bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of milk and dairy consumption on the development and progression of breast cancer
Authors: Patnaik Kakoli , Sharma Nitin , Thadani Deepa 
Published: December 2024

Abstract
Recent studies have shown a link between the consumption of bovine milk and human breast cancer, apparently by agonizing the estrogen receptor (ER), which results in the proliferation of the breast tissues, leading to formation of a tumor. Bovine milk may also promote tumor formation via insulin-like growth factor-1 (IGF-1) signaling. In addition, numerous potentially carcinogenic compounds have been found in bovine milk, including exosomal microRNAs (miR-148a-3p, miR-21-5p), aflatoxin M1, bisphenol A, pesticides, and micro- and nanoplastics. Subjects with specific genetic mutations (e.g., BRCA1 loss-of-function) and polymorphisms (e.g., FTO and IGF-1 upregulation) that enhance IGF-1/mTORC1 signaling might be especially susceptible to ER+ breast cancer promoted by the consumption of bovine dairy products. However, in the previous large-scale meta-analyses, data about the milk processing methods, such as pasteurization and ultra-high temperature treatment, are lacking, thus limiting the accuracy of risk assessments. Clearer and more convincing evidence, detailed milk processing information, and data regarding the timing of exposure (consumption) are required because the current evidence suggests that the dietary recommendations regarding milk and dairy consumption may need to be reevaluated.
Integrating Worker Health Education in Community Agencies to Address Immigrant Worker Health: A Pilot Implementation Trial
Authors: Tsai Jenny Hsin-Chun , Herting Jerald R. 
Published: December 2024

Abstract

Objective
This pilot trial aimed to determine implementation processes and outcomes to integrate Basic Worker Health Education (WHEB) in co-ethnic, not directly worker-focused, community agencies that function as cultural-linguistic brokers and service providers to immigrants.

Methods
A Chinese WHEB prototype was developed and implemented at Chinese, Pan-Asian, and nonprofit community-based and Chinese faith-based organizations (N = 8). The implementation process (delivery model choice and areas for change) and outcomes (suitability and adoption sustainability) were evaluated qualitatively.

Results
The agencies selected four delivery models. Five agencies reached ≥70% of their target goal. Respondents described the chosen delivery models as suitable for the varying agency contexts. Three agencies continued WHEB; reasons for continuing or not continuing were identified.

Conclusions
Findings highlight strategies to enhance the uptake and diffusion of worker health educational interventions in community settings.
Rapid COVID-19 Testing of Symptomatic Health Care Personnel: A Strategy for Safely Maintaining the Workforce
Authors: McNicholas James E. , Whitman Jeffrey D. , Tulsky Jacqueline P. , Villanueva Allyson H. , Kang Joy , Blanc Paul D. , Solomon Gina M. , Jacobson Mark A. 
Published: December 2024

STRUCTURED ABSTRACT

Objective
Determine performance characteristics and safety outcomes of two rapid COVID-19 screening methods to inform immediate return to work (RTW) decisions while (health care personnel) HCP await results of pending confirmatory laboratory test.

Methods
Retrospective, occupational health quality improvement study comparing screening with rapid SARS-CoV-2 nucleic acid amplification (NAAT) and antigen test.

Results
531 mildly symptomatic HCP screened over 16 months.

Conclusion:
Until more accurate affordable NAAT tests become available, antigen test screening alone addresses simultaneous needs to minimize COVID-19 transmission from symptomatic HCP and maintain an adequate workforce.
Clinical and economic outcomes associated with fidaxomicin in comparison to vancomycin, metronidazole, and FMT: A systematic literature review
Authors: Li Qinghua , Obi Engels , Marciniak Anne , Newman Rebecca , Whittle Isabelle , Kufakwaro Jason 
Published: December 2024

Background:
There are an estimated half a million cases of Clostridioides difficile infection (CDI), in the United States annually. Fidaxomicin, vancomycin, and metronidazole are commonly used for CDI treatment, with fidaxomicin recommended by clinical guidelines as the preferred treatment for initial and recurrent CDI. This systematic literature review aimed to explore clinical and economic outcomes associated with fidaxomicin use with or without comparison to vancomycin, metronidazole, or fecal microbiota transplantation (FMT).

Methods:
The EMBASE, Medline, EconLit, and Evidence Based Medicine Reviews databases were searched from January 1st, 2012 to December 6th, 2022, as fidaxomicin was first approved for adult use in 2011. Identified publications were assessed and extracted by 2 independent reviewers.

Results:
Seventy-nine publications were included. Articles reporting at least 50 patients with follow-up ≤90 days were selected to obtain comparable outcome definitions (N = 14). Sustained clinical cure rate at 30- and 60-days follow-up was higher among fidaxomicin-treated patients (70.0–75.1% and 63.2–78.9%; N = 3) than vancomycin (45.1–58.2% and 38.9–50.0%; N = 3). Lower recurrence rates were reported post-fidaxomicin treatment compared to vancomycin, however the ranges overlapped at 30-, 60-, and 90-days follow-up. Limited outcomes for comparators metronidazole and FMT were identified. Healthcare resource use data were limited, with 2 studies reporting direct costs finding that fidaxomicin use-associated savings were driven by reduced hospital admission-related costs. Fidaxomicin was cost-effective in 14 of 21 economic analyses (11 vs vancomycin). Three studies reported vancomycin or FMT as more cost-effective than fidaxomicin. Fidaxomicin was consistently cost-effective or cost-saving among patients receiving concomitant antibiotics, and patients with cancer or renal impairment. Ten publications reported that the higher acquisition cost of fidaxomicin was offset by reduced recurrence and hospital readmission costs.

Conclusions:
Fidaxomicin was clinically effective compared to vancomycin. Fidaxomicin is often reported as cost-effective, consistently within high-risk subpopulations.
Impact of a multimodal health education combined with teach-back method on self-management in hemodialysis patients: A randomized controlled trial
Authors: Liu Yan , Luo Xi , Ru Xue , Wen Caijin , Ding Ning , Zhang Jing 
Published: December 2024

Background:
To explore the impact of multimodal health education combined with the teach-back method in the self-management of hemodialysis patients.

Methods:
Using the convenience sampling method and random number table method, 112 patients who received treatment in the hemodialysis center of a tertiary hospital in Sichuan Province from January 2023 to October 2023 were selected and divided into a control group (n = 56) and an experimental group (n = 56). The control group was given routine care and traditional health education for maintenance hemodialysis patients, of which 31 were male and 25 were female; the average age was (56.04 ± 11.26) years old. The experimental group was given multimodal health education combined with the teach-back method based on the control group, of which 37 cases were male and 19 cases were female; the average age was (53.71 ± 12.72) years old. The changes in self-management score, quality of survival score, and health literacy score were compared between the 2 groups.

Results:
Before the intervention, the differences in self-management scores, survival quality scores, and health literacy scores between the 2 groups were not statistically significant (P > .05). After the intervention, the total self-management score (96.91 ± 3.02) and the total survival quality score (96.59 ± 4.27) of the experimental group were higher than those of the control group, and the difference was statistically significant (P < .05); the total health literacy score of the experimental group (80.30 ± 6.11) was higher than those of the control group, and the difference was statistically significant (P < .05); in which, the willingness of financial support of the experimental group score (3.27 ± 4.13) improved, but the difference was not statistically significant (P > .05).

Conclusion:
Multimodal health education combined with the teach-back method can effectively enhance the self-management level and health knowledge of hemodialysis patients, improve the quality of patients’ survival and disease prognosis, and improve the level of patients’ disease health literacy.
Isolated pulmonary epithelioid hemangioendothelioma: A case report
Authors: Xuan Rong , Cui Zhengsen , Zhao Liuyan 
Published: December 2024

Rationale:
Pulmonary epithelioid hemangioendothelioma (P-EHE), initially named “intravascular bronchoalveolar tumor,” is an exceptionally rare malignant tumor with an incidence of <1 in a million. Diagnosis depends primarily on pathological and immunohistochemical findings, and currently, there is no established treatment standard.

Patient concerns:
A 50-year-old woman had a physical examination that revealed a lung shadow, followed by a cough and sputum. A chest computed tomography (CT) scan displayed a mass shadow in the upper lobe of the left lung. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT indicated increased uptake of a clumped shadow.

Diagnosis:
The patient underwent a wedge resection of the left upper lung and pleural biopsy, confirming P-EHE.

Interventions:
Following P-EHE diagnosis, chemotherapy, targeted therapy, and immunosuppressive therapy are administered.

Outcomes:
The patient and his family gave up the treatment because it was not satisfactory. Later, we conducted a phone follow-up and learned that the patient passed away on May 18, 2023.

Lessons:
The scarcity of P-EHE complicates its diagnosis and treatment, underscoring the importance of ongoing research to enhance our understanding of this condition.
Atrial fibrillation and the risk of bone fractures: A meta-analysis of prospective cohort studies
Authors: Wang Yuexiao , Wang Zhaoyan , Gu Weipeng , Zhang Mingliang , Zheng Guanlin , Yang Libo 
Published: December 2024

Background:
Some observational studies have suggested that atrial fibrillation (AF) might be associated with an increased risk of bone fracture, but the results remain inconsistent. Therefore, we aimed to evaluate the relationship between them by performing a meta-analysis of prospective cohort studies.

Methods:
We identified relevant studies through PubMed and Embase databases up to the end of October 2023. Study characteristics and outcomes were abstracted for each included study. Pooled relative risks (RRs) and 95% confidence intervals (CIs) for associations of AF with fracture risk were calculated with fixed- or random-effects models.

Results:
Six prospective cohort studies were finally included in the analysis. The pooled RRs of any type of fractures for AF were 1.53 (95% CI: 1.26–1.86, P = .026) with substantial heterogeneity (I2
= 87.9%, P = .000). For the specific type of fracture, a statistically significant association of AF with hip fracture was found (RR = 1.71, 95% CI: 1.25–2.34, P = .001, n = 5). No evidence of publication bias was observed.

Conclusion:
Our results demonstrated that AF was significantly and independently associated with a higher risk of bone fracture, especially for hip fracture.
Heparin-free veno-venous ECMO for airway obstruction: A case report and review of literature
Authors: Sun Bin , Zhou Meiyan , Wang Rongguo , Liu Qian , Yan Li , Zhang Yan , Zhang Jinghao , Wang Liwei 
Published: December 2024

Rationale:
Life-threatening airway obstructions caused by tumors demand prompt and effective intervention. Traditional surgical methods are often complicated by bleeding risks, especially with the use of anticoagulation during extracorporeal membrane oxygenation (ECMO). This report investigates the innovative application of heparin-free veno-venous ECMO (VV-ECMO) to minimize bleeding risks while maintaining effective oxygenation during airway obstruction surgeries, thereby offering a safer alternative in high-risk scenarios.

Patient concerns:
A 44-year-old female with a history of recurrent synovial sarcoma presented with severe dyspnea, requiring a forced lateral position to breathe. A chest CT scan revealed a complete obstruction of the left mainstem bronchus by a tumor.

Diagnoses:
The patient was diagnosed with airway obstruction secondary to metastatic synovial sarcoma.

Interventions:
Preemptive heparin-free VV-ECMO was initiated before general anesthesia to maintain oxygenation. Surgical resection of the obstructing tumor was performed using rigid bronchoscopy and high-frequency electrocautery, followed by argon plasma coagulation to control bleeding.

Outcomes:
Postoperatively, the patient showed significant improvement in respiratory status. VV-ECMO was successfully weaned off, and the patient was extubated shortly after surgery. She was discharged in stable condition 4 days later.

Lessons:
Heparin-free VV-ECMO is an effective strategy for managing airway obstructions in patients at high-risk of bleeding. This case supports the use of ECMO without anticoagulation in airway surgeries, offering a balance between maintaining oxygenation and reducing bleeding complications.
A case report of varicella-zoster virus-related cerebral infarction in an AIDS patient
Authors: Cai Rentian , Yu Fengxue , Cheng Cong , Wei Hongxia 
Published: December 2024

Rationale:
Acquired immune deficiency syndrome (AIDS) patients with varicella-zoster virus (VZV) encephalitis rarely progress to cerebral infarction. This case highlights the potential for such complications in immunocompromised individuals.

Patient concerns:
A 33-year-old male with AIDS experienced recurrent hospitalizations due to neurological complications associated with VZV.

Diagnoses:
During the course of 3 hospitalizations, the patient’s primary diagnoses included non-herpetic herpetic neuralgia, VZV meningoencephalitis, and cerebral infarction.

Interventions:
The patient initially presented with herpetic neuralgia due to VZV infection. Treatment with anti-VZV acyclovir, analgesics, and anti-human immunodeficiency virus therapy improved the patient’s condition, leading to discharge. However, 8 days later, the patient developed fever, slurred speech, nausea, and vomiting. Testing confirmed VZV-related meningoencephalitis with high VZV deoxyribonucleic acid levels in the cerebrospinal fluid. Treatment included ganciclovir, foscarnet, and dexamethasone. Later, the patient suffered an acute cerebral infarction, resulting in limb paralysis and aphasia. Treatment adjustments included additional medications for VZV, human immunodeficiency virus, inflammation, antiplatelet function, and plaque stabilization, leading to improvement.

Outcomes:
During rehabilitation, the patient has shown improvement in right limb paralysis and aphasia, achieving grade 4 muscle strength in the affected limb and enhanced basic communication abilities. However, complete recovery has not yet occurred.

Lessons:
This case emphasizes the rare but significant risk of cerebral infarction in AIDS patients with VZV infection. It underscores the importance of early diagnosis, aggressive management, and continuous monitoring of neurological symptoms to mitigate long-term disability and reduce mortality in this vulnerable population.
Dangerousness: T-wave pseudonormalization in a patient with Wellens’ syndrome: A case report
Authors: Lei Meixian , Yuan Mingqing , Gao Ling 
Published: December 2024

Rationale:
Wellens’ syndrome electrocardiogram (ECG) pattern consists of symmetrically inverted (or biphasic) T waves in the precordial leads, frequently in V2–V3, which is associated with critical stenosis of the left anterior descending (LAD) coronary artery and impending myocardial infarction. Timely diagnosis and early treatment of Wernicke’s syndrome are of utmost importance. Here, we present the clinical characteristics and treatment outcomes of patients with Wellnes’ syndrome.

Patient concerns:
A 62-year-old male presented with intermittent chest pain for 6 days while resting, accompanied by chest tightness and sweating. On admission, the patient had no chest pain, vital signs were stable, and physical examination revealed no positive findings. ECG after admission revealed a normal sinus rhythm with poor progression of R waves in the precordial leads. Blood count, biochemical tests, and cardiac biomarkers were all within normal ranges. The patient’s ECG before admission revealed biphasic T waves in leads V2–V6.

Diagnoses and Interventions:
Dual antiplatelet, nitrate, and statin drugs were administered and the patient underwent urgent coronary angiography. The results revealed that the proximal LAD coronary artery was nearly completely occluded. Intravascular ultrasonography confirmed plaque rupture with thrombosis in the proximal LAD artery, with a minimum lumen area of 2.4 mm2. The patient was diagnosed with Wellens’ Syndrome. A drug-eluting stent was successfully implanted following balloon dilatation.

Outcomes:
The left ventricular ejection fraction and reexamination levels of troponin T and B-type natriuretic peptides were normal after the operation. The patient was discharged 6 days later.

Lessons:
Enhancing physicians’ awareness of the electrocardiographic patterns associated with Wellens’ syndrome facilitates the early identification of this condition, enabling the timely initiation of pharmacological and revascularization treatments for acute coronary syndrome. This proactive approach effectively mitigates the risk of acute myocardial infarction in patients and significantly improves their prognoses.
Facility-Level Differences in Antipsychotic Drug Use
Authors: Chen Amanda C. , Grabowski David C. 
Published: December 2024

Objective:
To quantify quality of care following an admission to a nursing home with low or high antipsychotic drug use.

Background:
Misuse of antipsychotics in U.S. nursing homes is a huge concern for policymakers.

Methods:
We utilized an instrumental variable approach to estimate the effect of facility-level antipsychotic use on patient outcomes. The instrument was the differential distance to the nearest low-use antipsychotic nursing home relative to the nearest high-use antipsychotic nursing home. Post-acute care short-stay and long-stay residents in U.S. nursing homes were identified using Medicare administrative claims and the Minimum Dataset 3.0 (2014–2019). Outcomes included hospitalizations, falls, pressure ulcers, physical restraint use, medication use, and diagnosis of schizophrenia, bipolar disease, anxiety, or depression.

Results:
Among long-stay residents, receiving care from a low-use facility reduced the diagnosis of schizophrenia, use of restraints, and hospitalizations. There was also a reduction in the hospitalization rate [−0.9 percentage point (pp)], likelihood of long-stay status (−1.8 pp), and diagnosis of schizophrenia (−0.2 pp) at 90 days among short-stay residents. We also observed larger reductions among residents with dementia and serious mental illness.

Conclusions:
Admission to a nursing home with a low use of antipsychotics led to decreased hospitalizations, restraint use, and diagnosis of schizophrenia. Curbing the high use of antipsychotics remains a priority of policymakers as the centers for medicare and medicaid services conducts off-site audits to assess whether nursing homes accurately code residents with schizophrenia. It will be important to monitor if centers for medicare and medicaid services downgrades any quality star ratings due to inappropriate coding and assess the implications on quality of care.
Predicting Discharge Destination from Inpatient Rehabilitation Using Machine Learning
Authors: Anderson Hans E. , Polovneff Alexandra O. , Durand Matthew J. 
Published: December 2024

Abstract
Predicting discharge destination for patients at inpatient rehabilitation facilities is important as it facilitates transitions of care and can improve healthcare resource utilization. This study aims to build on previous studies investigating discharges from inpatient rehabilitation by employing machine learning models to predict discharge disposition to home versus non-home and explore related factors. Fifteen machine learning models were tested. A total of 4922 patient encounters from 4401 patients undergoing inpatient rehabilitation at a Midwestern academic center’s inpatient rehabilitation facilities were included. Input variables included demographic and hospital encounter-specific data. The total dataset contained 3687 discharges to home, and 1235 discharges to non-home destinations. A bagging classifier utilizing a decision tree base classifier utilizing random undersampling and without feature selection performed the best in terms of area under the receiver operating characteristic curve with a score of 0.722. Shapley value analysis suggested that length of stay, intravenous medication administration, urinary dysfunction, age, abnormalities white blood cell count or plasma sodium, and fatigue were the factors with the greatest impact on model output. Machine learning can help predict inpatient rehabilitation discharge disposition and identify factors associated with home or non-home discharges.
Autologous Fascia Nerve Wrap in a Rodent Primary Epineurial Repair Model and Preliminary Case Series
Authors: Rowley Emma K. , Zamore Zachary H. , Padovano William , Aslami Zohra V. , Qiu Chenhu , Mantilla-Rivas Esperanza , Weitzner Aidan S. , Suresh Rachana , Lee Erica B. , Tuffaha Sami H. 
Published: December 2024

BACKGROUND:
Nerve wraps composed of various autologous and bioengineered materials have been used to bolster nerve repair sites. In this study, we describe the novel use of autologous fascia nerve wraps (AFNW) as an adjunct to epineurial repair and evaluate their effect on inflammatory cytokine expression, intraneural collagen deposition and end-organ reinnervation in rats and use of AFNW in a patient case series.

METHODS:
Lewis rats received sciatic transection with repair either with or without AFNW, sciatic-to-common peroneal nerve transfer with or without AFNW, or sham surgery (n=14/group). AFNW (1 cm2) were obtained from gluteal muscle fascia. Cytokine expression was assessed at both the coaptation site and L3-L5 dorsal root ganglia (DRG) at 4 weeks following repair using ELISA. Intraneural scarring and end-organ reinnervation were evaluated at 12 weeks. We also demonstrate the clinical application of AFNW for various potential indications in 28 patients.

RESULTS:
AFNW-treated animals demonstrated a significant (p<0.001) decrease in pro-inflammatory cytokines (TNF-α and IL-1β) and increase in anti-inflammatory cytokines (TGF-β and IL-10) within the L3-L5 DRGs and at the coaptation site. AFNW also resulted in reduced intraneural collagen content and an increased mean number of retrograde labeled sensory neurons (p<0.01). Patients receiving AFNW demonstrated favorable motor and sensory functional outcomes and no significant reports of neuropathic pain or other complications.

CONCLUSION:
AFNW serve as a valuable adjunct to epineurial coaptation that reduces intraneural inflammation and collagen deposition in both size-matched and size-mismatched nerve coaptations in a rodent model. Initial clinical experience with AFNW demonstrates feasibility for various indications.

CLINICAL RELEVANCE:
Our early clinical experience with AFNW demonstrates safety, practicality, technical feasibility, and cost-effectiveness and serves to identify a set of potential indications for nerve wrapping that warrant further consideration.