bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of an Electronic Algorithm to Target Outpatient Antimicrobial Stewardship Efforts for Acute Bronchitis and Pharyngitis
Authors: Lautenbach Ebbing , Hamilton Keith W , Grundmeier Robert , Neuhauser Melinda M , Hicks Lauri A , Jaskowiak-Barr Anne , Cressman Leigh , James Tony , Omorogbe Jacqueline , Frager Nicole , Menon Muida , Kratz Ellen , Dutcher Lauren , Chiotos Kathleen , Gerber Jeffrey S 
Published: June 2022

Abstract

Background
A major challenge for antibiotic stewardship programs is the lack of accurate and accessible electronic data to target interventions. We developed and validated separate electronic algorithms to identify inappropriate antibiotic use for adult outpatients with bronchitis and pharyngitis.

Methods
We used International Classification of Diseases, 10th Revision, diagnostic codes to identify patient encounters for acute bronchitis and pharyngitis at outpatient practices between 3/15/17 and 3/14/18. Exclusion criteria included immunocompromising conditions, complex chronic conditions, and concurrent infections. We randomly selected 300 eligible subjects each with bronchitis and pharyngitis. Inappropriate antibiotic use based on chart review served as the gold standard for assessment of the electronic algorithm, which was constructed using only data in the electronic data warehouse. Criteria for appropriate prescribing, choice of antibiotic, and duration were based on established guidelines.

Results
Of 300 subjects with bronchitis, 167 (55.7%) received an antibiotic inappropriately based on chart review. The electronic algorithm demonstrated 100% sensitivity and 95.3% specificity for detection of inappropriate prescribing. Of 300 subjects with pharyngitis, 94 (31.3%) had an incorrect prescribing decision. Among 29 subjects with a positive rapid streptococcal antigen test, 27 (93.1%) received an appropriate antibiotic and 29 (100%) received the correct duration. The electronic algorithm demonstrated very high sensitivity and specificity for all outcomes.

Conclusions
Inappropriate antibiotic prescribing for bronchitis and pharyngitis is common. Electronic algorithms for identifying inappropriate prescribing, antibiotic choice, and duration showed excellent test characteristics. These algorithms could be used to efficiently assess prescribing among practices and individual clinicians. Interventions based on these algorithms should be tested in future work.
Health consequences of early-onset compared with late-onset type 2 diabetes mellitus
Authors: Hou Can , Yang Huazhen , Qu Yuanyuan , Chen Wenwen , Zeng Yu , Hu Yao , Narayan K M Venkat , Song Huan , Li Dong 
Published: June 2022

ABSTRACT

Background
Although cumulating evidence has suggested that early-onset type 2 diabetes mellitus (T2DM) conferred on patients a broader tendency for complications beyond vascular ones, a comprehensive analysis of patterns of complications across all relevant systems is currently lacking.

Method
We prospectively studied 1 777 early-onset (age at diagnosis ≤ 45 years) and 35 889 late-onset (&gt;45 years) T2DM patients with matched unexposed individuals from the UK Biobank. Diabetes-specific and -related complications were examined using phenome-wide association analysis, with patterns identified by comorbidity network analysis. We also evaluated the effect of lifestyle modifications and glycemic control on complication development.

Results
The median follow-up times for early-onset and late-onset T2DM patients were 17.83 and 9.39 years, respectively. Compared to late-onset T2DM patients, patients with early-onset T2DM faced a significantly higher relative risk of developing subsequent complications that primarily affected sense organs [hazard ratio (HR) 3.46 vs. 1.72], the endocrine/metabolic system (HR 3.08 vs. 2.01), and the neurological system (HR 2.70 vs. 1.81). Despite large similarities in comorbidity patterns, a more complex and well-connected network was observed for early-onset T2DM. Furthermore, while patients with early-onset T2DM got fewer benefits (12.67% reduction in pooled HR for all studied complications) through fair glycemic control (median HbA1c ≤ 53 mmol/mol) compared to late-onset T2DM patients (18.01% reduction), they seemed to benefit more from favorable lifestyles, including weight control, healthy diet, and adequate physical activity.

Conclusions
Our analyses reveal that early-onset T2DM is an aggressive disease resulting in more complex complication networks than late-onset T2DM. Aggressive glucose-lowering intervention, complemented by lifestyle modifications, are feasible strategies for controlling early-onset T2DM-related complications.
Historical Markers or Markers of White Supremacy? Confederate Memorialization, Racial Threat, and Hate Crime
Authors: Lantz Brendan , Wenger Marin R , Malcom Zachary T 
Published: June 2022

Abstract
Many Confederate monuments were erected during the Jim Crow era, sending symbolic messages of intimidation and hostility to the Black population. Yet no studies have examined the relationship between contemporary Confederate memorialization and bias crime. Drawing from research on hate crime law compliance, we posit an inverse relationship between Confederate monuments and mobilization of hate crime law, such that compliance with hate crime laws will be lower in communities with memorialization, but that among complying agencies, anti-Black hate crime rates will be higher. To examine these relationships, we combined data from the Uniform Crime Report Hate Crime Statistics and the American Community Survey with Confederate monument data from the Southern Poverty Law Center. We conducted analyses predicting a) monument presence, b) agency non-compliance, and c) anti-Black hate crime. Results indicate that monuments are located in communities exemplifying a challenge to racial hierarchies: economically advantaged communities with larger Black populations. Regarding hate crime, analyses show that (1) the American South is associated with reduced compliance, and, (2) after accounting for compliance, Confederate memorialization is associated with increased anti-Black hate crime. These findings have implications for intergroup conflict and the impact of local symbolism on the formal mobilization of hate crime law.
Knockdown of circ_CDYL Contributes to Inhibit Angiotensin II–Induced Podocytes Apoptosis in Membranous Nephropathy via the miR-149-5p/TNFSF11 Pathway
Authors: Qiu Donghao , Zhao Ning , Chen Qi , Wang Ming 
Published: June 2022

Abstract:
Circular RNAs (circRNAs) have been verified as vital regulators in various diseases, including membranous nephropathy (MN). Therefore, the role of circ_CDYL in podocyte apoptosis and MN was investigated. The real-time quantitative polymerase chain reaction was performed to measure the expression of circ_CDYL, microRNA-149-5p (miR-149-5p), and tumor necrosis factor superfamily member 11 (TNFSF11) in podocytes. In addition, angiotensin II (Ang II) was used to induce apoptosis of podocytes. The apoptosis-related protein expression was quantified by western blot assay. The apoptosis of podocytes was evaluated by flow cytometry assay. The interaction relationship between miR-149-5p and circ_CDYL or TNFSF11 was confirmed by dual-luciferase reporter assay. Circ_CDYL was significantly overexpressed in MN patients and Ang II–induced podocytes compared with control groups. Importantly, loss-of-functional experiments indicated that knockdown of circ_CDYL protected podocytes from Ang II–induced apoptosis. MiR-149-5p was verified as target of circ_CDYL and negatively correlated with circ_CDYL expression in MN patients. Knockdown of circ_CDYL–mediated effects on Ang II–induced podocyte cells were abolished by silencing miR-149-5p. Besides, the upregulation of miR-149-5p could suppress apoptosis in Ang II–induced podocyte cells by targeting TNFSF11. Under Ang II stimulation, the upregulation of TNFSF11 could increase the expression of TNFSF11 and induce apoptosis in circ_CDYL-silencing podocytes. Our results confirmed that circ_CDYL specifically targeted miR-149-5p/TNFSF11 pathway to regulate Ang II–induced apoptosis in podocytes, which might be useful diagnostic biomarkers in MN.
Dantrolene for Generalized Tetanus in Pediatrics
Authors: Khan Natasha , Zulfiqar Fizza , Hollander Leanna , Johnson Travis , Lamsal Riwaaj 
Published: June 2022

Abstract
There are only sporadic cases of tetanus in children in the United States. We describe an unimmunized child with generalized tetanus who required nearly a month of mechanical ventilation with analgesia, sedation, and neuromuscular blockade. Dantrolene showed benefit in spasm control and patient comfort when used in combination with other drugs.
Correlations among the Mandarin Voice Handicap Index, its shortened version, and the Voice-Related Quality of Life Measure for laryngectomees
Authors: Wang Chen-Chi , Liao Jia-Shiou 
Published: June 2022

Background:
The Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL) are seldom administered to alaryngeal patients who use pneumatic artificial larynx (PAL) and esophageal speech (ES). As such, the specificity of VHI and 10-item VHI (VHI-10) for assessing voice-related changes in such patients is unclear. Accordingly, this study investigated the correlation between scores on the VHI, its shortened version (VHI-10), and the V-RQOL for Mandarin-speaking laryngectomees using PAL and ES, with the aim of establishing which of these instruments is suited to such patients.

Methods:
The participants comprised 126 PAL and 26 ES patients from Taiwan who completed the Mandarin VHI and V-RQOL. Fifty-two of these alaryngeal participants then completed both those instruments a second time, between 8 and 64 days later.

Results:
One item appearing in both the Mandarin long-form VHI and the VHI-10 was excluded because more than half the participants left it unanswered. The correlation of scores on the remaining 29 items on the former with the nine on the latter was high (r = 0.968), while that between the former and V-RQOL scores was moderate (r = −0.569), as was the correlation between short-form VHI and Mandarin V-RQOL scores (r = −0.582). Structural equation modeling was then used as the basis for simplifying the Mandarin long-form VHI into a new 10-item VHI specifically for alaryngeal Mandarin speakers (MA-VHI-10), to eliminate the scoring effect of the original VHI’s and VHI-10’s work-related item. MA-VHI-10 scores were highly correlated with those on the Mandarin long-form VHI (r = 0.983).

Conclusion:
The Mandarin versions of long-form VHI, short-form VHI, and MA-VHI-10 are interchangeable for a Mandarin-speaking alaryngeal population. However, neither of the former two instruments should be substituted for the V-RQOL.
The study of cancer cell in stromal environment through induced pluripotent stem cell–derived mesenchymal stem cells
Authors: Loh Jit-Kai , Wang Mong-Lien , Cheong Soon-Keng , Tsai Fu-Ting , Huang Shu-Huei , Wu Jing-Rong , Yang Yi-Ping , Chiou Shih-Hwa , Ong Alan Han-Kiat 
Published: June 2022

Background:
The development of mesenchymal stem cells (MSCs) has gained reputation from its therapeutic potential in stem cell regeneration, anti-inflammation, tumor suppression, and drug delivery treatment. Previous studies have shown MSCs have both promoting and suppressing effects against cancer cells. While the limitation of obtaining a large quantity of homologous MSCs for studies and treatment remains a challenge, an alternative approach involving the production of MSCs derived from induced pluripotent stem cells (iPSCs; induced MSCs [iMSCs]) may be a promising prospect given its ability to undergo prolonged passage and with similar therapeutic profiles as that of their MSC counterparts. However, the influence of iMSC in the interaction of cancer cells remains to be explored as such studies are not well established. In this study, we aim to differentiate iPSCs into MSC-like cells as a potential substitute for adult MSCs and evaluate its effect on non-small-cell lung cancer (NSCLC).

Methods:
iMSCs were derived from iPSCs and validated with reference to the International Society of Cellular Therapy guidelines on MSC criteria. To create a stromal environment, the conditioned medium (CM) of iMSCs was harvested and applied for coculturing of NSCLC of H1975 at different concentrations. The H1975 was then harvested for RNA extraction and subjected to next-generation sequencing (NGS) for analysis.

Results:
The morphology of iMSCs-CM–treated H1975 was different from an untreated H1975. Our NGS data suggest the occurrence of apoptotic events and the presence of cytokines from H1975’s RNA that are treated with iMSCs-CM.

Conclusion:
Our results have shown that iMSCs may suppress the growth of H1975 by releasing proapoptotic cytokines into coculture media. Using iPSC-derived MSC models allows a deeper study of tumor cross talk between MSC and cancer cells that can be applied for potential future cancer therapy.
Surgical outcome of benign cases with pelvic adhesions undergoing robotic total hysterectomy
Authors: Wang Pei-Yi , Lee Yu-Chieh , Liu Wei-Min , Chen Ching-Hui 
Published: June 2022

Background:
Robotic total hysterectomies have been considered contraindicated for patients with intra-abdominal adherences, but the evidence for this is not strong, and we hypothesized that the procedure can be of benefit even in these cases. In our research, we analyzed how the severity of pelvic adhesions affects robotic total hysterectomy, and by comparing different types of adhesions, we can further identify the outcomes differences in between, which may aid in future surgical decision making.

Methods:
Prospective cohort study (Canadian Task Force classification II-2). All 410 patients with uterine myoma or adenomyosis undergoing robotic total hysterectomies between 2011 and 2016 using the da Vinci Si system by the same surgeon in Taipei Medical University Hospital were included in the study.

Results:
Baseline characteristics, blood loss, docking time, operation time, time to perform uterine artery ligation (UAL), pain score, hospital stay, complication rate, and laparotomy conversion rate were analyzed between benign cases with or without pelvic adhesions undergoing robotic total hysterectomy. Furthermore, in our subgroups analysis, we have divided the patients with adhesion into different groups according to the severity of adhesion. The abdomen and pelvic cavity was divided into nine sections, and the outcomes of different adhesion condition were compared. We found that patients with adhesions had increased docking time and operation time, but other differences between groups were not statistically significant. The results of the adhesion group showed no significant increases in blood loss, intra- and postoperative complications, and length of hospital stay. Only significantly longer surgical time compared with the normal group was noted.

Conclusion:
Our results suggest that robotic total hysterectomies with UAL are effective and safe for patients with benign gynecologic conditions, and the surgical method should be considered even for patients with adhesion risks.
The efficacy and safety of non-resistance manual therapy in inpatients with acute neck pain caused by traffic accidents
Authors: Kim Suna , Kyeong Da-Hyun , Kim Min-Kyung , Kim Chang-Yeon , Lee Yoon Jae , Lee Jinho , Ha In-Hyuk , Park Kyoung Sun 
Published: June 2022

Abstract

Background:
Neck pain and functional impairment are common complications of traffic accidents (TAs); however, the effects of manual therapy on these symptoms have rarely been studied in the literature. Thus, this randomized controlled trial aims to assess the effectiveness and safety of non-resistance manual therapy (NRT)—a treatment combining mobilization and pressure release techniques—on acute neck pain caused by TA.

Method:
This study will use a two-armed, parallel, assessor-blinded randomized controlled trial design and will be conducted in the Daejeon Jaseng Hospital of Korean Medicine in South Korea. One hundred twenty patients will be recruited and randomized into an integrative Korean medicine treatment (IMKT) + NRT group and IMKT group in a 1:1 ratio. The primary outcome is a change in the numeric rating scale for neck pain immediately after treatment on hospital day 5 compared to those at baseline. The secondary outcomes are numeric rating scale for radiating arm pain, visual analogue scale for neck pain and radiating arm pain, cervical active range of motion, neck disability index, Patient Global Impression of Change, Short Form-12 Health Survey, and Posttraumatic Stress Disorder Checklist for DSM-5.

Discussion:
The findings of this study on the effectiveness and safety of NRT will be helpful for patients with TA-induced neck pain in clinical practice and will provide evidence for developing relevant healthcare-related policies.

Trial registration:
This protocol has been registered at Clinicaltrials.gov (NCT04660175).
The effect of 0.01% atropine on ocular axial elongation for myopia children
Authors: Gao Yue , Yu Yan 
Published: June 2022

Abstract

Background:
Orthokeratology (OK) has a significant effect on the control of myopia progression, and has been accepted by doctors and patients. A small number of studies have shown that the combination of OK and atropine can enhance myopia control. However, owing to individual differences, research groups, drug concentrations, and research design differences, the safety and effectiveness of the combined treatment still need to be verified. Therefore, the present meta-analysis aimed to determine the effect of 0.01% atropine on ocular axial elongation in myopic children.

Methods:
We searched the PubMed, Cochrane Library, and CBM databases from inception to March 1, 2022. Meta-analysis will be conducted using STATA version 14.0 and Review Manager version 5.3 softwares. We calculated the weighted mean differences (WMD) to analyze the change in ocular axial length (AL) between orthokeratology combined with 0.01% atropine (OKA) and OK alone. Cochran's Q-statistic and I
2 test were used to evaluate the potential heterogeneity between studies. A sensitivity analysis was performed to evaluate the influence of single studies on the overall estimate. We will also perform subgroup and meta-regression analyses to investigate potential sources of heterogeneity. We will conduct Begger's funnel plots and Egger's linear regression tests to investigate the publication bias.

Results:
This systematic review aimed to determine the effect of 0.01% atropine on ocular axial elongation in children with myopia.

Conclusions:
These findings provide helpful evidence for the effect of 0.01% atropine on ocular axial elongation in myopic children.
Anesthetic management of hip fracture in geriatric patient with respiratory and heart failure using pericapsular nerve group block
Authors: Niu Zejun , Xu Xiaolin , Chu Haichen , Yin Jihui 
Published: June 2022

Abstract

Introduction:
Hip fracture with severe cardiopulmonary and cerebral dysfunction is a relatively common problem in the elderly population and poses a great challenge to anesthetic management. Pericapsular nerve group (PENG) block combined with nerve blocks of the hip region has recently attracted significant interest from anesthesiologists, and very few reports on its anesthetic management exist.

Patient concerns:
Patient suffered from the right femoral neck fracture, combined with respiratory failure, heart failure, moderate-to-severe pulmonary hypertension, cerebral infarction, atrial fibrillation, and cognitive dysfunction.

Diagnosis:
Because of right femoral neck fracture, artificial femoral head replacement was scheduled for this patient.

Interventions:
Ultrasound-guided PENG block combined with sacral plexus, thoracic 11 to 12 paravertebral block, and lateral femoral cutaneous block were performed to a high-risk elderly patient.

Outcomes:
The patient successfully received artificial femoral head replacement with our effective anesthesia techniques and no postoperative complication was reported.

Conclusions:
Among elderly patients with multiple organ dysfunction undergoing hip surgery, PENG block combined with nerve blocks of the hip region is an ideal anesthesia method. This case demonstrated that these regional analgesia techniques had a stable hemodynamic process, satisfactory anesthetic effect, effective postoperative analgesia, and no effect on postoperative cognitive function. Further studies are needed to determine the appropriate doses of local anesthetics in the elderly with multiple organ system failure to reduce delayed local anesthesia systemic toxicity.
Intramuscular administration of autologous total immunoglobulin G induces immunomodulatory effects on T cells in healthy human subjects
Authors: Kwon Byul , Yang Seung-Jung , Cho Su-Mi , Kim Myoung-Eun , Nahm Dong-Ho 
Published: June 2022

Abstract

Background:
We hypothesized that intramuscular administration of autologous total immunoglobulin G (IgG) could induce an immunomodulatory effect in human subjects. In our previous studies, we showed that intramuscular administration of autologous total IgG could induce significant clinical improvements and increases of the serum levels of interleukin-10 (IL-10) and interferon-gamma (IFN-γ) in patients with atopic dermatitis.

Objective:
To investigate the mechanism of immunomodulation induced by intramuscular administration of autologous total IgG, we evaluated changes in T cells before and after intramuscular administrations of autologous total IgG in this study.

Methods:
Thirteen healthy adults received 8 intramuscular injections of 50 mg autologous total IgG for 4 weeks (from week 0 to week 4). The percentages of IL-10- or IFN-γ-producing peripheral blood T cells, as well as serum levels of IL-10, IFN-γ, and immunoglobulins, were measured at baseline (week 0) and at weeks 4, 8, and 12.

Results:
The percentage of IL-10-producing CD4+ T cells was significantly increased at weeks 8 and 12 compared to baseline (P < .05), while the percentage of IFN-γ-producing CD3+ T cells was significantly increased at week 12 compared to baseline (P < .05). There were no significant differences in the serum levels of IL-10, IFN-γ, and immunoglobulins before and after intramuscular administration of autologous total IgG (P > .05). No serious adverse events were observed.

Conclusion:
Intramuscular administration of autologous total IgG induced immunomodulatory effects on T cells in healthy human subjects. This simple intervention could be a safe, effective, and economical T cell immunomodulation method for human subjects (NCT03695757).
Outcomes of an Innovative Best Practice Clinical Immersion Framework
Authors: King Simmy , Cieslowski Bethany , Pope Denise , Winkfield Devora 
Published: June 2022

Background:
Academic nursing has a long history of partnering with practice-based settings to provide clinical learning experiences for nursing students; however, these placements are not easily obtained, especially in pediatrics.

Approach:
A freestanding academic pediatric hospital and 3 academic nursing programs collaborated to provide clinical practice to nursing students hired in a practice-based internship program. A second aim was to pilot a best practice clinical immersion framework to provide academic credit to bachelor of science in nursing (BSN) students using a shared clinical syllabus and e-learning platform.

Outcomes:
Sixteen nursing students successfully completed the program; 11 (68.7%) completed the pre- and postevaluation with significant (P < .05) changes in scores for 7 of the 20 questions.

Conclusion:
This best practice clinical immersion framework provided a strategy for obtaining clinical practice and academic credit, demonstrating the potential of innovative practice-academic partnerships. Further, this framework can be easily adapted in other practice-academic partnerships in all clinical areas.