bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of sedation using Ketamine for primary closure of pediatric facial laceration
Authors: Lee Ju Ho , Woo Sang Seok , Shin Se Ho , Kim Hyeon Jo , Kim Jae Hyun , Kim Seong Hwan , Suh In Suck 
Published: August 2022

Pediatric lacerations are frequently encountered by plastic surgeons in the emergency room. Since pediatric patients cannot cooperate due to the anxiety and pain occurring during the suture procedure, sedation is induced. Since commonly used drugs inducing shallow sedation such as chloral hydrates are insufficient to perform procedures, the need or deep sedation has been increased. In our experience, inducing sedation with ketamine is safe and allows for accurate procedures.
A total of 106 pediatric patients aged between 3 months to 5 years who visited the emergency room between August 2020 and January 2021 were included in this study. Of the 106 patients, 54 were sedated using ketamine, and the remaining 52 patients who did not cooperate were operated under local anesthesia, and these were set as the control group. The patients were intravenously injected with ketamine 1.5–2.0 mg/kg ketamine while monitoring the blood oxygen saturation, end-tidal CO2, and other vital signs. The patients were discharged as a complete awakening was confirmed by physicians.
The number of patients who received sedation induced by ketamine was 54 and the number of patients who underwent the procedure without sedation was 52. The mean induction time of a single injection was 35.3 ± 11.3 minutes, and that of additional injection was 253.5 ± 54.1 minute. The total procedure time of the ketamine group was 20.3 ± 11.85 minutes, and that of the nonketamine group was 19.31 ± 10.50 minutes (P = .454). No statistically significant differences were found between the 2 groups.
The need for sedation during the suture procedure in an emergenc9y room has been arising not only for reducing pain and anxiety, but also for safe and accurate procedures and scar minimization.
Based on the parental satisfaction and the safety of the procedure, using ketamine is more effective than other drugs and should be used more actively.
The effect of high-frequency oscillatory ventilator combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome
Authors: Wang Tie-Yan , Zhu Ying , Yin Jia-Lin , Zhao Li-Yan , Wang Hai-Jun , Xiao Chun-Wang , Wu Li-Yan 
Published: August 2022

Objective:
To investigate the efficacy of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS).

Methods:
This study is a retrospective clinical study. Seventy-two NRDS neonates were selected as the subjects from November 2019 to November 2020, and divided into observation group (40 cases, HFOV treatment) and control group (32 cases, conventional mechanical ventilation treatment). All cases were treated with PS and comprehensive treatment. The therapeutic effect, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), Percentage of inhaled oxygen concentration (FiO2), mean arterialpressure, oxygenation index (OI), and complications were compared in the 2 groups.

Results:
The total effective rate of the observation group was 90.0%, significantly higher than that of the control group. After treatment, the observation group has higher PaO2 levels and lower levels of PaCO2, mean arterial pressure, FiO2, and OI than the control group. There was no significant difference in the incidence of complications between the 2 groups.

Conclusion:
HFOV combined with PS has a significant effect on NRDS, which can improve the arterial blood gas index without increasing the incidence of complications.
Evaluation of age-related thymic changes using computed tomography images: A retrospective observational study
Authors: Suzuki Kosuke , Kitami Akihiko , Okada Momoka , Takamiya Shinnosuke , Ohashi Shinichi , Tanaka Yoko , Uematsu Syugo , Kadokura Mitsutaka , Suzuki Takashi , Hashizume Norihiro , Fujisawa Hidefumi 
Published: August 2022

We aimed to investigate if Computed tomography (CT) attenuation values can help improve the identification of age-related changes in the thymus.
We assessed CT images of 405 patients aged 0 to 80 years. We measured the area of the anterior mediastinum at the level of the carina and its average CT attenuation value. We evaluated the thymic area, the ratio of the thymus area to the total thoracic area, and the CT attenuation value. Additionally, we evaluated changes in the thymus area in the 0 to 13-year age group.
The area of the thymus decreased from birth to the middle 20s. After the middle 20s, the area tended to increase and plateau till after 50 years of age. The ratio of the thymic area to the thoracic area decreased from age 0 to 20 years, but remained stable after 20 years of age. The CT attenuation values were stable from birth to puberty, decreased after puberty, and were stable again in the late 50s and beyond. The thymus of children showed mass formation, but the shape changed with age. No significant differences in the CT attenuation value were found across underlying conditions for the 0 to 13-year age group.
The decrease in the CT attenuation values, observed with advancing age, reflects adipose degeneration of the thymus, indicating that by the late 50s, thymic tissue is replaced completely by adipose tissue. Our data suggest that adipose degeneration of the thymus begins after puberty and advances with age.
The efficacy of combined therapy of qingfeiPaidu capsule and lianhuaqingwen capsule nursing interventions for hospitalized patients with COVID-19: A retrospective study of medical records
Authors: Li Yan , Yu Wenhan , Zhai Jinxia , Wang Kun , Huo Hongdan , Du Zonghua 
Published: August 2022

Coronavirus disease-19 (COVID-19) caused a global pandemic burden, affecting hundreds of thousands of individuals, having life-threatening outcomes. Traditional Chinese Medicine plays a crucial role in the treatment of patients with COVID-19. The purpose of this study was to investigate the efficacy of combined therapy of qingfeiPaidu (QFPD) capsule and lianhuaqingwen (LHQW) capsule nursing interventions in the treatment of patients with COVID-19. A total of 318 patients with COVID-19 were enrolled and randomly received QFPD (n = 106), LHQW (n = 106), and QFPD-LHQW (n = 106). The clinical characteristics of COVID-19, the total lung severity scores, and blood laboratory indices were recorded in each patient in each group before treatment and at the end of treatment.
The outcomes demonstrated that QFPD-LHQW group shortened the length of hospitalization, decreased C-reactive protein, creatine kinase, creatine kinase-myocardial band, lactate dehydrogenase, and blood urea nitrogen levels, and improved clinical symptoms, pulmonary inflammation, and prognosis. At the end of treatment, inflammation, immune function, circulating white blood cells, total lymphocyte count, and glutamic-oxaloacetic transaminase levels improved dramatically in 3 groups compared with baseline. All patients met the discharge criteria after 30-day treatment in 3 groups. Combined therapy of QFPD and LHQW demonstrated significant anti-inflammatory effects compared with those of only QFPD or LHQW in patients with mild and moderate COVID-19. The combined therapies may alleviate clinical symptoms of COVID-19 patients by improving inflammation and immune function.
Novel homozygous nonsense mutation associated with Bardet–Biedl syndrome in fetuses with congenital renal malformation
Authors: Cai Meiying , Lin Min , Lin Na , Xu Liangpu , Huang Hailong 
Published: August 2022

Background:
The Bardet–Biedl syndrome (BBS) is a rare autosomal recessive disorder, characterized by clinical and genetic heterogeneity. BBS is more commonly reported in adults and children than in fetuses. Here, a retrospective study on 210 fetuses with congenital renal malformation was conducted.

Methods:
The fetuses were diagnosed using invasive prenatal tests, including chromosome karyotype analysis, whole exome sequencing (WES), and single-nucleotide polymorphism array. We found the intrauterine phenotype of a fetus presenting enlarged kidneys, enhanced echo, and oligohydramnios; therefore, the fetus was characterized to have BBS.

Results:
Chromosome karyotype analysis presented normal results. Analysis using an Affymetrix CytoScan 750K array revealed 2 homozygous regions. However, WES revealed a homozygous mutation of c.1177C>T (p.Arg393*) on exon 12 of BBS1 and a heterozygous variation of c.2704G>A (p.Asp902Asn) on exon 22 of CC2D2A. The American College of Medical Genetics and Genomics guidelines identified c.1177C>T and c.2704G>A as a pathogenic mutation and of uncertain significance, respectively. Sanger sequencing identified heterozygous mutation, that is, c.1177C>T and heterozygous variation, that is, c.2704G>A in the parents of the fetus.

Conclusions:
WES identified a novel homozygous nonsense mutation c.1177C>T in BBS1 of a Chinese fetus with congenital renal malformation. This finding provides insight into the BBS1 mutations in Asian populations in general and shows the necessity of genetic counseling.
Effects of antioxidant intervention in patients with polycystic ovarian syndrome: A systematic review and meta-analysis
Authors: Zhao Junde , Sui Xiaohui , Shi Qingyu , Su Dan , Lin Zhiheng 
Published: August 2022

Background:
The role of antioxidant intervention in polycystic ovary syndrome (PCOS) patients has been increasingly investigated in recent years. In order to further clarify whether antioxidant therapy is beneficial for PCOS patients and the emphasis of its effects, this study provides a systematic review and meta-analysis of randomized controlled trials examining the effect of antioxidant intervention on PCOS.

Methods:
Enrolled study designs related to antioxidant interventions and PCOS, published from 1999 to 2020, were searched from EMBASE, PubMed, and Web of Science databases to sort out proven studies on antioxidant interventions and PCOS. Data were reported as weighted mean difference (WMD) or standard mean difference with associated confidence intervals of 95%. The analysis was conducted using Stata version 16.0.

Results:
Twenty-three studies were included in total. Antioxidant intervention had a positive impact on homeostasis model assessment of insulin resistance (WMD = –0.37, P = .011) and Triglycerides (WMD = –25.51, P < .001). And antioxidant intervention did not improve testosterone levels significantly (WMD = –0.20, P = .2611). Subgroup analysis showed that except for the D-chiro-inosito subgroup, no difference in body mass index was observed between the intervention group and the control group.

Conclusions:
This meta-analysis demonstrates the efficacy of antioxidant intervention in patients with PCOS, demonstrating that antioxidant intervention has a significant effect on insulin resistance and lipid metabolism improvement. However, antioxidant intervention therapy has no discernible impact on testosterone levels or body mass index. Omega-3 may be a more effective antioxidant intervention for PCOS. In addition, this meta-analysis provides important reference opinions and treatment recommendations for PCOS.
Fibroscan® and Shear Wave correlated well in hepatic fibrosis evaluation of patients with chronic liver diseases “in real life situation”
Authors: Zougmoré Honoré Tegwendé , Cadranel Jean François David , Fantognon Gildas , Azzi Badia , Smadhi Ryad , Ngele Efole Jean René , Mrabti Samir , Heng Ratmony , Ntsama Marie Adrienne , Medmoun Mourad , Kazerouni Firouzeh , Le Magoarou Tristan 
Published: August 2022

Background:
A new noninvasive medical device based on ultrasound elastography such as the Shear Wave Elastography (SWE) was designed in order to measure the liver hardness. The purpose of this work was to evaluate the correlation of the results of the liver elasticity measurements obtained by Fibroscan® (FS) and SWE for patients with chronic liver diseases.

Methods:
Between January and October 2017, the patients who were followed during this period of time underwent noninvasive assessments of liver fibrosis by SWE in the intercostal spaces during abdominal ultrasound procedures and/or FS. The correlation between FS and SWE was estimated and tested at a 0.05 significance level.

Results:
Four hundred and seventy-six patients were included in this study. The main etiologies of chronic liver disease were non alcoholic fatty disease (NAFLD), chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV). All patients underwent a SWE and 167 among them underwent a FS procedure. The patients who were followed revealed a median FS measurement of 5.80 kpa (Q25 = 4.90 kPa; Q75 = 8 kPa) and a median SWE measurement of 7.00 kPa (Q25 = 6.10 kPa; Q75 = 8.10 kPa). We could observe a significant correlation between the FS and SWE measurements (0.49; P = .001) in the total cohort. The average absolute difference between the measurements of these 2 methods was of 2.54 kPa (sd = 3.39). There was no significant correlation for patients with NAFLD no matter whether they presented with signs of suspected non alcoholic steatohepatitis (NASH) or not (R = 0.20; P = .108). All patients intending to perform the examination were able to undergo the SWE, allowing 33.3% of the patients who failed the FS to have a noninvasive evaluation of their fibrosis.

Conclusion:
The SWE technique proved to be as efficient as the FS one for the evaluation of the liver fibrosis in real life situation.
Increased NOX1 and DUOX2 expression in the colonic mucosa of patients with chronic functional constipation
Authors: Wei Xiuqin , Xue Mei , Kang Chunbo , Gao Lei , Zhang Mengqiao , Ma Chao , Jia Wei , Zheng Yufeng , Cao Lei , Chen Pan , Jiang Shujing , Chu Fong-Fong , Gao Qiang 
Published: August 2022

To determine whether oxidative stress and inflammation are associated with constipation by examining the expression of the main producers of reactive oxygen species, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, and pro-inflammatory cytokines in the colon of patients with chronic functional constipation.
The colonic biopsies were collected from 32 patients with chronic functional constipation and 30 healthy subjects who underwent colonoscopy. Colonic mucosal histology was observed. Interleukin (IL)-1β, IL-6, IL-8 messenger RNA (mRNA), and 4 members of NADPH oxidase (NOX1, NOX2, DUOX2, and NOX4) protein and mRNA were assessed by immunohistochemistry, western blotting, and reverse transcription polymerase chain reaction.
The tissues from both patients and healthy subjects showed normal histological structure without increase of inflammatory cells. NOX1 protein and mRNA levels were significantly increased compared to controls (P < .05). DUOX2 protein, but not mRNA, was increased by 2-fold compared to controls (P < .05). The levels of NOX2 and NOX4 protein and mRNA demonstrated no significant difference between patients and control subjects. The levels of IL-1β and IL-6 mRNA were significantly higher in constipation patients (P < .05), while IL-8 mRNA level was no different between the 2 groups.
NADPH oxidase and pro-inflammatory cytokine might be involved in the pathogeneses of chronic functional constipation.
Transformation from polycythemia vera to acute promyelocytic leukemia: Case report and literature review
Authors: Li Wen-Wen , Sui Xiu-Fang , Fan Shuang , Xu Hong , Wang Cheng-Lei , Wang Fei-Ying , Mo Xiao-Dong 
Published: August 2022

Introduction:
Transformation from chronic myeloproliferative neoplasm to acute leukemia is a feature of myeloproliferative neoplasm; however, the rate is not high. Transformation to acute promyelocytic leukemia is rare. Here, we report a case of transformation of polycythemia vera to acute promyelocytic leukemia and describe a process of clonal evolution that has not yet been reported.

Patient concerns:
In this case, a 51-year-old woman was diagnosed with polycythemia vera and concomitant JAK2/V617F mutations in July 2019. She underwent intermittent phlebotomy and oral hydroxyurea irregularly. After 2 years, the patient complained of fatigue and poor sleep quality for 2 months.

Diagnosis:
Further examination revealed marked hypercellularity and grade 1 bone marrow fibrosis with the PML/RARαV variant (23.85% mutation load), WT1-Exon1 (37.8%), WT1-Exon9 (4.1%), JAK3-Exon7 (49.3%), and RELN-Exon55 (45.8%). According to the World Health Organization classification of tumors of hematopoietic and lymphoid tissues, the patient was ultimately diagnosed with a rare transformation of polycythemia vera to acute promyelocytic leukemia.

Interventions:
The patient underwent dual induction therapy with all-trans-retinoic acid and arsenic trioxide.

Outcomes:
After 28 days of induction therapy, the patient achieved complete remission, was compliant and the treatment was well tolerated.

Conclusion:
Polycythemia vera can transform into acute promyelocytic leukemia; therefore, it is important to review bone aspiration and other tests to perform a comprehensive assessment and monitor the disease status, to detect disease progression and intervene early when it transforms into acute promyelocytic leukemia.
Medicaid Expansion and Change in Federally Qualified Health Center Accessibility from 2008 to 2016
Authors: Evans Leigh , Fabian M. Patricia , Charns Martin P. , Gurewich Deborah , Stopka Thomas J. , Cabral Howard J. 
Published: August 2022

Background:
The Affordable Care Act expanded health coverage for low-income residents through Medicaid expansion and increased funding for Health Center Program New Access Points from 2009 to 2015, improving federally qualified health center (FQHC) accessibility. The extent to which these provisions progressed synergistically as intended when states could opt out of Medicaid expansion is unknown.

Objective:
To compare change in FQHC accessibility among census tracts in Medicaid expansion and nonexpansion states.

Research Design:
Tract-level FQHC accessibility scores for 2008 and 2016 were estimated applying the 2-step floating catchment area method to American Community Survey and Health Resources and Services Administration data. Multivariable linear regression compared changes in FQHC accessibility between tracts in Medicaid expansion and nonexpansion states, adjusting for sociodemographic and health system factors and accounting for state-level clustering.

Subjects:
In total, 7058 census tracts across 10 states.

Results:
FQHC accessibility increased comparably among tracts in Medicaid expansion and nonexpansion states (coef: 0.3; 95% CI: −0.3, 0.8; P-value: 0.36). FQHC accessibility increased more in tracts with higher poverty and uninsured rates, and those with lower proportions of non-English speakers and Black or African American residents.

Conclusion:
Similar gains in FQHC accessibility across Medicaid expansion and nonexpansion states indicate improvements progressed independently from Medicaid expansion, rather than synergistically as expected. Accessibility increases appeared consistent with HRSA’s goal to improve access for individuals experiencing economic barriers to health care but not for those experiencing cultural or language barriers to health care.
Health Care Professionals' Perceptions of Caring for Patients with Substance Use Disorders during Pregnancy
Authors: Merritt Elizabeth L. , Burduli Ekaterina , Purath Janet , Smart Denise 
Published: August 2022

Abstract

Purpose:
Pregnant patients with substance use disorders (SUDs) may experience stigma and implicit and explicit bias from health care professionals when seeking prenatal care. This study explored the perceptions of health care professionals caring for pregnant women with SUDs and examined changes in their perceptions over time following attendance at an educational conference about SUDs.

Study Design and Methods:
Evidence-based education was presented to health care professionals at a conference to reinforce the complex needs of pregnant women with SUDs. An adapted version of the Attitudes of Healthcare Providers Survey (AHPS) was administered at three intervals and assessed health care professionals' perceptions of pregnant women with SUDs. Data from the three time points were analyzed using repeated measures ANOVA.

Results:
There was a significant decrease in mean AHPS scores between T1 (38.24 ± 8.93) and T2 (32.71 ± 7.77), p < .05, and then a significant increase in mean AHPS score between T2 and T3 (37.08 ± 8.45), p < .05. High mean scores on health care professionals' knowledge and competence were noted after the educational intervention but were not sustained over time.

Clinical Implications:
Education cannot change health care professional perceptions of pregnant individuals with SUD. Health care professionals need access to additional clinical and community resources. Nurse leaders must continue to advocate for institutional and community resources to meet referral, treatment, and follow-up needs during pregnancy. Reducing perceptions of stigma and acknowledging the impact of implicit bias toward pregnant women with SUD may reduce barriers and improve their care.
Controlled attenuation parameter accurately detects liver steatosis in people with HIV
Authors: Duarte Maria , Tien Phyllis , Ma Yifei , Noworolski Susan M. , Korn Natalie , Price Jennifer C. 
Published: August 2022

Objectives:
Hepatic steatosis is a leading cause of cirrhosis and hepatocellular carcinoma and is highly prevalent in persons with HIV (PWH). However, most studies of hepatic steatosis diagnosis in PWH have focused on those at high risk. We determined the accuracy of vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP) in detecting mild or greater hepatic steatosis as compared with the noninvasive gold standard magnetic resonance spectroscopy (MRS) in PWH.

Methods:
Among 149 participants with and without HIV, we evaluated test characteristics of CAP and calculated serum indices Hepatic Steatosis Index (HSI) and STEATO-ELSA in identifying 3T MRS-measured hepatic steatosis (defined as a liver fat fraction ≥5%).

Results:
Most participants were women and over half were African American. Median BMI was 27 kg/m2. Hepatic steatosis prevalence by MRS and CAP (cutoff 248 dB/m) was 36% and 47%, respectively. CAP had an AUROC of 0.82, and the at least 248 dB/m cutoff yielded a sensitivity, specificity, positive-predictive value, and negative-predictive value of 83%, 72%, 61%, and 88%, respectively. These test characteristics were not statistically different from the optimal cutoff of at least 252 dB/m. Higher waist circumference, greater visceral adipose tissue, heavy alcohol use, and VCTE scans flagged as having the probe positioned too low were associated with CAP and MRS discordance. Serum indices of hepatic steatosis had slightly worse performance characteristics than CAP.

Conclusion:
CAP may be an effective alternative to MRS for noninvasive hepatic steatosis assessment in PWH. The commonly used CAP cutoff of at least 248 dB/m to diagnose hepatic steatosis can be used in PWH.