bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Time to Rapid Response Team Activation With Patient Outcomes Using a Range of Physiologic Deterioration Thresholds
Authors: Mitchell Oscar J. L. , Neefe Stacie , Ginestra Jennifer C. , Schweickert William D. , Falk Scott , Weissman Gary E. , Covin Donna , Shults Justine , Abella Benjamin S. , Shashaty Michael G. S. 
Published: December 2022

OBJECTIVES:
Clinical deterioration of hospitalized patients is common and can lead to critical illness and death. Rapid response teams (RRTs) assess and treat high-risk patients with signs of clinical deterioration to prevent further worsening and subsequent adverse outcomes. Whether activation of the RRT early in the course of clinical deterioration impacts outcomes, however, remains unclear. We sought to characterize the relationship between increasing time to RRT activation after physiologic deterioration and short-term patient outcomes.

DESIGN:
Retrospective multicenter cohort study.

SETTING:
Three academic hospitals in Pennsylvania.

PATIENTS:
We included the RRT activation of a hospitalization for non-ICU inpatients greater than or equal to 18 years old.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary exposure was time to RRT activation after physiologic deterioration. We selected four Cardiac Arrest Risk Triage (CART) score thresholds a priori from which to measure time to RRT activation (CART score ≥ 12, ≥ 16, ≥ 20, and ≥ 24). The primary outcome was 7-day mortality—death or discharge to hospice care within 7 days of RRT activation. For each CART threshold, we modeled the association of time to RRT activation duration with 7-day mortality using multivariable fractional polynomial regression. Increased time from clinical decompensation to RRT activation was associated with higher risk of 7-day mortality. This relationship was nonlinear, with odds of mortality increasing rapidly as time to RRT activation increased from 0 to 4 hours and then plateauing. This pattern was observed across several thresholds of physiologic derangement.

CONCLUSIONS:
Increasing time to RRT activation was associated in a nonlinear fashion with increased 7-day mortality. This relationship appeared most marked when using a CART score greater than 20 threshold from which to measure time to RRT activation. We suggest that these empirical findings could be used to inform RRT delay definitions in further studies to determine the clinical impact of interventions focused on timely RRT activation.
Biological Effects of Electric, Magnetic, and Electromagnetic Fields from 0 to 100 MHz on Fauna and Flora: Workshop Report
Authors: Pophof Blanka , Henschenmacher Bernd , Kattnig Daniel R. , Kuhne Jens , Vian Alain , Ziegelberger Gunde 
Published: December 2022

Abstract
This report summarizes effects of anthropogenic electric, magnetic, and electromagnetic fields in the frequency range from 0 to 100 MHz on flora and fauna, as presented at an international workshop held on 5–7 November in 2019 in Munich, Germany. Such fields may originate from overhead powerlines, earth or sea cables, and from wireless charging systems. Animals and plants react differentially to anthropogenic fields; the mechanisms underlying these responses are still researched actively. Radical pairs and magnetite are discussed mechanisms of magnetoreception in insects, birds, and mammals. Moreover, several insects as well as marine species possess specialized electroreceptors, and behavioral reactions to anthropogenic fields have been reported. Plants react to experimental modifications of their magnetic environment by growth changes. Strong adverse effects of anthropogenic fields have not been described, but knowledge gaps were identified; further studies, aiming at the identification of the interaction mechanisms and the ecological consequences, are recommended.
Biological Effects of Radiofrequency Electromagnetic Fields above 100 MHz on Fauna and Flora: Workshop Report
Authors: Pophof Blanka , Henschenmacher Bernd , Kattnig Daniel R. , Kuhne Jens , Vian Alain , Ziegelberger Gunde 
Published: December 2022

Abstract
This report summarizes the effects of anthropogenic radiofrequency electromagnetic fields with frequencies above 100 MHz on flora and fauna presented at an international workshop held on 5–7 November 2019 in Munich, Germany. Anthropogenic radiofrequency electromagnetic fields at these frequencies are commonplace; e.g., originating from transmitters used for terrestrial radio and TV broadcasting, mobile communication, wireless internet networks, and radar technologies. The effects of these radiofrequency fields on flora, fauna, and ecosystems are not well studied. For high frequencies exceeding 100 MHz, the only scientifically established action mechanism in organisms is the conversion of electromagnetic into thermal energy. In accordance with that, no proven scientific evidence of adverse effects in animals or plants under realistic environmental conditions has yet been identified from exposure to low-level anthropogenic radiofrequency fields in this frequency range. Because appropriate field studies are scarce, further studies on plants and animals are recommended.
Effect of physical activity interventions on quality of life in older adults: A protocol for systematic review and meta-analysis
Authors: Lamberti Nicola , Manfredini Fabio , Babjaková Jana , Gallè Francesca , Medijainen Kadri , Karatzaferi Christina , Pavlova Iuliia , Netz Yael , López-Soto Pablo Jesús 
Published: December 2022

Introduction:
Quality of life (QoL) has been acknowledged as a fundamental concept in the field of health and is favorably improved by physical activity (PA). This systematic review aims to assess the benefits and harms of different types of PA to improve health-related QoL in both community-dwelling and diseased older adults to provide a recommendation for the minimum amount of PA needed to obtain measurable QoL benefits.

Methods and analysis:
We will search MEDLINE, Cochrane Central Register of Controlled Trials, CINHAL, Epistemonikos, Web of Science and gray literature. Randomized controlled trials enrolling healthy or diseased older adults aged > 65 years, providing any kind of physical activity intervention and having quality of life as an outcome will be included. There will be no language restriction. Two independent reviewers will screen the papers, and a third reviewer will resolve the conflicts. The quality of the included studies will be assessed through the Risk of Bias 2.0 tool. Finally, data will be extracted to create proper meta-analyses of comparisons between the different kinds of physical activity interventions or to control groups.

Ethics and dissemination:
This review does not require approval from the Ethics Committee. The results will be disseminated in peer-reviewed journals and at international conferences; moreover, the findings will be shared on social media using an accessible language.
Effects of acupuncture in the treatment of occipital neuralgia: A systematic review and meta-analysis
Authors: Zheng Huabin , Li Chong , Hu Jike , Zeng Li 
Published: December 2022

Background:
Acupuncture is used to treat subjects with occipital neuralgia, which is 1 of the main causes of occipital pain; however, its effect is conflicting. Hence, the current study aims to evaluate the effects of acupuncture in the treatment of occipital neuralgia.

Methods:
In a systematic search of PubMed, Embase, OVID, China National Knowledge Infrastructure, Cochrane Library, Chinese Biomedical Literature Database, Wanfang databases, and Google Scholar until July 2021, 15 studies aimed to evaluate the effects of acupuncture in the treatment of occipital neuralgia were included. Human-related trials were considered in different languages. The size of the study was not considered a limit for its inclusion and the study intervention should focus on comparing the impact of acupuncture in the intervention group compared with the control group.
The odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were calculated with a random or fixed-effect model for different subgroup analyses. Publication bias was assessed using the Egger test, while the risk of bias was assessed using the Review manager software.

Results:
Acupuncture had a significantly higher effective rate of treatment (OR, 5.40; 95% CI, 2.48 to 11.77, P < .001) compared to control in the treatment of occipital neuralgia and lower visual analogue scale (MD, −2.45; 95% CI, −2.69 to −2.21, P < .001). Acupuncture plus medication had a significantly higher effective rate of treatment (OR, 3.96; 95% CI, 2.10 to 7.47, P < .001) compared to medication in the treatment of occipital neuralgia. Acupuncture analysis for safety issues showed a significant reduction of adverse events compared with the medication group.

Conclusion:
Acupuncture alone or acupuncture plus medication had a significantly beneficial effect on the effective rate of treatment, safety and visual analog scale compared to medication in the treatment of occipital neuralgia. Further studies are required to validate these findings.
Endobronchial removal of the peripherally located foreign body with the ultrathin bronchoscopy and ultrathin cryoprobe guided by a manual navigating method: A case report
Authors: Yuan Mingli , Xiao Yang , Ni Fang , Yin Wen , Hu Yi 
Published: December 2022

Rational:
The bronchoscope is a preferential method used to remove airway foreign bodies, but for those located in the distal lumen of bronchus with long-time retention, how to remove them remains an intractable problem.

Patient concerns:
A 57-year-old male presented with 2-week history of intermittent hemoptysis. Chest CT upon admission revealed a high-density opacity incarcerated in the distal basal segment of the left lower lobe, along with obstructive pneumonia.

Diagnoses:
The patient was diagnosed as foreign body aspiration.

Interventions:
We firstly used a manual navigating method to draw a bronchoscopic map according to the thin-section CT. Then we adopted ultrathin bronchoscope (UTB) to remove the peripherally located foreign body.

Outcomes:
UTB successfully found the foreign body incarcerated in LB10ciiβ under the guidance of manual navigation, but it was too tender to be extracted completely by forceps, and it was even pushed further away. Then 1.1 mm ultrathin cryoprobe was used, with an activation time of 4 seconds, the chili was frozen and completely removed.

Lessons:
This first combined application of manual navigating method, UTB and ultrathin cryoprobe, successfully extracted foreign bodies lodged in the distal airways and thus avoided thoracic surgery.
Oral Chinese patent medicines for acute myocardial infarction after percutaneous coronary intervention: A protocol for systematic review and network meta-analysis
Authors: Zhao Wei , Xiong Fan-Jie , Feng Shu-Gui , Li Yan-Ming , Lei Xing-Hua , Jia Shi-Jian 
Published: December 2022

Background:
Acute myocardial infarction (AMI) is a serious and fatal heart disease with one of the highest mortality rates in the world. In some countries, percutaneous coronary intervention (PCI) is the preferred reperfusion strategy after AMI, but it cannot achieve safe and effective treatment of AMI after PCI remains a challenging clinical problem. The potential of oral Chinese patent medicines to treat AMI after PCI has been demonstrated, but which type of oral Chinese patent medicines may be preferred remains controversial. The aim of this network meta-analysis was to investigate the efficacy and safety of multiple oral Chinese patent medicines in the treatment of AMI after PCI.

Methods:
We will conduct a literature search from China National Knowledge Infrastructure, formerly Chinese Biomedical Database (SinoMed), Wanfang Data, Chongqing VIP, PubMed, Embase, Web of Science and Cochrane Library (The Cochrane Database of Systematic Reviews) from their inception until to November 1, 2022, with language restricted to Chinese and English. Then, the study selection process will follow the Preferred Reporting Items for Meta-Analyses guideline, and the quality assessment will be conducted with Cochrane Collaboration’s tool. Pairwise and network meta-analysis will be conducted using the WinBUGS V.1.4.3.37 and STATA V.13. Additionally, sensitivity analysis, subgroup analysis, quality assessment, Small-study effects and publication bias will be performed.

Ethics and dissemination:
This work is based on published research and therefore does not require ethical approval. This review will be published in peer-reviewed journals.

PROSPERO registration number:
CRD42020188065.
Fungal keratitis treated with a combination of traditional Chinese medicine and Western medicine: A case report
Authors: Huang Yu , Yu Juan , Peng Qinghua 
Published: December 2022

Rationale:
Currently, the primary treatments for fungal keratitis (FK) are drugs and surgery. However, drug treatment has low efficacy and many side effects, and surgical treatment is costly. Therefore, it is critical to develop a new method of FK treatment. This report describes a 56-year-old male patient with FK who was treated with a combination of traditional Chinese medicine (TCM) and Western medicine with noticeable results and few side effects.

Patient concerns:
The main symptoms were blurred vision in the right eye and pain. On the corneal surface, a large area of ulcer with a turbid margin was visible, along with an oral ulcer. Additionally, the patient was afraid of corneal transplantation due to financial constraints.

Diagnoses:
The case was diagnosed as FK. In vivo confocal microscopy is the first choice for the diagnosis of this condition. Corneal ulcer was infiltrated with numerous inflammatory cells and dendritic fungal hyphae, as determined by in vivo confocal microscopy.

Interventions:
Early in his illness, the patient was treated with only Western medicine, which resulted in poor outcomes and severe adverse reactions. Corneal transplantation was recommended by the first hospital. The patient was later transferred to our hospital for treatment with TCM decoction.

Outcomes:
After 21 days of treatment, the corneal ulcer of the patient became shallower, his vision improved, and his discomfort disappeared. Due to financial concerns, the patient and his family requested early discharge, so no follow-up disease information was obtained. However, when analyzing the disease development process in the hospital, the combination of TCM and Western medicine had obvious effects and a high level of safety.

Lessons:
This case report shows that TCM is safe and effective in the treatment of FK and is worthy of promotion. However, in practice, we found that TCM is better for patients with early FK, so early diagnosis of FK is crucial.
A case of EBV encephalomyelitis with positive anti-GFAP-IgG antibody with recurrent fever and dysuresia as the main symptoms: Case report and retrospective analysis
Authors: Wang Lulu , Dong Lulu , Zhao Mingmin , Jiang Chao , Geng Minxia , Li Shuang , Xing Jiahao , Wang Tianjun 
Published: December 2022

Rationale:
Due to neuronal destruction caused by Epstein-Barr virus (EBV) infection, exposure to neuronal surface antigens may lead to an imbalance in immune tolerance, which in turn triggers an autoimmune response. In addition, due to the involvement of nonspecific B-cell activation or molecular mimicry, EBV and Glial Fibrillary Acidic Protein (GFAP) receptors may have common epitopes. Viral infection triggers activation of B-cell and cross-reaction with viral antibodies, resulting in autoimmune encephalomyelitis. The clinical presentation may be complex or even atypical. A small number of patients may develop autoimmune reactions.

Patient concerns:
Most patients with EBV encephalomyelitis have a good prognosis, with the disease generally having a short course, few complications, and a good prognosis. In most patients, after treatment, their neurological function basically recovers within a few weeks or months.

Diagnosis interventions:
The patient had fever and headache. His 3 tests for cerebral spinal fluid (CSF) are consistent with the features of viral encephalomyelitis. Pathogenic examination of CSF confirmed EBV, and imaging suggested brain and spinal cord involvement. After antiviral treatment, the patient’s symptoms relieved. The diagnosis of EBV encephalomyelitis was considered. However, the patient’s temperature continued to increase. He was transferred to a superior hospital and was given GFAP-Ab in CSF, which was strongly positive. The patient was given immunoglobulin and antiviral therapy. This supports the diagnosis of GFAP-IgG antibody positive with EBV encephalomyelitis.

Outcomes:
After treatment with antiviral drugs and immunoglobulins, the patient’s symptoms improved and he was able to function.

Lessons:
EBV encephalomyelitis is a rare clinical disease. Therefore, more attention should be paid to the early diagnosis and treatment of similar patients to avoid misdiagnosis. CSF tests, genetic tests, and imaging tests can confirm the diagnosis.
Cuticular drusen presenting with central serous chorioretinopathy in both eyes: A case report
Authors: Hosoda Shuhei , Sakurada Yoichi , Shijo Taiyo , Kashiwagi Kenji 
Published: December 2022

Rationale:
Drusen are precursor lesions to advanced age-related macular degeneration. Although cuticular drusen are located between the retinal pigment epithelium and Bruch’s membrane, as are conventional drusen, they possess unique characteristics that are distinct from those of conventional drusen on clinical presentations. Central serous chorioretinopathy (CSC) is a rare complication in eyes with cuticular drusen.

Patient concern:
A 58-years-old man was referred to our institute for the treatment of persistent subretinal fluid (SRF) in both eyes. Spectral-domain optical coherence tomography revealed focal SRF that did not involve the central macula of the right eye and SRF in the central macula of the left eye. Fluorescein angiography exhibited focal leakage corresponding to SRF and hyperfluorescence resembling a “stars in the sky” appearance in both eyes. On initial presentation, the best-corrected visual acuity values were 1.2 and 0.9 in the right and left eye decimal formats, respectively.

Diagnosis:
Cuticular drusen presenting with CSC in both eyes.

Interventions:
No treatment was administered for CSC in the right eye, whereas photodynamic therapy was administered for CSC in the left eye.

Outcomes:
At the 6-month visit, extrafoveal SRF persisted in the right eye and resolved in the left eye. Best-corrected visual acuity improved from 0.9 to 1.2 in the decimal format in the left eye.

Lessons:
Although cuticular drusen presenting with CSC are rare, physicians should be aware of the possibility of CSC development in eyes with cuticular drusen.
Clinical efficacy and safety of warm acupuncture in the treatment of type 2 diabetic kidney disease: A protocol of a randomized controlled trial
Authors: Gao Yuancheng , Ji Yue , Song Yulin , Gong Rui , Chen Cheng , Chen Hongbo 
Published: December 2022

Background:
Type 2 diabetic kidney disease (DKD) is one of the most common and harmful chronic complications in clinical practice, and there is no reliable and targeted treatment plan at present. As a classic complementary and alternative therapy, evidence have shown that warm acupuncture has advantages in the treatment of type 2 DKD. However, there is still a lack of high-quality and long-term follow-up randomized controlled trials of warm acupuncture in the treatment of type 2 DKD.

Methods:
This is a prospective randomized controlled trial to investigate the efficacy and safety of warm acupuncture in the treatment of type 2 DKD. Participants will be randomly assigned in a 1:1 ratio to either the treatment group (treated with conventional Western medicine) or the control group (treated with warm acupuncture added on the basis of the control group). Both groups will receive 12 weeks of treatment followed by 24 weeks of follow-up. Observation indicators include: 24-hour urinary protein quantification, kidney function, TCM syndrome score and adverse reactions. Finally, SPSS21.0 software will be used to analyze the data.

Discussion:
This study will evaluate the efficacy and safety of warm acupuncture in the treatment of DKD, and the results of this trial will provide clinical evidence for the treatment of type 2 DKD.

Trial registration:
The TCTR identification number is TCTR20221104004.
Neural mechanisms underlying peripheral facial nerve palsy: A protocol for systematic review and meta-analysis of neuroimaging studies
Authors: Lee Dong Hyuk , Kwon Bo-In , Yu Jun-Sang , Park Sang Kyun , Kim Joo-Hee 
Published: December 2022

Background:
Peripheral facial nerve palsy is a general term used to describe diseases that cause lower motor neuron lesions in the facial nerve. The most common cause of peripheral facial nerve palsy is idiopathic Bell’s palsy (BP), accounting for 60% to 70% of all peripheral facial nerve palsy cases. Idiopathic BP is found in various medical conditions, such as ischemia, viral infection, and neuroinflammation; however, the specific pathophysiology remains unclear. Neuroimaging techniques help understand the neural mechanisms underlying various neurological disorders. In recent years, several studies have applied functional neuroimaging to investigate alterations of brain function in BP patients. However, the results have been inconsistent due to differences in methodology and quality. Moreover, systematic reviews of studies on functional neuroimaging for BP are insufficient. Therefore, the present study aims to verify the neural mechanisms of brain alterations and draw conclusions about the functional reorganization in patients with BP.

Methods:
This review includes all suitable studies published on or before October 31, 2022. A thorough search will be conducted using the following databases: MEDLINE, Cochrane Library, Excerpta Medica Database (EMBASE), China Knowledge Resource Integrated Database (CNKI), Korean Medical database (KMBASE), Korean Studies Information Service System (KISS). Clinical studies of BP using functional neuroimaging will be selected. We will apply a coordinate-based meta-analysis because most individual neuroimaging studies provide their results as coordinates in the standard space. The primary outcomes will include the types of functional neuroimaging methods and alterations of brain function in BP patients. The secondary outcomes will include the information about clinical measurement of the disease. Study selection, data extraction, and risk of bias assessment will be conducted. If possible, heterogeneity tests, data synthesis, and subgroup analyses will be conducted.

Results:
The study will analyze the alterations in brain activity and worsening of clinical symptoms caused by idiopathic BP.

Conclusion:
The aim of this study is to investigate functional reorganization of brain alterations in patients with BP. This review will improve the understanding of the neural mechanisms of BP based on the most recent publications through extensive data retrieval. If sufficient data are collected, a sensitivity analysis is performed to verify the robustness of the conclusions.