bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herbal medicine for the treatment of non-erosive reflux disease: A systematic review and meta-analysis
Authors: Kim Minjeong , Park Chaehyun , Park Jae-Woo , Kim Jinsung , Ko Seok-Jae 
Published: November 2024

Background:
Non-erosive reflux disease (NERD) is the most prevalent gastroesophageal reflux disease. Currently, proton pump inhibitors are the most commonly used treatment for NERD. Recently, the demand for herbal medicines with relatively few side effects is increasing and trials confirming the effectiveness and safety of herbal medicines for the treatment of NERD have been conducted. This study aimed to investigate the effectiveness and safety of herbal medicine in the treatment of NERD through published randomized-controlled trials.

Methods:
Ten electronic databases were searched from inception until May 2023. Disease, intervention-related terms, and publication type keywords were combined as search terms. Studies designed as randomized controlled trials, including participants diagnosed with NERD with any type of herbal medicine as a treatment intervention were included. Data extraction and analysis were conducted by 2 independent reviewers. The total clinical efficacy rate was assessed as a primary outcome, while the secondary outcomes were recurrence rate, reflux diagnostic questionnaire score, short-form 36 health survey score, and serum motilin level. The risk of bias in each study and quality of evidence were assessed.

Results:
Thirty-four randomized controlled trials involving 3759 patients were analyzed. Herbal medicine was significantly more effective in improving total clinical efficacy, recurrence rate, reflux diagnostic questionnaire score, some domains of short-form 36 health survey, and serum motilin levels in patients with NERD than conventional medical therapy. No severe intervention-related adverse effects were observed. Regarding the quality of evidence, most outcomes were revealed to have moderate to low levels of evidence.

Conclusion:
This systematic review and meta-analysis suggests that herbal medicine can be an effective and safe therapy for NERD; however, there are several limitations regarding the methodological quality of the included studies. Further research with high methodological quality is necessary to improve the quality of evidence.
Current status and prospects of congenital adrenal hyperplasia: A bibliometric and visualization study
Authors: Chen Sheng , Wu Lingling , Ma Xiaohan , Guo Lin , Zhang Jianqiang , Gao Hongjun , Zhang Ting 
Published: November 2024

Background:
Congenital adrenal hyperplasia (CAH) is increasingly prevalent, leading to a surge in related research. To pinpoint emerging trends and recommend future directions, a bibliometric analysis of relevant CAH literature was performed.

Methods:
From January 1, 2000, to October 1, 2023, we searched the Web of Science Core Collection for CAH literature. For the bibliometric analysis, tools such as VOSviewer, CiteSpace, and the R package “bibliometrix” were employed.

Results:
The United States and England are at the forefront among 113 countries, contributing 5034 papers to CAH research. However, there is a need for more extensive global collaboration across institutions in this field. The number of publications on CAH is increasing annually. Leading research institutions include the University of Michigan, University of California, San Francisco, Karolinska Institutet, and Karolinska University Hospital. The Journal of Clinical Endocrinology & Metabolism is the most cited in this area. The most prolific author is Falhammar H, with 88 publications, 2568 co-citations, and a significant overall contribution. Key research areas include diagnostic methods and therapeutic strategies for CAH. Emerging research hotspots are identified by keywords such as “disorders of sex development,” “21-hydroxylase deficiency,” “ambiguous genitalia,” “testosterone” and “adrenal insufficiency.”

Conclusions:
Research on CAH is expected to expand globally. Future studies will primarily focus on exploring CAH’s diagnostic aspects and developing new therapies. This paper will help scholars better understand the dynamic evolution of the CAH and point out the direction for future research.
Intranasal acupuncture for allergic rhinitis: A systematic review and meta-analysis
Authors: Li Yongjun , Wang Yijie , Liang Yuan , Si Xiuying , Li Zhixiang , Wang Youpeng 
Published: November 2024

Background:
To evaluate the efficacy of intranasal acupuncture as a treatment for allergic rhinitis (AR) through a comprehensive review.

Methods:
Comprehensive searches were performed in both Chinese (CNKI, VIP, CBM, and Wanfang) and English databases (PubMed, Embase, Cochrane Library, and Web of Science) to gather randomized controlled trials available from the inception of the database until August 2024. The primary outcomes considered were the effectiveness rate, visual analog scale score, total nasal symptom scores, total nonnasal symptom scores, Rhinoconjunctivitis Quality-of-Life Questionnaire score, adverse effects, and follow-up observations. The quality of each study was assessed using the Cochrane Collaboration risk of bias tool, and data analysis was conducted using RevMan 5.4 software.

Results:
This study incorporated 14 articles involving a total of 1009 patients. The meta-analysis revealed that patients with AR who underwent intranasal acupuncture experienced more significant improvements compared to the control group. Notably, the treatment considerably improved both nasal and nonnasal symptoms, along with the patients’ quality of life. Moreover, during the follow-up, it was noted that intranasal acupuncture patients had a lower recurrence rate compared to the control group, indicating better long-term effects in alleviating symptoms like nasal congestion, runny nose, and sneezing. Nonetheless, there was no marked improvement of nasal itching. It’s noteworthy that some adverse effects were reported, but all were mild.

Conclusions:
The findings suggest that intranasal acupuncture serves as an effective intervention for AR, particularly in alleviating both nasal and nonnasal symptoms and enhancing quality of life. However, these positive outcomes should be approached with caution, and further high-quality and extensive studies to substantiate these results are warranted.
Rehabilitation for complicated dysphagia after synchronous head-and-neck and esophageal cancer surgery: A case report
Authors: Xue Xinyuan , Azman Amerull , Zhang Cuicui , Chen Yangjia , Ni Jun , Wang Zhi-Yong 
Published: November 2024

Rationale:
Surgical intervention for synchronous head-and-neck and esophageal cancers often results in complex dysphagia, significantly affecting postoperative quality of life. Swallowing dysfunction may become permanent or worsen, with potential impacts on noncancer-related mortality.

Patient concerns:
We report a rare case of multiple synchronous squamous cell carcinomas of the head and neck (tonsillar and epiglottic cancer) along with esophageal cancer, presenting for dysphagia rehabilitation following surgery.

Diagnoses:
Comprehensive evaluations—including magnetic resonance imaging, laryngoscopy, gastroscopy, and histopathology—led to diagnoses of left tonsil cancer (squamous cell carcinoma, T2N2bM0), epiglottic cancer (squamous cell carcinoma, T1N2bM0), and lower esophageal cancer (squamous cell carcinoma, T2N0M0). Postoperative videofluoroscopic swallowing study identified an anastomotic stricture at the level of the fifth cervical vertebra.

Interventions:
The patient underwent an 8-week rehabilitation program incorporating stretching exercises, swallowing behavior therapy, super-supraglottic swallow techniques, catheter balloon dilation, electrical stimulation, and respiratory therapy.

Outcomes:
Following rehabilitation, the patient was able to resume partial oral intake without aspiration, with significant improvement in anastomotic stricture and swallowing function.

Lessons:
This case of dysphagia underscores the anastomotic stenosis resulting from oncological surgical intervention. Dysphagia is a frequent complication in patients with synchronous head-and-neck and esophageal cancers. Comprehensive rehabilitation and assessment of swallowing function enabled safe oral intake postoperatively in this patient.
Successful delivery in a cornual pregnancy after expectant management with traditional Chinese medicine and low-molecular-weight heparin: A case report
Authors: Lin Xiao , Fu Yizhou , Lin Richu , Cai Xiaqin , Zhang Mingli 
Published: November 2024

Rationale:
Horn pregnancy is a rare subtype of ectopic pregnancy that presents a diagnosis and treatment challenge due to its nonspecific symptoms and high risk of rupture.

Patient concerns:
A 32-year-old woman without vaginal pregnancy with history of right corner who presented with painless vaginal bleeding.

Diagnoses:
A transvaginal ultrasound revealed a pregnancy sac implanted in the left corner of the uterus, confirming the diagnosis of a cornual pregnancy.

Interventions:
Treatment options include pharmacological or surgical interventions, and anticipatory treatment is rarely recommended. Conservative treatment was chosen after extensive consultation, and the patient was treated with low molecular weight heparin and traditional Chinese medicine.

Outcomes:
Subsequent ultrasound tests showed stable fetal development and a successful cesarean section.

Lessons:
This case highlights the success of combining low molecular weight heparin with traditional Chinese medicine in the treatment of cornual pregnancy. Factors affecting horn pregnancy, diagnostic challenges, and treatment considerations are discussed. Further research is necessary to determine the best management strategy and to ensure safe delivery for patients with impaired fertility but a strong desire to conceive.
The role of blood cell morphology in understanding and diagnosing severe fever with thrombocytopenia syndrome (SFTS): Insights from a case report
Authors: Gu Kailong , Gao Jin , He Lingyan , Lu Zengyun , Zhang Yan 
Published: November 2024

Rationale:
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonotic disease characterized by a high fatality rate of 12% to 15%. Despite hematologic abnormalities being frequently reported in SFTS patients, detailed characterization of peripheral blood cells, especially in severe cases, is scarce. This case report aims to fill this gap by describing the unique morphological features of blood cells in a patient with a severe outcome.

Patient concerns:
A male patient presented with severe symptoms of SFTS, including high fever and thrombocytopenia, and was subsequently infected with a highly virulent strain of the SFTS virus.

Diagnoses:
The patient was diagnosed with virus-associated hemophagocytic syndrome related to SFTS based on clinical presentation and laboratory findings.

Interventions:
The interventions included comprehensive supportive care and treatment aimed at managing the severe symptoms and complications associated with SFTS.

Outcomes:
Despite the interventions, the patient experienced significant morphological changes in white blood cells and ultimately succumbed to the illness.

Lessons:
The detailed description of abnormal cell morphology in this case provides valuable insights into the pathophysiology of SFTS. Recognizing these morphological abnormalities can aid in early detection and may have implications for assessing disease severity and guiding treatment strategies.
Vanishing Bile Duct Syndrome in Pediatric Hodgkin Lymphoma: First Statistical Analysis of All Published Cases in Children and a Case Report
Authors: Ul Ain Rahat , Gull Aiman , Mohsin Bushra , Rathore Zonaira , Faizan Mahwish 
Published: November 2024

Hodgkin lymphoma with vanishing bile duct syndrome is a rare paraneoplastic syndrome and has never been studied in the pediatric population. The objectives of this study were to determine the clinical characteristics of this rare condition in children through a literature review, and a descriptive analysis of all published cases with the index case report. All reported cases fulfilling the inclusion criteria were found through a literature search, and analyzed in descriptive statistics. A total of 10 cases were included in the study with a median age of 9.5 years and a male-to-female ratio of 9:1. The median duration of symptoms was 5.5 weeks with 3 cases having jaundice before the symptoms of lymphoma. The median bilirubin level was 8.4 mg/dL. Seven cases received modified chemotherapy, and 5 used ursodeoxycholic acid. The survival rate was 50%. Normalization of liver functions after the lymphoma treatment was observed in 4 cases and was the only statistically significant factor (P=0.01) associated with the outcome. This is a rare entity in the pediatric population with a guarded prognosis comparable to the adult counterparts but a marked male predominance.
Leiomyosarcoma of the inferior vena cava: case report
Authors: Hafhaf Ouahiba , Bengrad Ahmed , Fliti Abdelhamid , Arbaoui Said , Anane Oussama , Abdellah Rezziki , Serji Badr , Benzirar Adnane , El Mahi Omar 
Published: November 2024

Introduction and Importance:
Leiomyosarcomas of the inferior vena cava are exceedingly rare tumors, presenting diagnostic dilemmas due to their nonspecific clinical features. This case report aims to shed light on the challenges associated with diagnosing and managing such tumors, emphasizing the importance of a multidisciplinary approach. This article uses SCARE2023 criteria as a framework to sort out a case report in order[1].

Case Presentation:
We present a case of leiomyosarcoma of the inferior vena cava in a patient presenting with abdominal pain. Initial clinical signs, supported by computed tomography (CT) and magnetic resonance imaging (MRI), led to the suspicion of the tumor. Histological analysis confirmed the diagnosis, prompting surgical intervention.

Clinical Discussion:
The diagnosis of tumors within the inferior vena cava is often challenging due to their nonspecific presentation. Imaging modalities such as CT and MRI play an important role in describing the extent of the tumor and guiding surgical planning. Histological analysis remains supreme for definitive diagnosis. Surgical resection, aimed at complete excision, is the keystone of treatment to minimize the risk of recurrence.

Conclusion:
Leiomyosarcomas of the inferior vena cava pose diagnostic and therapeutic challenges due to their rarity and nonspecific clinical presentation. A comprehensive approach integrating clinical assessment, imaging, and histological analysis is essential for accurate diagnosis and optimal management. Multidisciplinary collaboration is key for navigating the complexities associated with these rare vascular neoplasms, ensuring positive patient outcomes.
Prevalence and determinants of poor sleep quality among patients of diabetes mellitus: A tertiary hospital based cross sectional study
Authors: Hamayal Muhammad , Shahid Warda , Wali Saad , Ahmad Naveed , Ahmad Raouf , Iftikhar Iqra , Tahir Muhammad Danyal , Hafeez Momina , Haseeb Abdul , Siddiqui Shajee Ahmad 
Published: November 2024

Background:
The effects of diabetes on sleep quality are pronounced and have a cause-effect relationship. The major aim of this study was to check for the prevalence of poor sleep quality and associated factors among patients of diabetes mellitus in Pakistan as every 1 in 4th individual is suffering from diabetes in Pakistan.

Materials and Methods:
A hospital based cross-sectional study was conducted on diagnosed patients of diabetes mellitus from September 2023 to March 2024 using Pittsburgh Sleep Quality Index (PSQI). SPSS v.27 was used for data analysis. Frequencies, percentages for sample characteristics and means for PSQI were calculated. Chi-square and spearman were run for association and correlations respectively. Risk factors were predicted using binary logistic regression.

Results:
384 responses were collected with 12 excluded. The prevalence of poor sleepers came out to be 82% and poor sleep was significantly associated and correlated with increasing age, poor glycemic control, and metformin as well as income, education and duration of diabetes respectively. Presence of comorbidities and uncontrolled diabetes were the only associated risk factors.

Conclusions:
Pakistani population with diabetes mellitus have an extremely high rate of poor sleep quality which should be addressed by adding sleep quality-oriented guidelines in the management of diabetes.
Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis
Authors: Rojas Lilian Otalora , Ramsubeik Karishma , Sanchez-Ramos Luis , Motilal Shastri , Singh Jasvinder A. , Kaeley Gurjit S. 
Published: November 2024

Objective
This systematic review and meta-analysis assess the efficacy and safety of rituximab (RTX) in treating idiopathic inflammatory myositis (IIM).

Methods
PubMed and Embase were systematically searched for trials and observational studies involving RTX use in IIM. Data were analyzed using a random-effects model to generate pooled estimates for overall response, complete remission, partial response, and adverse events, with subgroup analyses by myositis type and RTX dosage (PROSPERO registered number CRD42022353740). Risk of bias assessments were done using the Newcastle-Ottawa Scale for observational studies and risk of bias 1 tool for trials.

Results
Seventeen studies (1 randomized controlled trial and 16 observational studies), encompassing 362 patients, were included. The overall pooled response rate was 70% (95% confidence interval [CI]: 57%–82%; I
2 = 74%, p < 0.001). Complete remission occurred in 13% (95% CI: 3%–25%; I
2 = 79%, p < 0.001) and partial response in 48% (95% CI: 30%–67%; I
2 = 87%, p < 0.001), both with significant heterogeneity. Subgroup analysis revealed high response rates across all myositis types: polymyositis 69%, dermatomyositis 67%, antisynthetase syndrome 70%, juvenile dermatomyositis 60%, and immune-mediated necrotizing myopathy 86%. Response rates were similar between RTX induction doses of 1 g IV on days 0 and 14 (68%) and 375 mg/m2 weekly for 4 weeks (71%). Reported adverse events totaled 120, including infusion reactions (18.5%) and infections (12.4%).

Conclusions
RTX shows a favorable clinical response in IIM treatment, though response rates vary. There was a significant heterogeneity in treatment effect estimates that are based on a small number of patients. The incidence of infusion reactions and infections highlights the need for careful monitoring. Further controlled trials are essential to refine treatment protocols and evaluate long-term outcomes for RTX's role in IIM.
Trends in Medicare Reimbursement for Gender-Affirming Procedures
Authors: Corbett John , Johnson Mira , Gombaut Cindy , Ranganath Bharat , Chao Jerry W. 
Published: November 2024

Background
Medicare reimbursement rates are essential knowledge for gender-affirming plastic surgeons. The goal of this project was to examine trends in Medicare reimbursement rates for gender-affirming plastic surgery procedures from 2007 to 2020.

Methods
Changes in reimbursement rates were measured for 35 commonly used gender-affirming procedure CPT codes from 2007 to 2020 adjusted for inflation to the 2020 US dollar value. The Unadjusted Percent Change in Consumer Price Index (CPI) was calculated using data from the US Bureau of Labor Statistics. Reimbursement rates were adjusted for inflation using the CPI for each year. Student t test was utilized for mean comparisons.

Results
Mean percent change in reimbursement rates was +16.01% while the percent change in CPI was +27.45%. Comparison between rate change of inflation versus rate change in adjusted medical reimbursement was significantly higher in the inflation group (P < 0.0001). Inflation adjustments for the Compound Annual Growth Rate was negative (−0.76%). The adjusted total percent change was also calculated at an average of −8.97%.

Conclusions
This is the first study evaluating trends in Medicare reimbursement rates for commonly selected gender-affirming procedures in the United States. After adjusting for inflation, Medicare reimbursement rates for all gender-affirming surgeries analyzed declined from the years 2007 to 2020 compared to expected inflation base. Increased consideration of these trends will be important for US policymakers, hospitals, and surgeons to ensure ease of access to gender-affirming care for transgender individuals.
Challenges in Radial Forearm Free Flap Surgery
Authors: Biagiotti Jessica , Longfellow Grace Anne , DiDonna Nicole , Khan Kamran , Knoll Gregory M. , Damitz Lynn 
Published: November 2024

Abstract
The radial forearm free flap (RFFF) has emerged as a leading option for microvascular reconstruction of head and neck soft-tissue defects. Despite the favorable outcomes conferred by RFFFs, complications such as skin graft loss and tendon exposure can occur. We present the case of a 77-year-old man who underwent RFFF reconstruction after excision of squamous cell carcinoma from the head and neck. The patient subsequently developed flexor tenosynovitis, septic arthritis of the wrist, and osteomyelitis of several carpal bones as a direct result of partial skin graft loss and prolonged tendon exposure at the donor site. To the best of our knowledge, this is the first reported case of this specific complication. Review of the literature reveals the need for continued research into RFFF donor site complications to mitigate the incidence of significant morbidity.
Sphenoid Ridge in Fetuses: Size Analysis, Classification, and Clinical Implications
Authors: İnce Rümeysa , Çalişir Ebru Sena , Öztürk Cansu , Şencan Zeynep , Cihan Ömer Faruk , Beger Orhan 
Published: November 2024

Objective:
To identify the size and angle of the sphenoid ridge (SR) in fetuses.

Methods:
Skull bases of 32 fetuses (11 males / 21 females) aged 17 to 32 weeks of gestations were included the study. The angle of SR (SRA), length of LW (SRL), and also LW widths at the midline (SRW-ML), at the midpoint (SRW-MP), and at the lateral point (SRW-L) were measured.

Results:
SRL, SRA, SRW-ML, SRW-MP, and SRW-L were measured as 22.98±4.62 mm, 150.69±8.05 degrees, 6.57±1.46 mm, 4.68±1.07 mm, and 2.68±0.71 mm, respectively. No significant difference was observed between the measurements in terms of sex and sides. Apart from SRA, the parameters were greater in the third-trimester fetuses than the second-trimester fetuses. SRA was similar in both trimester fetuses. SRA did not alter with advancing gestational weeks, but the other increased. In fetuses, only one configuration regarding SRA types was observed. Type A was observed in all fetuses. Linear function was calculated as y=1.411 + 0.902×age for SRL, y=−0.137 + 0.281×age for SRW-ML, and y=1.024 + 0.069×age for SRW-L.

Conclusion:
Our study provides beneficial data for neurosurgeons and anatomists to understand the development of SR in the prenatal period. The authors' regression equations for determining the growth dynamics of the ridge may be used to estimate SR parameters.