bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of exercise-based pulmonary rehabilitation on severe/very severe COPD: a systematic review and meta-analysis
Authors: He Wenqing , Wang Jiajia , Feng Zhenzhen , Li Jiansheng , Xie Yang 
Published: March 2023

Objective: Pulmonary rehabilitation (PR) has been considered to be an effective treatment method for various respiratory diseases. However, the effects of exercise-based PR on patients with severe/very severe chronic obstructive pulmonary disease (COPD) are unclear. This review aimed to investigate the effects of exercise-based PR on patients with severe/very severe COPD. Methods: PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases were searched from inception to December 23, 2022, without language restrictions. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on patients with severe/very severe COPD were included. Study selection, data extraction, and risk of bias assessment were conducted independently. RevMan software (version 5.3) was used for meta-analysis. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation system. Results: Six studies (263 patients) were identified. Compared with the control group, the 6-min walking distance [MD = 52.91, 95% CI (3.80, 102.03)], the St. George’s Respiratory Questionnaire total scores [MD = −7.70, 95% CI (−14.32, −1.08)] and the Borg scale scores [MD = −0.68, 95% CI (−1.28, −0.08)] in the experimental group improved, respectively. The St. George’s Respiratory Questionnaire and Borg scale scores were rated as ‘moderate quality’ and ‘low quality’, respectively, and the 6-min walking distance was rated as ‘very low quality’. Conclusions: Exercise-based PR may improve the exercise capacity, quality of life and dyspnea of patients with severe/very severe COPD, which can be regarded as an adjuvant treatment. High quality and large sample RCTs are needed. Registration: This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No. CRD42022294085).
Knowledge, attitude, and practice on antibiotics use among healthcare workers: A cross-sectional study in Niger state, Nigeria
Authors: Abubakar Bala , Sárváry Attila 
Published: March 2023

Introduction Antibiotic resistance is a public health concern in Nigeria and the world, and healthcare workers contributed to the upsurge of antibiotic resistance in hospital settings. This study focused on the knowledge, attitude, and practice (KAP) of antibiotic use and the frequency of prescriptions of antibiotics from the list of WHO Model Essentials Antibiotics (AWaRe) (in the last 6 months) among healthcare workers and established the determining factors in six hospitals in Niger state, Nigeria. Methodology A KAP survey was conducted in Niger State, Nigeria, from March to June 2022. A structured self-administered, pretested questionnaire was distributed to six hospitals in the state following a stratified random sampling considering the staff capacity, the population of the city, and patients’ patronage. Results A total of 350 questionnaires distributed, and 313 (89.4%) completed and returned from the six hospitals. The median scores were knowledge (75%), attitude (69%), practice (62%), and self-reported prescription (70%), and respondents with good scores were knowledge [195 (62.3%)], attitude [185 (59.1%)], practice [201 (64.2%)], and prescription [117 (37.4%)]. In multivariate analysis, older respondents are more likely to have a good prescription ( p = 0.006), and prior antimicrobial training improved their knowledge ( p < 0.001), attitude ( p = 0.007), and prescription pattern ( p = 0.009). All the study participants had prescribed one or more of the most prescribed antibiotics; Amoxicillin clavulanate (Access group, 96.5%), Amoxicillin (Access group, 95.9%), and Metronidazole (Access group, 95.7%). Conclusions The study suggests that antibiotic education for healthcare workers and antimicrobial stewardship programs are significant interventions to mitigate antibiotic overuse in the state.
A Retrospective Cohort Analysis of Two Computerized Insulin Infusion Protocols
Authors: Lalani Benjamin , Gosselin Kevin , Penno Ruth , Puryear Bruce , Rilo Horacio , Lalani Atul 
Published: March 2023

Objective: The primary objective of this analysis was to compare the safety and efficacy of a novel computerized insulin infusion protocol (CIIP), the Lalani Insulin Infusion Protocol (LIIP), with an established CIIP, Glucommander. Methods: We conducted a 10-month retrospective analysis of 778 patients in whom LIIP was used (August 18, 2020 to June 25, 2021) at six HonorHealth Hospitals in the Phoenix metropolitan area. These data were compared with Glucommander that was used at those same hospitals from January 1, 2018 to August 17, 2020, n = 4700. Primary end points of the project included average time to euglycemia and average time in hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL). Additional subgroup analysis was done to evaluate CIIP performance in patients in whom maintenance of euglycemia was more challenging. Results: The LIIP had a faster time to euglycemia (191 vs 222 minutes, P < .001) and similar time in hypoglycemia (2.79 vs 2.76 minutes, P = .50) for all patients, when compared with Glucommander. Similar observations were made for the following subgroups: diabetic ketoacidosis/hyperosmolar hyperglycemic state (DKA/HHS) patients, COVID-19 patients, patients on steroids, patients with ≥60 glomerular filtration rate (GFR), patients with renal insufficiency, and patients with sepsis. Conclusions: The LIIP is a safe and effective CIIP in managing intravenous insulin infusion rates. Utilization of LIIP resulted in reduced time to euglycemia, P < .001, when compared with Glucommander and did not cause increased hypoglycemia during the project period. Contributing factors to the success of LIIP may include improved clinical workflow, learnability and ease of use, compatibility with the Epic electronic health record (EHR), and its unique, dynamic and adaptive algorithm.
Use of a Harmonic scalpel for laparoscopic adrenalectomy in two cats
Authors: Zhang Rey M , Case J Brad 
Published: March 2023

Case series summary Adrenal tumors are rare in cats and reports of laparoscopic adrenalectomy in cats are limited. This case series describes two cats that underwent laparoscopic adrenalectomy using a Harmonic scalpel for dissection and coagulation. Both surgeries were successful, with minimal hemorrhage, smoke production and lateral thermal damage. Vessels were appropriately sealed and surgical times were appropriate. Both cats recovered without complications postoperatively. Relevance and novel information To our knowledge, this is the first veterinary report to describe the use of the Harmonic scalpel for laparoscopic adrenalectomy as the sole device in cats. Owing to the absence of hemorrhage, there was no indication for irrigation, suction or hemostatics. The Harmonic scalpel is an ultrasonic vessel-sealing device with benefits over conventional electrosurgery, including less lateral thermal damage, less smoke production and improved safety due to the lack of an electrical current. This case report aims to highlight the usefulness of ultrasonic vessel-sealing devices for laparoscopic adrenalectomy in cats.
Elevated CO2 Priming as a Sustainable Approach to Increasing Rice Tiller Number and Yield Potential
Authors: Sloan Jennifer M. , Mujab Azzami Adam Muhamad , Mashitah Jusoh , Zulkarami Berahim , Wilson Matthew J. , Toh Liang Su , Nur Zahirah A. Jalil , Afiq Kamaruzali , Asyraf Ahmad Tajuddin , Zhu Xin-Guang , Yaapar Nazmin , Fleming Andrew J. 
Published: March 2023

AbstractTillering and yield are linked in rice, with significant efforts being invested to understand the genetic basis of this phenomenon. However, in addition to genetic factors, tillering is also influenced by the environment. Exploiting experiments in which seedlings were first grown in elevated CO2 (eCO2) before transfer and further growth under ambient CO2 (aCO2) levels, we found that even moderate exposure times to eCO2 were sufficient to induce tillering in seedlings, which was maintained in plants grown to maturity plants in controlled environment chambers. We then explored whether brief exposure to eCO2 (eCO2 priming) could be implemented to regulate tiller number and yield in the field. We designed a cost-effective growth system, using yeast to increase the CO2 level for the first 24 days of growth, and grew these seedlings to maturity in semi-field conditions in Malaysia. The increased growth caused by eCO2 priming translated into larger mature plants with increased tillering, panicle number, and improved grain filling and 1000 grain weight. In order to make the process more appealing to conventional rice farmers, we then developed a system in which fungal mycelium was used to generate the eCO2 via respiration of sugars derived by growing the fungus on lignocellulosic waste. Not only does this provide a sustainable source of CO2, it also has the added financial benefit to farmers of generating economically valuable oyster mushrooms as an end-product of mycelium growth. Our experiments show that the system is capable of generating sufficient CO2 to induce increased tillering in rice seedlings, leading eventually to 18% more tillers and panicles in mature paddy-grown crop. We discuss the potential of eCO2 priming as a rapidly implementable, broadly applicable and sustainable system to increase tillering, and thus yield potential in rice.
Prediction of vancomycin initial dosage using artificial intelligence models applying ensemble strategy
Authors: Ho Wen-Hsien , Huang Tian-Hsiang , Chen Yenming J. , Zeng Lang-Yin , Liao Fen-Fen , Liou Yeong-Cheng 
Published: March 2023

AbstractBackgroundAntibiotic resistance has become a global concern. Vancomycin is known as the last line of antibiotics, but its treatment index is narrow. Therefore, clinical dosing decisions must be made with the utmost care; such decisions are said to be “suitable” only when both “efficacy” and “safety” are considered. This study presents a model, namely the “ensemble strategy model,” to predict the suitability of vancomycin regimens. The experimental data consisted of 2141 “suitable” and “unsuitable” patients tagged with a vancomycin regimen, including six diagnostic input attributes (sex, age, weight, serum creatinine, dosing interval, and total daily dose), and the dataset was normalized into a training dataset, a validation dataset, and a test dataset. AdaBoost.M1, Bagging, fastAdaboost, Neyman–Pearson, and Stacking were used for model training. The “ensemble strategy concept” was then used to arrive at the final decision by voting to build a model for predicting the suitability of vancomycin treatment regimens.ResultsThe results of the tenfold cross-validation showed that the average accuracy of the proposed “ensemble strategy model” was 86.51% with a standard deviation of 0.006, and it was robust. In addition, the experimental results of the test dataset revealed that the accuracy, sensitivity, and specificity of the proposed method were 87.54%, 89.25%, and 85.19%, respectively. The accuracy of the five algorithms ranged from 81 to 86%, the sensitivity from 81 to 92%, and the specificity from 77 to 88%. Thus, the experimental results suggest that the model proposed in this study has high accuracy, high sensitivity, and high specificity.ConclusionsThe “ensemble strategy model” can be used as a reference for the determination of vancomycin doses in clinical treatment.
Palaeobotanical evidence reveals the living conditions of Miocene Lufengpithecus in East Asia
Authors: Lu Li-Li , Yao Yi-Feng , Wang Guo-An , Xie Gan , Lu Kai-Qing , Sun Bin , Li Jin-Feng , Bruch Angela A. , Ferguson David K. , Cui Yi-Ming , Wang Qiang , Zhou Xin-Ying , Gao Feng , Wang Yu-Fei 
Published: March 2023

Abstract
Background
Understanding the relationship between human evolution and environmental changes is the key to lifting the veil on human origin. The hypothesis that environmental changes triggered the divergence of humans from apes (ca. 9.3–6.5 million years ago, Ma) has been poorly tested because of limited continuous environmental data from fossil localities. Lufengpithecus (12.5-6.0 Ma) found on the southeastern margin of the Tibetan Plateau (SEMTP) across the ape–human split provides a good chance for testing this hypothesis.

Results
Here, we reconstructed the habitats of L. keiyuanensis (12.5–11.6 Ma) with comprehensive vegetation, climate, and potential food web data by palaeobotanical evidence, together with other multidisciplinary data and partly tested the environment-driven hypothesis by revealing the living conditions of Lufengpithecus.

Conclusion
A detailed comparison of hominoids on different continents reveals their behaviour and fate divergence across the ape–human split against the background of global climate change, i.e., the stable living conditions of SEMTP not only provided a so-called ‘refuge’ for arboreal Lufengpithecus but also acted as a ‘double-edged sword’, preventing their further evolution while vegetation shifts in East Africa probably stimulated the emergence of human bipedalism, and the intense climatic changes in Europe possibly prevented those hominoids from surviving that time interval. Our findings provide interesting insight into the environmental impacts on the behavioural evolution of hominoids.
Anaemia in the first week may be associated with long-term mortality among critically ill patients: propensity score-based analyses
Authors: Lin I-Hung , Liao Pei-Ya , Wong Li-Ting , Chan Ming-Cheng , Wu Chieh-Liang , Chao Wen-Cheng 
Published: March 2023

Abstract
Background
Anaemia is highly prevalent in critically ill patients; however, the long-term effect on mortality remains unclear.

Methods
We retrospectively included patients admitted to the medical intensive care units (ICUs) during 2015–2020 at the Taichung Veterans General Hospital. The primary outcome of interest was one-year mortality, and hazard ratios (HRs) with 95% confidence intervals (CIs) were determined to assess the association. We used propensity score matching (PSM) and propensity score matching methods, including inverse probability of treatment weighting (IPTW) as well as covariate balancing propensity score (CBPS), in the present study.

Results
A total of 7,089 patients were eligible for analyses, and 45.0% (3,189/7,089) of them had anaemia, defined by mean levels of haemoglobin being less than 10 g/dL. The standardised difference of covariates in this study were lower than 0.20 after matching and weighting. The application of CBPS further reduced the imbalance among covariates. We demonstrated a similar association, and adjusted HRs in original, PSM, IPTW and CBPS populations were 1.345 (95% CI 1.227–1.474), 1.265 (95% CI 1.145–1.397), 1.276 (95% CI 1.142–1.427) and 1.260 (95% CI 1.125–1.411), respectively.

Conclusions
We used propensity score-based analyses to identify that anaemia within the first week was associated with increased one-year mortality in critically ill patients.
Epidemiological and clinical characteristics of older adults with burns: a 15-year retrospective analysis of 2554 cases in Wuhan Institute of Burns
Authors: Wu Hong , Xi Maomao , Xie Weiguo 
Published: March 2023

Abstract
Background
With the increase of geriatric burns, it’s urgent to summarize its characteristics. The aim of this study was to analyze the epidemiological and clinical characteristics of older adults with burns in a large center, and to provide suggestions for the prevention and treatment of geriatric burns.

Methods
This retrospective study was conducted at Wuhan Institute of Burns which is the largest burn center in central China between 2004 to 2018. Demographic and clinical data of the 60 years or above older burn inpatients were collected from medical records, analyzed and compared among groups.

Results
This study analyzed 2554 elderly burns, which included 50.9% in young geriatric group (60–69 years old), 32.9% in middle geriatric group (70–79 years old) and 16.2% in the oldest geriatric group (80 years old or above). The most common causes of elderly burns were flames (1081, 42.3%) and scalding (1041, 40.8%). Elderly burns with total body surface area (TBSA) of 0–9% accounted for 60.6% and the larger TBSA, the fewer number of patients. The majority of patients (70.5%) injured at home.The median of time interval from injury to admission was 7 h and the oldest geriatric group (24 h) was highest. One hundred and twenty-one cases (8.5%) were treated by cooling treatment, and 72.7% of these patients were treated less than 10 min. The median number of pre-injury diseases was one. Ninety patients (6.3%) had inhalation injury.The median length of stay (LOS) was 14 days.The median hospital cost was 10,410 CNY or 2137 CNY per % TBSA, which was correlated with TBSA, LOS, surgery, inhalation injury, number of pre-injury diseases and etiology. The mortality rate was 3.0% and correlated with TBSA, inhalation injury, pulmonary disease and Alzheimer’s disease. The lethal area 50% (LA50) for total admitted elderly burns was 78.3% TBSA (95% confidence interval [CI] = 69.8 ~ 89.9% TBSA).

Conclusion
Geriatric burns was still common and even increasing in central China, with flame burns and scalds the most common causes, majority of whom injured at home and often had problems such as few cooling treatment, improper emergency management and delayed admission. TBSA, etiology, pre-injury diseases and inhalation injury were the risk factors of length of stay, hospital cost and treatment outcomes.
Impact of early initiation of renin-angiotensin blockade on renal function and clinical outcomes in patients with hypertensive emergency: a retrospective cohort study
Authors: Endo Keita , Hayashi Koichi , Hara Yuki , Miyake Akihiro , Takano Keisuke , Horikawa Takehiro , Yoshino Kaede , Sakai Masahiro , Kitamura Koichi , Ito Shinsuke , Imai Naohiko , Fujitani Shigeki , Suzuki Toshihiko 
Published: March 2023

Abstract
Background
Hypertensive emergency is a critical disease that causes multifaceted sequelae, including end-stage kidney disease and cardiovascular disease. Although the renin–angiotensin–aldosterone (RAA) system is enormously activated in this disease, there are few reports that attempt to characterize the effect of early use of RAA inhibitors (RASi) on the temporal course of kidney function.

Methods
This retrospective cohort study was conducted to clarify whether the early use of RASi during hospitalization offered more favorable benefits on short-term renal function and long-term renal outcomes in patients with hypertensive emergencies. We enrolled a total of 49 patients who visited our medical center with acute severe hypertension and multiple organ dysfunction between April 2012 and August 2020. Upon admission, the patients were treated with intravenous followed by oral antihypertensive drugs, including RASi and Ca channel blockers (CCB). Kidney function as well as other laboratory and clinical parameters were compared between RASi-treated and CCB- treated group over 2 years.

Results
Antihypertensive treatment effectively reduced blood pressure from 222 ± 28/142 ± 21 to 141 ± 18/87 ± 14 mmHg at 2 weeks and eGFR was gradually restored from 33.2 ± 23.3 to 40.4 ± 22.5 mL/min/1.73m2 at 1 year. The renal effect of antihypertensive drugs was particularly conspicuous when RASi was started in combination with other conventional antihypertensive drugs at the early period of hospitalization (2nd day [IQR: 1–5.5]) and even in patients with moderately to severely diminished eGFR (< 30 mL/min/1.73 m2) on admission. In contrast, CCB modestly restored eGFR during the observation period. Furthermore, renal survival probabilities were progressively deteriorated in patients who had manifested reduced eGFR (< 15 mL/min/1.73 m2) or massive proteinuria (urine protein/creatinine ≥ 3.5 g/gCr) on admission. Early use of RASi was associated with a favorable 2-year renal survival probability (0.90 [95%CI: 0.77–1.0] vs. 0.63 [95%CI: 0.34–0.92] for RASi ( +) and RASi (-), respectively, p = 0.036) whereas no apparent difference in renal survival was noted for CCB.

Conclusions
Early use of RASi contributes to the renal functional recovery from acute reduction in eGFR among patients with hypertensive emergencies. Furthermore, RASi offers more favorable effect on 2-year renal survival, compared with CCB.
Nonlinear relationship between glycated hemoglobin and cognitive impairment after acute mild ischemic stroke
Authors: Xu Lei , Xiong Qin , Du Yang , Huang Lu-wen , Yu Ming 
Published: March 2023

Abstract
Background
Stroke is the second most common cause of morbidity and mortality. Even mild stroke survivors have an increased risk of cognitive impairment. Studies have been conducted on the relationship between glycated hemoglobin (HbA1c) and cognitive decline, but the findings have been inconsistent. Therefore, this study examined the link between HbA1c levels and cognitive impairment following acute mild ischemic stroke.

Methods
Data from 311 patients with acute mild ischemic stroke admitted to Suining Central Hospital, Sichuan Province, China, from January 1, 2015, to December 31, 2018, were evaluated. Fasting venous blood was taken to assess HbA1c levels on the day after admission. Cognitive function was assessed using the Chinese version of the Montreal Cognitive Assessment Scale (MoCA) 3–6 months after stroke onset. We used a generalized additive model and smooth curve fitting (penalty spline method) to assess the nonlinear relationship between HbA1c and poststroke cognitive impairment (PSCI).

Results
This study included 311 patients aged 23 to 96 years old (mean age: 67.37 ± 11.92 years), of whom 198 (63.67%) were men. Among the 311 stroke patients, 120 (38.59%) had PSCI. After adjusting for potential confounders, there was a nonlinear relationship between HbA1c and PSCI, with an inflection point of 8.2. To the left of the inflection point, the effect size, 95% confidence interval, and P value were 0.87, 0.58 to 1.31, and 0.5095, respectively; however, to the right of the inflection point, these numbers were 1.96, 1.08 to 3.58, and 0.0280.

Conclusion
We found a nonlinear relationship between HbA1c and PSCI. When HbA1c was greater than 8.2%, HbA1c was positively correlated with PSCI.