bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy and safety of Dermatophagoides pteronyssinus extracts used for skin prick test
Authors: Tang Rui , Lyu Xiaohong , Liu Yuxi , Wang Ruiqi , Wang Lianglu , Li Hong , Sun Jinlyu , Zhi Yuxiang , Gu Jianqing , Guan Kai , Wen Liping , Wang Zixi , Li Lisha , Cui Le , Xu Yingyang , Zhou Junxiong , Xu Tao , Yin Jia 
Published: December 2022

Abstract

Background:

Dermatophagoides pteronyssinus is a common allergen causing allergic diseases in China. The aim of this study was to evaluate the efficacy and safety of D. pteronyssinus extracts produced by Peking Union Medical College Hospital (PUMCH) for the skin prick test (SPT) in the diagnosis of D. pteronyssinus allergy.

Methods:
A total of 910 subjects with allergic diseases were prescribed D. pteronyssinus SPT and specific sIgE (sIgE) test among the Outpatients of Department of Allergy, PUMCH from August 10, 2015 to August 30, 2017. Receiver operating characteristic curve (ROC) analysis was performed according to the results of D. pteronyssinus-sIgE detection. The accuracy of D. pteronyssinus extracts used for SPT in the diagnosis of D. pteronyssinus allergy was evaluated under different cutoff values. Adverse events after SPT were recorded to evaluate safety.

Results:
There were 796 and 618 subjects in the full analysis set (FAS) and the per protocol set (PPS), respectively. The areas under the curve of FAS and PPS were 0.871 and 0.873, respectively. According to the ROC of PPS, the optimal and 95% specificity diagnostic cutoff values of D. pteronyssinus SPT mean wheal diameter were 3.25 and 3.75 mm, respectively. No adverse events occurred.

Conclusion:
The extracts of D. pteronyssinus for SPT were simple, highly accurate, and safe and should be considered for recommendation in the clinical diagnosis of D. pteronyssinus allergy.
Isolated systolic or diastolic hypertension and mortality risk in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline: a longitudinal cohort study
Authors: Bo Yacong , Yu Tsung , Guo Cui , Chang Ly-yun , Huang Junjie , Wong Martin C.S. , Tam Tony , Lao Xiang Qian 
Published: December 2022

Background:
Little is known regarding the health effects of different hypertension phenotypes including isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH) defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline among young adults. We conducted this longitudinal study using time-varying analyses to evaluate the relationship between cardiovascular/all-natural mortality risk and different hypertension phenotypes in young adults.

Methods:
A total of 284 597 young adults (aged 18–39 years) were recruited between 1996 and 2016. Participants were classified into eight mutually exclusive BP groups: normal blood pressure (BP), elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH. The outcomes were cardiovascular and all-natural mortality.

Results:
After a median follow-up of 15.8 years, 2341 all-natural deaths with 442 cardiovascular deaths were observed. When compared with individuals with normal BP, the multivariable adjusted hazard ratios (95% confidence interval) of cardiovascular mortality was 1.39 (1.01–1.93) for elevated BP, 2.00 (1.45–2.77) for stage 1 IDH, 1.66 (1.08–2.56) for stage 1 ISH, 3.08 (2.13–4.45) for stage 1 SDH, 2.85 (1.76–4.62) for stage 2 IDH, 4.30 (2.96–6.25) for stage 2 ISH, and 6.93 (4.99–9.61) for stage 2 SDH, respectively. In consideration to all-natural mortality, similar results were observed for stage 1 SDH, stage 2 ISH, and stage 2 SDH; but not for elevated BP, stage 1 IDH, stage 1 ISH, and stage 2 IDH.

Conclusion:
Young adults with stage 1 or stage 2 ISH, IDH, and SDH are at increased risk of cardiovascular death than those with normal BP. Regardless of BP stage, SDH was associated with a higher cardiovascular mortality risk than IDH and ISH.
Sleep fragmentation during rapid eye movement sleep and hypertension in obstructive sleep apnea
Authors: Ren Rong , Zhang Ye , Yang Linghui , Shi Yuan , Covassin Naima , Tang Xiangdong 
Published: December 2022

Objective:
Sleep fragmentation determined by repetitive arousals from sleep in obstructive sleep apnea (OSA) is associated with hypertension. We aimed to quantify the independent association of arousals during rapid eye movement (REM)/non-rapid eye movement (NREM) sleep with prevalent hypertension.

Methods:
We included adults with 4 h of total sleep time and at least 30 min of REM sleep obtained from overnight in-laboratory polysomnography. Logistic regression models were fitted to explore the association between arousals during REM/NREM sleep and prevalent hypertension. All models controlled for OSA metrics and arousals during NREM/REM sleep, either by statistical adjustment or by stratification.

Results:
The sample comprised of 11 643 patients, of which 10 055 were OSA patients. Fully adjusted models demonstrated significant dose-relationships between arousal index during REM sleep (AI-REM) and prevalent hypertension (P trend = 0.002). The higher relative odds of prevalent hypertension were most evident with AI-REM > 40 events/h. In OSA patients with arousal index during NREM sleep (AI-NREM) <15 events/h, every10-unit increase in the AI-REM was associated with 18% higher odds of hypertension (odds ratio, 1.18; 95% confidence interval, 1.11–1.27) in OSA. On the contrary, AI-NREM was not a significant predictor of hypertension in any of the models.

Conclusions:
Our findings indicate that arousals during REM sleep are associated with prevalent hypertension. This is clinically relevant because treatment of OSA is often limited to the first half of the sleep period leaving most of sleep fragmentation during REM sleep untreated.
Concomitantly higher resting arterial blood pressure and transduction of sympathetic neural activity in human obesity without hypertension
Authors: Holwerda Seth W. , Gangwish Megan E. , Luehrs Rachel E. , Nuckols Virginia R. , Thyfault John P. , Miles John M. , Pierce Gary L. 
Published: December 2022

Objective:
Central (abdominal) obesity is associated with elevated adrenergic activity and arterial blood pressure (BP). Therefore, we tested the hypothesis that transduction of spontaneous muscle sympathetic nerve activity (MSNA) to BP, that is, sympathetic transduction, is augmented in abdominal obesity (increased waist circumference) and positively related to prevailing BP.

Methods:
Young/middle-aged obese (32 ± 7 years; BMI: 36 ± 5 kg/m2, n = 14) and nonobese (29 ± 10 years; BMI: 23 ± 4 kg/m2, n = 14) without hypertension (24-h ambulatory average BP < 130/80 mmHg) were included. MSNA (microneurography) and beat-to-beat BP (finger cuff) were measured continuously and the increase in mean arterial pressure (MAP) during 15 cardiac cycles following MSNA bursts of different patterns (single, multiples) and amplitude (quartiles) was signal-averaged over a 10 min baseline period.

Results:
MSNA burst frequency was not significantly higher in obese vs. nonobese (21 ± 3 vs. 17 ± 3 bursts/min, P = 0.34). However, resting supine BP was significantly higher in obese compared with nonobese (systolic: 127 ± 3 vs. 114 ± 3; diastolic: 76 ± 2 vs. 64 ± 1 mmHg, both P < 0.01). Importantly, obese showed greater increases in MAP following multiple MSNA bursts (P = 0.02) and MSNA bursts of higher amplitude (P = 0.02), but not single MSNA bursts (P = 0.24), compared with nonobese when adjusting for MSNA burst frequency. The increase in MAP following higher amplitude bursts among all participants was associated with higher resting supine systolic (R = 0.48; P = 0.01) and diastolic (R = 0.48; P = 0.01) BP when controlling for MSNA burst frequency, but not when also controlling for waist circumference (P > 0.05). In contrast, sympathetic transduction was not correlated with 24-h ambulatory average BP.

Conclusion:
Sympathetic transduction to BP is augmented in abdominal obesity and positively related to higher resting supine BP but not 24-h ambulatory average BP.
Effects of Myopia and Glaucoma on the Neural Canal and Lamina Cribrosa Using Optical Coherence Tomography
Authors: Lee Sieun , Heisler Morgan , Ratra Dhanashree , Ratra Vineet , Mackenzie Paul J. , Sarunic Marinko V. , Beg Mirza Faisal 
Published: December 2022

Précis:
Glaucoma was associated with axial bowing and rotation of Bruchs membrane opening (BMO) and anterior laminar insertion (ALI), skewed neural canal, and deeper anterior lamina cribrosa surface (ALCS). Longer axial length was associated with wider, longer, and more skewed neural canal and flatter ALCS.

Purpose:
Investigate the effects of myopia and glaucoma in the prelaminar neural canal and anterior lamina cribrosa using 1060-nm swept-source optical coherence tomography.

Patients:
19 control (38 eyes) and 38 glaucomatous subjects (63 eyes).

Materials and Methods:
Participants were imaged with swept-source optical coherence tomography, and the images were analyzed for the BMO and ALI dimensions, prelaminar neural canal dimensions, and ALCS depth.

Results:
Glaucomatous eyes had more bowed and nasally rotated BMO and ALI, more horizontally skewed prelaminar neural canal, and deeper ALCS than the control eyes. Increased axial length was associated with a wider, longer, and more horizontally skewed neural canal and a decrease in the ALCS depth and curvature.

Conclusion:
Our findings suggest that glaucomatous posterior bowing or cupping of lamina cribrosa can be significantly confounded by the myopic expansion of the neural canal. This may be related to higher glaucoma risk associated with myopia from decreased compliance and increased susceptibility to IOP-related damage of LC being pulled taut.
Efficacy of the Crisis Risk Triage Scale in Inpatient Units Within the United States
Authors: Zimbro Kathie S. , Maduro Ralitsa S. , Ver Schneider Patricia , Hahn Donna S. , Paulson James F. , Morgan Merri K. 
Published: December 2022

ABSTRACT
Patient violence toward others, including doctors and nurses, is a serious concern worldwide. A wealth of literature supports the assertion that violent behavior can be prevented with proper screening and management policies. This project aimed to evaluate the Crisis Triage Rating Scale (CTRS) within a 12-hospital integrated healthcare delivery system located in the southeastern United States. An initial sample of 112,708 unique patient visits between January 2019 and December 2020 was included in this retrospective review of electronic health records. We found that the CTRS harm triage question and risk levels were significant predictors of harm to others. Consistent with previous literature, positive predictive values ranged between 0.025 and 0.070 and negative predictive values ranged between 0.991 and 0.995. Our results support the assertion that clinicians should make balanced judgments about using a positive risk score to allocate safety measures. Variations in practice were evident across our healthcare systems. Improving appropriate assessment procedures may improve the diagnostic tools and risk stratification. When documented correctly, the CTRS performed as expected in an environment where harm to others occurred infrequently.
Increasing Language Interpreter Services Use and Documentation: A Quality Improvement Project
Authors: Behairy Mohga , Alenchery Amala , Cuesta-Ferrino Claudia , Bhakta Hemangini , Zayas-Santiago Arnaldo 
Published: December 2022

ABSTRACT

Background/Purpose:
Based on the Civil Rights Act of 1964, hospitals receiving funding from the Department of Human and Health Services must ensure adequate language assistance via a qualified interpreter for Limited English Proficiency (LEP) patients. Despite availability at our institution, official interpreter services were underutilized with inconsistent documentation of use. Baseline data over a 6-week period revealed a median of 43% of LEP parents reported use of official interpreter services, with a median of 0% documentation of use. We aimed to improve both over a 3-month period.

Methods:
This quality improvement project was conducted at a children's hospital between April and August 2020. Surveys were provided to inpatient LEP families. Four intervention periods were implemented with ongoing data collection for 12 weeks. Interventions included developing best practices, incorporating language identification into daily workflow, empowering families, and standardizing documentation. Data were analyzed by run chart and descriptive statistics.

Results:
After interventions and several plan-do-study-act cycles, a median of 73% reported use of official interpreter services, and a median of 59% were documented.

Conclusions:
After multiple interventions, specifically noted after intervention period #2, improvement of official interpreter service use and documentation were identified in all inpatient units.
Efficacy and safety of extracorporeal shock wave on low back pain: A systematic review and meta-analysis
Authors: Li Chunhong , Xiao Zhibo , Chen Liuli , Pan Songli 
Published: December 2022

Background:
Extracorporeal shock wave therapy (ESWT) is a relatively new type of treatment for many musculoskeletal disorders. However, ESWT for low back pain remains controversial as the pain relieve benefit is questionable. We performed this systematic review and meta-analysis to explore the effectiveness and safety of ESWT interventions on pain and disability in patients with low back pain (LBP).

Methods:
In this meta-analysis, we searched electronic databases in the Pubmed, Embase, Cochrane’s library, China National Knowledge Infrastructure, and Wanfang Database to determine the equivalence of ESWT and placebo for the treatment of LBP up to April 4, 2022. A number of other outcomes were measured, including functional status, quality of life, and psychological outcomes measured by the Oswestry Disability Index. Weighted mean differences were calculated for continuous outcomes, while risk ratios were calculated for binary outcomes. Stata 12.0 software was used for statistical analysis.

Results:
Thirteen randomized controlled trials included for further analysis. Compared with control, the ESWT group showed lower pain intensity at month 1 (P < .05), as well as lower disability score at month 1 (P < .05) and at month 3 (P < .05). There was no statistically significant difference between ESWT and control groups in terms of the pain intensity at month 3 (P > .05). No serious adverse events related to treatment were reported. Sensitivity analysis demonstrates that the conclusions from this analysis were robust.

Conclusions:
ESWT is effective in alleviating pain and improving the functional outcomes for patients with LBP. However, there remains a lack of high-level evidence to verify their effectiveness and safety and support their clinical application.
Association between polymorphisms in miRNAs and ischemic stroke: A meta-analysis
Authors: Jing Yunnan , Hu Siya , Song Jing , Dong Xu , Zhang Ying , Sun Xiaowei , Wang Dongyan 
Published: December 2022

Background:
Atherosclerosis remains a predominant cause of ischemic stroke (IS). Four miRNA polymorphisms associated with arteriosclerosis mechanism were meta-analyzed to explore whether they had predictive significance for IS.

Methods:
PubMed, Excerpta Medica database, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure, and China Wanfang Database were searched for relevant case-control studies published before September 2022. Two researchers independently reviewed the studies and extracted the data. Data synthesis was carried out on eligible studies. Meta-analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were performed using Stata software 16.0.

Results:
Twenty-two studies were included, comprising 8879 cases and 12,091 controls. The results indicated that there were no significant associations between miR-146a C>G (rs2910164), miR-196a2 T>C (rs11614913) and IS risk in the overall analyses, but miR-149 T>C (rs2292832) and miR-499 A>G (rs3746444) increased IS risk under the allelic model, homozygote model and recessive model. The subgroup analyses based on Trial of Org 101072 in Acute Stroke Treatment classification indicated that rs2910164 increased small artery occlusion (SAO) risk under the allelic model, heterozygote model and dominant model; rs11614913 decreased the risk of SAO under the allelic model, homozygote model, heterozygote model and dominant model.

Conclusion:
This Meta-analysis showed that all 4 single nucleotide polymorphisms were associated with the risk of IS or SAO, even though the overall and subgroup analyses were not entirely consistent.
Acupoint catgut embedding for chronic low back pain: A protocol for systematic review and meta-analysis
Authors: Zhong Guofu , Yin Xiuju , Li Jingyi , Li Xiaohui , Zhang Qiang 
Published: December 2022

Background:
The treatment of acupoint catgut embedding (ACE) effective and safe for patients with chronic low back pain (CLBP) is not yet known. This systematic review will objectively and systematically evaluate the efficacy and safety of ACE in CLBP according to the existing evidence.

Methods:
The protocol of this systematic review and meta-analyses has been registered in PROSPERO with the registration number CRD42019142256. The following electronic databases from inception to November 29, 2022 will be searched: PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang Data and Chinese Science Journal Database. Randomised controlled clinical(RCTs) using ACE to treat CLBP will be included. Outcomes will include pain intensity, instrument with assessment function and disability, quality-of-life, and costs. Adverse events will be reported for safety assessment. By screening the titles, abstracts, and full texts, two independent reviewers will select studies, extract data, and assess study quality. Data synthesis, sensitivity analysis, subgroup analysis and risk of bias assessment will be conducted using RevmanV.5.3 software. The Grading of Recommendations Assessment, Development and Evaluation system will be used to assess the quality of
the evidence.

Results:
The efficacy and safety of ACE in the treatment of CLBP has not yet been determined.

Conclusion:
This systematic review will objectively and systematically evaluate the efficacy and safety of ACE in CLBP according to the existing evidence, which can give high level clinical recommendations to improve patient care and clinical outcomes.
Long-term use of ultra-low-dose mifepristone for uterine leiomyoma control and safety discussion: A case report
Authors: Zhou Guangdi , Li Qin 
Published: December 2022

Rationale:
In recent years, many clinical trials have used low-dose mifepristone to control uterine fibroids, some of which have achieved good results. However, according to the classic concept, long-term use of mifepristone could induce malignant transformation of the endometrium, and the effect of ultra-low-dose of mifepristone on uterine fibroids is still uncertain. Researchers are short on cases of uterine fibroids treated with mifepristone for long periods (more than a year).

Patient concerns:
A 47-year-old woman went to the hospital because of anemia.

Diagnoses:
The patient was diagnosed with uterine leiomyoma.

Interventions:
The patient refused the suggestion of surgery, she was continuously treated with an ultra-low-dose (12.5 mg per 5 days) of mifepristone monotherapy for 4 years.

Outcomes:
The uterine leiomyoma was stable, anemia and other symptoms disappeared, and the menstrual cycle, liver and kidney function, and tumor markers were normal.

Lessons:
Judging from our case, long-term, ultra-low-dose mifepristone for uterine fibroids treatment was safe and more effective than conventional therapy.
A case report of delayed treatment of acute exertional osteofascial compartment syndrome in the anterior compartment of the calf
Authors: Liu Shiwei , Wang Congcong , Song Wenjing , Wang Jun , Zhao Shibo 
Published: December 2022

Rationale:
Acute exertional osteofascial compartment syndrome (OCS) is a rare cause of lower-leg pain and is often associated with delayed diagnosis, which can lead to irreversible muscle and nerve damage.

Patient concerns:
A 23-year-old man presented with acute-onset anterior calf pain and ankle dorsiflexion after hiking.

Diagnosis:
The patient’s pain was initially diagnosed as muscle strain at a county hospital, but was eventually diagnosed as OCS at our hospital 8 days after the injury. This case presents several challenges in the diagnosis and treatment phases.

Interventions:
Three surgeries were performed in total. On the day after admission (9 days after injury), fasciotomy was performed, followed by vacuum sealing drainage (VSD). Six days after the first surgery, necrotic muscle debridement was performed and VSD was reperformed. Ten days after the second surgery, the covering foam material was removed and the incision was sutured.

Outcomes:
Satisfactory postoperative results were achieved. The erythrocyte sedimentation rate, C-reactive protein level, and white blood cell count were within normal ranges. The skin healed well, and nerve damage and muscle strength improved significantly 3 months after surgery.

Lessons:
OCS in the absence of trauma or fracture is rare, but treatment delays can have devastating consequences. Acute nontraumatic OCS requires prompt diagnosis and surgical intervention to prevent adverse outcomes. VSD is an effective surgical treatment for this disease.
Implantation of computed tomography-guided high-dose-rate 192Ir brachytherapy in oldest old patients with advanced non-small cell lung cancer: A case report and literature review
Authors: Cui Ran , Wang Xiu-Lan , Cao Jian 
Published: December 2022

Background:
With the increasing aging and the popularization of medical diagnosis, the growing number of oldest old with lung cancer needs to be focused on. Several medical and physiological challenges often accompanying the oldest old cancer patients make the choice of the optimal treatment daunting. The current research suggests that people who get adequate treatment can benefit, but it is worth discussing which treatment will benefit them more. High-dose-rate (HDR) 192Ir brachytherapy deserves attention in this context owing to its association with less trauma and reduced complications.

Case presentation:
An 86-years-old woman with a right glandular lung carcinoma presented with progressive lesions 11 months after chemotherapy. Because of her old age and poor performance status (eastern cooperative oncology group performance status 3), she received HDR 192Ir brachytherapy for her right lung lesion without any common complications, such as pneumothorax and hemorrhage. She continued on 0.25 g oral gefitinib each day after received brachytherapy treatment. The right lung lesion keeps a partial response until 18 months later now.

Conclusion:
HDR 192Ir brachytherapy can potentially be used as a safe and effective choice for the oldest old with advanced non-small cell lung cancer. It can especially benefit cancer patients with concurrent chemotherapy or targeted therapy.