bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Acupuncture and Sham Acupuncture in Migraine Treatment
Authors: Li Mao , Wang Weijun , Gao Wen , Yang Dongdong 
Published: November 2021

Background:
Acupuncture is widely used for treating migraine; however, evidence of its efficacy when compared with sham acupuncture is equivocal. This study aimed to compare the evaluate efficacy of acupuncture versus sham acupuncture in migraine treatment.

Methods:
We searched PubMed, the Cochrane Library, Web of Science, and EMBASE databases from their inception to April 25, 2021, for randomized controlled trials. The outcome measurement included response rate, migraine days, intensity, and frequency.

Results:
Twenty randomized controlled trials involving 2725 patients were included. Pooled data suggested that acupuncture was superior to sham acupuncture [mean difference (MD)=−0.52, 95% confidence interval (CI): −0.71 to −0.34, P<0.00001] in reducing the migraine frequency after treatment and follow-up (MD=−0.51, 95% CI: −0.70 to −0.32, P<0.00001). In reducing Visual Analog Scale, acupuncture was superior to sham acupuncture (MD=−0.72, 95% CI: –1.17 to −0.27, P=0.002) after treatment, and also superior to sham acupuncture (MD=−0.82, 95% CI: −1.31 to −0.33, P=0.001) on the follow-up. As for responder rate, acupuncture’s efficacy was better than sham acupuncture (relative risk=1.28, 95% CI: 1.00-1.64, P=0.05). However, the reduction of migraine days in the acupuncture group was not significantly different from that in the sham acupuncture group after treatment (MD=−0.62; 95% CI: −1.31 to 0.08; P=0.08) and on the follow-up (MD=−0.68; 95% CI: −1.52 to 0.17; P=0.12).

Conclusions:
Acupuncture appears to be an effective treatment modality for migraine. Compared with sham acupuncture, acupuncture had greater improvements in migraine frequency, Visual Analog Scale, and responder rate, but there was no statistically significant difference for the number of migraine days.
The Korea National Patient Safety Incidents Inquiry Survey: Characteristics of Adverse Events Identified Through Medical Records Review in Regional Public Hospitals
Authors: Kim Min Ji , Seo Hee Jung , Koo Hong Mo , Ock Minsu , Hwang Jee-In , Lee Sang-Il 
Published: November 2021

Objectives
In 2019, the Korean National Patient Safety Incidents Inquiry was conducted in the Republic of Korea to identify the national-level incidence of adverse events. This study determined the incidence and detailed the characteristics of adverse events at 15 regional public hospitals in the Republic of Korea.

Methods
Medical records data of 500 randomly selected patients (discharged in 2016) were extracted from each of the 15 studied hospitals and reviewed in 3 stages. First, for each hospital, 2 nurses independently reviewed the medical records, using 41 screening criteria. Second, 2 physicians independently reviewed the records of those patients with at least 1 screening criterion from the first stage for adverse events occurrence and their characteristics. Third, a 9-member committee conducted a final review and compiled the final adverse event report.

Results
Among 7500 patients, 4159 (55.5%) had at least 1 screening criterion; 745 (9.9%) experienced 901 adverse events (incidence, 12.0%). By type of institution, adverse event incidence varied widely from 1.2% to 45.6%. In 1032 adverse events, the majority (33.5%) were “patient care–related.” By severity, the majority (638; 70.8%) were temporary, requiring intervention, whereas 38 (4.2%) resulted in death. The preventability score was high for “patient care–related” and “diagnosis-related” adverse events. Duration of hospitalization was extended for 463 (44.9%) adverse events, with “diagnosis-related” (30.8%) and “surgery/procedural-related” (30.1%) types extended by at least 21 days.

Conclusions
A review of medical records aids in identifying adverse events in medical institutions with varying characteristics, thus helping prioritize interventions to reduce their incidence.
Reliability and validity of the Turkish version of the satisfaction module of the Orthotics and Prosthetics Users' Survey
Authors: Demirdel Senem , Ulaş Kardem , Erol Çelik Seher , Karahan Sevilay , Topuz Semra 
Published: November 2021

Background:
Evaluation of prosthesis and orthosis (P&O) devices and service satisfaction in patients using P&O are important to understand the patient perspective and improve the quality of devices and the services.

Objective:
The aim of this study was to translate the original Orthotics and Prosthetics Users' Survey (OPUS) satisfaction module into Turkish and examine its psychometric properties in lower limb P&O users.

Study Design:
Cross-sectional study.

Methods:
The Turkish versions of the OPUS-Client Satisfaction with Device (CSD) and Service (CSS) modules were applied to 157 individuals using a lower limb prosthesis or orthosis. The retest of the survey was applied 5–7 days later. Intraclass correlation coefficient was used to determine test–retest reliability, and Cronbach alpha was used to determine internal consistency. Criterion validity was evaluated using the Nottingham Health Profile. Exploratory factor analysis was used to examine the factor structure of the Turkish version of the OPUS satisfaction module.

Results:
The test–retest correlation (intraclass correlation coefficient = 0.92 for CSD and 0.91 for CSS) and internal consistency (Cronbach's alpha = 0.84 for CSD and 0.95 for CSS) were high. A statistically significant correlation was found between the OPUS CSD and CSS modules and the Nottingham Health Profile (r = −0.325 for CSD module, r = −0.381 for CSS module, P < 0.001). The factor analysis revealed one-factor structure for both modules.

Conclusions:
This study demonstrated the reliability and validity of the Turkish version of the OPUS satisfaction module, and it provides a useful starting point for future studies on this survey.
The role of Gram-negative bacteria in skin and soft tissue infections
Authors: Russo Alessandro , Trecarichi Enrico Maria , Torti Carlo 
Published: November 2021

Purpose of review
Skin and soft tissue infections (SSTIs) are a leading cause of morbidity, emergency department visits and hospitalization. In recent years, the spread of carbapenem-resistant gram-negative bacteria (GNB) is also increasing in SSTIs. However, the armamentarium of available drugs is recently expanding as well. In this review, we reported the most recent data and about management and treatment of SSTIs caused by GNB, mainly for the treatment of carbapenem-resistant Enterobacterales (CRE), Pseudomonas spp and Acinetobacter spp.

Recent findings
The increasing incidence of carbapenem-resistant GNB is challenging for management and treatment, considering the high rate of inappropriate empiric and targeted antimicrobial treatments. The role of new antibiotics, mainly licensed for the treatment of other infections, is an object of continuous debate. As a matter of fact, no specific clinical trials on SSTIs have been performed for new drugs; however, recent data about the use in real life of new compounds in clinical practice are available.

Summary
Some recently approved drugs are actually considered the backbone of targeted therapy in patients with severe infections caused by susceptible carbapenem-resistant GNB strains. Prompt diagnosis of cSSTIs is crucial and, when necessary, surgical debridement for source control of infection is the milestone of the treatment. The physicians should be confident to identify patients at high risk for multidrug-resistant pathogens to minimize inappropriate empiric therapy.
Spasticity, Pain, and Fatigue
Authors: Bhimani Rozina , Chappuis Diane , Mathiason Michelle A. , Anderson Lisa Carney 
Published: November 2021

Abstract

Purpose
The purpose of this study was to determine whether spasticity, pain, and fatigue symptoms were related to functional outcomes in people with stroke.

Design
A longitudinal correlation design was used.

Methods
Twenty-two stroke patients experiencing spasticity, pain, and fatigue were followed for 7 days over 6 weeks: 3 days in acute rehabilitation units, 3 days postdischarge to home/community, and an additional 1 day at 1 month postdischarge. Demographics, numeric ratings, and PROMIS tools were used to determine associations over time.

Results
Pain was related to fine motor activities on admission. Fatigue was significantly associated with activities of daily living, motor functions, mobility, and ability to perform physical tasks at 1 month. Spasticity was significantly related to activities of daily living, pain experiences and fatigue at 1 month.

Conclusions
Symptoms of spasticity, pain, and fatigue were associated with functional outcomes in this sample of patients.

Clinical Relevance to Rehabilitation Nursing
Symptoms can influence physical recovery; therefore, nurses could improve care through recognition of suspected correlation of symptoms in people with stroke.
PEG-PEI/siROCK2 inhibits Aβ42-induced microglial inflammation via NLRP3/caspase 1 pathway
Authors: Liu Yunyun , Zhang Han , Peng Anping , Cai Xiaodong , Wang YuZhou , Tang Ke , Wu Xiuqin , Liang Yanran , Wang Limin , Li Zhong 
Published: November 2021

Objectives
There is an urgent need to develop therapeutic strategies to improve the treatment outcome of Alzheimer’s disease. The treatment strategy of gene therapy mediated by nanocarrier systems brings new hope for the treatment of Alzheimer’s disease. ROCK2 is involved in various pathological processes of Alzheimer’s disease and may be a potential target for the treatment of Alzheimer’s disease. Our previous study indicated that PEG-PEI/siROCK2 [polyethyleneglycol-polyethyleneimine deliver ROCK2-siRNA, (PPSR)] prevented Aβ42-induced neurotoxicity and showed a promising prospect for the treatment of Alzheimer’s disease. However, whether PPSR has an effect on the microglial inflammation in Alzheimer’s disease is still unclear.

Materials and methods
3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay was used to detect the cytotoxicity of PEG-PEI and PPSR in primary microglial cells. Real-time PCR and western blotting were used to assess the expression of ROCK2 and nucleotide oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3)/caspase 1 pathway in primary microglial cells. ELISA assay was used to measure the effect of PPSR on attenuating the lipopolysaccharide (LPS) + Aβ-induced increase in IL-1β.

Results
PEG-PEI concentration less than 20 μg/ml and the N/P (molar ratio of PEG-PEI amino/siRNA phosphate) ratio of PPSR less than 50 showed no significant cytotoxicity in primary microglia cells. PPSR could effectively inhibit the expression of ROCK2 in primary microglial cells. A further study revealed that PPSR attenuates the LPS+Aβ-induced increase in IL-1β without affecting cell viability. In addition, we found that PPSR suppressed the Aβ-induced NLRP3/caspase 1 pathway in primary microglial cells.

Conclusion
PPSR inhibits Aβ42-induced microglial inflammation via NLRP3/caspase 1 pathway.
The effect of Iridoids effective fraction of Valeriana jatamansi Jones on movement function in rats after acute cord injury and the related mechanism
Authors: Xiong Deqi , Liu Hao , Pang Rizhao , Yan Zhiyong , Sun Nianyi , Liu Jiancheng , Zheng Jinqi , Zhu Jiali , Lu Jiachun , Wang Wenchun , Zhang Anren 
Published: November 2021

Objectives
Spinal cord injury (SCI) is a disastrous central nervous system (CNS) disorder, which was intimately associated with oxidative stress. Studies have confirmed that Iridoids Effective Fraction of Valeriana jatamansi Jones (IEFV) can scavenge reactive oxygen species. This study aimed to confirm the efficacy of IEFV in ameliorating SCI.

Methods
For establish the SCI model, the Sprague-Dawley rats underwent a T10 laminectomy with transient violent oppression by aneurysm clip. Then, the rats received IEFV intragastrically for 8 consecutive weeks to evaluate the protective effect of IEFV on motor function, oxidative stress, inflammation and neurotrophic factors in SCI rats.

Results
Basso, Beattie and Bresnahan scores, hematoxylin and eosin (H&E) staining and transmission electron microscopy experiments found IEFV protected motor function and alleviated neuron damage. Meanwhile, IEFV treatment decreased the release of malondialdehyde, interleukin-6 (IL-6), cyclooxygenase-2 and tumor necrosis factor-α. Moreover, IEFV treatment elevated the expression levels of brain-derived neurotrophic factor and nerve growth factor of SCI rats. Finally, administration of IEFV significantly inhibited the expression of p-p65 and toll-like receptor 4 (TLR4).

Conclusions
This study suggests that IEFV could attenuate the oxidative stress and inflammatory response of the spinal cord after SCI, which was associated with inhibition of the TLR4/nuclear factor-kappaB signaling pathway.
Host life-history traits influence the distribution of prophages and the genes they carry
Authors: Pattenden Tyler , Eagles Christine , Wahl Lindi M. 
Published: November 2021

Bacterial strains with a short minimal doubling time—‘fast-growing’ hosts—are more likely to contain prophages than their slow-growing counterparts. Pathogenic bacterial species are likewise more likely to carry prophages. We develop a bioinformatics pipeline to examine the distribution of prophages in fast- and slow-growing lysogens, and pathogenic and non-pathogenic lysogens, analysing both prophage length and gene content for each class. By fitting these results to a mathematical model of the evolutionary forces acting on prophages, we predict whether the observed differences can be attributed to different rates of lysogeny among the host classes, or other evolutionary pressures. We also test for significant differences in gene content among prophages, identifying genes that are preferentially lost or maintained in each class. We find that fast-growing hosts and pathogens have a greater fraction of full-length prophages, and our analysis predicts that induction rates are significantly reduced in slow-growing hosts and non-pathogenic hosts. Consistent with previous results, we find that several proteins involved in the packaging of new phage particles and lysis are preferentially lost in cryptic prophages.This article is part of the theme issue ‘The secret lives of microbial mobile genetic elements’.
Gene sharing among plasmids and chromosomes reveals barriers for antibiotic resistance gene transfer
Authors: Wang Yiqing , Batra Aditi , Schulenburg Hinrich , Dagan Tal 
Published: November 2021

The emergence of antibiotic resistant bacteria is a major threat to modern medicine. Rapid adaptation to antibiotics is often mediated by the acquisition of plasmids carrying antibiotic resistance (ABR) genes. Nonetheless, the determinants of plasmid-mediated ABR gene transfer remain debated. Here, we show that the propensity of ABR gene transfer via plasmids is higher for accessory chromosomal ABR genes in comparison with core chromosomal ABR genes, regardless of the resistance mechanism. Analysing the pattern of ABR gene occurrence in the genomes of 2635 Enterobacteriaceae isolates, we find that 33% of the 416 ABR genes are shared between chromosomes and plasmids. Phylogenetic reconstruction of ABR genes occurring on both plasmids and chromosomes supports their evolution by lateral gene transfer. Furthermore, accessory ABR genes (encoded in less than 10% of the chromosomes) occur more abundantly in plasmids in comparison with core ABR genes (encoded in greater than or equal to 90% of the chromosomes). The pattern of ABR gene occurrence in plasmids and chromosomes is similar to that in the totalEscherichiagenome. Our results thus indicate that the previously recognized barriers for gene acquisition by lateral gene transfer apply also to ABR genes. We propose that the functional complexity of the underlying ABR mechanism is an important determinant of ABR gene transferability.This article is part of the theme issue ‘The secret lives of microbial mobile genetic elements’.
Intraspecific antagonism through viral toxin encoded by chronicSulfolobusspindle-shaped virus
Authors: DeWerff Samantha J. , Zhang Changyi , Schneider John , Whitaker Rachel J. 
Published: November 2021

Virus–host interactions evolve along a symbiosis continuum from antagonism to mutualism. Long-term associations between virus and host, such as those in chronic infection, will select for traits that drive the interaction towards mutualism, especially when susceptible hosts are rare in the population. Virus–host mutualism has been demonstrated in thermophilic archaeal populations whereSulfolobusspindle-shaped viruses (SSVs) provide a competitive advantage to their hostSulfolobus islandicusby producing a toxin that kills uninfected strains. Here, we determine the genetic basis of this killing phenotype by identifying highly transcribed genes in cells that are chronically infected with a diversity of SSVs. We demonstrate that these genes alone confer growth inhibition by being expressed in uninfected cells via aSulfolobusexpression plasmid. Challenge of chronically infected strains with vector-expressed toxins revealed a nested network of cross-toxicity among divergent SSVs, with both broad and specific toxin efficacies. This suggests that competition between viruses and/or their hosts could maintain toxin diversity. We propose that competitive interactions among chronic viruses to promote their host fitness form the basis of virus–host mutualism.This article is part of the theme issue ‘The secret lives of microbial mobile genetic elements’.
Native American Ancestry and Pigmentation Allele Contributions to Skin Color in a Caribbean Population
Authors: Ang Khai C , Canfield Victor A , Foster Tiffany C , Harbaugh Thaddeus D , Early Kathryn A , Harter Rachel L , Reid Katherine P , Leong Shou Ling , Kawasawa Yuka I , Liu Dajiang J , Hawley John W , Cheng Keith C 
Published: November 2021

AbstractOur interest in the genetic basis of skin color variation between populations led us to seek a Native American population with African admixture but low frequency of European light skin alleles. Analysis of 458 genomes from individuals residing in the Kalinago territory of the Commonwealth of Dominica showed approximately 55% Native American, 32% African, and 12% European ancestry, the highest Native American ancestry among Caribbean populations to date. Skin pigmentation ranged from 20 to 80 melanin units, averaging 46. Three albino individuals were determined to be homozygous for a causative multi-nucleotide polymorphismOCA2NW273KVcontained within a haplotype of African origin; its allele frequency was 0.03 and single allele effect size was -8 melanin units. Derived allele frequencies ofSLC24A5A111TandSLC45A2L374Fwere 0.14 and 0.06, with single allele effect sizes of -6 and -4, respectively. Native American ancestry by itself reduced pigmentation by more than 20 melanin units (range 24 - 29). The responsible hypopigmenting genetic variants remain to be identified, since none of the published polymorphisms predicted in prior literature to affect skin color in Native Americans caused detectable hypopigmentation in the Kalinago.
Prioritizing interventions for preventing COVID-19 outbreaks in military basic training
Authors: España Guido , Perkins T. Alex , Pollett Simon , Smith Morgan E. , Moore Sean M. , Kwon Paul O. , Hall Tara L. , Beagle Milford H. , Murray Clinton K. , Hakre Shilpa , Peel Sheila , Modjarrad Kayvon , Scott Paul T. 
Published: November 2021

AbstractLike other congregate living settings, military basic training has been subject to outbreaks of COVID-19. We sought to identify improved strategies for preventing outbreaks in this setting using an agent-based model of a hypothetical cohort of trainees on a U.S. Army post. Our analysis revealed unique aspects of basic training that require customized approaches to outbreak prevention, which draws attention to the possibility that customized approaches may be necessary in other settings, too. In particular, we showed that introductions by trainers and support staff may be a major vulnerability, given that those individuals remain at risk of community exposure throughout the training period. We also found that increased testing of trainees upon arrival could actually increase the risk of outbreaks, given the potential for false-positive test results to lead to susceptible individuals becoming infected in group isolation and seeding outbreaks in training units upon release. Until an effective transmission-blocking vaccine is adopted at high coverage by individuals involved with basic training, need will persist for non-pharmaceutical interventions to prevent outbreaks in military basic training. Ongoing uncertainties about virus variants and breakthrough infections necessitate continued vigilance in this setting, even as vaccination coverage increases.Significance StatementCOVID-19 has presented enormous disruptions to society. Militaries are not immune to these disruptions, with outbreaks in those settings posing threats to national security. We present a simulation model of COVID-19 outbreaks in a U.S. Army basic training setting to inform improved approaches to prevention there. Counterintuitively, we found that outbreak risk is driven more by virus introductions from trainers than the large number of trainees, and that outbreak risk is highly sensitive to false-positive results during entry testing. These findings suggest practical ways to improve prevention of COVID-19 outbreaks in basic training and, as a result, maintain the flow of new soldiers into the military. This work highlights the need for bespoke modeling to inform prevention in diverse institutional settings.
Understanding the burden and mitigating risks in the utilisation of the Emergency Medical Services in the management of community mental health emergencies
Authors: Howard Ian , Castle Nicholas , Shaikh Loua Al , Owen Robert 
Published: November 2021

ABSTRACTIntroductionMental health disorders are highly prevalent globally with access to appropriate care oftentimes problematic. The Emergency Medical Services (EMS) have been suggested as a potential solution to improve access, however, it is unclear whether these services provide the most appropriate response with respect to the needs of patients experiencing a mental health emergency.MethodsA multi-method study was conducted to assess the current burden and potential risks associated with the transportation of patients experiencing a mental health emergency by EMS. Part 1 utilised a cross-sectional study of routinely collected clinical data for the period January 2018 to December 2019. Part 2 employed a systematic risk identification methodology focused on identifying the hazards associated with the transportation of this patient cohort, to identify key action plans towards mitigating their occurrence.ResultsPatients experiencing a mental health emergency were transported at an average rate of 11.96 per 1000 transports. Approximately 7% were administered prehospital sedation, with Ketamine administered as the most common sedative. Altogether, 50 potential hazards were identified involving the transportation of patients experiencing a mental health emergency. The Patient Assessment subprocess contained the most potential hazards/failure points (n=13). Risks categorized as occasional (n=33) and moderate (n=16) made up the majority.ConclusionThe burden of mental health emergencies on EMS is considerable, with the potential for several significant risks. Despite this, there was unequal focus on the development of care pathways and clinical guidance for this patient cohort compared with the more “traditional” case types serviced by EMS. Consequently, we identified several strategic-level action plans to mitigate these hazards and improve the delivery of care for these patients in the community.