bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a weekly functional independence measure scale on the recovery of patient with acute stroke
Authors: Kawamura Kenta , Murayama Kumi , Takamura Jumpei , Minegishi Shinobu 
Published: March 2022

Abstract
Excessive assistance may decrease stroke patients’ physical activity and make them more dependent on assistance. We have structured a system that provides an ADL (activities of daily living) educational program that focuses on stroke patients’ toileting in our daily clinical practice. Here, we investigated the effect of a functional independence measure (FIM) scale on the recovery of patients with acute stroke.
We retrospectively collected the data of 407 stroke patients from the medical record system of our emergency hospital in Tsukuba, Japan. The enrolled stroke patients (n = 373) were divided into FIM and control groups. Both groups received the standard treatment, but for the FIM group, ward and rehabilitation staff calculated the toilet FIM score for patients 1 ×/wk. The FIM scale measures the amount of assistance a patient needs to perform activities of daily living and is often used in rehabilitation settings. The rehabilitation staff then instructed the ward staff about better assistance methods based on each patient’s physical function and executive dysfunction. We evaluated the usefulness of the FIM scale was based on the patients’ FIM scores at discharge and improvements in their scores.
The recoveries of the total, motor, and cognitive FIM scores recovery at discharge were significantly greater in the FIM group compared with the control group (68.0 vs 45.0, P = .004; 41.0 vs 24.0, P = .005; and 24.0 vs 20.0, P = .007, respectively). The use of the FIM scale contributes to the patients’ recovery of physical function and cognitive function.
The FIM scale can contribute to stroke patients’ recovery of activities of daily living.
Extensive skull ossification after decompressive craniectomy in an elderly patient
Authors: Yang Huanhuan , Liang Man , Su Lijian 
Published: March 2022

Abstract

Rationale:
After severe traumatic brain injury, patients often present with signs of increased intracranial hypertension and partially require decompressive craniectomies. Artificial materials are usually required to repair skull defects and spontaneous skull ossification is rarely observed in adults.

Patient concerns:
This study reported a 64-year-old man was admitted to the hospital with a coma due to a traffic accident.

Diagnosis:
Emergency computed tomography (CT) examination upon admission showed a left temporo-occipital epidural hematoma with a cerebral hernia and skull fracture.

Interventions:
The patient underwent urgent craniotomy for hematoma removal and decompression under general anesthesia. The patient was discharged after 1 month of treatment.

Outcomes:
The patient returned to the hospital for skull repair 145 days after the craniotomy. Pre-operative CT showed island skull regeneration in the skull defect area; therefore, skull repair was postponed after clinical evaluation. Regular follow-up is required. Twenty-three months after surgery, head CT showed that the new skull had completely covered the defect area.

Lesson:
We collected other 11 similar cases of spontaneous human skull regeneration in a literature search to analyze the possible factors impacting skull regeneration. The analysis of the cases indicated that maintaining the integrity of the periosteum, dura, and blood vessels during craniotomy may play an important role in skull regeneration. Skull regeneration predominantly occurs in young patients with rapid growth and development; therefore, an appropriate postponement of the cranioplasty time under close monitoring could be considered for young patients with skull defects.
Development and external validation of a nomogram with inflammatory markers for predicting invasiveness of intraductal papillary mucinous neoplasm of pancreas
Authors: Yoon So Jeong , Kim Hongbeom , Lee Okjoo , Jung Ji Hye , Lim Chang-Sup , Shin Yong Chan , Kwon Wooil , Jang Jin-Young , Shin Sang Hyun , Heo Jin Seok , Han In Woong 
Published: March 2022

Abstract
Recent studies have reported that inflammatory markers, such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and advanced lung cancer inflammation index, are associated with invasiveness of intraductal papillary mucinous neoplasm (IPMN). This study aimed to develop and validate a new nomogram that includes inflammatory markers for predicting the invasiveness of IPMN.
The data of 365 patients who underwent surgical resection for IPMN at 4 centers between 1995 and 2016 were retrospectively reviewed to develop a new nomogram. For external validation, a separate patient cohort was used. The predictive ability of the nomogram was evaluated using the area under the receiver operating characteristic curve.
The new nomogram was developed using the following variables which were identified as risk factors for invasive IPMN: body mass index, preoperative serum bilirubin level, carbohydrate antigen 19-9, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, advanced lung cancer inflammation index, main duct type, presence of solid portion, and tumor size. After external validation, the area under the curve value was 0.649 (95% CI: 0.578-0.720, P < .001).
To the best of our knowledge, this study is the first to predict and externally validate the invasiveness in IPMN using inflammatory markers. Further research is necessary to improve predictability of the model for selecting patients for surgical resection.
Effect of Pei Yuan Tong Nao capsules on cerebral infarction
Authors: Chen Wangkun , Yu Junchi , Li Suting 
Published: March 2022

Abstract

Background:
Pei Yuan Tong Nao (PYTN) capsules has been widely used for the treatment of cerebrovascular disease, including cerebral infarction. However, the mechanisms of action of PYTN capsule on cerebral infarction are ambiguous and unclear. We conducted a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of PYTN capsules for the treatment of cerebral infarction.

Methods:
A comprehensive search of several databases from 1966 to February 2022 will be conducted. The databases includes Ovid Medline In-Process & Other NonIndexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Two authors independently performed the literature searching, data extraction, and quality evaluation. The risk of bias in each included study will be assessed utilizing the Cochrane Collaboration’s risk of bias tool. The Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) will be used to analyze the data.

Result:
A synthesis of current evidence of PYTN capsules for cerebral infarction will be provided in this protocol.

Conclusion:
This review will provide more reliable references to help clinicians make decisions when dealing with cerebral infarction.
Late-onset posttransplant Epstein-Barr virusrelated lymphoproliferative disease after cord blood transplantation for chronic active Epstein Barr virus infection
Authors: Yamamoto Masayo , Shindo Motohiro , Funayama Takuya , Sumi Chihiro , Saito Takeshi , Toki Yasumichi , Hatayama Mayumi , Imadome Ken-Ichi , Mizukami Yusuke , Okumura Toshikatsu 
Published: March 2022

Abstract

Introduction:
Posttransplant lymphoproliferative disease (PTLD) is a critical complication of hematopoietic stem cell transplantation (HSCT). PTLD is classified into early and late-onset PTLDs. In post-HSCT patients, late-onset PTLD is rare, particularly PTLD after HSCT for Epstein-Barr virus (EBV)-related lymphoproliferative disease. Here, we report the case of a patient diagnosed with late-onset EBV-related hemophagocytic lymphohistiocytosis (HLH), that of PTLD, after HSCT for chronic active EBV infection (CAEBV), that of EBV related lymphoproliferative disease, probably because of EBV reactivation.

Patient concerns and diagnosis:
A 22-year-old woman with abdominal fullness visited our hospital. Blood examination showed pancytopenia with atypical lymphocytes, liver dysfunction, and elevated lactate dehydrogenase level. In contrast, bone marrow aspiration showed slight hemophagocytosis with increased natural-killer cells (NK cells). As serum antibodies against EBV were atypical, we calculated the EBV-DNA level in peripheral blood and this level was significantly high. EBV was infected with NK cells, and EBV's monoclonality in NK cells was confirmed. Thus, the patient was diagnosed with CAEBV

Interventions and outcomes:
The patient received chemotherapy and cord blood cell transplantation (CBT); CAEBV was well controlled. Approximately 6years from CBT for CAEBV, she visited our hospital because of fever. Blood examination revealed pancytopenia with atypical lymphocytes, liver dysfunction, and elevated lactate dehydrogenase level. In contrast, bone marrow aspiration showed hemophagocytosis with increased B and T cell counts without increased NK cell count. Additionally, serum antibody titers against EBV were atypical, and the EBV-DNA level in the peripheral blood was high. EBV was infected with only B cells, and EBV's monoclonality was confirmed. A more detailed analysis indicated that EBV-specific cytotoxic T lymphocytes were inactive. Therefore, she was diagnosed with late-onset EBV-related HLH. She received extensive treatment, but EBV-related HLH did not improve. Finally, she died about 3 weeks after diagnosis.

Conclusion:
PTLD, including HLH, is a life-threatening complication after transplantation, including HSCT. To our knowledge, this is the first case of late-onset EBV-related HLH after CBT for CAEBV. Late-onset PTLD has an indolent clinical course, but our patient's disease course was extremely aggressive. Therefore, late-onset EBV-related PTLD may be life-threatening.
Evaluation of clinical safety and efficacy of left bundle branch area pacing in comparison with right ventricular septal pacing
Authors: Liu Xing , Li Wenbin , Zeng Jianping , Huang He , Wang Lei , Tian Shaohua , Wu Mingxing 
Published: March 2022

Abstract
Left bundle branch area pacing (LBBaP) has recently emerged as a new physiological pacing strategy. The purpose of this study is to compare LBBaP with right ventricular sepal pacing (RVSP) in terms of their clinical safety and efficacy.
From February 2019 to May 2020, consecutive pacing-indicated patients were prospectively enrolled and divided into 2 groups. Ventricular synchrony indexes such as QRS duration (QRSd), interventricular mechanical delay and septal-posterior wall motion delay, left ventricular function such as left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF), pacing parameters, and complications were evaluated in the perioperative period and during follow-up.
LBBaP was successful in 45 patients (88.2%), and finally 46 patients underwent RVSP. With LBBaP, ventricular electricalmechanical synchrony were similar to those of native-conduction system (P = .78). However, the ventricular electrical synchrony (QRSd, 108.47±7.64 vs 130.63±13.63ms, P < .001) and mechanical synchrony (interventricular mechanical delay, 27.68±4.33 vs 39.88±5.83, P < .001; septal-posterior wall motion delay, 40.39±23.21 vs 96.36±11.55, P < .001) in the LBBaP group were significantly better than those in the RVSP group. No significant differences in LVEDD (46 [44-48.5] vs 47 [44-52] mm, P = .49) and LVEF% (66 [62.5-70] vs 64 [61-68], P = .76) was observed between 2 groups at last follow-up. But, in the subgroup analysis, LVEDD was shorter (46 [44-49] vs 50 [47-58] mm, P = .03) and the LVEF% was higher (65 [62-68] vs 63 [58-65], P = .02) in the LBBaP-H (high ventricular pacing ratio >40%) group compared with RVSP-H group at last follow-up. There were lower capture thresholds (0.59±0.18V vs 0.71 ± 0.26 V, P = 0.01) at implantation in the LBBaP group than those in the RVSP group, with R-wave amplitudes and pacing impedances showing no significant difference between 2 groups. No serious complications were found in both 2 groups at implantation and follow-ups.
This study confirms the clinical safety and efficacy of LBBaP, and it produces better ventricular electrical-mechanical synchrony than RVSP. The event of pacing-induced left ventricular dysfunction is lower in the LBBaP-H group than RVSP-H group.
How to manage falls in hospitalized patients
Authors: Cioce Marco , Lohmeyer Franziska Michaela , Botti Stefano , Rostagno Elena , Orlando Laura , Vetrugno Giuseppe , Oppedisano Paolo , Zega Maurizio , Sica Simona , Valerio De Stefano , Bacigalupo Andrea , Fiore Alberto 
Published: March 2022

Abstract
In allogeneic hematopoietic stem cell transplantation (AHSCT), falls can lead to immediate and late consequences and in some cases to death. We analyzed risks and causes of falls with root cause analysis (RCA) based on which improvement interventions were implemented.
A retrospective observational study was conducted to analyze with RCA data of incidence reports and medical records of patients admitted; an expert panel identified actions to prevent falls, which were collected in a checklist.
Between December 2017 and November 2019, 214 patients were admitted to ordinary hospital stays for AHSCT or AHSCTrelated complications. In this period, 15 falls, involving 11 patients, occurred resulting in a 2.32 d/patient incidence. In 66.67% of cases minor head trauma occurred. Diuretic drugs (93.33%), induced hyper-diuresis in nonbladder catheter patients (93.33%) and antihypertensive drugs (93.33%) were reported as most common cause in our incident reports. The most frequent fall time slot was between 10 PM and 7 AM (60%). We determined with RCA diuretics and consequent induced hyper-diuresis (80%), self-insufficiency (40%), antihypertensive (33.3%) and noncompliance (33.3%) as the most common cause of falls. Finally, 16 actions, collected in a “safe comfort” checklist, were identified to prevent falls.
Diuretic drugs inducing hyper-diuresis, self-insufficiency, poor patient compliance, orthostatic hypotension, fever, night-time and obstacles within inpatient units are the most common contributing factors. Therefore, administration of diuretic and antihypertensive drugs should be rescheduled and a multidimensional risk assessment scale integrated with a preventive action plan, such as the safe comfort checklist, should be implemented to reduce falls.
Spontaneous Uterine Vessel Rupture During Pregnancy or in the Puerperium: A Review of the Literature
Authors: Mercier Ann Marie , Caldwell Madison G. , Rabie Nader Z. , Pagan Megan , Ramseyer Abigail M. , Magann Everett F. 
Published: March 2022

ImportanceSpontaneous perinatal rupture of a uterine vessel is a rare occurrence that may lead to severe hemorrhage and requires prompt identification and management.ObjectiveThe aim of this study was to examine the etiologies, locations, diagnostic tools, treatment options, and risks in subsequent pregnancies when spontaneous rupture of a uterine vessel occurs in pregnancy.Evidence AcquisitionA literature search was performed by university research librarians using the PubMed, CINAHL, and Web of Science search engines. Identified were 78 cases of perinatal spontaneous uterine vessel rupture and formed the basis for this review.ResultsIncreased uterine blood flow during pregnancy may alter the integrity of pelvic vessels leading to increased risk of spontaneous rupture. The uterine artery is the most common site of vessel rupture; the second most common site is the uterine-ovarian plexus. The most common presentation is abdominal or pelvic pain, maternal vital sign abnormalities, and an absence of vaginal bleeding. Exploratory laparotomy and embolization (interventional radiology) have been reported as management options.ConclusionsSpontaneous rupture of uterine vessels is a rare but potentially life-threatening complication of pregnancy that should be included in the differential diagnosis of pregnant patients presenting with an acute abdomen.RelevanceOur aim is to increase the awareness of spontaneous vessel rupture during pregnancy to improve detection, management, and perinatal outcomes.Target AudienceObstetrician-gynecologists, radiologists, family medicine physiciansLearning ObjectivesAfter completing this CME activity, participants should be better able to describe spontaneous uterine vessel rupture; identify its risk factors and presenting symptoms; and explain preferred diagnostic imaging modalities, management options, and possible complications in future pregnancies.
Differences in transcriptional response underlie why prior vaccination exceeds prior infection in eliciting robust immune responses in Omicron infected outpatients
Authors: Lee Hye Kyung , Knabl Ludwig , Walter Mary , Knabl Ludwig , Dai Yuhai , Füßl Magdalena , Caf Yasemin , Jeller Claudia , Knabl Philipp , Obermoser Martina , Baurecht Christof , Kaiser Norbert , Zabernigg August , Wurdinger Gernot M. , Furth Priscilla A. , Hennighausen Lothar 
Published: March 2022

AbstractAntibody response following Omicron infection is reported to be less robust than that to other variants. Here we investigated how prior vaccination and/or prior infection modulates that response. Disease severity, antibody responses and immune transcriptomes were characterized in four groups of Omicron-infected outpatients (n=83): unvaccinated/no prior infection, vaccinated/no prior infection, unvaccinated/prior infection and vaccinated/prior infection. The percentage of patients with asymptomatic or mild disease was highest in the vaccinated/no prior infection group (87%) and lowest in the unvaccinated/no prior infection group (47%). Significant anti-Omicron spike antibody levels and neutralizing activity were detected in the vaccinated group immediately after infection but were not present in the unvaccinated/no prior infection group. Within two weeks, antibody levels against Omicron, increased. Omicron neutralizing activity in the vaccinated group exceeded that of the prior infection group. No increase in neutralizing activity in the unvaccinated/no prior infection group was seen. The unvaccinated/prior infection group showed an intermediate response. We then investigated the early transcriptomic response following Omicron infection in these outpatient populations and compared it to that found in unvaccinated hospitalized patients with Alpha infection. Omicron infected patients showed a gradient of transcriptional response dependent upon prior vaccination and infection status that correlated with disease severity. Vaccinated patients showed a significantly blunted interferon response as compared to both unvaccinated Omicron infected outpatients and unvaccinated Alpha infected hospitalized patients typified by the response of specific gene classes such as OAS and IFIT that control anti-viral responses and IFI27, a predictor of disease outcome.
Persistent health issues, adverse events of significant concern, and effectiveness of COVID-19 vaccination- findings from a real-world cohort study of healthcare workers in north India
Authors: Kaur Upinder , Bala Sapna , Joshi Aditi , Srija Reddy Noti Taruni , Chetan  , Chauhan Mayank , Pedapanga Nikitha , Kumar Shubham , Mukherjee Anurup , Mishra Vaibhav , Talda Dolly , Singh Rohit , Gupta Rohit Kumar , Yadav Ashish Kumar , Rana Poonam Jyoti , Srivastava Jyoti , Bhat K Shobha , Singh Anup , PG Naveen Kumar , Pandey Manoj , Patwardhan Kishor , Kansal Sangeeta , Chakrabarti Sankha Shubhra 
Published: March 2022

AbstractBackgroundThere is paucity of real-world data on COVID-19 vaccine effectiveness and safety from cohort designs. The current study aimed to evaluate vaccine performance during second wave in India. It also aimed to determine adverse events of significant concern (AESCs), and to ascertain the effect of vaccination on persistent health issues in individuals post COVID-19.MethodsA cohort study was conducted from July-2021 to December-2021 in a tertiary hospital of north India. The primary outcome was vaccine-effectiveness against COVID-19. Secondary outcomes were AESCs, and persistent health issues in those receiving vaccine. Regression analyses were performed to determine risk factors.ResultsIn 2760 healthcare workers (HCWs) included, 1033 COVID-19 events were reported. Around 6-17% vaccine effectiveness was observed against COVID-19 occurrence. One dose-recipients were at 1.6-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate-severe COVID-19 by 57%. Those with lung disease were at 2.5-times increased risk of moderate-severe COVID-19. AESCs were observed in 1.3% including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times and those receiving vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues.ConclusionCOVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. Relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. Independent protection of prior SARS-CoV-2 infection was high and persistent health issues were common in individuals receiving vaccine post COVID-19. Recommendations of vaccinating those recovered from COVID-19 need further studies.