bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring respiratory muscles effort during mechanical ventilation
Authors: van Oosten Julien P. , Akoumianaki Evangelia , Jonkman Annemijn H. 
Published: November 2024

Purpose of review
To summarize basic physiological concepts of breathing effort and outline various methods for monitoring effort of inspiratory and expiratory muscles.

Recent findings
Esophageal pressure (Pes) measurement is the reference standard for respiratory muscle effort quantification, but various noninvasive screening tools have been proposed. Expiratory occlusion pressures (P0.1 and Pocc) could inform about low and high effort and the resulting lung stress, with Pocc outperforming P0.1 in identifying high effort. The pressure muscle index during an inspiratory hold could unveil inspiratory muscle effort, however obtaining a reliable inspiratory plateau can be difficult. Surface electromyography has the potential for inspiratory effort estimation, yet this is technically challenging for real-time assessment. Expiratory muscle activation is common in the critically ill warranting their assessment, that is, via gastric pressure monitoring. Expiratory muscle activation also impacts inspiratory effort interpretation which could result in both under- and overestimation of the resulting lung stress. There is likely a future role for machine learning applications to automate breathing effort monitoring at the bedside.

Summary
Different tools are available for monitoring the respiratory muscles’ effort during mechanical ventilation – from noninvasive screening tools to more invasive quantification methods. This could facilitate a lung and respiratory muscle-protective ventilation approach.
Epidemiology of Early-onset Colorectal Cancer in a Safety-net Hospital System in Texas
Authors: Tran Vinh , Spezia-Lindner Nathaniel , Millien Valentine O. , Bilal Mohammad , Liu Yan , Montealegre Jane , Gould-Suarez Milena 
Published: November 2024

Goals:
We aimed to characterize risk factors for early versus advanced-stage early-onset colorectal cancer (eoCRC) at our safety-net hospital system.

Background:
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Rates of CRC diagnosis in young adults (age below 50) have been rising despite an overall decrease in CRC. CRC in this group is often detected late due to screening historically being for persons 50 years and older. Etiologies for the increase in rates of eoCRC remain unclear, as do the risk factors for advanced-stage, defined as stage III or IV, at presentation.

Study:
We conducted a retrospective cohort study of 556 adults younger than 50 years of age with an ICD-10 diagnosis of malignant neoplasm of the colon or rectum within a 10-year span. Data collected included demographics, age at diagnosis, time to diagnosis, and cancer stage at diagnosis. Multivariable analysis was used to determine factors associated with advanced-stage CRC.

Results:
A total of 279 patients met the inclusion criteria. Most were Hispanic (67.03%), followed by non-Hispanic Black (NHB, 24.01%). Most had advanced-stage CRC at diagnosis (85.7%, n=239), despite 67.7% (n=189) being diagnosed within 3 months of symptom onset. When compared with non-Hispanic White (NHW) patients, NHB (OR: 2.02, CI: 0.59-6.96) and Hispanic (OR: 1.68, CI: 0.57-4.95) patients had higher odds of advance-stage CRC, albeit not statistically significant.

Conclusions:
Most patients were diagnosed with advanced-stage disease. NHB and Hispanic patients had a nonstatistically significant higher odds of presenting at advanced-stage CRC compared with NHW patients. System-wide quality improvement interventions may be needed to screen for eoCRC in safety-net hospital systems.
Evaluating the GALAD Score for Detection of Hepatocellular Carcinoma in Patients With Cirrhosis
Authors: Vo Thong Duy , Mai Sang Hoai , Lam Huong Tu 
Published: November 2024

Introduction:
Early diagnosis of hepatocellular carcinoma (HCC) is crucial but challenging, and late detection limits its treatment and prognosis. We aimed to evaluate the GALAD score as a novel yet highly accurate and promising diagnostic tool for HCC.

Methods:
A prospective and retrospective cohort study was conducted in 196 adult patients with cirrhosis, including 102 with HCC and 94 without. The diagnostic performance of the GALAD score for HCC detection was compared with that of single biomarkers.

Results:
In patients with cirrhosis with HCC, the GALAD score was 2.5 (95% CI: −2.43 to 11.09), which was significantly higher than the GALAD score of −2.46 (95% CI: −6.15 to 2.04) in patients with cirrhosis without HCC (P<0.001). Patients with multiple tumors had a significantly higher GALAD score than those with a single tumor (P=0.0081). There was a moderate correlation between the GALAD score and tumor size in patients with cirrhosis (r=0.44; P<0.001). The GALAD score had an area under the receiver operating characteristic curve of 0.91, higher than that of all single biomarkers used to diagnose HCC (all P<0.001). The optimal cutoff for diagnosing HCC using the GALAD score was −0.518, achieving a sensitivity of 87.25%, specificity of 82.98%, positive predictive value of 84.62%, and negative predictive value of 84.78%. At this cutoff, the GALAD score demonstrated superior sensitivity compared with single or combined biomarkers.

Conclusions:
The GALAD score shows promise in detecting HCC in patients with cirrhosis. The GALAD score could be applied in clinical practice to diagnose HCC in patients with cirrhosis, and calculating the GALAD score in clinical settings may help predict tumor size and quantity before imaging results become available.
High Rate of Seroprotection With Heplisav-B in Patients With Inflammatory Bowel Disease
Authors: Hegde Yash , Lazarus Sarah K. , Farraye Francis A. , Hollnagel Fauzia , Hayney Mary S. , Caldera Freddy 
Published: November 2024

Objective:
Patients with inflammatory bowel disease (IBD) are commonly treated with immunosuppressive therapies that increase the risk for infections, including hepatitis B (HepB) virus. Adult patients with IBD have suboptimal seroprotection rates after vaccination with a 3-dose recombinant recombinant HepB vaccine. Heplisav-B is an adjuvanted 2-dose HepB series that is more immunogenic in the general adult population. Herein, we evaluated the immunogenicity of Heplisav-B in adult patients with IBD.

Patients and Methods:
We conducted a prospective observational study of adult patients with IBD who were not seroprotected to HepB virus and received a Heplisav-B series with postimmunization HepB surface antibody (anti-HBs) serologic testing. Postimmunization anti-HBs ≥10 IU/mL was considered seroprotection. The primary outcome was the rate of seroprotection. Secondary outcomes were rates of seroprotection in different age groups, those on immunosuppressive therapy, and previous HepB vaccine nonresponders using a univariate analysis.

Results:
Eighty-five patients met the inclusion criteria with the majority (72%) achieving seroprotection with a median anti-HBs level of 48.7 IU/mL and 28 patients (33%) having an anti-HBs level >100 IU/mL. Those on immunosuppressive therapy [49 (58%), 18 nonresponders, odds ratio: 0.34, 95% CI: 0.12-0.99] and primary nonresponders to a previous HepB series [22 (26%), 11 nonresponders, odds ratio: 0.26, 95% CI: 0.09-0.73] were less likely to achieve seroprotection. Seven patients who did not respond received a third dose of Heplisav-B, and 2 achieved seroprotection.

Conclusions:
Heplisav-B achieved higher rates of seroprotection than those seen with 3-dose recombinant HepB vaccines in patients with IBD and may be the preferred option.
Association Between Indices of Thyroid Hormone Resistance and Constipation Prevalence in the US Population
Authors: Li Cheng , Wu Ruozhen , Xie Diya 
Published: November 2024

Background:
Chronic constipation is a common and complex condition that significantly impairs the quality of life and health care costs. Identifying the underlying cause is crucial for effective management, and hypothyroidism is frequently implicated. Nevertheless, extensive studies are scarce regarding this correlation. The research aims to examine the association between indices of thyroid hormone resistance, particularly the Thyroid Feedback Quantile-based Index of Free Thyroxine (TFQIFT4), and the occurrence of constipation among the population of the United States.

Methods:
The analysis examined data collected from 6354 participants in the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2010. Chronic constipation was determined as the Bristol Stool Form Scale (BSFS) types of 1 to 2 or <3 bowel movements weekly. Thyroid hormone resistance was assessed using various indices. The statistical analysis comprised weighted logistic regression, restricted cubic splines (RCS), subgroup analysis, and sensitivity analysis.

Results:
Chronic constipation was diagnosed in 10% of participants, displaying distinct characteristics. A nonlinear association between TFQIFT4 and constipation was observed, with inflection points at −0.25 and 0.376. Above a TFQIFT4 value of −0.25, a significantly negative association with constipation was found, primarily in females (OR=0.21; 95% CI: 0.10-0.44). No such association was found in males.

Conclusions:
The study elucidates a complex correlation between thyroid hormone resistance, particularly TFQIFT4, and constipation. Gender-specific correlations were evident, with TFQIFT4 demonstrating a negative association with constipation, primarily in females. These findings underscore the need for further investigation into the underlying mechanisms involving central thyroid resistance and constipation across genders.
The effectiveness of vasodilators on chronic obstructive pulmonary disease: A systematic review and meta-analysis
Authors: Han Ningxin , Qi Hui , Yin Yujie , Liu Yi , Jin Peipei , Hou Yunlong , Jia Zhenhua 
Published: November 2024

Background:
Chronic obstructive pulmonary disease (COPD) is a complex progressive disease. Some vasodilators have been reported with therapeutic potential to protect vascular function therefore may delay the progression of COPD.

Methods:
We searched PubMed, Embase, Cochrane Library, Web of Science, OVID and Clinicaltrials.gov database for eligible randomized controlled trials (RCTs) published before January 1, 2024. RCTs which treatment with vasodilators to COPD patients were included. Gas-blood exchange indicators were the primary outcomes, and ventilation function and quality of life indicators were the secondary outcomes. Mean differences with 95% confidence intervals were extracted. Subgroup analysis of vasodilator category and COPD complicated with or without pulmonary hypertension (PH) were performed. The risk of bias was assessed using Cochrane risk of bias tool, and the meta-analysis was conducted.

Results:
Twenty studies with a total sample size of 986 were included. The results showed that the 2 types of drugs in vasodilators included PDE-5 inhibitors could improve DLCO (MD = 6.56 [95% CI (1.74, 11.39)], P = .008) and iNO could reduce PaCO2 (MD = −0.10 [95% CI (−0.17, −0.03)], P = .006). Vasodilators could reduce PaCO2 in COPD complicated with PH (COPD-PH) (MD = −0.10 [95% CI (−0.17, −0.03)], P = .006). There were no statistically significant differences in FEV1 (MD = 0.02 [95% CI (−0.11, 0.16)], P = .74), FEV1% predicted (MD = 0.07 [95% CI (−1.90, 2.05)], P = .94), FEV1/FVC (MD = 0.70 [95% CI (−4.02, 5.42)], P = .77) and V

E

/V

CO2
(MD = −0.17 [95% CI (−2.39, 2.05)], P = .88) levels. The total SGRQ score was significantly lower in vasodilator groups (MD = −5.53 [95% CI (−9.81, −1.24)], P = .01).

Conclusions:
The therapeutic effects of vasodilators for COPD are controversial. In this meta-analysis, vasodilators have benefits in improving gas-blood exchange function and quality of life in COPD patients. However, vasodilators may have a limited capacity to improve pulmonary function.
Current status and hotspots in breast cancer patient self-management research: A bibliometric and visual analysis via CiteSpace
Authors: Chen Xinyue , Cao Yan , Huang Shan , Chen Yanyan , Zhang Cui-ping 
Published: November 2024

Background:
Breast cancer remains a leading cause of cancer-related mortality worldwide. Patient self-management plays a pivotal role in enhancing outcomes and quality of life for individuals affected by this disease. This study employed bibliometric and visual analysis techniques utilizing CiteSpace to elucidate the current status and research hotspots in breast cancer patient self-management from January 1, 2005, to August 31, 2023.

Methods:
A comprehensive search was conducted in the Web of Science Core Collection (WoSCC). The retrieved literature was subjected to visualization and analysis using CiteSpace, focusing on publication timeline, article count, geographical distribution, institutional affiliations, journal sources, reference co-citation networks, and keyword analysis.

Results:
The analysis encompassed 1413 English-language documents. The United States emerged as the most prolific contributor, while the University of Toronto demonstrated the highest institutional output. The two-map overlay revealed prominent citation paths, indicating strong interconnections between publications in “Medicine, Medicine, Clinical” and “Health, Nursing, Medicine,” as well as “Psychology, Education, Health” and “Health, Nursing, Medicine.” The most frequently co-cited reference was “Self-Management: Enabling and Empowering Patients Living with Cancer as a Chronic Illness.” High-frequency keywords identified included quality of life, chronic disease, self-management, patient education, randomized controlled trials, education, and intervention. These keywords formed 11 distinct clusters related to intervention content, methodologies, outcome indicators, and emerging research trends. Keyword burst analysis predicted future research hotspots focusing on patient needs, psychological distress, Internet technology, and mobile applications.

Conclusions:
Research in breast cancer self-management is experiencing significant growth. Enhanced collaboration between countries, regions, and institutions is imperative. Further investigation is warranted, particularly in the domains of “quality of life,” “patient education,” and “mobile health.” These findings provide valuable insights to guide future research directions in this critical field.
Does the intervention for adhesive capsulitis in patients with diabetes differ from that for patients without diabetes?: A systematic review
Authors: Tang Shuquan , Tan Xiaoya 
Published: November 2024

Background:
Adhesive capsulitis (AC) is often accompanied by pain and restriction in range of movement, which long lasting symptoms often have negative impact on patients’ work and lives. Since diabetes mellitus (DM) is an independent risk factor for developing AC, and AC with DM have more limitations of joint motion than general people.

Aims:
The aim of the present study is to evaluate the difference of clinical efficacy between diabetes and non-diabetes, and to explore whether AC with diabetes need special intervention compared to non-diabetes.

Methods:
Pubmed NCBI and Embase were searched for studies published in the last 30 years. We conducted a literature search for terms regarding AC and DM on Pubmed NCBI and Embase.

Results:
A total of 9 studies eligible for inclusion. The affected shoulders in these studies ranged from 26 to 135, 460 shoulders (551 participants) in total, including 166 shoulders in diabetic group and 394 shoulders in non-diabetic/idiopathic group. Interventions included shock wave therapy, hydrodilatation, arthroscopic capsular release, manipulation under cervical nerve root block. Evaluation indicators included pain, certain shoulder questionnaires, range of motion. Positive clinical efficacy were emerged after interventions between the 2 groups. The studies that better improvement of pain in non-diabetic/idiopathic group were 2 of 6, that of certain shoulder questionnaires were 4 of 8, that of range of motion were 3 of 6.

Conclusions:
Whether AC combined with DM or not, the current treatment could achieve positive clinical effectiveness and there is some statistical evidence show that the curative effect of AC combined with DM is worse than non-diabetic. In other words, the available evidence suggests that patients with DM might require additional rehabilitation measures with routine glycemic control.
Traditional Chinese medicine combined with chemotherapy for breast cancer after operation: A systematic review and meta-analysis
Authors: Zhang Yanran , Shi Lihui 
Published: November 2024

Background:
This systematic review aims to explore the effect of traditional Chinese medicine combined with chemotherapy on the clinical efficacy of breast cancer postoperative patients, providing theoretical basis for the treatment of breast cancer postoperative patients with traditional Chinese medicine.

Methods:
A comprehensive search was conducted on databases such as China National Knowledge Infrastructure, Wanfang Database, VIP Database, Chinese Biomedical Literature Database, PubMed, and the Cochrane Library from their inception to August 2023 to screen RCTs comparing the effect of traditional Chinese medicine combined with chemotherapy with that of chemotherapy alone on the clinical efficacy of breast cancer postoperative patients. The included literature was systematically reviewed.

Results:
A total of 22 RCTs involving 1834 breast cancer postoperative patients were finally included, with 918 patients in the traditional Chinese medicine combined with chemotherapy group (treatment group) and 916 patients in the chemotherapy alone group (control group). Meta-analysis showed that compared with the control group, therapeutical effective rate, CD3, CD4, CD4/CD8, and adverse reactions in the treatment group were all improved, and the incidence of leukopenia and thrombocytopenia after chemotherapy were all reduced, with statistically significant differences.

Conclusion:
Traditional Chinese medicine combined with chemotherapy is superior to chemotherapy alone in improving the therapeutical effective rate after breast cancer surgery, reducing chemotherapy adverse reactions, and enhancing immune function.
Comparative efficacy and safety of second-line medications for status epilepticus: A network meta-analysis
Authors: Zhang Qishun , Peng Shaokang , Wei Ziyi , Cheng Xiangshu 
Published: November 2024

Background:
To systematically review the efficacy and safety of second-line medications for status epilepticus (SE).

Methods:
Electronic searches were conducted in PubMed, Embase, and The Cochrane Library for randomized controlled trials of second-line medications for SE from inception to January 2024. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was performed using R 4.2.2 software.

Results:
A total of 23 randomized controlled trials were analyzed, examining the efficacy of 5 different treatment regimens: levetiracetam (LEV), phenytoin (PHT), fosphenytoin (FPHT), valproate (VPA), and phenobarbital (PHB). The results of the network meta-analysis indicated that the seizure control rate ranking was as follows: PHB (98.1%) > LEV (60.7%) > FPHT (40.3%) > PHT (33.0%) > VPA (17.8%). The surface under the cumulative ranking (SUCRA) values revealed that PHB had the highest ranking (SUCRA, 91.8%), followed by VPA (SUCRA, 69.3%), PHT (SUCRA, 56.1%), and FPHT (SUCRA, 5.9%) for the recurrence of seizures within 24 hours. Subgroup analysis revealed that PHB was most effective for seizure control in both pediatric and adult populations, VPA demonstrated superior efficacy in children across various indicators, LEV was deemed the safest option for children and elderly individuals, and VPA was identified as the safest choice for adult patients.

Conclusions:
PHB continues to be a prominent option for managing SE, although its safety profile warrants careful consideration. Meanwhile, both VPA and LEV offer distinctive advantages in the treatment of SE, with each demonstrating commendable safety profiles.
Selinexor in combination with pomalidomide and dexamethasone for the treatment of primary plasma cell leukemia with 1q21+ abnormality: A case report
Authors: Fan Wenxia , Wang Lei , Wang Xinyou , Liu Ying , Sun Mingling , Abduklimu Nadia , Zhang Rui , Jiang Ming , Guo Xinhong 
Published: November 2024

Rationale:
Primary plasma cell leukemia is a rare and highly aggressive malignancy of the blood system, with rapid disease progression and a high early mortality rate. Currently, there is no recognized therapeutic regimen, leading to the adoption of strategies typically utilized for multiple myeloma, which, however, exhibit limited efficacy. Selinexor is considered effective in treating relapsed/refractory multiple myeloma, but there are currently no reports on its application in primary plasma cell leukemia. Here, we reported a case of primary plasma cell leukemia with multiple high-risk genetic factors (including 1q21+, 17p‐, and 13q‐) who received a chemotherapy regimen including selinexor, pomalidomide, and dexamethasone.

Patient concerns:
This case was a 58-year-old male presenting with lower back pain, abdominal pain, and various systemic symptoms.

Diagnoses:
The initial diagnosis of intestinal obstruction at a local hospital was followed by a referral to our emergency department due to abnormal blood test results indicative of a hematologic disorder. Further investigations confirmed a rare diagnosis of primary plasma cell leukemia of the IgA-k light chain subtype.

Interventions:
The patient was promptly treated with a chemotherapy regimen comprising selinexor, pomalidomide, and dexamethasone in addition to supportive care.

Outcomes:
Subsequent assessments showed a significant response to treatment, with improvement in symptoms, normalization of blood parameters, and achievement of very good partial response. However, due to financial constraints, the patient declined hematopoietic stem cell transplantation and eventually opted to discontinue treatment, leading to disease progression.

Lessons:
The combination of selinexor with pomalidomide and dexamethasone has shown good efficacy in primary plasma cell leukemia with high-risk genetic abnormalities. Our case may provide evidence for developing an effective selinexor-based regimen for treating primary plasma cell leukemia with high-risk genetic abnormalities.