bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care maps are an effective tool for optimizing quality of care of infectious diseases in a resource-constrained short-stay ambulatory care setting
Authors: Washirasaksiri Chaiwat , Phisalprapa Pochamana , Chaisathaphol Thanet , Auesomwang Chonticha , Sitasuwan Tullaya , Tinmanee Rungsima , Kositamongkol Chayanis , Sutee Rungsinee , Chouriyagune Charoen , Srivanichakorn Weerachai 
Published: February 2021

Abstract
Care maps (CMs), which are innovative, comprehensive, educational, and simple medical tools, were developed for 6 common diseases, including heart failure, stroke, hyperglycemia, urinary tract infection, dengue infection, and upper gastrointestinal bleeding, were implemented in a short-stay ambulatory ward. This study aimed to investigate the effectiveness of and level of clinician satisfaction with CMs in an ambulatory care setting.
A retrospective chart review study comparing the quality of care between before and after CM implementation was conducted. The medical records of patients who were admitted to a short-stay ambulatory ward in a tertiary referral center were reviewed. Demographic data, severity of disease, quality of care, length of stay (LOS), admission cost, and CM user satisfaction were collected and recorded.
The medical records of 1116 patients were evaluated. Of those, 589 and 527 patients were from before (non-CM group) and after CM (CM group) implementation, respectively. There were no significant differences between groups for age, gender, or disease-specific severity the median (interquartile range) total and essential quality scores were significantly higher in the CM group than in the non-CM group [total quality score 85.3 (75.0–92.9) vs 61.1 (50.0–75.0); P < .001, and essential quality scores 90.0 (75.0–100.0) vs 60.0 (40.6–80.0); P < .0001, respectively]. All aspects of quality of care were significantly improved between before and after CM implementation. Overall median LOS was significantly decreased from 3.8 (2.5–5.7) to 3.0 (2.0–4.9) days, but there was no significant decrease for admission cost. However, CMs were able to significantly reduce both LOS and admission cost in the infectious disease-related subgroup. Most CM users reported satisfaction with CMs.
CMs were shown to be an effective tool for improving the quality of care in patients with ambulatory infectious diseases. In that patient subgroup, LOS and admission cost were both significantly reduced compared to pre-CM implementation.
TurboHawk plaque rotation system for treatment of arteriosclerosis occlusion in lower extremities
Authors: Yuan Zhao , Yang Bo , Wang Jian , An Huan-song , Xu Hai 
Published: February 2021

Abstract
This pilot study retrospectively assessed the feasible efficacy of TurboHawk plaque rotation system (THPRS) for treatment of arteriosclerosis occlusion in lower extremities (AOLE).
A total of 36 eligible patients with AOLE were included in this pilot retrospective study. We divided all those patients into a treatment group and a control group, each group 18 patients. All patients in both groups administered conventional therapy. Additionally, all patients in the treatment group received THPRS, while all patients in the control group received percutaneous transluminal angioplasty (PTA) and percutaneous transluminal stenting (PTS). All outcomes were evaluated and analyzed at 3-month after surgery.
At 3-month postsurgery, there were not significant statistical differences in clinical manifestations (intermittent claudication, P = .49; resting pain, P = .28), ankle brachial index change (P = .07), 6-minute walk distance (P = .43), and complications between 2 groups.
This pilot study did not show better outcome improvement of THPRS for patients with AOLE. We cautiously draw the present conclusion, because it suffers from several major restrictions. Thus, further studies with larger sample size and longer term follow-up are still needed to warrant the current conclusion.
Endplate injury as a risk factor for cage retropulsion following transforaminal lumbar interbody fusion
Authors: Zhou Zhi-Jie , Xia Ping , Zhao Feng-Dong , Fang Xiang-Qian , Fan Shun-Wu , Zhang Jian-Feng 
Published: February 2021

Abstract
Although transforaminal lumbar interbody fusion (TLIF) is a widely accepted procedure, major complications such as cage retropulsion (CR) can cause poor clinical outcomes. Endplate injury (EI) was recently identified as a risk factor for CR, present in most levels developing CR. However, most EIs occurred in non-CR levels, and the features of EIs in CR levels remain unknown.
The aim of this study was to identify risk factors for CR following TLIF; in particular, to investigate the relationship between EIs and CR, and to explore the features of EIs in CR.
Between October 2010 and December 2016, 1052 patients with various degenerative lumbar spinal diseases underwent bilateral instrumented TLIF. Their medical records, radiological factors, and surgical factors were reviewed and factors affecting the incidence of CR were analyzed.
Twenty-one patients developed CR. Nine had back pain or leg pain, of which six required revision surgery. A pear-shaped disc, posterior cage positioning and EI were significantly correlated with CR (P < .001, P = .001, and P < .001, respectively). Computed tomography (CT) scans revealed the characteristics of EIs in levels with and without CR. The majority of CR levels with EIs exhibited apparent compression damage in the posterior part of cranial endplate on the decompressed side (17/18), accompanied by caudal EIs isolated in the central portion. However, in the control group, the cranial EIs involving the posterior part was only found in four of the total 148 levels (P < .001). Most of the injuries were confined to the central portion of the cranial or caudal endplate or both endplates (35 in 148 levels, 23.6%). Additionally, beyond cage breaching into the cortical endplate on lateral radiographs, a characteristic appearance of coronal cage misalignment was found on AP radiographs in CR levels with EIs.
A pear-shaped disc, posterior cage positioning and EI were identified as risk factors for CR. EI involving the posterior epiphyseal rim had influence on the development of CR. Targeted protection of the posterior margin of adjacent endplates, careful evaluation of intraoperative radiographs, and timely remedial measures may help to reduce the risks of CR.
A case report of congenital idiopathic hypogonadotropic hypogonadism caused by novel mutation of GNRHR gene
Authors: Wang Liping , Lin Weisheng , Li Xiaohong , Zhang Lijuan , Wang Kai , Cui Xiaoli , Tang Shanmei , Fang Guangguang , Tan Yan , Wang Xuelai , Chen Chuan , Yang Chuanchun , Tang Huiru 
Published: February 2021

Abstract

Rationale:
This study aimed to investigate the genetic mutation characteristics of congenital idiopathic hypogonadotropic hypogonadism (IHH) through the clinical features and genetic analysis of 2 patients with IHH in 1 pedigree.

Patient concerns:
A 23-year-old girl presented with primary amenorrhea, sparse pubic hair, lack of breast development, and delayed sexual development.

Diagnoses:
Combined with the clinical characteristics, auxiliary examinations, and molecular genetic analysis, the patient was diagnosed as IHH.

Interventions:
Whole exome and Sanger sequencing were performed to validate the mutation in family members.

Outcomes:
A novel homozygous missense mutation c.521A > G (p.Q174R) in the GNRHR gene was identified in the 2 affected sisters. Familial segregation showed that the homozygous variant was inherited from their parents respectively and the eldest sister was the carrier without correlative symptom.

Lessons:
We reported a novel GNRHR mutation in a pedigree with congenital idiopathic hypogonadotropic hypogonadism. Glutamine at amino acid position 174 was highly conserved among various species. The molecular structure of GNRHR protein showed that p.Q174R mutation brought in a new stable hydrogen bond between position 174 and 215, may impede conformational mobility of the TMD4 and TMD5. It suggests that the missense mutation c.521A > G related to congenital idiopathic hypogonadotropic hypogonadism was probably a causative factor for both sisters. Through high-throughput sequencing and experimental verification, we had basically determined the patient's pathogenic mutation and inheritance, which could better guide doctors for treatment.
The effect of oral low molecular weight liquid hyaluronic acid combination with glucosamine and chondroitin on knee osteoarthritis patients with mild knee pain
Authors: Wang Shyu-Jye , Wang Ya-Hui , Huang Liang-Chen 
Published: February 2021

Abstract

Background:
The popularity of dietary supplements for knee osteoarthritis (OA) management is on the rise; however, their effects are still debated.

Methods:
This study aimed to investigate the effect of an oral low molecular weight liquid hyaluronic acid supplement in the treatment of knee OA patients with mild knee pain (visual analogue scale [VAS] ≤ 3) in Taiwan population. This was a randomized, double-blind, placebo-controlled study. Forty-seven subjects were enrolled and randomly allocated to either the A+HA or the placebo groups. The subjects were required to drink a bottle contained 20 mL of A+HA or placebo daily throughout an 8-week study period. The efficacy was assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-item Short Form Survey (SF-36).

Results:
At Week 8, significant reductions from baseline in the WOMAC pain (–2.6 ± 1.68, P < .0001), stiffness (–1.2 ± 1.50, P = .007), physical function (–5.8 ± 4.39, P < .0001), and total (–9.4 ± 5.82, P < .0001) scores were observed in the A+HA group but not in the placebo group. Significant differences in the mean change of WOMAC scores from baseline at Week 8 between groups were detected (P < .01). At Week 8, the A+HA group also showed significant improvements in SF-36 physical functioning (2.7 ± 3.10, P = .001) and bodily pain (0.7 ± 1.50, P < .05) domains. Although the A+HA group had a higher increase in the SF-36 total score than the placebo group but the difference was not statistically significant (2.1 ± 12.75 vs 0.3 ± 19.66, P = .12).

Conclusions:
Oral administration of low molecular weight liquid HA appeared to be effective for knee OA patients with mild knee pain (VAS ≤ 3) in the relief of knee OA symptoms, particularly in pain and physical function.
Clinical Trial Registration: NCT04352322.
Repetitive syncope caused by a rare massive sporadic malignant peripheral nerve sheath tumor involving carotid arteries
Authors: Wang Tiehao , Wang Jiarong , Zhao Jichun , Yuan Ding , Yao Wenqing 
Published: February 2021

Abstract

Rationale:
Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas arising from peripheral nerves. MPNSTs are uncommon in the head and neck, and various clinical manifestation often make the diagnosis challenging.

Patient concerns:
A 67-year-old female was referred for evaluation of repetitive syncope with a massive mass in the neck. Preoperative evaluation revealed potential neuroendocrine activity of the mass and enhanced computed tomography showed carotid artery was involved.

Diagnosis:
According to the preoperative imaging, intraoperative finding and postoperative pathological examination, the diagnosis of left neck MPNST involving left carotid arteries was made.

Interventions:
Volume expansion therapy with phenoxybenzamine started one week before surgery. Complete surgical resection of the mass was performed and pathological analysis suggested the diagnosis of MPNST. The postoperative radiotherapy was not given due to her poor nutrition.

Outcomes:
This patient recovered well after surgery and no sign of recurrence was noted at 2-year follow-up.

Lessons:
Though the involvement of carotid artery with neuroendocrine activity is rare in sporadic MPNST, preoperative scanning of blood and urine catecholamine is crucial for intraoperative hemodynamic stability, especially when carotid artery is involved.
Postoperative complications and mortality following emergency digestive surgery during the COVID-19 pandemic
Authors: Madrazo Zoilo , Osorio Javier , Otero Aurema , Biondo Sebastiano , Videla Sebastian 
Published: February 2021

Abstract
Infection with the SARS-CoV-2 virus seems to contribute significantly to increased postoperative complications and mortality after emergency surgical procedures. Additionally, the fear of COVID-19 contagion delays the consultation of patients, resulting in the deterioration of their acute diseases by the time of consultation. In the specific case of urgent digestive surgery patients, both factors significantly worsen the postoperative course and prognosis. Main working hypothesis: infection by COVID-19 increases postoperative 30-day-mortality for any cause in patients submitted to emergency/urgent general or gastrointestinal surgery. Likewise, hospital collapse during the first wave of the COVID-19 pandemic increased 30-day-mortality for any cause. Hence, the main objective of this study is to estimate the cumulative incidence of mortality at 30-days-after-surgery. Secondary objectives are: to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for COVID-19-infected patients.
A multicenter, observational retrospective cohort study (COVID-CIR-study) will be carried out in consecutive patients operated on for urgent digestive pathology. Two cohorts will be defined: the “pandemic” cohort, which will include all patients (classified as COVID-19-positive or -negative) operated on for emergency digestive pathology during the months of March to June 2020; and the “control” cohort, which will include all patients operated on for emergency digestive pathology during the months of March to June 2019. Information will be gathered on demographic characteristics, clinical and analytical parameters, scores on the usual prognostic scales for quality management in a General Surgery service (POSSUM, P-POSSUM and LUCENTUM scores), prognostic factors applicable to all patients, specific prognostic factors for patients infected with SARS-CoV-2, postoperative morbidity and mortality (at 30 and 90 postoperative days). The main objective is to estimate the cumulative incidence of mortality at 30 days after surgery. As secondary objectives, to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for SARS-CoV-2 infected patients.
The protocol (version1.0, April 20th 2020) was approved by the local Institutional Review Board (Ethic-and-Clinical-Investigation-Committee, code PR169/20, date 05/05/20). The study findings will be submitted to peer-reviewed journals and presented at relevant national and international scientific meetings.
ClinicalTrials.gov Identifier: NCT04479150 (July 21, 2020).
Galactose-deficient IgA1 and nephritis-associated plasmin receptors as markers for IgA-dominant infection-related glomerulonephritis
Authors: Han Wei , Suzuki Tomo , Watanabe Shiika , Nakata Mayumi , Ichikawa Daisuke , Koike Junki , Oda Takashi , Suzuki Hitoshi , Suzuki Yusuke , Shibagaki Yugo 
Published: February 2021

Abstract

Rational:
Immunoglobulin A (IgA) nephropathy is a common heterogeneous kidney disease. One of the causes of secondary immunoglobulin A nephropathy is infection-related glomerulonephritis (IRGN), however, its accurate diagnosis is difficult.

Patient concerns:
We report a rare case of an 82-year-old male presenting rapidly progressive glomerulonephritis. Assessment of a kidney biopsy by light microscopy revealed endocapillary glomerulonephritis with subendothelial deposits, such as wire loop lesions and cellular crescents. Immunofluorescence demonstrated strong staining for IgA and C3 along the glomerular capillary. Additional tests included positive staining for nephritis-associated plasmin receptor and positive plasmin activity in the glomeruli. Moreover, IgA and galactose-deficient IgA1 (Gd-IgA1) staining merged using immunofluorescence, followed by confirmation of high serum levels of Gd-IgA1 (9.3 μg/mL) by ELISA was observed.

Diagnosis:
The diagnosis of IgA-dominant IRGN was made.

Interventions and outcomes:
We have initiated treatment with intravenous methylprednisolone 500 mg/day for 3 days, followed by oral prednisolone 25 mg/d as rapidly progressive glomerulonephritis. However immunosuppressive therapy was halted because of a poor response, and hemodialysis was initiated.

Lessons:
This is a case of IgA-dominant IRGN patient exhibiting positive glomerular staining for nephritis-associated plasmin receptor accompanied with high titers of serum Gd-IgA1. Our observations suggest that serum and kidney tissue of Gd-IgA1 may be useful for the diagnosis of IgA-dominant IRGN.
Systemic inflammatory status – a bridge between gestational weight gain and neonatal outcomes (STROBE-compliant article)
Authors: Rugină Cosmin , Mărginean Cristina Oana , Meliţ Lorena Elena , Huţanu Adina , Ghiga Dana Valentina , Modi Viviana , Mărginean Claudiu 
Published: February 2021

Abstract
Pregnant women with excessive gestational weight gain express an inflammatory status with multiple negative effects on birth outcomes.
The aim of this study was to identify the relationship between gestational weight gain at different gestational ages and inflammatory status in pregnant women and their newborns assessing both interleukin 6 and 8, as well as hepcidin in these couples.
Our study included 170 pregnant women and their newborns. Pregnant women were clinically assessed at the end of the 1st trimester and at term, whereas the newborns were assessed over the first 3 days of life. The levels of interleukin 6, 8 and hepcidin were measured in both pregnant women and their newborns.
We noticed higher levels of interleukin 6, interleukin 8 and hepcidin in pregnant women at the time of delivery as compared to the end of the 1st trimester. We observed a direct significant correlation between gestational weight gain at the time of delivery and interleukin 8 in both mothers [r = 0.1834, 95% CI: 0.0293–0.3290, (P = .0167)] and newborns [r = 0.1790, 95% CI: 0.0248–0.3249, (P = .0195)]. Our study underlined that a higher gestational weight gain resulted in a significantly higher birth weight [r = 0.2190, 95% CI: 0.0663–0.3617, (P = .0041)].
Our findings suggest that interleukin 8 might be an important indicator of inflammatory status in both mothers and newborns. Moreover, excessive gestational weight gain was associated with an increase in birth weight.
Effect of continuous nursing on angina attack and quality of life in patients with coronary artery disease
Authors: Zhou Xiaohuan , Yuan Yamin , Wang Zhanglin , Zhang Ke , Fan Weiwei , Zhang Yawei , Ma Pu 
Published: February 2021

Abstract

Background:
Coronary Artery Disease is an ischemic or necrotic heart disease caused by myocardial hypoxia caused by coronary artery stenosis or occlusion. The main symptoms are heart failure and recurrent angina pectoris. Continuous nursing refers to the nursing mode from in-hospital nursing to out-of-hospital nursing, including guiding patients’ follow-up treatment and lifestyle, which can effectively improve the quality of life in patients with Coronary Artery Disease and reduce the number of angina attacks. The study implemented in this program will systematically evaluate the efficacy and safety of continuous nursing intervention on an angina attack and quality of life in Coronary Artery Disease, and provide evidence-based basis for clinical application of continuous nursing intervention in Coronary Artery Disease.

Method:
The 2 researchers search the databases of China Knowledge Network, VP Information Chinese Journal Service Platform, PubMed, Embase, the Cochrane Library and Web of Science. From the establishment of the database in December 2020, all the randomized controlled trials on continuous nursing intervention for Coronary Artery Disease are collected. The relevant data are extracted and the quality is evaluated. meta-analysis is performed on the included literature using Stata15.0 software.

Result:
In this study, the efficacy and safety of continuous nursing intervention on Coronary Artery Disease are evaluated by Seattle angina questionnaire and other indicators.

Conclusion:
This study will provide reliable evidence for the clinical application of nursing intervention in Coronary Artery Disease.

Ethics and dissemination:
Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:
DOI 10.17605/OSF.IO/7QRKV.
Predicting factors of adverse pregnancy outcomes in Thai patients with systemic lupus erythematosus
Authors: Louthrenoo Worawit , Trongkamolthum Thananant , Kasitanon Nuntana , Wongthanee Antika 
Published: February 2021

Abstract
Studies on predicting factors for adverse pregnancy outcomes (APOs) in Thai patients with systemic lupus erythematosus (SLE) are limited. This retrospective observation study determined APOs and their predictors in Thai patients with SLE.
Medical records of pregnant SLE patients in a lupus cohort, seen from January 1993 to June 2017, were reviewed.
Ninety pregnancies (1 twin pregnancy) from 77 patients were identified. The mean age at conception was 26.94 ± 4.80 years. At conception, 33 patients (36.67%) had active disease, 23 (25.56%) hypertension, 20 (22.22%) renal involvement, and 6 of 43 (13.95%) positive anti-cardiolipin antibodies or lupus anti-coagulants, and 37 (41.11%) received hydroxychloroquine. Nineteen patients (21.11%) had pregnancy loss. Of 71 successful pregnancies, 28 (31.11%) infants were full-term, 42 (46.67%) pre-term and 1 (11.11%) post-term; 19 (26.39%) were small for gestational age (SGA), and 38 (52.58%) had low birth weight (LBW). Maternal complications occurred in 21 (23.33%) pregnancies [10 (11.11%) premature rupture of membrane (PROM), 8 (8.89%) pregnancy induced hypertension (PIH), 4 (4.44%) oligohydramnios, 2 (2.22%) post-partum hemorrhage, and 1 (1.11%) eclampsia]. Patients aged ≥ 25 years at pregnancy and those ever having renal involvement had predicted pregnancy loss with adjusted odds ratio (AOR) [95% CI] of 4.15 [1.10–15.72], P = .036 and 9.21 [1.03–82.51], P = .047, respectively. Renal involvement predicted prematurity (6.02 [1.77–20.52, P = .004), SGA (4.46 [1.44–13.78], P = .009), and LBW in infants (10.01 [3.07–32.62], P < .001). Prednisolone (>10 mg/day) and immunosuppressive drugs used at conception protected against prematurity (0.11 [0.02–0.85], P = .034). Flares and hematologic involvement predicted PROM (8.45 [1.58–45.30], P = .013) and PIH (9.24 [1.70–50.24], P = .010), respectively. Cutaneous vasculitis (33.87 [1.05–1,094.65], P = .047), and renal (31.89 [6.66–152.69], P < .001), mucocutaneous (9.17 [1.83–45.90], P = .007) and hematologic involvement (128.00 [4.60–3,564.46], P = .004) during pregnancy predicted flare; while prednisolone (>10 mg/day) and immunosuppressive drug use at conception reduced that risk (0.08 [0.01–0.68, P = .021).
APOs remain a problem in Thai pregnant SLE patients. Renal involvement and SLE flares were associated with the risk of APOs.