bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Preferential Use of Subcutaneous Arteries (SCIA-SB and SIEA) in Abdominal-based Autologous Breast Reconstruction with a Modified Flap Design
Authors: Franchi Alberto , Patanè Luca , Hummel Carmen Elena , Walber Jonas , Najaf Zadeh Shadi , Jandali Abdul Rahman , Jung Florian 
Published: October 2024

Background:
Despite its many advantages, the deep inferior epigastric artery perforator flap requires fascial incision and intramuscular dissection, which can lead to pain and weakening of the abdominal wall. The superficial inferior epigastric artery (SIEA) flap offers an alternative to avoid this damage but is often considered unreliable due to its variable anatomy. In this study, we report our experience in autologous breast reconstruction using either the superficial branch of the superficial circumflex iliac artery (SCIA-SB) or the SIEA as the sole flap pedicle.

Methods:
A retrospective study was conducted from August 2022 to December 2023. A total of 17 patients underwent breast reconstruction with 18 flaps (1 bilateral and 16 unilateral reconstructions). The SCIA-SB (14 flaps) or SIEA (4 flaps) served as the exclusive arterial sources. Preoperative vessel identification was performed using color-coded duplex sonography, and the flap design was adjusted accordingly. Intraoperative flap perfusion was assessed via indocyanine green angiography. Demographic, intraoperative, and postoperative data were recorded.

Results:
The mean follow-up was 5.7 months (range: 3–17 mo). Of the 18 flaps, 1 was lost due to arterial insufficiency. Partial flap necrosis requiring revision occurred in 1 case, whereas minor complications (seroma, wound dehiscence, mastectomy skin necrosis, and infection) were observed in 7 patients.

Conclusion:
In our experience, either the SCIA-SB or SIEA can be successfully used as a pedicle in autologous breast reconstruction, provided that the abdominal flap design is modified to include their functional angiosomes.
Liver transplantation for primary and secondary liver tumors: Patient-level meta-analyses compared to UNOS conventional indications
Authors: Ciria Ruben , Ivanics Tommy , Aliseda Daniel , Claasen Marco , Alconchel Felipe , Gaviria Felipe , Briceño Javier , Berardi Giammauro , Rotellar Fernando , Sapisochin Gonzalo 
Published: October 2024

Background and Aims:
Liver transplant (LT) for transplant oncology (TO) indications is being slowly adopted worldwide and has been recommended to be incorporated cautiously due to concerns about mid-long-term survival and its impact on the waiting list.

Approach and Results:
We conducted 4 systematic reviews of all series on TO indications (intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma [phCC]) and liver metastases from neuroendocrine tumors (NETs) and colorectal cancer (CRLM) and compared them using patient-level meta-analyses to data obtained from the United Network for Organ Sharing (UNOS) database considering conventional daily-practice indications. Secondary analyses were done for specific selection criteria (Mayo-like protocols for phCC, SECA-2 for CRLM, and Milan criteria for NET). A total of 112,014 LT were analyzed from 2005 to 2020 from the UNOS databases and compared with 345, 721, 494, and 103 patients obtained from meta-analyses on intrahepatic cholangiocarcinoma and phCC, and liver metastases from NET and CRLM, respectively. Five-year overall survival was 53.3%, 56.4%, 68.6%, and 53.8%, respectively. In Mantel-Cox one-to-one comparisons, survival of TO indications was superior to combined LT, second, and third LT and not statistically significantly different from LT in recipients >70 years and high BMI.

Conclusions:
Liver transplantation for TO indications has adequate 5-year survival rates, mostly when performed under the selection criteria available in the literature (Mayo-like protocols for phCC, SECA-2 for CRLM, and Milan for NET). Despite concerns about its impact on the waiting list, some other LT indications are being performed with lower survival rates. These oncological patients should be given the opportunity to have a definitive curative therapy within validated criteria.
Parental Perspectives on Human Papillomavirus (HPV) Vaccination in Gulf Cooperation Council Countries: A systematic review
Authors: Alshahrani Najim Z. , Alshahrani Jaber Abdullah , Almushari Badur Saad , Alshammri Fahad Marzooq , Alshahrani Wael Saeed , Alzabali Ahmed Ayed Hadi , Alshehri Abdulrahman Ahmed , Alduaydi Nasser Z. , Alqarni Manea , Alamri Ammar Mohammed A. , Alotaibi Khalid 
Published: October 2024

Background:
This systematic review aims to synthesize existing research on parental knowledge, attitudes, and barriers to human papillomavirus (HPV) vaccination in the Gulf Cooperation Council (GCC) countries.

Methods:
Following PRISMA guidelines, this systematic review analyzed parental knowledge, attitudes, and barriers to HPV vaccination in 6 GCC countries. A comprehensive search across multiple electronic databases (Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, Ovid MEDLINE, Web of Science, and PubMed) was conducted, focusing on studies published between January 2010 and December 2023. Inclusion criteria targeted studies in English or Arabic involving parents in GCC countries, excluding non-research publications and those not using survey techniques.

Results:
The review included 7 studies from Saudi Arabia, the United Arab Emirates, and Qatar. No study was found in Oman, Bahrain, and Kuwait. The findings highlighted low knowledge and awareness of HPV and the vaccine, with significant variation across studies. According to our review findings, the level of awareness in the 7 studies was found to be low to high. These studies collectively illustrate a range of awareness levels, from as low as 11% awareness of the HPV-cervical cancer link to as high as 68% general awareness of HPV. Attitudes towards vaccination were poor in Saudi Arabia but more positive in the United Arab Emirates and Qatar. Major barriers included safety concerns, lack of information, and cultural beliefs.

Conclusion:
Despite moderate awareness in some GCC countries, substantial knowledge gaps and vaccine hesitancy persist. Targeted educational campaigns, effective communication strategies, and involvement of community leaders are essential to improve HPV vaccination uptake.
Research progress on correlative prediction factors and prediction models of endometriosis associated ovarian carcinoma
Authors: Liu Jing , Ma Yu , Jiang Wen , Xie Ping 
Published: October 2024

Background:
Endometriosis is a common benign disease in women of childbearing age, with a malignant change rate of about 1%. Endometriosis associated ovarian cancer (EAOC), which usually occurs in the ovaries, is a serious threat to women’s health. Early identification of high-risk groups of EMs malignant transformation is of great significance for the prevention and treatment of EAOC. However, there is still a lack of specific and sensitive prediction factors. In recent years, scholars at home and abroad have used traditional statistical methods and machine learning to explore EAOC related prediction factors and prediction models. This paper mainly reviews and evaluates the diagnosis and prediction model of EAOC.

Methods:
Studies were identified by searching the CNKI, PubMed and Web of Science Core Collection, (WOSCC) till 2023, Data which met the inclusion criteria of clinical studies were evaluated about the quality. This paper analyzes and summarizes the prediction factors and prediction models in the literature.

Results:
After screening, 7 relevant studies were finally obtained. Prediction factors included: age, menstruation, menopausal status, course of disease, infertility associated with endometriosis, history of single estrogen use during menopause, serological indexes: human epididymis protein 4, carbohydrate antigen 125(CA125), ovarian malignancy risk algorithm, indications for ultrasound examination: cyst shape, structure and blood flow signal, etc. Prediction models: Alignment diagram, Multivariate logistic regression model, Gail model, Gradient Boosting Decision Tree and Lasso-logistics regression.

Conclusion:
Related models were in good agreement with the actual situation, and have good sensitivity and specificity. The relevant prediction factors and prediction models were summarized to provide reference and new thinking for the research of prediction models in the field of EAOC, in order to develop standardized long-term management strategies for high-risk groups of EAOC and realize the advance of the diagnosis threshold of patients with EAOC.
Hematopoietic stem cell transplantation therapy for refractory’ Crohn disease: A systematic review and meta-analysis
Authors: Serrano-Fernandez Victor , Carmona-Torres Juan Manuel , Arroyo-Rodriguez Almudena , Lopez-Gonzalez Angel , Rabanales-Sotos Joseba , Laredo-Aguilera Jose Alberto 
Published: October 2024

Background:
Despite the availability of numerous treatments for Crohn disease, there are patients who do not respond to any therapy, thereby diminishing their quality of life. The aim of this review is to analyze the efficacy and safety of autologous hematopoietic stem cell transplantation therapy for refractory Crohn disease.

Methods:
This work is a systematic review with meta-analysis conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses. Electronic databases such as PubMed, Scopus, Web of Science, and ClinicalTrials were consulted. The searches were carried out in August 2024. To evaluate the efficacy of autologous hematopoietic stem cell transplantation in inducing remission, the mean and standard deviation of the Crohn’s Disease Activity Index pre- and post- treatment were used, and a fixed-effects meta-analysis was conducted. Additionally, to assess the efficacy in perianal fistulas, a random-effects meta-analysis was performed, collecting data on the number of subjects with fistulas at the beginning and end of the intervention. All 95% confidence intervals were calculated, and the I
2 statistic was used to assess the heterogeneity of the outcome variables.

Results:
A total of 609 records were identified from databases, with 12 studies selected for inclusion in the review. Immediate intervention proved effective in inducing a decrease in the Crohn Disease Activity Index compared to late intervention with conventional therapies. Moreover, the meta-analysis demonstrated efficacy for Crohn disease and associated fistulas with a mean decrease in the CDAI of −217.53 ± 14.3. When evaluating the efficacy of the procedure in perianal fistulas, a risk ratio of 0.47 with a 95% CI of [0.26, 0.86] was obtained. However, the procedure showed adverse effects, such as infections, acute renal failure or deaths.

Conclusion:
Systemic autologous hematopoietic stem cell transplantation has shown efficacy in patients who fail to achieve remission of their Crohn disease with conventional therapies. This procedure has also demonstrated efficacy in treating perianal fistulas. However, it is essential to carefully evaluate de implementation of this procedure due to the associated risks.
Identification of a novel TSC1 variant in a family with developmental and epileptic encephalopathies: A case report and literature review
Authors: Wang Chao , Zhai Jin-Xia , Chen Yong-Jun 
Published: October 2024

Rationale:
Tuberous sclerosis (TSC) is an autosomal dominant neurocutaneous syndrome resulting from mutations in the tumor suppressor genes TSC1 and TSC2. Unfortunately, the absence of accurate diagnosis has significantly impacted the well-being of both patients and their families. Furthermore, the pathogenicity of numerous variants remains unverified, which could potentially result in misinterpretation of their functional implications.

Patient concerns:
Proband 1 was a 33-year-old Chinese male, this patient presents with hamartomas in multiple organ systems, accompanied by clinical symptoms such as intellectual disability, epilepsy, and lipid adenoma. The patient and their family members used targeted next-generation sequencing and Sanger sequencing to identify the pathogenic variant.

Diagnoses:
The TSC1 (c.2923G>T, c.2924C>T) variant was identified and the patient was diagnosed with TSC disease.

Interventions:
After the definite diagnosis, the patient was treated with valproic acid, oxcarbazepine, and various organ supports.

Outcomes:
At present, the patient has intellectual decline, multiple sebaceous adenomas, multiple fiber nodules on the back, palpable mass in the right subcostal and middle upper abdomen, and percussion pain in the right kidney area, 1 to 2 times a month seizure, poor intelligence than peers.

Lessons:
This finding strengthens the significant phenotypic variability associated with TSC and expands the mutational spectrum of this rare disease.
Acupuncture combined with opioid for treatment of lung cancer-related pain: A systematic review and meta-analysis
Authors: Jia Liting , Wang Keyi , Chen Shuquan 
Published: October 2024

Background:
Many individuals diagnosed with lung cancer suffer from tremendous pain, and it is crucial to implement more effective measures to assist these patients in alleviating their pain. The present study utilizes a meta-analysis to evaluate the safety and efficacy of acupuncture combined with opioids for treating lung cancer-related pain in patients.

Methods:
We have searched 8 electronic databases: The Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and SinoMed. We included all randomized controlled trials of acupuncture combined with opioids for lung cancer-related pain in adults. We observed the main outcome indicators, including pain relief rates, numeric rating scale scores, and adverse events. Two researchers independently conducted literature screening, literature data extraction, and assessment of bias risk in the literature quality. Any disagreements were resolved through discussions between the 2 researchers or consultations with a third researcher. The risk of bias in the included studies was assessed using the revised risk of bias assessment tool. The overall quality of evidence for each outcome was evaluated using Grading of Recommendations, Assessment, Development and Evaluations.

Results:
We retrieved 812 lung cancer patients from 11 trials. The study showed that compared to opioids alone, the combination of acupuncture and opioids significantly reduced numeric rating scale scores, increased pain relief rates, and decreased the occurrence of side effects.

Conclusion:
The current evidence indicates that combining acupuncture with opioid analgesics is superior to using opioid analgesics alone for managing lung cancer-related pain. Additionally, this combination therapy has fewer adverse reactions.
A case series: Three cases of Morvan’s syndrome as a rare autoimmune disorder with anti-Caspr2 antibody
Authors: Ma Dan , Xiang Qiong , Mo Zhengbo , Du Qilian , Tang Yanqing , Mei Shasha , Song Enfeng 
Published: October 2024

Rationale:
Morvan syndrome (MoS) is an uncommon male-dominant autoimmune disorder marked by peripherally innervated hyperexcitability, autonomic disturbances, and encephalopathic encephalopathy, frequently with mass complaints manifesting as neuromyotonia (involuntary jerking, twitching, and stiffening of muscles), myotonia, neuropathic pain, hyperhidrosis, severe constipation, and severe sleep disturbances accompanied by dream reenactments, agrypnia agitation, and delusions, associated with autoantibodies to voltage-gated and potassium channel complexes such as anti-contactin–associated protein-like 2 (Caspr2) antibody. All this misery can be very disabling and even life-threatening. Reported cases show an unforeseeable outcome, with fatalities occurring even in those who initially responded. It has been reported that patients have reacted to immunologic therapies—corticosteroids, intravenous immunoglobulins, plasma exchanges, azathioprine, cyclophosphamide, rituximab, or carbamazepine, gabapentin, and clonazepam. However, no long-term effective cure has yet been found for this condition. Clinicians and researchers increasingly emphasize alternative and complementary medicine, with a growing trend toward traditional Chinese medicine (TCM).

Patient concerns:
Following glucocorticoid therapy, all 3 patients experienced a recurrence of the disease. Patients 1 and 2 observed symptomatic relief after intravenous immunoglobulin administration; however, upon discontinuation of the treatment, their conditions relapsed and worsened compared with the previous state.

Diagnoses:
The 3 patients were definitively diagnosed with serum Caspr2-positive MoS, accompanied by a constellation of neurological manifestations.

Interventions:
The 3 patients were treated under the guidance of TCM theory. According to the principles of TCM, the patients were characterized by the deficiency of Yin, so the prescriptions were as follows: Shaoyao-Gancao decoction combined with Sanjia-Fumai decoction.

Outcomes:
After the application of TCM, there was a reversal of neuropsychiatric manifestations such as unintentional rippling, jerking, muscle stiffness, myokymia, hyperhidrosis, and extreme constipation. Patients’ quality of life improved significantly; to date, they have achieved Karnofsky Performance Status scores of 100, and the anti-Caspr2 antibody result in case 2 dropped from 1:32 to normal.

Lessons:
We first report the effective treatment of the MoS case series with TCM as complementary and alternative medicine.
Quantifying Parental Perceptions of Their Experiences With Their Young Children’s Use of Power Mobility Devices
Authors: Aldrich Naomi J. , Kenyon Lisa K. , Lambert Rachel , Marsman Kristen , Vasseur Malorie , Sloane Bethany , Logan Samuel W. , Feldner Heather A. 
Published: October 2024

Purpose:
To quantify and explore parental perceptions of their experiences with their child’s use of the Explorer Mini (EM) and a modified ride-on car (mROC) in young children with cerebral palsy.

Method:
Data were gathered throughout a multisite, randomized, counterbalanced AB crossover 16-week clinical trial, wherein all participants used device A (EM) and device B (mROC) for 8-weeks each. Semistructured parent interviews were conducted at baseline (T0), post-intervention period 1 (T1), and post-intervention period 2 (T2). The Linguistic Inquiry and Word Count program was used to objectively analyze the transcribed interviews.

Results:
Twenty-four child-parent dyads participated in the study. Parental perceptions were related to children’s gross motor abilities, cognitive development scores, and device use order (EM-mROC or mROC-EM).

Conclusions:
Parents were positive about a potential means of helping their children. While most preferred the EM, opinions were contingent on the PM device, device use order, and child-centered factors.
Feasibility of a Home-Based Developmental Behavioral Intervention for Children With Autism Spectrum Disorder in Underserved Taiwanese Families
Authors: Cheong Pou-Leng , Wu Yen-Tzu , Lin Chia-Wei , Huang Fang-Yi , Pan Yi-Ling , Kuo Hsiao-I , Sun Jia-Ling , Huang Cheng-Yi 
Published: October 2024

Purpose:
This study aims to investigate the feasibility of the home-based parent- mediated intervention Naturalistic developmental behavioral intervention (HB-NDBI) in underserved Taiwanese families of children with Autism spectrum disorder (ASD) and explore its effects on children’s developmental skills and parents’ parenting stress.

Method:
24 underserved Taiwanese families of children with ASD (mean age = 46.5 months) received 12-week HB-NDBI programs. Social Responsiveness Scale, Second Edition (SRS-2), Mullen Scales of Early Learning (MSEL), Child Behavior Checklist (CBCL/1.5-5), and Parenting Stress Index (PSI) were administered before and after the HB-NDBI programs.

Results:
Following the HB-NDBI programs, significant improvements in social cognition, social communication subscales, receptive language subscale, internalizing, externalizing, and total behavioral problems scales of children, and release of parenting stress were observed.

Conclusion:
This study demonstrated the feasibility of home-based parent-mediated intervention for underserved families in Taiwan. These promising results might facilitate the development of such interventions for underserved families.
High-Intensity Gait Training Intervention for Children With Cerebral Palsy: A Case Series
Authors: Sanjiv Megha , Bloyer Martha H. , Gimenez Cheryl , Moore James G. 
Published: October 2024

Purpose:
The purpose of this pilot case series was to describe participation in high-intensity gait training (HIGT) and changes in (1) gait speed/endurance, (2) aerobic capacity, and (3) walking ability in children diagnosed with cerebral palsy (CP).

Methods:
Three children with CP participated in HIGT for 5weeks in lieu of their routine physical therapy. Outcome measures were collected at baseline and post-intervention.

Results:
Post-intervention, all had at or above the minimal clinically important difference for 10-m walk test speed and 6-minute walk test distance. Two participants performed above the minimal clinically important difference in 7.5-m shuttle run test level and Gross Motor Function Measure—88 Dimension E score.

Conclusion:
This case series demonstrates short-term improvements in the walking outcome measures with participation in HIGT. Further research is needed with a larger and more diverse randomized controlled trial to determine parameters and long-term effects of HIGT in this population.
Assessment of an Antimicrobial Stewardship Program for Enhancing Clinical Knowledge in Neonatal Care Settings With High Antimicrobial Resistance
Authors: Iqbal Faiza , Siva N. , Lewis Leslie Edward S. , Purkayastha Jayashree , Bharadwaj Shruthi K. , Nayak Baby S. , Shenoy Padmaja A. , Ranjan Deepshri , Vandana K. E. 
Published: October 2024

Introduction:
Antimicrobial resistance (AMR) is a global problem, which is particularly challenging in developing countries like India. This study attempts to determine the competencies of health care professionals and to update evidence-based policies to address AMR.

Method:
A survey-based educational interventional study was conducted using a validated structured survey and knowledge questionnaire under 3 domains through an antimicrobial stewardship program. Pooled data were analyzed using SPSS version 16.0.

Results:
Out of 58 participants, 53 (91%) have observed an increasing trend of multidrug-resistant infections over the last 5 years. There is a significant difference between the overall pretest mean scores (8.12 ± 2.10) and posttest mean scores (12.5 ± 1.49) of clinicians’ knowledge with a mean difference of 4.38 ± 0.61, 95% CI of 5.003-3.92, t
(57) = 16.62, P < .001).

Discussion:
The antimicrobial stewardship program was effective in improving the competencies of clinical physicians to improve antimicrobial prescribing and reduce AMR. Moreover, improving the knowledge and competencies among health care professionals will minimize neonatal morbidity and mortality.