Rejected

Background Influenza is commonly called the flu which is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs, usually a self-limiting, febrile disease of global importance. It occurs every year and infects the respiratory tract and can lead to sporadic, local outbreaks of widespread epidemics. The global burden of influenza epidemics on incidence rate and mortality is considerable. It is noted that patients with early coronavirus disease-2019 (COVID-19) have symptoms such as headache, nasal congestion, sneezing, and cough, which are like those of influenza. And the outbreak of COVID-19 coincided with the winter and spring season in the northern hemisphere with a high incidence of influenza. And it leads to the public's attention to influenza. Method In order to better clarify the social concern of Chinese people about "influenza" during the COVID-19 pandemic, this study conducted a trends analysis using the Baidu index from January 1, 2018, to January 1, 2022, and compared the public's search index with "COVID-19" during this period. This study used ArcGIS version 10.4 (https://www.esri.com/) to conduct a Global Moran's I analysis of the public concern of "influenza" in 31 provinces (municipalities directly under the central government and autonomous regions) in China from 2018 to 2021, except for Hong Kong, Macao, and Taiwan and a Local Moran's I of the "influenza" concern in 2018 and 2021. Results We observed that before the outbreak of COVID-19, the search trend of the public for "influenza" was concentrated in the winter and spring of each year, showing seasonal characteristics. However, after the outbreak of COVID-19, the public's search trend for "influenza" increased sharply, and then it leveled off. This shows completely that there is a certain correlation between the COVID-19 outbreak and the online search for "influenza". Regarding the Global Moran's I, the spatial clustering of national "influenza" concerns was observed. During the COVID-19 pandemic, the spatial correlation between the magnitude of public concern and the spatial correlation became larger as the number of years increased and is greater than that before the outbreak of the COVID-19 pandemic. The results of Local Moran's I showed that the main types of local spatial autocorrelation in 2018 and 2021 were both positive high-high correlations, but the former was mainly concentrated in the eastern coastal region, while the latter began to spread to the central region. Conclusion The analysis of the Baidu Index shows that during the COVID-19 pandemic, the public's interest in "influenza" first increased and then decreased, and then remained at a trough, no longer showing the seasonal change characteristics before the outbreak of the COVID-19, indicating that there may be a correlation between COVID-19 and "influenza". The Moran's I indicate that the national "influenza" concern is spatially clustered, while the spatial correlation is increasing and greater than before the outbreak of the COVID-19 pandemic. This is most likely related to the daily update of information related to patients with COVID-19. Meanwhile, the "high-high" local clustering of "influenza" concerns in the central and eastern regions during the COVID-19 pandemic is related to the frequent human and logistic exchanges in the central and eastern regions, which contributed to the spread of the disease.

And importance: The most common postoperative complications after inguinal hernia repair are hernia recurrence, hematoma, seroma, wound infection, chronic pain, numbness and swelling. The aim of this case report is to present a rare complication of inguinal hernia repair, a large scrotal abscess that was caused by an inoculated scrotal hematoma 3 months after Transabdominal Preperitoneal bilateral inguinal hernia repair.

Fixed drug eruptions (FDEs) are dermatological manifestations of drug reactions that often occur in the same location upon re-exposure to a drug. They usually appear as erythematous-violaceous, circular patches, but several different variants have been described. They can often present without any associated symptoms, but in some cases, patients may complain of pain and pruritus. The lesions are often underdiagnosed or mistaken for insect bites, urticaria, or erythema multiforme; thus, an effort to bring awareness to this condition is warranted. We present a 33-year-old African-American female who presented to the urgent care presenting with several violaceous patches of varying sizes that started two days ago. The lesions were located on the left shoulder, abdomen, right flank region, and behind the right knee. The lesions were associated with mild pain and pruritus. She believed she was bit by insects but denied seeing any insects at home or participating in any recent outdoor activities. She stated that she had a similar rash in the exact locations five months ago. Upon survey of new medications, she stated that she recently started taking her medications again, which include: hydrochlorothiazide, semaglutide, vitamin D supplement, and ibuprofen. Examination of the skin revealed several black, non-blanching macules with a surrounding ring of erythema on the left shoulder (3 x 3cm), abdomen (4 x 3cm), right popliteal region (3 x 2cm), and right flank region (6 x 7 cm). She was prescribed a medium-dose topical steroid cream to apply to the skin twice a day to decrease the intensity of the inflammatory reaction and thus relieve her symptoms. She was also educated on FDEs and was advised to discontinue Ibuprofen, one of the most commonly implicated drugs in FDEs. Upon returning for a follow-up four weeks later, she noted that she discontinued Ibuprofen, and her cutaneous reactions had fully resolved. This case illustrates the prompt and accurate diagnosis of FDE leading to discontinuation of the offending drug and resolution of symptoms. It also represents the essential questions to ask when suspecting FDE.

Abnormal stepping strategies have been associated with handheld tasks in subjects with chronic low back pain (LBP). However, the dominant ankle reactions of subjects with LBP remain unclear following a perturbation during handheld tasks.

Transcutaneous auricular vagus nerve stimulation (taVNS) refers to stimulation of the vagus nerve through the skin of the left cymba conchae and is a unique strategy that is investigated as a useful therapeutic approach for a variety of conditions including epilepsy, depression, cardiac diseases, tinnitus, and migraine. A randomized double-blind clinical trial was performed in patients with drug-resistant epilepsy. Although several pilot studies were performed before this trial and showed that taVNS was safe, well tolerated, and feasible for long-term treatment, no statistically significant difference was observed between the high- and low-stimulation groups, and further studies are warranted to gain a deeper understanding of this subject. A tingling sensation or pain at the site of stimulation is the most common adverse effect associated with taVNS. Therefore, intermittent stimulation, ranging from 30 minutes to several hours, is provided during each session several times a day. Currently, taVNS is not approved for insurance coverage by the Japan Ministry of Health, Labour, and Welfare. Further studies and investigations are necessary in the near future.

Guidelines for evaluating patients with suspected coronary artery disease (CAD) recommend pretest probability (PTP) estimation but provide no clear recommendations regarding diagnostic testing in patients with >5% to 15% risk of obstructive CAD. The diagnostic and prognostic value of PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) minimal risk score (PMRS) calculation in this patient group is unknown.

One of the most common fractures in the elderly population is a fracture of the neck of femur. Effective post-operative analgesia is a major challenge. Age-related co-morbidities restrict the choice of analgesics. The purpose of this study was to compare the efficacy and safety of transdermal buprenorphine [TDB] patch and conventional analgesics following hemiarthroplasty for intra-capsular fracture neck of femur.

There are differences in the clinical treatment schemes for patients with different severities of herpes zoster (HZ). Therefore, effective and accurate evaluation of disease severity is of great significance for the formulation of treatment plans. Postherpetic neuralgia (PHN) with long-term chronic pain leads to anxiety, depression, and even suicidal thoughts, which place a heavy burden on society and the family. Therefore, identifying risk factors and taking early intervention to reduce the occurrence of PHN is meaningful. Electromyography (EMG) can provide technical support for the early diagnosis of peripheral neuropathy. However, the application of EMG in HZ and PHN has rarely been reported. The purpose of this study was to compare the detection indices of EMG in patients with different severities and prognoses of HZ and to analyze the application of EMG in severity and prognosis of HZ.

85%-95% of patients with cancer experience chemotherapy-induced peripheral neuropathy (CIPN), which may lead to neuropathic pain, emotional distress, functional difficulties, and interpersonal problems. Although exercise interventions have been proposed for improving and preventing CIPN, evidence regarding the efficacy of these interventions has been inconsistent and of inadequate quality. In addition, few domestic systematic reviews have examined the effects of exercise on CIPN.