bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic effect of acupuncture and moxa combustion on prostate hyperplasia
Authors: Bo Huajun , Peng Jisheng , Zhuang Minzhi , Qiu Wenchao , Yu Qianqian , Yao Quanbao , Liang Huazheng 
Published: October 2022

Introduction:
Both acupuncture and moxibustion have been used for thousands of years in China for diverse conditions. But there are few reports on their combined effect in managing benign prostatic hyperplasia (BPH). To answer this question, we designed a prospectively study and the present protocol described details of this randomized controlled trial (RCT).

Methods:
In this RCT, an estimated number of 200 patients with BPH will be enrolled from Shanghai Fourth People’s Hospital, China. They will be assigned to either the combined therapy group or the conventional western medicine group in a ratio of 1:1. The International Prostate Symptom Score (IPSS) will be assessed as the primary outcome, other parameters, including the post-voiding residual urine volume, maximum flow rate (Qmax), and average flow rate (Qave), voiding time, and time to maximum flow, are secondary outcomes.

Discussion:
Results of this study will provide the theoretical basis for clinicians to select combined therapy or conventional western medicine treatments for BPH patients based on the efficacy of these therapies.

Trial registration:
chictr.org.cn, ID: ChiCTR2000030504/ChiMCTR2000003082. http://www.chictr.org.cn/edit.aspx?pid=47719&htm=4, Registered on 5th March 2020.
Effectiveness and safety of repetitive transcranial magnetic stimulation on memory disorder in stroke: A protocol for systematic review and meta-analysis
Authors: Xie Haihua , Xiong Dan , Zhu Pan , Li Hao , Zhang Hong , Tan Jie , Zhao Ning 
Published: October 2022

Background:
Approximately 23% to 55% of patients have memory impairments with a greatly negative effect on daily life 3 months after stroke. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the rehabilitation of stroke as it is safe, painless, and noninvasive. Moreover, few studies have investigated the effect of rTMS on poststroke memory disorder (PSMD). However, the efficacy of rTMS is not consistent and the optional stimulation frequency is unclear. Therefore, this protocol aims to evaluate the clinical effect and safety of rTMS on PSMD by analyzing results from randomized controlled trials.

Methods:
Search strategies will be performed on seven databases: PubMed, EMBASE, CENTRAL, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and Technology Periodical Database (VIP). Only randomized controlled trials registered before August 2021 will be included. Additionally, the language will be limited to English or Chinese. For the outcome, we will focus on the Rivermead Behavioral Memory Test. Additionally, the Montreal Cognitive Assessment, Mini-mental State Examination, Modified Barthel Index, and advent events will be included. Two authors will independently select the study, extract data, and assess quality. Moreover, disagreements will be resolved by the third author. STATA 14 and Review Manager 5.4 will be used to perform the analysis. We will evaluate bias risk in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. To assess the quality of evidence, the Grading of Recommendations Assessment, Development, and Evaluation method will be employed.

Results:
This study will provide a comprehensive analysis of the current evidence on rTMS for PSMD.

Conclusion:
A reliable conclusion regarding whether rTMS is an effective and safe intervention for patients with PSMD and the effect of stimulation frequency and sham stimulation will be provided. This study will provide new insights for TMS in treating PSMD, and offer appropriate treatmentoptions to patients and clinicians.

PROSPERO registration number:
CRD42021282439.
Art therapy as an adjuvant treatment for schizophrenia: A protocol for an updated systematic review and subgroup meta-analysis of randomized clinical trials following the PRISMA guidelines
Authors: Luo Xuexing , Zhang Zheyu , Zheng Zhong , Ye Qian , Wang Jue , Wu Qibiao , Huang Guanghui 
Published: October 2022

Background:
The efficacy of art therapy as an adjuvant treatment for schizophrenia remains inconclusive, and variation in the effects of art therapy on schizophrenia by the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations has never been systematically assessed. The objective of this study is to systematically evaluate the effects of art therapy on schizophrenia and to determine whether there are some potential influencing factors affecting the effects of art therapy.

Methods:
Seven online databases will be searched from their inception until June 30, 2022. All the relevant randomized clinical trials (RCTs) comparing art therapy plus standardized treatment versus standardized treatment alone for schizophrenia will be selected and assessed for inclusion. The Cochrane risk-of-bias tool will be used to evaluate the methodological quality of the included RCTs. Review Manager 5.4 will be used to analyze all the data obtained. Mental health symptoms are defined as the primary outcome, and the secondary outcomes include the Global Assessment of Functioning score, quality of life, functional remission, and the level of self-esteem. Subgroup analyses will be performed based on the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations.

Results:
The results will be published in a peer-reviewed journal.

Conclusions:
This updated systematic review and subgroup meta-analysis will evaluate the effects of art therapy as adjunctive treatment to standardized treatment in patients with schizophrenia and determine whether there are some potential confounding variables affecting the effects of art therapy on the outcomes of schizophrenia patients, thus strengthening the evidence base for the clinical application of this combination therapy for schizophrenia.
Increased frequency of angiotensin converting enzyme D allele in Chinese Han patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis
Authors: Wu Xiaozheng , Li Wen , Huang Gao , Luo Zhenliang , Chen Yunzhi 
Published: October 2022

Background:
To explore the association between Angiotensin Converting Enzyme (ACE) insert(I)/defect(D) gene polymorphism and the susceptibility to idiopathic pulmonary fibrosis (IPF).

Methods:
Searching PubMed, EMbase, CENTRAL, MEDLINE, CBM, China National Knowledge Infrastructure, WanFang Database and VIP Chinese Science database through a computer and collect the literature from China and foreign countries published before January 22, 2022. Screen the literatures and extract data such as first author, year of publication, diagnostic criteria and gene frequency, and draw a funnel chart and perform Begg’s Test and Egger’s test to evaluate publication bias. The influence analysis was performed for heterogeneous results and at the same time, the trial sequential analysis (TSA) was also conducted to confirm the robustness of the meta-analysis results. Registration number: CRD42021259341.

Results:
There were a total of 4 literatures (4 studies conducted in the Chinese Han population), and a total of 292 IPF patients and 351 healthy controls were included in this study. The results showed that in the Chinese Han population, the ACE I/D gene polymorphism was associated with the susceptibility of IPF (D vs I: [odds ratio, OR] = 0.53, 95% confidence interval [95%CI] [0.42, 0.67], P < .00001; DD vs II: [OR] = 0.37, 95%CI [0.24, 0.57], P < .00001; DD vs II + ID:[OR] = 0.30, 95%CI [0.21, 0.43], P < .00001), and the angiotensin II (Ang Ⅱ) level of IPF patients was higher than that of the control group (mean difference [MD] = 14.29, 95%CI [11.20,17.37], P < .00001).The TSA also confirmed that D allele was closely related to the susceptibility of IPF.

Conclusion:
In the Chinese Han population, the D allele of the ACE I/D gene polymorphism is associated with the susceptibility of IPF.
Gunao-Yizhi decoction combined with donepezil for vascular dementia: A systematic review and meta-analysis
Authors: Hu Yibin , Zhang Lijuan , Guan Xiuju , Hou Hanru , Bi Shuyue , Liu Changning , Li Mingxiang , Wang Kangfeng 
Published: October 2022

Background:
Gunao-Yizhi decoction has the effects of supplementing intelligence, strengthening marrow, resolving phlegm, and reducing turbidity. It is clinically used for the treatment of vascular dementia (VaD). However, there is still a lack of systematic evaluation of its efficacy and safety. This review conducted a systematic review of the current evidence on the efficacy and safety of Gunao-Yizhi decoction combined with donepezil for VaD.

Methods:
China National Knowledge Infrastructure (CNKI), Wanfang database (Wanfang), Chinese Science and Technology Periodical Database (VIP), China Biology Medicine disc (CBM), MEDLINE, EMBASE, and Cochrane Library were searched for randomized controlled trials on Gunao-Yizhi decoction combined with donepezil for VaD. RevMan 5.3 software was used for data analysis.

Results:
Twelve studies were obtained, including 1036 patients. Compared with donepezil alone, meta-analysis showed that Gunao-Yizhi decoction combined with donepezil could improve clinical efficacy, mini-mental state examination (MMSE) score, Hasegawa dementia scale (HDS), increase the level of superoxide dismutase (SOD) in serum, and reduce the level of malonaldehyde dismutas (MDA) in serum. The GRADE system was adopted to evaluate the outcome index. Clinical efficiency and the MMSE score were evaluated as very-low-quality evidence. HDS score, serum SOD level, and serum MDA level were evaluated as low-quality evidence.

Conclusion:
Gunao-Yizhi decoction combined with donepezil has a significant prevalence in the treatment of vascular dementia, with no increase in adverse events. Gunao-Yizhi decoction can be recommended for routine use in the treatment of VaD.
Assessment of stress management coaching among Nigerian pre-service history teachers: A randomized controlled study
Authors: Vita-Agundu Uche Calista , Eseadi Chiedu , Obasuyi Hero Usiomoefo , Sewagegn Abatihun Alehegn , Amedu Amos Nnaemeka 
Published: October 2022

Background:
Studies have found that pre-service teachers commonly face stressful circumstances that prevent them from completing their academic tasks effectively. In terms of psychological factors and interventions, pre-service history teachers in Nigeria are the least studied group. The objective of this study was to investigate the effect of stress management coaching among Nigerian pre-service history teachers.

Methods:
The research participants consisted of a randomized sample of 109 pre-service history teachers from Nigerian public higher education institutions (55 pre-service history teachers composed the stress management coaching group while 54 pre-service history teachers composed the waitlist control group). The stress management coaching for the pre-service history teachers was guided by a coaching manual created using the theoretical framework of rational emotive behavior coaching.

Results:
Pre-service history teachers who participated in stress management coaching showed significantly reduced stress levels at the post-test and follow-up. There was an interaction effect between group and time on the stress of pre-service history teachers.

Conclusion:
The study suggests that pre-service history teachers can benefit from a stress management coaching intervention that uses the rational emotive behavior coaching approach. The development of this form of stress management coaching program on a large scale among pre-service history teachers could prove beneficial to their academic and personal success. Studies may be conducted in the future to examine the stress of history teachers in colleges and the efficacy of stress management coaching.
Astrocytoma with myelin oligodendrocyte glycoprotein antibody associated encephalomyelitis: A case report
Authors: Zhong Guanghong , Zhang Jia , Liu Xi , Yang Shaoming , Gu Hongli 
Published: October 2022

Background:
Demyelination is similar with malignancy in clinical symptoms. Magnetic resonance imaging (MRI) is an important auxiliary examination in the diagnosis of demyelinating diseases and malignancy. Since MRI and symptoms can be difficult to distinguish demyelination from malignancy, other auxiliary examinations, such as demyelinating disease-specific antibodies, play an important role in distinguishing them. Previous studies have reported demyelinating disease-specific antibodies in patients with malignancy. What’s more, it is more difficult to confirm the diagnosis when the malignant tumor co-occurs with demyelinating diseases, which has never been reported in previous studies. We report the diagnosis of myelin oligodendrocyte glycoprotein antibody associated encephalomyelitis (MOG-EM) in a patient who had astrocytoma for several years.

Case presentation:
Patient’s concerns and diagnoses: our case report records a 49-year-old woman with astrocytoma for more than 4 years, who recently developed the symptoms of MOG-EM, including dizziness, vomiting, and vision loss. This astrocytoma patient was diagnosed with MOG-EM according to comprehensive evidence, including MRI, visual evoked potential (VEP), serum myelin oligodendrocyte glycoprotein antibody (MOG-IgG), and therapeutic effect. Interventions and outcomes: this patient was diagnosed with astrocytoma by surgical biopsy 4 years earlier. This patient has been treated with tumor resection, postoperative radiation treatment and chemotherapy. After treatment, the patient was left with right limb weakness while other symptoms were improved. Recently, the intravenous steroid agent was used to treat this patient after being diagnosed with MOG-EM. Dizziness, vomiting, and vision loss have gone into remission. This patient did not relapse in 7 months after discharge. This patient is still being followed up at the outpatient clinic. And the patient will next be treated with azathioprine.

Conclusions:
In previous studies, polyclonal antibody has been found in cancer patients, such as aquaporin-4 and MOG-IgG in astrocytoma patients. But the case of our study finds that astrocytoma can coexist with MOG-EM. Therefore, MOG-EM should not be excluded easily in astrocytoma patients when the relative antibody of encephalomyelitis is positive. What’s more, it reminds us that the pathogenesis of MOG-EM might be related to astrocytoma.
Clinical effectiveness of hypertonic sodium lactate infusion for intraoperative brain relaxation in patients undergoing scheduled craniotomy for supratentorial brain tumor resection: A study protocol of a single center double-blind randomized controlled phase II pilot trial
Authors: Besch Guillaume , Parmentier Anne-Laure , Berthier Francis , Jaeg Hélène , Villeneuve Julien , Hammoudi Fethi , Scaringella Nans , Clairet Anne-Laure , Vettoretti Lucie , Chopard Gilles , Thines Laurent , Ferreira David , Samain Emmanuel , Pili-Floury Sebastien 
Published: October 2022

Introduction:
Hyperosmolar solutions are prescribed in neurosurgery patients to provide satisfactory intraoperative brain relaxation and to lower cerebral injuries related to surgical retractors. Mannitol is traditionally considered as the first-choice solution for brain relaxation in neurosurgery patients. Hypertonic sodium lactate infusion was reported to provide a higher and longer osmotic effect compared to mannitol in severely brain-injured patients and to prevent impaired cerebral energetics related to brain injuries. To date, the clinical effectiveness of hypertonic sodium lactate infusion has never been studied in neurosurgery patients. The hypothesis of the study is that hyperosmolar sodium lactate infusion may provide satisfactory intraoperative brain relaxation in patients undergoing scheduled craniotomy for supratentorial brain tumor resection.

Methods and analysis:
We designed a phase II randomized, controlled, double-blind, single-center pilot trial, and aim to include 50 adult patients scheduled for craniotomy for supratentorial brain tumor resection under general anesthesia. Patients will be randomized to receive either mannitol (conventional group) or hypertonic sodium lactate (intervention group) infusion at the time of skin incision. Brain relaxation (primary outcome) will be assessed immediately after opening the dura by the neurosurgeon blinded to the treatment allocated using a validated 4-point scale. The primary outcome is the proportion of satisfactory brain relaxation, defined as brain relaxation score of 3 or 4.

Ethics and dissemination:
This study was approved by the Ethics Committee (Comité de Protection des Personnes Est III) and authorized by the French Health Authority (Agence Nationale de Sécurité des Médicaments, Saint-Denis, France). The University Hospital of Besancon is the trial sponsor and the holder of all data and publication rights. Results of the study will be submitted for publication in a peer-review international medical journal and for presentation in abstract (oral or poster) in international peer-reviewed congresses.

Registration:
The trial is registered with ClinicalTrials.gov (Identifier: NCT04488874, principal investigator: Prof Guillaume Besch, date of registration: July 28, 2020).
Hypoglycemia Management Using a Bundled Care Approach
Authors: Mattathil Reni 
Published: October 2022

ABSTRACT

Background:
Hypoglycemia is a leading cause of preventable hospitalization, and can increase morbidity, mortality, and length of hospital stay. Up to 35% of diabetic patients experience severe hypoglycemia during hospitalization; this concerns veterans, as 25% have been diagnosed with diabetes.

Local Problem:
A medical-surgical unit in a Veterans Affairs facility saw increased hypoglycemic episodes, with 26.8 episodes per 1000 patient days. Staff noted knowledge deficits with how to manage hypoglycemia episodes.

Methods:
A pre-/post-implementation quality improvement project was conducted over 8 weeks.

Interventions:
An implementation bundle was used to improve hypoglycemic episodes, including patient and staff education, coordination between meal delivery and insulin coverage, and developing a hypoglycemia protocol.

Results:
Hypoglycemia rates significantly decreased to 10.27 per 1000 patient days (P = .001), and occasions where insulin was given with food increased significantly to 76.2% (P < .001).

Conclusions:
A bundled approach was effective in decreasing hypoglycemia episodes and improved consistent management of hypoglycemia.
Validation of a Computational Phenotype to Identify Acute Brain Dysfunction in Pediatric Sepsis
Authors: Alcamo Alicia M. , Barren Gregory J. , Becker Andrew E. , Hayes Katie , Fitzgerald Julie C. , Balamuth Fran , Pennington Jeffrey W. , Curley Martha A. Q. , Tasker Robert C. , Topjian Alexis A. , Weiss Scott L. 
Published: October 2022

OBJECTIVES:
To validate a computational phenotype that identifies acute brain dysfunction (ABD) based on clinician concern for neurologic or behavioral changes in pediatric sepsis.

DESIGN:
Retrospective observational study.

SETTING:
Single academic children’s hospital.

PATIENTS:
Four thousand two hundred eighty-nine index sepsis episodes.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
An existing computational phenotype of ABD was optimized to include routinely collected variables indicative of clinician concern for acute neurologic or behavioral change (completion of CT or MRI, electroencephalogram, or new antipsychotic administration). First, the computational phenotype was compared with an ABD reference standard established from chart review of 527 random sepsis episodes to determine criterion validity. Next, the computational phenotype was compared with a separate validation cohort of 3,762 index sepsis episodes to determine content and construct validity. Criterion validity for the final phenotype had sensitivity 83% (95% CI, 76–89%), specificity 93% (90–95%), positive predictive value 84% (77–89%), and negative predictive value 93% (90–96%). In the validation cohort, the computational phenotype identified ABD in 35% (95% CI 33–36%). Content validity was demonstrated as those with the ABD computational phenotype were more likely to have characteristics of neurologic dysfunction and severe illness than those without the ABD phenotype, including nonreactive pupils (15% vs 1%; p < 0.001), Glasgow Coma Scale less than 5 (44% vs 12%; p < 0.001), greater than or equal to two nonneurologic organ dysfunctions (50% vs 25%; p < 0.001), and need for intensive care (81% vs 65%; p < 0.001). Construct validity was demonstrated by higher odds for mortality (odds ratio [OR], 6.9; 95% CI, 5.3–9.1) and discharge to rehabilitation (OR, 11.4; 95% CI 7.4–17.5) in patients with, versus without, the ABD computational phenotype.

CONCLUSIONS:
A computational phenotype of ABD indicative of clinician concern for new neurologic or behavioral change offers a valid retrospective measure to identify episodes of sepsis that involved ABD. This computational phenotype provides a feasible and efficient way to study risk factors for and outcomes from ABD using routinely collected clinical data.
Descriptive Analysis of Clinical Encounters by Emergency Medical Services Physicians Using the RE-AIM Framework
Authors: Rosenblum Andrew J. , Wend Christopher M. , Ide Reef A. , Owens Matthew A. , Cutchins V Clifford A. , Levy Matthew J. 
Published: October 2022

Context:
Emergency medical services (EMS) medicine continues to expand and mature as a recognized subspeciality within emergency medicine. In the United States, EMS physicians historically supported training, protocol development, and EMS clinician credentialing. In the past, only limited programs existed in which prehospital physicians were engaged in the direct and routine care of prehospital patients; however, a growing number of EMS programs are recognizing the value and impact of direct EMS physician involvement in prehospital patient care.

Program:
A large suburban, volunteer-based EMS agency implemented a volunteer prehospital physician program where providers routinely responded to emergency calls for service.

Implementation:
Beginning in November 2019, a cadre of board-certified physicians completed a field preceptorship and local protocol orientation. Once complete, the physicians were released to function and respond independently to high acuity emergency calls or any call at their discretion. Prehospital physicians were authorized to utilize their full scope of practice and expected to provide field mentorship to traditional prehospital clinicians.

Evaluation:
This study systematically evaluated a prehospital physician program for public health relevance, sustainability, and population health impact using the RE-AIM framework. A retrospective descriptive analysis was performed on the role and responses by a cohort of prehospital physicians using dispatch data and electronic medical records.

Discussion:
Over the 17-month study period, 9 prehospital physicians responded to 482 calls, predominately cardiac arrests, traumatic injuries, and cardiac/chest pain. The physicians performed 99 procedures and administered 113 medications. Ultimately, the program added physician-level care to the prehospital setting in an ongoing and sustainable way. The routine placement of physicians in the prehospital environment can help benefit patients by enhancing access to advanced clinical knowledge and skills, while also benefiting EMS clinicians through opportunities for enhanced patient-side training, education, and medical control.