bluuebunny/crossref_metadata_2025_split huggingface dataset:
Head-to-head comparison of ventilation/perfusion single photon emission computed tomography/computed tomography and multidetector computed tomography angiography for the detection of acute pulmonary embolism in clinical practice
Authors: Martins Gustavo H , Contardi Ewandro B , Lopes Djon M , de Souza Thiago F , Grangeia Tiago AG , Dertkigil Sergio SJ , Amorim Bárbara J , Ramos Celso D 
Published: February 2022

Introduction Computed tomography angiography (CTA) and ventilation/perfusion (V/Q) single photon emission computed tomography/CT (SPECT/CT) images have been widely used to detect PE, but few studies have performed a direct comparison between them. We aimed to evaluate the performance of these tests in the same group of patients, selected from the routine practice of a general hospital. Methods Patients with suspected acute PE were prospectively submitted to CTA and V/Q SPECT/CT. General radiologists and nuclear physicians, respectively, interpreted the images. Data regarding age, sex, time between examinations, symptoms, and Wells score were also recorded. The final diagnosis was decided through a consensus among the clinicians, taking into account clinical, laboratory, follow-up, and all imaging procedures data. Results Twenty-eight patients (15 male, 13 female, and median age of 51.5 years) were studied. Median duration of the onset of symptoms was 4 (1–14) days, and the median Wells score was 3.5 (1.5–6). Sensitivity, specificity, positive and negative predictive values, and accuracy were 84.6%, 80.0%, 78.6%, 85.7%, and 82.1% for V/Q SPECT/CT, and 46.1%, 100%, 100%, 68.2%, and 75.0% for CTA. The overall agreement between the methods was 57.1%. Of the 22 patients with negative CTA, 10 (45.4%) had positives V/Q SPECT/CT and seven of them classified as true positives. Conclusions Our results suggest that V/Q SPECT/CT is more sensitive and accurate than CTA when interpreted by general radiologists and nuclear medicine physicians.
Predictive role of C-reactive protein in sudden death: a meta-analysis of prospective studies
Authors: Zhou Ruhua , Xu Jingjing , Luan Jiaochen , Wang Weiyun , Tang Xinzhi , Huang Yanling , Su Ziwen , Yang Lei , Gu Zejuan 
Published: February 2022

Objective C-reactive protein (CRP) is a powerful predictor of and risk factor for cardiovascular disease. However, the relationship between CRP and sudden death (SD) is controversial. Therefore, we performed a meta-analysis to evaluate the association between CRP and SD. Methods We conducted a comprehensive search of the databases of PubMed, Web of Science, Embase, Cochrane Library, Wanfang, CNKI, China Biology Medicine disc, and Weipu. Two researchers independently screened the literature, extracted data, and evaluated the data quality. The overall effect size was meta-analyzed using Stata software version 12.0 (StataCorp, College Station, TX, USA). Results Twelve prospective studies involving 36,646 patients were included in the present meta-analysis. The data revealed that patients with higher CRP concentrations had a greater risk of SD (hazard ratio, 1.19; 95% confidence interval, 1.09–1.29). When the hazard ratio of SD was calculated by multivariate analysis of nine studies, CRP was confirmed to be an independent predictive factor for SD (hazard ratio, 1.05; 95% confidence interval, 1.03–1.07). Conclusions This meta-analysis confirmed that CRP is an independent predictor of SD. These results support the recommendation of recording the CRP concentration for risk assessment of SD in clinical practice.
Th17/Treg balance and indoleamine 2,3 dioxygenase activity in periodontitis-associated atherosclerotic patients
Authors: Yang Jie , Hao Ting , Liu Yu , Huang Jin , Wu Wenlei , Wu Juan , Sun Weibin 
Published: February 2022

Objective This study investigated the peripheral Th17/Treg balance and its potential controlling factor indoleamine 2,3 dioxygenase (IDO) in patients with periodontitis and atherosclerosis (AS), as well as its correlation with Porphyromonas gingivalis infection. Methods In this retrospective study, P. gingivalis-infected atherosclerotic patients (Pg-AS), atherosclerotic patients (AS), P. gingivalis-infected periodontitis patients (Pg), and healthy controls (HCs) were selected after clinical examination, subgingival plaque examination, and plasma anti- P. gingivalis antibody analysis. Treg and Th17 cell percentages, related transcription factors, and functional cytokines in peripheral blood were analysed. Plasma tryptophan (Trp) and kynurenine (Kyn) were measured to determine IDO activity. Results Atherosclerotic patients (Pg-AS and AS groups) had significantly lower IDO activity and higher Th17/Treg ratio than those in the Pg and HC groups. The Th17/Treg ratio was higher and IDO activity was lower in the Pg-AS group compared with the AS group. Transcription factors and cytokines exhibited the same trend as the Th17 and Treg cells. Additionally, IDO activity was negatively correlated with the plasma anti- P. gingivalis antibody titre and the Th17/Treg ratio in the atherosclerotic group. Conclusions P. gingivalis may reduce IDO activity and further promote Th17/Treg imbalance to facilitate AS development. IDO may be a novel molecular marker to predict periodontitis-associated AS.
Association of the methylenetetrahydrofolate reductase (MTHFR) gene variant C677T with serum homocysteine levels and the severity of ischaemic stroke: a case–control study in the southwest of China
Authors: Huang Lu-Wen , Li Lin-Lin , Li Juan , Chen Xiao-Rong , Yu Ming 
Published: February 2022

Objective To determine whether the methylenetetrahydrofolate reductase ( MTHFR) C677T gene polymorphism is linked to the risk of ischaemic stroke and circulating homocysteine (Hcy) levels in a Chinese population. Methods This case–control study recruited angiogram-diagnosed patients with ischaemic stroke and healthy control subjects. The plasma Hcy concentrations were measured and the MTHFR C677T gene polymorphism was genotyped. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of the ischaemic stroke. Results This study recruited 198 patients with ischaemic stroke and 168 controls. The TT genotype conferred a higher risk for ischaemic stroke than the CC genotype (odds ratio of 3.563; 95% confidence interval [CI] 1.412, 4.350). The T allele was the predisposing allele for ischaemic stroke. Hcy had an area under the receiver operating characteristic (ROC) curve of 0.624 (95% CI 0.530, 0.758). The ROC for Hcy demonstrated its usefulness in predicting ischaemic stroke. Hcy levels were not associated with ischaemic stroke severity as measured by the NIHSS. Conclusion The MTHFR C677T gene polymorphism affects circulating Hcy levels. The MTHFR C677T gene polymorphism and hyperhomocysteinaemia may play important roles in predicting the risk of ischaemic stroke.
Comparison of the clinical parameters of patients with COVID-19 and influenza using blood test data: a retrospective cross-sectional survey
Authors: Fukui Sayato , Inui Akihiro , Saita Mizue , Kobayashi Daiki , Naito Toshio 
Published: February 2022

Objective The characteristic features, including blood test data, of the novel coronavirus disease 2019 (COVID-19) versus influenza have not been defined. We therefore compared the clinical parameters, including blood test data, of COVID-19 and influenza. Methods This retrospective cross-sectional survey was conducted at Juntendo University Nerima Hospital. We recruited patients diagnosed with COVID-19 between 1 January 2020 and 31 December 2020 who underwent blood tests. For comparison, we recruited an equivalent number of patients who were diagnosed with influenza and who underwent blood tests. Results During the study period, 228 patients (male:female, 123 [54.0%]:105 [46.0%]; age, 54.68 ± 18.98 years) were diagnosed with COVID-19. We also recruited 228 patients with influenza (male:female, 129 [56.6%]:99 [43.4%]; age, 69.6 ± 21.25 years). An age of 15 to 70 years (vs. 71 years), breathing difficulty, and malaise were significantly more common in patients with COVID-19 than in those with influenza. However, nausea, body temperature >38.1°C, and white blood cell count >9000/μL were more common in patients with influenza. Conclusions Our results are useful for differentiating COVID-19 from influenza, and these findings will be extremely helpful for future practice as we learn to coexist with COVID-19.
Effectiveness of client-centered intervention delivered with face-to-face and telerehabilitation method after total knee arthroplasty—A pilot randomized control trial
Authors: Torpil Berkan , Kaya Özgür 
Published: February 2022

Introduction Total knee arthroplasty (TKA) negatively affects the quality of life, perceived occupational performance, and satisfaction. Face-to-face rehabilitation services have been adversely affected by problems such as time, cost, accessibility, and the COVID-19 pandemic. The telerehabilitation (TR) method is recommended for these problems. This pilot study was planned to examine the comparison of client-centered (CC) intervention with TR and face-to-face (FF) method on quality of life, perceived occupational performance, and satisfaction after TKA. Methods Forty-eight older adults that after TKA (13 men and 35 women) were randomized to the TR group ( n = 24; 68.25 ± 3.32 years) or FF group ( n = 24; 68.91 ± 2.56 years). The Nottingham Health Profile (NHP) was used to assess the quality of life, and the Canadian Occupational Performance Measure (COPM) was used to assess perceived occupational performance and satisfaction. Results There was no difference in all parameters between the groups before and after the intervention program (p > .05). The intervention consisting of 4 days a week for 4 weeks and 45 min sessions applied with both methods had a strong effect size (p < .001 for all). Conclusion As a result, CC intervention applied with both methods in the first postoperative week increased quality of life, perceived occupational performance, and satisfaction. Trail Registration: NCT04969432
Varying Estimates of Sepsis among Adults Presenting to US Emergency Departments: Estimates from a National Dataset from 2002-2018
Authors: Ramgopal Sriram , Horvat Christopher M , Adler Mark D 
Published: February 2022

Background A variety of approaches to defining sepsis using administrative datasets have been previously reported. We aimed to compare estimates, demographics, treatment factors, outcomes and longitudinal trends of patients identified with sepsis in United States emergency departments (EDs) using differing sets of sepsis criteria. Methods We performed a cross-sectional study using the National Healthcare Ambulatory Medical Care Survey, a complex survey of nonfederal US ED encounters between 2002 to 2018. We obtained survey-weighted population-adjusted encounters of sepsis using the following criteria: explicit sepsis, severe sepsis, and quick Sequential Organ Failure Assessment (qSOFA) score combined with the presence of infection. Results Age-adjusted for US adults, 18.6, 16.1 and 8.9 encounters per 10 000 population were identified when using the explicit, severe sepsis and qSOFA definitions, respectively. A higher proportion of the explicit cohort was hospitalized and had blood cultures performed, compared to cohorts ascertained using severe sepsis and qSOFA criteria, though confidence intervals overlapped. Antibiotic use was highest in encounters meeting qSOFA criteria. When inspecting unweighted encounters meeting each set of criteria, there was minimal overlap, with only 3% meeting all three. Encounters meeting the explicit and severe sepsis criteria were increasing over time. Conclusion The explicit, severe sepsis and qSOFA criteria generated similar annual rates of presentation when applied to US ED encounters, with some evidence of the explicit sepsis cohort being higher acuity. There was minimal overlap of cases and instability in estimates when assessed longitudinally. Our findings inform research efforts to accurately identify sepsis among ED encounters using administrative data.
Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review
Authors: Grogg Kristin A. , Giacobbi Peter R. , Blair Emma K. , Haggerty Treah S. , Lilly Christa L. , Winters Carena S. , Kelley George A. 
Published: February 2022

Objective The purpose of this scoping review was to systematically examine interventions that focused on physical activity assessment and promotion in clinical settings in the United States. Data Sources A literature search was performed in 6 major databases to extract published peer-reviewed studies from 2008 to 2019. Inclusion and Exclusion Criteria Interventions with practicing health professionals in the United States who performed physical activity assessment and promotion with adult patients 18 years of age and older. Studies were excluded if they were published in non-English, observational or case study designs, or gray literature. Data Extraction Studies were screened and coded based on the population, intervention, comparison, outcomes and study setting for scoping reviews (PRISMA-ScR) framework. Of 654 studies that were identified and screened for eligibility, 78 met eligibility criteria and were independently coded by two coders. Data Synthesis Data were synthesized using qualitative and descriptive methods. Results Forty-three of the included studies were randomized controlled trials with a majority being delivered by physicians and nurses in primary care settings. Fifty-six studies reported statistically significant findings in outcome measures such as anthropometrics and chronic disease risk factors, with 17 demonstrating improvements in physical activity levels as a result of the interventions. Conclusion The assessment and promotion of physical activity in clinical settings appears to be effective but warrants continued research.
Experimental and numerical optimization of a centrifugal pump volute and its effect on head and hydraulic efficiency at the best efficiency point
Authors: Dehghan Amir Arsalan , Shojaeefard Mohammad Hassan 
Published: February 2022

There is a misunderstanding about the volute casing of the centrifugal pump. Since it is a stationary part, it is assumed that the volute has a slight impact on the efficiency of the pump; however, this part has a considerable effect on the efficiency and is considered an important part converting the dynamic energy to static pressure. To authenticate this fact, in this article, main parameters of the volute which consist of the cross-section shape, theories of designing the volute (i.e., conservation of angular momentum and constant velocity), volute throat area, cutwater angle, cutwater diameter, base circle diameter, volute inlet width, diffuser length and outlet cross-section, and linear and quadratic diffusers are investigated. First, the performance curve has been obtained experimentally and numerically. In simulations, a proper turbulence model has been used and the continuity and the Navier–Stokes equations have been solved. Moreover, with the accurate analysis of contours, streamlines, and recirculation areas on the volute throat area and diffuser, all parameters have been optimized. According to the results, hydraulic efficiency and head of the circular cross-section are 87.6% and 14.55 m, respectively, which is the most efficient compared with the other shapes. The results also revealed that the most appropriate theory for designing the volute is the conservation of angular momentum, and the cutwater angle of 10° with the lowest possible cutwater diameter (3 mm) has the best efficiency (88.1%). Furthermore, the base circle diameter has the optimal value (220 mm, efficiency = 88.7%); otherwise, head loss of the volute increases. The volute inlet width of 23 mm has a hydraulic efficiency of 88.93%, and its head loss is the lowest. Increasing the length of the diffuser decreases its efficiency, and the length and diameter of the discharge area of the most appropriate one are 160 mm and 65 mm, respectively.
Final-year medical student Psychiatry and Addiction Medicine synchronous summative tele-assessments during a COVID-19 Delta-variant stay-at-home lockdown
Authors: Looi Jeffrey CL , Maguire Paul A , Bonner Daniel , Reay Rebecca E , Finlay Angus JF , Keightley Philip , Tedeschi Michael , Wardle Claire , Kramer David 
Published: February 2022

Objective We describe the planning, process and evaluation of final-year Psychiatry and Addiction Medicine summative assessments in a four-year graduate medical degree program, during a COVID-19 Delta-variant public health stay-at-home lockdown. Conclusions We conducted separate written and clinical synchronous (real-time simultaneous) tele-assessments. We used online assessment technology with students, examiners and simulated patients, all in different physical locations. Medical students’ examination performance showed a good range. This was comparable to other discipline stations, and performance in previous years. There was no differential performance of students through the day of the assessments.
The Serious Game and Integrated Simulator for Cardiopulmonary Resuscitation Training in Nursing Students
Authors: Demirtas Ayla , Basak Tulay , Sahin Gul , Sonkaya Murat Çagatay 
Published: February 2022

Background Nurses are often the first health professional who identify cardiopulmonary arrests in hospital settings; therefore, they require proficient cardiopulmonary resuscitation skills. Aim The purpose of this study was to evaluate game-based cardiopulmonary resuscitation training for first-year nursing students in terms of students’ knowledge levels, performance, satisfaction, and confidence. Methods This study was conducted following a quasi-experimental design. A total of 104 students were randomly assigned to two study groups. A Serious Game & Integrated Real-Time Audiovisual Feedback Simulator was utilized in the cardiopulmonary resuscitation training of the intervention group. For the control group, only a real-time audiovisual feedback simulator was used. Results There was an increase of approximately 30 points between the pre-test and post-test scores for knowledge in both groups. In regard to performance scores, there were no statistically significant differences between the groups in regard to overall scores, compression depth, and compression frequency were similar at post-test and re-test (p>0.05). The difference between groups was not statistically significant for satisfaction and self-confidence statistically (p>0.05). Conclusion The integration of a serious game into a real-time audiovisual feedback simulator does not provide significant advantages over the use of only a real-time audiovisual feedback simulator in terms of cardiopulmonary resuscitation knowledge and performance.
Fast Serious Analogue Games in Planning: The Role of Non-Player Participants
Authors: Sousa Micael , Antunes António Pais , Pinto Nuno , Zagalo Nelson 
Published: February 2022

Objective Public participation has benefited from innovative engagement tools that facilitate the negotiation between diverse sets of stakeholders with different planning perspectives. Our objective is to test and evaluate the use of a fast Serious Game (SG) to support a participation process in the context of a conference on urban mobility. We also aim to explore how these analogue games engage Player Participants (PPs) and Non-Player Participants (NPPs). Methodology We developed an empirical approach where a fast analogue planning game was designed and deployed to support discussions during a conference on sustainable mobility. The game resulted from modding existing modern board games. We combined several game mechanisms and components with an urban map, following the Design, Play, Experience (DPE) framework for SG development. The low-tech game was available to Player Participants (PPs) and displayed in a way Non-Playing Participants (NPPs) could participate indirectly. Results The proposed SG engaged PPs and NPPs. PPs immediately started to plan the local transport system establishing a collaborative dynamic. NPPs participated by helping PPs, providing them with their expert and local knowledge. The simplicity of the game and the way it was displayed contributed to the engagement of PPs and NPPs. Conclusion Our findings show that layout configurations and facilitation techniques with analogue games can foster the participation of PPs and NPPs. Low-tech analogue SGs can be useful when resources are low, SG experience is reduced, and fast solutions for citizen and stakeholder engagement are necessary.
Variability and Excess in Opioid Prescribing Patterns After Cleft and Craniosynostosis Repairs
Authors: Zubovic Ema , Skolnick Gary B. , AuBuchon Jacob D. , Waters Erika A. , Snyder-Warwick Alison K. , Patel Kamlesh B. 
Published: February 2022

Objective To critically analyze pediatric opioid prescription patterns after cleft and craniosynostosis repairs. Design Observational study 1) retrospectively reviewing pediatric opioid prescriptions from July 2018 to June 2019 and 2) prospectively surveying patients about actual opioid use from August 2019 to February 2020. Setting Academic tertiary care pediatric hospital. Patients 133 pediatric patients undergoing cleft lip and/or palate or craniosynostosis repairs. Prospective surveys were offered at postoperative visits; 45 of 69 eligible patients were enrolled. Intervention None. Main Outcome Measures Opioid doses prescribed at discharge and actual home opioid use. Results 90 patients with cleft lip and/or palate and 43 patients with craniosynostosis were included. Median prescribed opioid doses were 10.3 for cleft lip and/or palate procedures (range 0–75), and 14.3 for craniosynostosis repairs (range 0–50). In patients with cleft lip and/or palate, there was a negative correlation between age at surgery and prescribed opioid doses ( rs  =  -0.228, p  =  0.031). 45 patients completed surveys of home opioid use. No patients used more than 10 doses. Forty percent used no opioids at home, 33% used 1 to 2 doses, 18% used 3 to 5 doses, and 9% used 6 to 10 doses. Conclusions Opioid prescriptions vary widely after common craniofacial procedures. Younger patients with cleft lip and/or palate may be more likely to be prescribed more doses. Actual home opioid use is less than prescribed amounts, with most patients using five or fewer doses. A prescribing guideline is proposed.