bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Performance of the CURB-65, A-DROP, and NEWS Scores for the Prediction of Clinical Outcomes in Pneumonia
Authors: Bastidas Goyes Alirio , Aponte Carolina , Acosta David , Barroso Da Silva Erika Alexandra , Tuta Quintero Eduardo , Gómez Carolina , Mantilla Flórez Fabian , Rodríguez Santiago , Álvarez David , Hernández Esteban , Ramírez Laura , Riveros Paola , Álvarez Daniela , Forero Julián , Gutiérrez Felipe , Moscote Adriana , Oke Gebran 
Published: March 2023

Objectives
This study aimed to compare the performance of the CURB-65, A-DROP, and NEWS scores for the prediction of clinical outcomes in patients with community-acquired pneumonia (CAP) in a Colombian population.

Materials and Methods
In this retrospective cohort study, we analyzed data from patients with CAP seen within the emergency department, general ward hospitalization, and intensive care unit in a tertiary care health institution located in Cundinamarca, from January 2012 to December 2020.

Results
A total of 1651 patients were included in our study. CURB-65 and A-DROP scores showed a good performance for primary outcomes related to in-hospital mortality and 30-day mortality with an area under the receiver operating characteristic curve (AUC-ROC) of 0.72 (95% confidence interval [CI], 0.69–0.76) and 0.69 (95% CI, 0.65–0.73), respectively. On the other hand, NEWS score exhibited an acceptable performance in predicting in-hospital mortality and 30-day mortality; furthermore, it showed better performance in anticipating the need for invasive mechanical ventilation and vasopressor therapy (AUC-ROC of 0.64 [95% CI, 0.59–0.69] and AUC-ROC of 0.65 [95% CI, 0.60–0.69], respectively).

Conclusions
Our findings suggest that, in patients with CAP, the use of CURB-65, A-DROP, and NEWS scores helps the clinician to predict in-hospital and 30-day mortality. However, NEWS score proves to be a more convenient tool to predict the need for several life support measures and management in the intensive care unit.
Underestimating a Dog Bite
Authors: Amadori Francesco , Fabiani Silvia , Lenzi Mirco , Forniti Arianna , Ferranti Simone , Tagliaferri Enrico 
Published: March 2023

Abstract
Dog bites may result in serious bacterial infections because of various microorganisms, including gram-negative rod Capnocytophaga canimorsus, whose disease can be complicated by acute development of sepsis and/or meningitis. In this review, we report a case of C. canimorsus meningitis in a patient with major risk factors and subsequently analyze 48 other cases described in literature. Approximately a little less than 50% of reported cases had a major predisposing condition such as splenectomy, alcoholism, or immunosuppressive treatment. In almost all of the cases, recent animal exposure was reported. Sensorineural hearing loss, which has been described as a permanent complication of C. canimorsus meningitis, was present in a minority of cases (18%), and a possible association with alcoholism was observed. In conclusion, C. canimorsus should be considered as a possible cause of sporadic meningitis in adults, particularly if presenting with a subacute course or deafness and in concomitance of major predisposing conditions, such as alcoholism.
Correlation of N-terminal-pro-brain natriuretic peptide with postoperative outcomes of older patients undergoing transcatheter aortic valve replacement
Authors: Huang Ying-Ching , Chang Hsiao-Huang , Chen Po-Lin , Chu Chi-Ming , Tsai Jen-Chen , Wang Kwua-Yun 
Published: March 2023

Background:
Patients undergoing transcatheter aortic valve replacement surgery (TAVR) are typically older adults with multiple chronic diseases and therefore have a high surgical risk. The N-terminal of brain natriuretic peptide (BNP) and pro-BNP, referred to as NT-pro-BNP, is an easily measurable biomarker of heart failure. Studies on correlation between higher NT-pro-BNP levels and adverse prognoses after TAVR have yielded inconsistent results. Here, we investigated whether preoperative NT-pro-BNP levels are correlated with outcomes among older adults undergoing TAVR.

Methods:
This retrospective study included older adults with severe aortic stenosis (AS) who received TAVR from a medical center between January 2013 and June 2017. The patients’ demographics, preoperative laboratory data, postoperative complications, and 1-year mortality were recorded. They were divided into two groups based on their preoperative NT-pro-BNP levels. The post-TAVR outcomes in the two groups were analyzed using a multivariate logistic regression analysis of the binary results.

Results:
Of the 132 patients included (mean age: 81.5 ± 8.1 years; 47% men), 96 (72.7%) had preoperative NT-pro-BNP levels ≤ 4853 ng/L, and 36 (27.3%) had preoperative NT-pro-BNP levels > 4853 ng/L. The postoperative outcomes were significantly better in the NT-pro-BNP≤4853 group than in the NT-pro-BNP>4853 group: postoperative extracorporeal membrane oxygenation fittings (4.2% vs 16.7%, p = 0.025), number of days in hospital (17.5 ± 21.0 vs 27 ± 17.0, p = 0.009), in-hospital mortality (4.2% vs 16.7%, p = 0.025), and 1-year mortality (11.5% vs 38.9%, p = 0.001); the significant differences persisted after controlling for other variables.

Conclusion:
For older patients undergoing TAVR with NT-pro-BNP levels > 4853 ng/L, their postoperative outcomes and 1-year mortality were correlated. Thus, NT-pro-BNP is useful for the risk assessment of patients undergoing TAVR and should be regarded as a biomarker in future risk assessments.
Cutaneous Manifestations of Scleroderma
Authors: Aggarwal Manushi , Sandhu Vaneet Kaur 
Published: March 2023

ABSTRACT
Scleroderma is a rare, female predominant clinically heterogenous, autoimmune condition characterized by the presence of autoantibodies, vascular abnormalities, and fibrosis. Skin thickening as a result of fibrosis is a hallmark clinical finding, and the extent of this skin thickening further classifies clinical subsets of scleroderma. Organ systems affected may include pulmonary (interstitial lung disease, pulmonary arterial hypertension), renal (scleroderma renal crisis), gastrointestinal (dysmotility, reflux esophagitis, gastric antral vascular ectasia), cardiac (arrhythmias, cardiac fibrosis), and musculoskeletal (arthritis, contractures). Raynaud phenomenon and telangiectasis occur as a result of vascular involvement. Diagnostic workup requires a thorough history and physical examination, supplemented by autoantibody testing. No single therapeutic agent is indicated to treat all manifestations of scleroderma. Rather, system- or organ-based treatment is indicated. Not only are skin manifestations often the presenting feature of scleroderma, progressive skin changes carry prognostic implications, underscoring the value of dermatology insight for early diagnosis suspicion, referral to rheumatology, and timely management.
Lichen Sclerosus
Authors: Reddy Meenu , O'Connell Katie A. , O'Connor Megan 
Published: March 2023

ABSTRACT
Lichen sclerosus is a chronic inflammatory condition characterized by irritation and dyspigmentation in the genital and perianal areas. Although this condition can affect any individual, it typically has a bimodal age distribution, occurring most frequently in postmenopausal women followed by prepubertal children. Physical examination often reveals thin, hypopigmented and hyperpigmented patches or plaques in the vulvar, perineal, or perianal region. The exact etiology of lichen sclerosus is unknown but is believed to be multifactorial with a combination of genetic, environmental, infectious, and autoimmune factors. Once diagnosed, this condition has a chronic course and long-term treatment is required to sustain remission. We present a case of lichen sclerosus involving the vulvar, perineal, and perianal regions in an elderly female patient that improved with topical clobetasol.
A Case of Transient Eruptive Keratoacanthoma Associated With Nivolumab
Authors: Irwin Thomas M. , Burkett Kristen M. , Johnson Emily , Bodenhamer William Spence , Wood Andrew , Fraga Garth R. , Doolittle Gary C. 
Published: March 2023

ABSTRACT
Anti-PD-1 immunotherapy agents are known to cause cutaneous side effects in up to 42% of patients with melanoma, infrequently including eruptive keratoacanthomas (de Golian et al., 2016, p. 57). Although traditionally documented with pembrolizumab use, increasing reports of eruptive keratoacanthomas with nivolumab use are emerging in the literature (Bednarek et al., 2018, pp. e28–e29). We present a similar case of a 74-year-old woman with melanoma of the right upper extremity with metastases to the lung. She received her first infusion of nivolumab and, within 2 weeks, developed a pruritic rash on the right arm. Within 1 month, the rash spread to all extremities and would blister, scale, and slough off. Punch biopsy of the right lower extremity revealed squamous proliferation suspicious for eruptive keratoacanthoma secondary to nivolumab therapy. The patient continued nivolumab and was referred to dermatology to monitor.
Meta-analysis of clinical risk factors of patients with systemic lupus erythematosus complicated with invasive fungal infection
Authors: Meng Yang , Chifeng Liao , Qinghuan Zhu , Zichan Huang , Jianmin Li , Danqi Deng 
Published: March 2023

Background:
To systematically evaluate the clinical risk factors of patients with systemic lupus erythematosus (SLE) complicated with invasive fungal infection (IFI) among patients.

Methods:
A meta-analysis was performed of all the literatures germane to estimate the clinical risk factors of patients with SLE complicated with IFI from published clinical trials from 1990 to April 2022. Mean differences, odds ratio and 95% confidence intervals were calculated, and the meta-analysis was conducted with Stata 12.0 software (StataCorp, College Station, TX).

Results:
A total of 14 clinical research involving 1129 patients were included. The results of meta-analysis demonstrated that immunosuppressant, glucocorticoids, systemic lupus erythematosus disease activity index score, antibiotic were risk factors associated with IFI in SLE patients. However, age, sex, course of disease, leukopenia, lymphopenia, C- reactive protein and hypoproteinemia were not the risk factors associated with IFI in patients with SLE.

Conclusion:
Our results indicate that immunosuppressant, glucocorticoids, systemic lupus erythematosus disease activity index score, antibiotic were risk factors for IFI in SLE patients. However, high quality of multicenter, large sample size-controlled trials are needed to validate the result.
Patent foramen ovale-associated stroke repeatedly misdiagnosed as cerebral small vessel disease: A case report
Authors: Zhang Yiwen , Zhu Ruihan , Yu Zhenzhen , Hou Songqi , Niu Jianping 
Published: March 2023

Background:
Transthoracic echocardiography (TTE) is the most commonly used screening method for cardiac structural abnormalities. However, it may lead to a missed diagnosis of partial patent foramen ovale (PFO)-associated stroke.

Case presentation:
A 60-year-old male was admitted to the hospital for recurrent left limb weakness with or without slurred speech for 14 months. No stroke-related cardiac structural abnormality was detected during repeated TTE, and the patient was diagnosed with cerebral small vessel disease. Finally, right-to-left shunt was detected by contrast-enhanced transcranial Doppler. Subsequently, the patient was diagnosed with PFO-associated stroke by transesophageal echocardiography and contrast transesophageal echocardiography.

Conclusions:
TTE has a low detection rate of PFO, such that it is easily missed. Contrast-enhanced transcranial Doppler is easy to operate and should be promoted as a supplementary measure to stroke etiological investigation and primary PFO screening.
An integrative pan-cancer analysis illustrating the key role of LRP11 in cervical cancer
Authors: Gu Fangyun , Xu Fang , Pan Zimeng , Shi Lin , Yu Jinglu , Song Feifei , Huang ShuFeng , Sun Miao 
Published: March 2023

Background:
Low density lipoprotein receptor-related protein 11 (LRP11) was involved in the progression of several tumors. However, its role in cervical cancer still remains uncertain.

Methods:
The original tumor data was downloaded from the Cancer Genome Atlas and genotype-tissue expression databases. The expression of LRP11 in normal tissues, tumor tissues and adjacent tissues were evaluated. In addition, we also explored the genetic alteration, prognostic value, and gene function of LRP11. We deeply assessed the interaction between LRP11 and tumor immunity at the pan-cancer level. Finally, research on the association between LRP11 and the resistance of anti-tumor drugs was carried out.

Results:
LRP11 was highly expressed and played a risk prognostic factor in cervical cancer and a variety of tumors. Enrichment analysis revealed that LRP11 was involved in multiple tumor malignant pathways. Our research also pointed out the unique role between LRP11 and tumor immune microenvironment. The tumor immune microenvironment of patients with high expression of LRP11 are lack of most immune cells, indicating a immune desert tumor microenvironment. The final drug resistant analysis suggested that patients with high expression of LRP11 may be related to the resistance of many anti-tumor drugs.

Conclusion:
LRP11 was a potential oncogene and prognostic marker in cervical cancer and pan-cancer. Patients with high LRP11 expression may have immune desert tumor microenvironment.
Using dashboards to verify coronavirus (COVID-19) vaccinations can reduce fatality rates in countries/regions: Development and usability study
Authors: Jen Tung-Hui , Wu Jian-Wei , Chien Tsair-Wei , Chou Willy 
Published: March 2023

Background:
The new coronavirus disease 2019 (COVID-19) pandemic is raging worldwide. The administered vaccination has become a significant vehicle against the virus. Three hypotheses were made and required for validation: the number of vaccines administered is related to the country gross domestic product (GDP), vaccines can reduce the fatality rate (FR), and dashboards can present more meaningful information than traditionally static visualizations. Research data were downloaded from the GitHub website. The aims of this study are to verify that the number of vaccination uptakes is related to the country GDP, that vaccines can reduce FR, and that dashboards can provide more meaningful information than traditionally static visualizations.

Methods:
The COVID-19 cumulative number of confirmed cases (CNCCs) and deaths were downloaded from the GitHub website for countries/regions on November 6, 2021. Four variables between January 1, 2021, and November 6, 2021, were collected, including CNCCs and deaths, GDP per capita, and vaccine doses administered per 100 people (VD100) in countries/regions. We applied the Kano model, forest plot, and choropleth map to demonstrate and verify the 3 hypotheses using correlation coefficients (CC) between vaccination and FRs. Dashboards used to display the vaccination effects were on Google Maps.

Results:
We observed that the higher the GDP, the more vaccines are administered (Association = 0.68, t = 13.14, P < .001) in countries, the FR can be reduced by administering vaccinations that are proven except for the 4 groups of Asia, Low income, Lower middle income, and South America, as well as the application (app) with dashboard-type choropleth map can be used to show the comparison of vaccination rates for countries/regions using line charts.

Conclusion:
This research uses the Kano map, forest plot, and choropleth map to verify the 3 hypotheses and provides insights into the vaccination effect against the FR for relevant epidemic studies in the future.
Effects of Otago Exercise Program on postural control ability in elders living in the nursing home: A systematic review and meta-analysis
Authors: Kong Lingyu , Zhang Xinwen , Zhu Xinrui , Meng Lingyue , Zhang Qiuxia 
Published: March 2023

Background:
Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders’ needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH.

Methods:
A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers.

Results:
Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = −0.84; 95% CI = −1.17, −0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = −6.39; 95% CI = −8.07, −4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001).

Conclusions:
Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders’ postural control ability, especially during the COVID-19 pandemic.
Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis
Authors: Wang Yunmeng , Ding Chaowei , Guo Chang , Wang Jingru , Liu Suyun 
Published: March 2023

Background:
Thyroid dysfunction plays an important role in the development of cardiovascular disease. However, its relationship with venous thromboembolism (VTE) remains unclear. We performed a meta-analysis of published cohort and case-control studies to investigate the association between thyroid dysfunction and VTE comprehensively.

Methods:
Three reviewers independently searched EMbase, PubMed, China national knowledge infrastructure, and Cochrane Library databases for relevant articles from the time of database establishment to 01 October 2022 and identified all studies on thyroid dysfunction and VTE as studies of interest. Of the 2418 publications retrieved, we identified 10 articles with 15 studies that met our selection criteria. Pooled ORs and 95% confidence intervals were calculated using fixed- or random-effect models.

Results:
We pooled 8 studies by a fixed-effect model, which suggested an increased risk of VTE in patients with (subclinical) hyperthyroidism (OR 1.33, 95% CI: 1.29–1.38). In the other 7 studies on patients with (subclinical) hypothyroidism, the risk was similarly increased when pooled by a random-effect model (OR 1.52, 95% CI: 1.23–1.89). After sensitivity analysis and risk of bias analysis, the risk of VTE was still increased in both (subclinical) hyperthyroidism (OR 1.322, 95% CI: 1.278–1.368) and (subclinical) hypothyroidism (OR 1.74, 95% CI: 1.41–2.16).

Conclusion:
Patients with thyroid dysfunction have an increased risk of VTE. Therefore, it is recommended to perform thyroid function screening routinely in patients at high risk of VTE.
Shear wave elastography of the diaphragm in acute exacerbation of chronic obstructive pulmonary disease: A prospective observational study
Authors: Zhang Jingfeng , Zhang Chunfeng , Yan Lijuan , Zhang Lei , Wan Yanping , Wang Qi , Wang Peng , Xu Jinzhi 
Published: March 2023

Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are prone to diaphragmatic dysfunction. However, dynamic assessment of diaphragmatic function is complex and difficult, and whether the assessment of diaphragmatic function can reflect clinical indicators such as lung function in AECOPD patients remains unclear. We studied diaphragm stiffness and diaphragm stiffening rate (DSR) in AECOPD patients with acute exacerbations ≥ 2 times within 1 year and their correlation with clinical data, the diaphragmatic thickening fraction (DTF), lung function, and blood gas values.
In total, 112 AECOPD patients in group C and Group D who had acute exacerbations ≥ 2 times within 1 year in the Global Initiative for Chronic Obstructive Lung Disease Guideline A (low risk, few symptoms), B (low risk, many symptoms), C (High risk, few symptoms), D (High risk, many symptoms) grouping system were included in the study. Their general clinical data, chronic obstructive pulmonary disease assessment test (CAT), modified medical research council (mMRC), number of acute exacerbations in 1 year, DTF, lung function, and blood gas analysis were collected. The diaphragm shear wave elasticity at functional residual capacity (DsweFRC) and DSR were measured by ultrasound.
The DsweFRC and DSR of Group D were higher than those of Group C (P < .05). DsweFRC, DSR were negatively correlated with DTF, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC (r ranged from −0.293 to −0.697, all P < .05), and positively correlated with CAT score, mMRC score, and arterial carbon dioxide pressure (r ranged from 0.274 to 0.462, all P < .05) in both groups; the correlation coefficients of DsweFRC, DSR and DTF, FEV1/FVC in group D were greater than those in group C. There was no correlation between DsweFRC, DSR and arterial oxygen partial pressure in both groups (P > .05). The DsweFRC, DSR increased with the number of acute exacerbations per year in both groups.
We found that diaphragmatic stiffness in AECOPD patients increased with the number of acute exacerbations within 1 year, correlated with DTF, CAT, mMRC, lung function, and arterial carbon dioxide pressure and provides a simple and practical method for dynamically assessing diaphragmatic function and disease severity in AECOPD patients.