bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the overlapping presentation of irritable bowel syndrome and vulvodynia: a scoping review of the evidence and mechanisms
Authors: Perelmuter Sara , Soogoor Anantha , Maliszewski Katelyn , Grimshaw Alyssa 
Published: August 2024

Abstract

Introduction
Vulvodynia is a complex and multifactorial medical condition characterized by pain in the vulvar area without any identifiable cause. Vulvodynia is underdiagnosed, leading to increased risk of sexual dysfunction and reduced quality of life. Irritable bowel syndrome (IBS) is a gastrointestinal disorder predominantly affecting women. Vulvodynia and IBS frequently co-occur in women, with a 2- to 4-fold increased likelihood of IBS diagnosis in those with vulvodynia. These conditions may share underlying causes, highlighting the need for research to better understand their shared pathophysiology and develop effective therapeutics.

Objective
The aim of this scoping review was to assess the evidence of simultaneous presentation of IBS and vulvodynia.

Methods
A comprehensive search was conducted in 6 databases between inception of database and August 2023: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane Library. Studies included primary research about IBS and vulvodynia in terms of presentation overlap, diagnosis, or treatment. Data were extracted from eligible studies, summarized, and collated.

Results
Of the 306 unique articles identified, 33 were included in the final analysis: 20 cross-sectional studies, 4 case-control studies, 2 case reports, 4 cohort studies, 2 quasi-experimental studies, and 1 randomized trial. Common themes included a high prevalence of overlapping vulvodynia and IBS with a significant diagnostic delay in vulvodynia, mast cell involvement and visceral hypersensitization as common pathophysiology, and the need for a multimodal treatment.

Conclusion
Our review adds to the evidence that there is an association between vulvodynia and IBS. Despite this, research on the underlying molecular mechanisms of this association is scarce, and diagnostic delays persist for vulvodynia. Increasing awareness of the overlap of these conditions will improve screening for vulvodynia in the patient population with IBS, thereby improving the diagnostic delay, and understanding the pathophysiology will enable treatment strategies that address both conditions.
Unveiling the potency of ready-to-use brodifacoum blocks in lesser bandicoot rats: exploring toxicity, blood clotting factors, and organ histology
Authors: Sharma Arshdeep , Singla Neena , Bansal Neelam 
Published: August 2024

Abstract

Background
The present study unveiled the effectiveness of ready-to-use brodifacoum blocks (0.005%) against the prevalent field rat species in southeast Asia, Bandicota bengalensis. Brodifacoum, a more potent second-generation anticoagulant, offers a solution for managing rodents resistant to other anticoagulants of its class.

Methodology
Male and female bandicoot rats caught wild were exposed to brodifacoum for 1, 2, and 3 days in both the no-choice and bi-choice tests. The observations included mortality rates, impact on body weight, food consumption, blood clotting factors, organ weights, and histological changes.

Results
Results indicated 100% mortality within 2–3 days in the no-choice tests, and 50.00%–83.33% mortality in the bi-choice tests within 5 to 8 days. The median lethal feeding periods were determined to be 2.10 and 2.33 days for male and female rats, respectively. Toxicity symptoms included bleeding from the nose, gums, and feet. While no significant effects were observed on body weight or organ weights, food consumption decreased notably in no-choice tests. Additionally, significant increases in prothrombin time and activated partial thromboplastin time were noted 24 h post-treatment in the no-choice tests, with post-treatment international normalized ratios of 9.45–14.20 and 1.52–3.03 in the no-choice and the bi-choice tests, respectively. Histological analysis revealed mild to severe necrotic changes in the liver and kidneys after brodifacoum treatment.

Conclusions
Overall, this study underscores the potential of ready-to-use brodifacoum blocks as an effective tool for rodent population control, offering a viable alternative to other second-generation anticoagulant rodenticides.
GALV-KoRV-related retroviruses in diverse Australian and African rodent species
Authors: Hayward Joshua A , Tian Shuoshuo , Tachedjian Gilda 
Published: August 2024

Abstract
The enigmatic origins and transmission events of the gibbon ape leukemia virus (GALV) and its close relative the koala retrovirus (KoRV) have been a source of enduring debate. Bats and rodents are each proposed as major reservoirs of interspecies transmission, with ongoing efforts to identify additional animal hosts of GALV-KoRV-related retroviruses. In this study, we identified nine rodent species as novel hosts of GALV-KoRV-related retroviruses. Included among these hosts are two African rodents, revealing the first appearance of this clade beyond the Australian and Southeast Asian region. One of these African rodents, Mastomys natalensis, carries an endogenous GALV-KoRV-related retrovirus that is fully intact and potentially still infectious. Our findings support the hypothesis that rodents are the major carriers of GALV-KoRV-related retroviruses.
The European Green Deal: climate action, social impacts and just transition safeguards
Authors: Arabadjieva Kalina , Bogojević Sanja 
Published: August 2024

Abstract
The European Green Deal (EGD) is a growth strategy that seeks to combine climate action with economic stimuli. Climate action, however, inevitably creates winners and losers, at least in the short term. Zooming in on two examples of such actions—the phase-out of coal in Bulgaria and the mining for lithium (necessary for electric vehicle batteries) in Serbia—we point to the significant social implications of the EGD and how these give rise to conflicts that threaten to undermine the economic transformation envisioned for achieving climate neutrality. We show that the remedies put in place by the EU to deal with the social consequences of climate action are too narrow and fragmented and contain almost no legal obligations to promote a socially ‘just transition’ that ‘leaves no-one behind’—the leitmotif of the EGD. We join forces here, as scholars of labour law and environmental law, to identify substantive and procedural legal safeguards that would strengthen the social element of the EU climate agenda and help mitigate some of the emerging conflicts and backlash against climate policies.
Transitional pain services updates and a novel service for the obstetric population
Authors: Blanco Rafael , Ansari Tarek 
Published: August 2024

Purpose of review
This paper is an update of the publications on Transitional Pain Services and explores the viability of a dedicated transitional pain service for women.

Recent findings
We address common pain pathologies establishing referral criteria, pathways, and effective strategies to decrease chronification of pain during pregnancy.

Summary
This review highlights the importance establishing transitional pain service models at every institution and in particular in obstetric population as pain is normalized by Society during pregnancy.
Complications of Hardware Removal in Pediatric Orthopaedic Surgery
Authors: Desai Vineet M. , Mahon Scott J. , Pang Amanda , Hauth Lucas , Shah Apurva S. , Anari Jason B. 
Published: August 2024

Background:
Hardware removal (HR) is one of the most common surgical procedures in pediatric orthopaedics. Surgeons advocate for HR for a variety of reasons, including to limit peri-implant fracture risk, restore native anatomy for adult reconstruction surgery, permit bone growth and development, and mitigate implant-related pain/irritation. To our knowledge, no recent study has investigated the characteristics and complications of HR in pediatric orthopaedics. The goal of this study is to report the prevalence and complications of hardware removals across all of pediatric orthopaedic surgery.

Methods:
A retrospective case series was conducted of all hardware removals from 2012 to 2023 performed at a single urban tertiary-care children’s hospital. Cases were identified using CPT codes/billing records. Spinal hardware and cases for which hardware was either implanted or explanted at an outside hospital were excluded. Patient demographic and clinical data were recorded. For patients with multiple hardware removals, each case was recorded independently.

Results:
A total of 2585 HR cases for 2176 children met study criteria (57.7% male; mean age 12.3±4.4 y). The median postoperative follow-up time was 1.7 months (interquartile range: 0.6 to 6.9). The most common sites of hardware removal were the femur/knee (32.7%), tibia/fibula/ankle (19.3%), and pelvis/hip (18.5%). The most common complications included sustained, new-onset postoperative pain (2.6%), incomplete hardware removal (1.6%), and perioperative fracture (1.4%). The overall complication rate of hardware removal was 9.5%. Eighty-eight percent of patients who underwent hardware removal for pain experienced pain relief postoperatively. HR >18 months after insertion had a 1.2x higher odds of overall complication (P=0.002) and 3x higher odds of incomplete removal/breakage (P<0.001) than hardware removed 9 to 18 months after insertion.

Conclusions:
The overall complication rate of hardware removal across a large series in the pediatric population was 9.5%. Despite hardware removal being one of the most common and often routine procedures in pediatric orthopaedics, the complication rate is not benign. Surgeons should inform patients and families about the likelihood of success and the risks of incomplete removal during the informed consent process.

Level of Evidence:
IV
A review of the addictive potential of pregabalin and gabapentin
Authors: Dalsgaard Helene , Dalhoff Kim Peder , Heerfordt Ida M. 
Published: August 2024

Summary
Following increasing inquiries to the Danish Poison Information Centre regarding pregabalin and gabapentin, this review investigates existing literature about the addictive potential of these two drugs, with a focus on publications after 2020. A systematic search of PubMed was conducted to identify studies concerning the recreational use, misuse and withdrawal symptoms associated with pregabalin and gabapentin. Five case studies, three observational studies, and two interviews were included. This review highlights demographical variations in the misuse of the drugs. Notably, a high prevalence of recreational use of pregabalin was observed among adolescents often co-ingested with sedatives, such as opioids and alcohol. Withdrawal symptoms often followed abrupt discontinuation even at recommended doses, underscoring the drugs’ potential for physical dependence. This review adds information to the already existing literature and provides new insights into the misuse and abuse of pregabalin and gabapentin. This review supports the need for further monitoring and better patient education to mitigate the rising misuse.
Pilot Safety Study of a Microfabricated Device for Anterior Stromal Puncture to Treat Corneal Epithelial Disease in the Optical Axis
Authors: Chaum Edward , Kim Dooho Brian , Kane Steven , Swann Forrest B. , Waite Aaron , Wade Lloyd R. , Riemann Christopher D. , Snyder Michael E. 
Published: August 2024

Purpose:
Anterior stromal puncture is an inexpensive and widely used technique at the slit lamp to treat recurrent corneal erosions (RCE), common sequelae of corneal abrasions, trauma, and epithelial basement membrane dystrophies (EBMDs). The purpose of this study was to determine safety of a novel anterior stromal micropuncture device (termed a “plexitome”) for use in the optical axis of the cornea.

Methods:
We performed an IRB-approved clinical pilot study on 45 patients with diverse corneal pathologies to determine the safety of the plexitome device and examined corneal healing responses clinically for a minimum of 30 days after treatment. Follow on efficacy data was collected for treated patients with RCE. Micropuncture treatment was performed either through loose epithelial tissue or after debridement using a cotton tip at the slit lamp. After “imprinting,” patients were treated with topical medications including antibiotics, hypertonic saline/ointment, bandage contact lenses, and/or patching according to the treating physician's routine care for the condition.

Results:
Micropuncture using the “plexitome” device did not create visible scars in the corneal stroma of the 45 patients treated and followed for at least 30 days. Photographic evidence of imprinting was seen at in 1 patient at 30 days. There were no significant adverse events associated with treatment.

Conclusions:
Micropuncture of the cornea using the “plexitome” device does not create optically evident anterior stromal scarring after treatment. Micropuncture using the device may be an effective way of treating RCE and other corneal manifestations of EBMD in the optical axis, which is not currently possible using standard anterior stromal puncture methods.
The effectiveness of HALP score in predicting mortality in non-ST-elevation myocardial infarction patients
Authors: Kiliç Raif , Güzel Tuncay , Aktan Adem , Güzel Hamdullah , Kaya Ahmet Ferhat , Çankaya Yusuf 
Published: August 2024

Background:
The HALP score, measured based on hemoglobin, albumin, lymphocyte, and platelet levels, is regarded as a novel scoring system that indicates the status of systemic inflammation and nutritional health. Our study aimed to evaluate the relationship between HALP score and prognosis in non-ST-elevation myocardial infarction (NSTEMI) patients.

Methods
Between 1 January 2020 and 1 January 2022, 568 consecutive patients diagnosed with NSTEMI from a single center were included in the study retrospectively. The patients were divided into two equal groups according to the median HALP cutoff value of 44.05. Patients were followed for at least 1 year from the date of admission.

Results
The average age of the patients was 62.3 ± 10.6 years and 43.7% were female. In-hospital and 1-year mortality were found to be significantly higher in the group with low HALP scores (6.0 vs. 2.1%, P = 0.019 and 22.5 vs. 9.9%, P < 0.001, respectively). In receiver operating characteristic curve analysis, a cutoff level of 34.6 of the HALP score predicted 1-year mortality with 71% sensitivity and 65% specificity (area under the curve: 0.707, 95% confidence interval: 0.651–0.762, P < 0.001). In Kaplan–Meier analysis, higher mortality rates were observed over time in the group with lower HALP scores (log-rank test=16.767, P < 0.001). In Cox regression analysis, the HALP score was found to be an independent predictor of 1-year mortality (odds ratio: 0.969, 95% confidence interval: 0.958–0.981, P < 0.001).

Conclusion
We found that a low HALP score could predict in-hospital and 1-year mortality in patients admitted to the hospital with a diagnosis of NSTEMI.
Management of Chyle Leak in Pediatric Surgical Oncology: A Systematic Review
Authors: Alhayek Nabil , Alwani Abdulkarim , Pio Luca , Abdelhafeez Abdelhafeez H. 
Published: August 2024

Introduction:
Chyle leak, a rare complication, arises from damage to primary lymphatic vessels due to congenital factors or medical interventions, leading to conditions such as chylothorax and chylous ascites. Managing chyle leaks is challenging, especially in pediatric surgical oncology, often arising as postoperative complications. Treatment options range from conservative dietary adjustments to surgical interventions, depending on leak severity and patient condition. This systematic review examines the management of chyle leaks in pediatric surgical oncology, emphasizing both conservative and surgical approaches.

Methods:
This systematic review involved extensive database searches (EMBASE, Web of Science, and PubMed) to identify relevant studies on chyle leak management in the pediatric population. The review included studies from 1982 to 2023 and focused on pediatric and adolescent patients, assessing various treatment approaches and outcomes. Nine articles composed of 163 patients (study population size ranging from 2 to 82 patients). Independent reviewers evaluated the selected studies for inclusion.

Results:
Among 9 articles analyzed, 98.8% of pediatric patients initially received conservative management for chyle leaks, with 11.7% eventually requiring surgical intervention due to persistent leaks (8, 10, and 16 to 22). Neuroblastoma resection is associated with 20% to 40% rate of chyle leak, and the extent of lymphadenectomy has been identified as a risk factor for chyle leak. The study highlighted variability in clinical success rates based on conservative management approaches.

Discussion:
Chyle leak, while rare, presents a complex challenge, especially in pediatric surgical oncology. Various causes and treatment options exist, with a preference for conservative management initially and surgical intervention in specific circumstances. Factors such as leak severity and patient condition guide the choice between approaches. However, the scarcity of comparative data and randomized trials in the pediatric population necessitates further research to establish optimal management strategies for chyle leaks.

Conclusions:
Conservative management of chyle leaks has proven to be the preferred approach in early stages of treatment, whereas surgical management could be the preferred choice in certain situations. Larger prospective studies are needed to further evaluate these results.
A quality improvement project to enhance the knowledge, skills, and attitude of healthcare workers regarding the use of defibrillators
Authors: Gul Fahad , Abid Seemab , Khalid Shafia , Khalid Shahrukh , Shad Iram , Saleem Samar , Qayyum Sardar Noman , Noori Samim 
Published: August 2024

Introduction:
Defibrillation is a critical intervention in managing cardiac emergencies, yet healthcare workers (HCWs) preparation for utilizing defibrillators remains inadequate, particularly in low and middle-income countries. This quality improvement project aimed to assess and enhance HCWs’ knowledge, skills, and attitudes toward defibrillator use in the emergency department (ED) through a 1-h defibrillator workshop.

Methodology:
An observational clinical audit was conducted within the ED of a tertiary care hospital. Pre- and post-workshop data were collected from the participants using structured questionnaires for demographics, knowledge assessment (20 multiple-choice questions), skills assessment (10-step checklist), and attitude evaluation (Likert-scale statements). The workshop included theoretical instruction and hands-on practice, with a post-workshop assessment conducted one week later. Data analysis employed descriptive statistics and paired t-tests, while ethical considerations ensured confidentiality and consent.

Results:
The study included 38 participants, demonstrating significant gaps in defibrillator knowledge, skills, and attitudes pre-workshop. Post-workshop assessments revealed a marked improvement in knowledge scores (P<0.05), attitudes (P<0.05), and practical skills (P<0.05). Participants’ confidence and preparation for managing cardiac emergencies notably increased, indicating the workshop’s efficacy in addressing the identified deficiencies.

Conclusion:
The 1-h defibrillator workshop effectively enhanced HCWs’ competence and readiness to utilize ED defibrillators. The observed improvements underscore the importance of targeted educational interventions in bridging knowledge gaps and fostering proactive attitudes toward emergency management. Regular training sessions should be conducted to sustain these enhancements and improve patient outcomes in the ED.
Tree-Based Reinforcement Learning for Identifying Optimal Personalized Treatment Decisions for Hand Deformity in Rheumatoid Arthritis
Authors: Yoon Alfred P. , Song Yao , Lin I-Chun F. , Wang Lu , Chung Kevin C. 
Published: August 2024

Background:
Silicone metacarpophalangeal (MCP) joint arthroplasty (SMPA) can reconstruct MCP joint deformities in the rheumatoid hand, but patient selection criteria for the procedure remains unclear. The authors used statistical learning to elucidate patient selection criteria that will enhance long-term patient-reported and functional outcomes in patients with severe hand rheumatoid arthritis (RA).

Methods:
This was a secondary analysis of a prospective study of 169 adults with severe hand RA (average combined ulnar deviation and extensor lag at the MCP joint ≥50 degrees, per finger) with 1-year follow-up, conducted at 3 centers in the United States and England from January 1, 2004, to December 31, 2011. Primary outcomes were Michigan Hand Outcomes Questionnaire pain subscore, changes in extensor lag and ulnar deviation, and Arthritis Impact Measurement Scale score. A tree-based reinforcement learning model was used to estimate clinical decision rules for treatment.

Results:
A total of 132 patients (mean ± SD age, 61 ± 9 years; 108 female patients [72%]) were included in the SMPA (n = 50) and non-SMPA (n = 82) cohorts. To minimize ulnar deviation and extensor lag, patients should undergo SMPA. To minimize pain, patients older than 55 years should undergo SMPA. To increase hand-related quality-of-life (QOL), patients with grip strength less than 12 kg should undergo SMPA. Estimations with imputed missing data were similar, aside from a lower grip strength (<8 kg) threshold for hand-related QOL.

Conclusions:
Unless there is significant comorbidity that precludes surgery, most patients older than 55 years with severe hand RA will have improved QOL, pain, and function after SMPA. Patients with preserved grip strength may benefit from continued medical management.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
No Clinical Efficacy of Adipose-Derived Regenerative Cells and Lipotransfer in Breast Cancer–Related Lymphedema: A Double-Blind Placebo-Controlled Phase II Trial
Authors: Jørgensen Mads Gustaf , Jensen Charlotte Harken , Hermann Anne Pernille , Andersen Ditte Caroline , Toyserkani Navid Mohamadpour , Sheikh Søren Paludan , Sørensen Jens Ahm 
Published: August 2024

Background:
Breast cancer–related lymphedema (BCRL) is a debilitating sequela affecting up to 1 in 3 breast cancer survivors. Treatments are palliative and do not address the underlying lymphatic injury. Recent preclinical and nonrandomized studies have shown promising results using adipose-derived regenerative cells (ADRCs) and lipotransfer in alleviating BCRL through regeneration of lymphatic tissue. However, no randomized controlled trial has been performed in an attempt to eliminate a placebo effect.

Methods:
This randomized, double-blind, placebo-controlled trial included patients with no-option, persistent disabling unilateral BCRL. Patients were randomly assigned in a 1:1 ratio to receive either autologous ADRCs (4.20×107 ± 1.75×107 cells) and 30-cc lipotransfer or placebo (saline) to the axilla. The primary outcome was a change in BCRL volume 1 year after treatment. Secondary outcomes included changes in quality of life, indocyanine green lymphangiography stage, bioimpedance, and safety.

Results:
Eighty patients were included, of whom 39 were allocated to ADRCs and lipotransfer treatment and 41 to placebo treatment. Baseline characteristics were similar in the groups. One year after treatment, no objective improvements were observed in the treatment or placebo groups. In contrast, significant subjective improvements were noted for both the treatment and placebo groups.

Conclusions:
This trial failed to confirm a benefit of ADRCs and lipotransfer in the treatment of BCRL. These nonconfirmatory results suggest that ADRC and lipotransfer should not be recommended for alleviating BCRL. However, the authors cannot exclude that repeated treatments or higher doses of ADRCs or lipotransfer could yield a clinical effect.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, I.