bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isometric handgrip versus aerobic exercise: a randomized trial evaluating central and ambulatory blood pressure outcomes in older hypertensive participants
Authors: Jae Sae Young , Yoon Eun Sun , Kim Hyun Jeong , Cho Min Jeong , Choo Jina , Kim Jang-Young , Kunutsor Setor K. 
Published: November 2024

Objective:
It remains unclear whether the hemodynamic effects of isometric handgrip exercise (IHG) are comparable to those of aerobic exercise (AE). This study investigated the efficacy of IHG in reducing central and ambulatory blood pressure in older hypertensive participants and compared its effects with AE.

Methods:
In a three-arm randomized controlled trial, 54 older hypertensive participants (age range: ≥60; mean age: 69 years) underwent 12 weeks of either IHG training (n = 17), AE training (n = 19), or were part of a no-exercise control group (n = 18). IHG participants engaged in bilateral handgrips using a digital device, four times for 2 min each at 30% of maximal voluntary contraction. AE participants undertook brisk walking and cycling exercises at moderate intensity for 30 min, thrice weekly. Baseline and postintervention measurements included resting office, central, and 24-h ambulatory blood pressures.

Results:
Both IHG and AE interventions led to significant reductions in office and ambulatory systolic blood pressure compared to control group (P < 0.05 for both), with no marked difference in the magnitude of systolic blood pressure reductions between the two groups. Notably, the IHG group exhibited greater reductions in office, central, and ambulatory diastolic blood pressure compared to the AE group and control group.

Conclusion:
While both IHG and AE effectively lowered ambulatory systolic blood pressure, IHG demonstrated superior efficacy in reducing central and ambulatory diastolic blood pressure. Consequently, IHG training presents a promising alternative antihypertensive therapy for hypertensive participants over the age of 60.
Case Report and Literature Review of Exophiala dermatitidis Fungal Endocarditis in a Prosthetic Aortic Valve
Authors: Whittaker George , Killingley Charlotte , Hawes David , Eades Christopher , Mushtaq Roofa , Ray Simon , Nwaejike Nnamdi 
Published: November 2024

Abstract
Prosthetic valve endocarditis is a rare complication following surgical aortic valve replacement, accounting for a small fraction of all endocarditis cases. This complication is typically caused by bacterial pathogens and carries a high mortality rate. In rare cases, prosthetic valve endocarditis may be attributed to fungal organisms. We present the case of a 47-year-old woman who developed prosthetic valve endocarditis from a fungus known as Exophiala dermatitidis. Prosthetic valve endocarditis caused by this pathogen is extremely rare, with only 3 previously reported cases of prosthetic valve endocarditis attributed to this fungus since 1969. Review of the previous literature revealed an additional 3 cases originating in native aortic valves. These cases tended to occur in relatively young patients and those with risk factors for infective endocarditis such as immunosuppression and intravenous drug use. Septic emboli to various organs, particularly the brain and spleen, appear to be a complication of fungal endocarditis caused by this organism. Management can be difficult due to the lack of guidelines to treat such rare infective complications, but replacement of the infected valve and a prolonged course of antifungal therapy appear to be effective in some cases.
Non-Pneuomophila Legionnaires' Disease in Cancer Patients
Authors: Pearson Emily M. , Shah Shivan M. , Wesolow Jacqueline T. , Yasukawa Kosuke , Greene John N. 
Published: November 2024

Abstract
Non-pneumophila Legionella species are rare atypical bacterial pathogens that are responsible for a minority of Legionnaires' disease cases. Compared to Legionella pneumophila, they are more likely to infect immunosuppressed patients, such as those undergoing treatment for hematological cancers. This paper describes 3 cases of cancer patients who were effectively treated for pneumonia caused by non-pneumophila species, definitively identified via culture or microbial cell-free DNA (mcfDNA) analysis. This paper also compiles a list of other reported cases of cancer patients diagnosed with non-pneumophila Legionnaires' disease. Although diagnosis of pneumonia by a non-pneumophila Legionella species is challenging with currently available techniques, recommended antibiotic regimens are well established in the literature. Although they statistically appear to be uncommon pathogens, non-pneumophila Legionella species should be considered as possible causes when treating immunosuppressed patients with unspecified pneumonia.
Enhancing healthcare professionals' biopsychosocial perspective to chronic pain: assessing the impact of implementing an interdisciplinary training program
Authors: Munneke Wouter , De Kooning Margot , Nijs Jo , Morin Carine , Berquin Anne , Meeus Mira , Hartvigsen Jan , Demoulin Christophe 
Published: November 2024

Abstract
Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means of an interdisciplinary training program (ITP) about chronic pain. Belgian HCPs, with a priority for medical doctors, physiotherapists, occupational therapists, nurses, psychologists, and pharmacists in primary care, participated in the ITP, which contained 2 e-learning modules and two 7-hour workshops provided in small interdisciplinary groups in 5 cities. The objective of ITP was to improve HCP's competencies for integrating biopsychosocial chronic pain management with a cognitive behavioral approach into clinical practice. Primary outcomes were changes in knowledge and attitudes about pain and guideline-adherent recommendations for continuation of physical activity, sports, and work; avoiding bed rest; and not supporting opioid usage measured through 2 clinical vignettes. They were measured before, immediately after, and 6 months after the ITP. Changes were analyzed using (generalized) linear mixed models. A total of 405 HCPs participated. The knowledge and attitudes about pain scores improved at post-training (Δ = 9.04, 95% confidence interval 7.72-10.36) and at 6-month follow-up (Δ = 7.16, 95% confidence interval 5.73-8.59). After the training program, HCPs provided significantly more recommendations in accordance with clinical guidelines. Thus, an ITP can improve the biopsychosocial perspective of chronic pain management among HCPs in the short-term and mid-term.
Tobacco use, cirrhosis, and age are predictors of readiness to change and continued drinking following brief alcohol intervention in veterans
Authors: Harris Spencer C. , Al-Yassin Sarmed , Chaudhari Rahul B. , Gallagher Mary Leslie , Davis Brian C. , Malpaya Zenaida , Puri Puneet , Lemmons Joelle , Fuchs Michael , Bajaj Jasmohan S. 
Published: November 2024

Alcohol use disorder is prevalent within the Veterans Health System, especially in patients being seen in hepatology clinics, and needs a point-of-care strategy. A brief alcohol intervention based on AUDIT-C (Alcohol Use Disorders Identification Test) may be needed for the management of hazardous alcohol intake, but feasibility is unclear. We aimed to define predictors of readiness to cease alcohol intake (0–10, 10 being ready to quit now) and continued drinking after using a brief alcohol intervention in veterans seen in hepatology clinics cross-sectionally and longitudinally over 6 months. A total of 414 men with liver disease (average age of 61 y old, 48% with cirrhosis, 31% with concomitant psychiatric conditions, 44% with tobacco use, and 14% with prior alcohol use disorder therapy) were approached. One hundred forty-four patients (35%) had a positive AUDIT-C (8.9 ± 4.0) and were given the brief intervention. Eighty of these patients (56%) had a high readiness to change, listing “wanting to improve health” and “prior success at reducing alcohol intake” as their most frequent reasons. On regression analysis, concomitant tobacco use was associated with a significantly lower readiness to quit alcohol score. On longitudinal follow-up at 6 months, 34 (23%) patients were still drinking. These patients were older and more likely to have concomitant diagnoses of cirrhosis and anxiety. Overall, we found that in a large cohort of veterans seen in hepatology clinics in routine practice, a brief intervention targeted at alcohol use is feasible. Older patients with concomitant tobacco use, cirrhosis, and anxiety may need more longitudinal attention to ensure that the initial interest in reducing problem drinking is sustained.
Primary clear cell adenocarcinoma of the seminal vesicle with ovarian homology: A rare case report
Authors: Yuan Yang , Li Yunlong , Zhang Shihao , Hu Dingli , Xu Song , Gu Tingting 
Published: November 2024

Rationale:
Primary seminal vesicle adenocarcinoma is a rare type of male reproductive system tumor, primarily manifesting as papillary adenocarcinoma. Meanwhile, clear cell adenocarcinoma (CCA) is a common malignancy in the female reproductive system. Therefore, the occurrence of CCA in the seminal vesicle, showing ovarian homology, is even rarer. This pathological type of seminal vesicle cancer has been seldom reported.

Patient concerns:
A 43-year-old male patient presented to the outpatient clinic with a decade-long history of intermittent hemospermia accompanied by a 2-month sensation of dragging in the left lower abdomen. Following an MRI scan that indicated a seminal vesicle mass, he was admitted for further treatment.

Diagnosis:
The MRI revealed 2 abnormal signal mass lesions located between the left side of the pelvic cavity, the prostate, and the left seminal vesicle, primarily exhibiting long T1 and long T2 cystic characteristics. The CT scan with enhancement showed mixed density mass shadows in the left seminal vesicle area of the pelvic cavity, with mild arterial phase enhancement and continued enhancement in the portal phase. Physical examination revealed mild tenderness in the lower left abdomen. Digital rectal examination detected a hard mass above the left prostate, with no bloodstain on the glove, and no other significant abnormalities were observed. Routine urinalysis and biochemistry did not reveal any notable abnormalities. Tumor markers were all within normal ranges.

Interventions:
The tumor was completely excised laparoscopically and sent for pathological examination. Nine days postoperatively, the patient was successfully discharged.

Outcomes:
Postoperative pathology indicated primary CCA of the seminal vesicle. During a 20-month follow-up via telephone, the patient reported a generally good condition without significant discomfort.

Lessons:
CCA occurring in the seminal vesicle is extremely rare, and radical surgical excision is the primary treatment method.
Successful treatment for a patient with antiphospholipid syndrome and decreased protein S activity exacerbated by heparin-induced thrombocytopenia: A case report
Authors: Nishihara Masahiro , Nagae Hiroto , Otake Shimon , Asatani Shinya , Nagasawa Yosuke , Akiya Kumiko , Inomata Hirotake , Kitamura Noboru , Nakamura Hideki 
Published: November 2024

Rationale:
Antiphospholipid antibody syndrome and protein S/C deficiency are diseases that are sometimes complicated by thrombus, and heparin-induced thrombosis (HIT) has also been reported.

Patient Concerns:
A male patient in his 60s with elevated D-dimer and superior mesenteric thrombus and portal vein thrombus underwent partial small intestine resection and thrombectomy. After administration of heparin, aortic thrombosis and pulmonary embolism occurred along with rapid thrombocytopenia.

Diagnosis:
The patient was diagnosed with HIT combined with protein S deficiency and antiphospholipid antibody syndrome.

Interventions and outcomes:
Heparin administration was discontinued, and plasma exchange with fresh frozen plasma replacement and argatroban administration were started. These treatments reduced D-dimer, restored platelet counts, and improved thrombosis.

Lessons:
Although HIT alone can cause severe arteriovenous thrombosis, our case suggests that it is important to search for the underlying procoagulant factors.
Migraine and the correlation between stroke: A systematic review and meta-analysis
Authors: Zhao Weiming , Wang Dong , Tan Yujie , Yang Ji , Zhang Shuning 
Published: November 2024

Background:
This study aims to analyze and evaluate the correlation between migraines and the onset of stroke, and further explore whether migraines increase the risk of stroke.

Methods:
Two researchers independently conducted a comprehensive search of Chinese biomedical literature databases (CBM disc), PubMed, Embase, Cochrane Library, and Web of Science databases, using a combination of subject terms and free words. Literature that met the inclusion and exclusion criteria was selected, and quality assessment was performed using The Newcastle–Ottawa Scale (NOS). Data necessary for the study were extracted as effect size as needed, and meta-analysis was conducted using Review Manager 5.4 software and Stata 16 software to calculate the combined odds ratio and its 95% confidence interval. The relevant data were analyzed, and publication bias was evaluated.

Results:
After conducting a meta-analysis of the 9 final included articles, the heterogeneity test showed chi2 = 10.7, df = 8 (P = .22), I
2 = 25%. Therefore, a fixed-effect model was used for analysis. The combined odds ratio (OR) for the risk of stroke in migraine patients compared to non-migraine patients was 2.04, with a 95% confidence interval [1.73, 2.4], which was statistically significant. In the analysis of migraine with aura, the respective ORs were 2.32 with a 95% CI of [1.70–3.18] and 1.77 with a 95% CI of [1.34–2.33]. Subgroup analysis of female migraine patients and young migraine patients showed statistically significant results, with ORs of 2.26 (95% CI [1.67–3.05]) and 2.39 (95% CI [1.9–3.01]), respectively. The relevant literature and results were evaluated for publication bias and assessed using the NOS, indicating the reliability of the results.

Conclusion:
The results of the meta-analysis indicate that there is a certain relationship between migraine and the onset of stroke, and the results are relatively reliable. The analysis of migraine with aura shows that both the presence and absence of aura are associated with an increased risk of stroke. Subgroup analysis based on gender and age shows that the increased risk of stroke is associated with females and young individuals. However, due to the limited data in subgroup analysis, the above conclusions still require further research for validation.
Concurrent Guillain–Barre/acute transverse myelitis overlap syndrome after COVID-19 infection in a patient with ITP: A case report
Authors: Chen Ruomeng , Wang Liang , Wang Binbin , Song Xiujuan , Liu Xiaoyun 
Published: November 2024

Rationale:
Patients with chronic immune diseases, such as idiopathic thrombocytopenic purpura (ITP), should be alert for Guillain–Barre/acute transverse myelitis (GBS/ATM) overlap syndrome after infection with coronavirus disease 2019 (COVID-19).

Patient concerns:
A 65-year-old male with an ITP history, who presented with limb numbness and weakness, urinary retention, right peripheral facial paralysis, and diplopia 2 weeks after being diagnosed with COVID-19.

Diagnosis:
GBS/ATM overlap syndrome secondary to COVID-19.

Interventions:
Five days intravenous immune globulin, methylprednisolone (500 mg) was added for treatment. He was discharged with medicine and continued to take Methylprednisolone tablets (60 mg/d), Eltrombopag olamine (25 mg 1/d), Mecobalamine tablets, vitamin B1, and rehabilitation treatment outside the hospital.

Outcomes:
The patient significantly improved after initial treatment, he returned to normal life after 8 weeks. Five months later, he was infected with COVID-19 for the second time, exhibiting only symptoms of upper respiratory tract infection and no other discomfort.

Lessons:
COVID-19 infection can lead to secondary myelitis and GBS, and GBS/ATM overlap syndrome is rare, but patients are significantly better after immunization and hormone therapy.
The effect of psychological intervention on the quality of life and rehabilitation outcome of stroke patients with anxiety and depression: A systematic review
Authors: Zhao Bingquan , Yao Yanyun , Gao Ting 
Published: November 2024

Background:
To systematically evaluate the effects of psychological interventions on the quality of life and rehabilitation efficacy of patients with poststroke anxiety and poststroke depression.

Methods:
All randomized controlled trials of psychological interventions for the treatment of patients with poststroke anxiety combined with poststroke depression in China National Knowledge Infrastructure, Wan Fang Database, the Chongqing VIP Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database, Cochrane Library, Embase, Web of Science, and PubMed were searched. Literature was screened according to inclusion and exclusion criteria, systematic evaluation, and meta-analysis were performed using revman5.0 software.

Results:
Seventeen randomized controlled trials were included, which showed that the psychological intervention group was more effective than the control group in reducing anxiety and depression and improving patients’ ability to perform daily life and quality of life. Subgroup analyses were performed according to intervention time and assessment scale, and the results showed that the intervention group was more effective in reducing anxiety and depression.

Conclusion:
Psychological interventions can improve the ability of patients with stroke combined with anxiety and depression to perform their daily lives, improve their quality of life, reduce their levels of depression and anxiety, and improve functional impairment. The registration number in PROSPERO is CRD42023325594 (http://www.crd.york.ac.uk/PROSPERO/).
Large inferior vena cava thrombosis in a 25-year-old female patient: A case report
Authors: Yang Jiyoul , Bae Dae-Hwan , Yang Bumhee , Bak Minjung , Shin Yoon Mi 
Published: November 2024

Rationale:
The incidence of venous thromboembolism is increasing, and it is more common in older than in younger patients. Inferior vena cava (IVC) thrombosis is a rare subtype of deep vein thrombosis, and it is associated with a high incidence of arterial and venous thrombosis in patients with systemic lupus erythematosus (SLE). We present the case of a 25-year-old female patient with a large IVC thrombosis caused by SLE that was intractable to thrombolytic therapy.

Patient concerns:
A 25-year-old previously healthy female patient presented to the emergency department with a 5-day history of fever.

Diagnoses:
Her computed tomography revealed a large thrombus with an approximate length 25 cm extending from the suprarenal IVC to the right common iliac vein and the left external and internal iliac veins.

Interventions:
We decided to perform intravenous thrombolysis (alteplase 65 mg) because of the massive thrombus burden followed by an infusion of intravenous heparin. However, the size of the thrombus did not showed reduction 3 days after treatment. For the next step, the catheter-directed thrombolysis (CDT) was performed; however, no changes were observed.

Outcomes:
She was diagnosed with SLE, and the large IVC thrombus gradually improved after primary treatment for SLE, including immunosuppressive drugs combined with anticoagulant.

Lessons:
We found a large IVC thrombus secondary to SLE in a young female patient. In this case, systemic thrombolysis or CDT did not improve the thrombus. The thrombus only improved after immunosuppressive treatment for SLE. Our case highlights the importance of treatment for etiologic disease in an intractable thrombosis developed by provoked cause.
Global research hotspots and trends of Buyang huanwu decoction: A visual analysis of the literature based on CiteSpace
Authors: Li Bowen , Du Maobo , Gao Weijuan 
Published: November 2024

Background:
Buyang huanwu decoction (BYHWD) has shown significant clinical efficacy in the treatment of several diseases, particularly stroke. However, bibliometric research has not been comprehensive.

Methods:
BYHWD articles were collected from literature databases published from January 1, 1915, to March 31, 2024, including the China National Knowledge Infrastructure, Weipu, Wanfang, Pubmed, Scopus, and Web of Science Core Collection. Knowledge network graphs of annual publication volume, authors, institutions, countries, keywords, and references were constructed.

Results:
Nine thousand two hundred thirty-eight Chinese literature and 559 English articles published between 1915 and 2024 showed an overall upward trend. The countries, institutions, journals, and authors with the highest output were China, Hunan University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangxian Cai, and Changqing Deng, respectively. Research teams outside China were located at Daejeon University, Gachon University, Aga Khan University, Yale University, etc. The results of keyword co-occurrence and burst analysis included clinical applications, animal experiments, action mechanisms, clinical efficacy, and safety evaluations based on systematic reviews and meta-analyses. Literature co-citation analysis revealed that BYHWD was highly correlated with neuroprotection and reduction of cerebral ischemia/reperfusion injury.

Conclusion:
Both Chinese and English literature have shown overall growth trend since 1984 and 1989, respectively. Clinical applications, pharmacological effects, mechanisms, active ingredients, evaluation of clinical efficacy and safety, modified BYHWD, methods, and biological techniques may be hotspots and focus of future research on BYHWD. Hotspot analytical methods and biological techniques include systematic reviews, meta-analyses, data mining, network pharmacology, and molecular docking. Future valuable research fields may include studies on neuroprotection, anti-inflammatory activity, ischemic stroke, bioactive compounds, and their underlying mechanisms.