 patients (57%) treated with immunosuppression achieved a clinical response, 1 had persistent renal dysfunction and 2 patients progressed to end-stage renal disease.
The present case series extends the existing literature on the clinical features and outcomes of FGN, as well as the use of rituximab-based regimens for the treatment of the disease. Further research is needed to establish the proper management of the disease.
Relationship between peripheral neuropathy and cognitive performance in the elderly population
Authors: Lin Yu-Jen , Kao Tung-Wei , Chen Wei-Liang 
Published: May 2021

Abstract
There are only a few studies that have shown an association of peripheral neuropathy with cognitive impairment in elderly individuals. Therefore, we investigated the relationship between cognitive performance and peripheral neuropathy.
From the database of the National Health and Nutrition Examination Survey (NHANES, 1999–2002), each participant completed a household interview, physical performance test, questionnaire regarding personal health, and Digit Symbol Substitution Test (DSST) to evaluate cognitive performance. The severity of peripheral neuropathy was assessed based on the number of insensate areas in both feet during monofilament examination. We used the multivariate linear regression to analyze the association of the DSST findings with insensate areas of the worse foot.
There were 828 participants in our study from NHANES 1999 to 2002; their mean age was 69.96 ± 7.38 years, and 51.3% were male. The β coefficients of the number of insensate areas associated with the DSST findings were all negative values, and the absolute value increased as the number of insensate areas increased. After adjustment for pertinent variables, the correlations remained significantly negative (all P for trend <.001). In addition, subgroup analysis showed no gender differences in the negative association, but this association was not significant in obese participants (P > .05).
Our study provides evidence that the severity of peripheral neuropathy is significantly negatively correlated with cognitive performance.
Comparative effectiveness and safety of growth hormone monotherapy and combination therapy with herbal medicine and growth hormone in short stature children
Authors: Shim Soo Bo , Ahn Hye Ri , Lee Ju Ah , Lee Hye Lim 
Published: May 2021

Abstract

Background:
Short stature (SS) is a state of two or more standard deviations below the average height of the same age and gender. Growth hormone (GH) and herbal medicine are commonly used treatments for SS in East Asia. In this review, we will evaluate the comparative effectiveness and safety of GH monotherapy and combination therapy with herbal medicine and GH for SS.

Methods and analysis:
In this study, randomized controlled trials and quasi- randomised controlled trials will be searched through various databases, including trial registries and databases in Korea, China, and Japan. The risk of bias will be evaluated through the Cochrane handbook criteria.

Ethics and dissemination:
The data used for this review is not the patient's personal information. Therefore, ethical approval is not required. This systematic review will be published and disseminated in peer-reviewed journals.

OSF registration number:
DOI 10.17605/OSF.IO/NMY5G.
Gated single-photon emission computed tomography myocardial perfusion imaging phase analysis as an imaging biomarker for mortality prediction in heart failure patients undergoing cardiac resynchronization therapy
Authors: Bazzy Jimmy , Gadiyaram Varuna , Nguyen Brian J. , Birgersdotter-Green Ulrika , Hoh Carl K. , Obrzut Sebastian 
Published: May 2021

Objective
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure patients. The purpose of this study was to assess the value of gated myocardial perfusion single-photon emission computed tomography (GMPS) phase analysis for predicting survival in heart failure patients undergoing CRT.

Methods
This retrospective cohort study evaluated heart failure patients who underwent GMPS prior to CRT. Phase histogram bandwidth (PHB) and phase SD (PSD) were calculated using GMPS data. Cox proportional hazards model was used to identify independent predictors of overall survival (OS).

Results
A total of 35 patients (age 65.1 ± 13.3, 27 men and 8 women), who were followed for mean of 4.1 ± 2.9 years, were enrolled in the study. PSD of greater than 45° was found to be an independent predictor of poor OS (hazard ratio = 12.63, P = 0.011) when compared with age (hazard ratio = 1.00, P = 0.922), gender (hazard ratio = 0.31, P = 0.155), NYHA class (hazard ratio = 0.45, P = 0.087), QRS duration greater than 150 ms (hazard ratio = 2.38, P = 0.401), pre-CRT left ventricular ejection fraction (LVEF) (hazard ratio = 0.95, P = 0.175) and etiology of heart failure (hazard ratio = 1.42, P = 0.641). Furthermore, PHB greater than 140° was also found to be an independent predictor of poor OS (hazard ratio = 5.63, P = 0.040) when compared with age, gender, NYHA class, QRS duration greater than 150 ms, pre-CRT LVEF and etiology of heart failure.

Conclusions
PSD and PHB, measured by GMPS, may serve as biomarkers for the prediction of survival in patients undergoing CRT.