bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of stem cell therapy in patients with chronic liver disease: an umbrella review of systematic reviews
Authors: Teng Yue , Gaidhane Abhay M. , Padhi Bijaya K. , Zahiruddin Quazi S. , Alhumaid Saad , Sharma Rakesh K. , Rustagi Sarvesh , Satapathy Prakasini , Sharma Divya , Arora Mithhil , Hazazi Ali , Alturaifi Amani , AlRshoud Mansoor A. , Zaidan Ali A. , Almosa Fadel A.M. , Alzayer Suha A. , Al Alqam Razi , Alhajaji Raghad , Rabaan Ali A. 
Published: May 2024

Background:
Stem cell therapy offers promising benefits like modulating immune responses, reducing inflammation, and aiding liver regeneration. This umbrella review seeks to compile evidence from systematic reviews to assess the efficacy of stem cell therapy for improving liver function and survival rates in chronic liver disease patients.

Methods:
We searched electronic databases up to February 15, 2024. The selection process focused on systematic reviews comparing stem cell therapy with standard care or a placebo. The primary outcomes evaluated were changes in liver enzymes, the Model for End-Stage Liver Disease score, and survival rates. Nested Knowledge software was utilized for screening and data extraction. All statistical analyses were performed using R software, version 4.3.

Results:
Our umbrella review included 28 systematic reviews. The meta-analysis showcased a notable improvement in survival rates with a pooled relative risk of 1.487 [95% confidence interval (CI): 1.281–1.727). In nonrandomized studies, albumin levels exhibited a standardized mean difference (SMD) of 0.786 (95% CI: 0.368–1.204), indicating positive therapeutic effects. For alanine aminotransferase, the meta-analysis revealed a decrease in levels with an SMD of −0.499 (95% CI: −0.834 to −0.164), and for aspartate aminotransferase, an overall SMD of −0.362 (95% CI: −0.659 to −0.066) was observed, suggesting hepatoprotective effects. No significant changes were observed in total bilirubin levels and Model for End-Stage Liver Disease scores in randomized controlled trials.

Conclusion:
Stem cell therapy exhibits potential as a novel treatment for chronic liver diseases, as it has demonstrated improvements in survival rates and certain liver function markers. More high-quality randomized controlled trials are needed in the future to fully ascertain the efficacy of stem cell therapy in this patient population.
Enlightenment of robotic gastrectomy from 527 patients with gastric cancer in the minimally invasive era: 5 years of optimizing surgical performance in a high-volume center – a retrospective cohort study
Authors: Xue Zhen , Lu Jun , Lin Jia , Xu Kai-Xiang , Xu Bin-Bin , Wu Dong , Zheng Hua-Long , Xie Jian-Wei , Wang Jia-Bin , Lin Jian-Xian , Chen Qi-Yue , Li Ping , Huang Chang-Ming , Zheng Chao-Hui 
Published: May 2024

Background:
Learning curves have been used in the field of robotic gastrectomy (RG). However, it should be noted that the previous study did not comprehensively investigate all changes related to the learning curve. This study aims to establish a learning curve for radical RG and evaluate its effect on the short-term outcomes of patients with gastric cancer.

Methods:
The clinicopathological data of 527 patients who underwent RG between August 2016 and June 2021 were retrospectively analyzed. Learning curves related to the operation time and postoperative hospital stay were determined separately using cumulative sum (CUSUM) analysis. Then, the impact of the learning curve on surgical efficacy was analyzed.

Results:
Combining the CUSUM curve break points and technical optimization time points, the entire cohort was divided into three phases (patients 1–100, 101–250, and 251–527). The postoperative complication rate and postoperative recovery time tended to decrease significantly with phase advancement (P<0.05). More extraperigastric examined lymph nodes (LN) were retrieved in phase III than in phase I (I vs. III, 15.12±6.90 vs. 17.40±7.05, P=0.005). The rate of LN noncompliance decreased with phase advancement. Textbook outcome (TO) analysis showed that the learning phase was an independent factor in TO attainment (P<0.05).

Conclusion:
With learning phase advancement, the short-term outcomes were significantly improved. It is possible that our optimization of surgical procedures could have contributed to this improvement. The findings of this study facilitate the safe dissemination of RG in the minimally invasive era.
Work–Life Balance of Faculty in Professional Physical Therapist Education: A Mixed-Methods Study
Authors: Andrea Catherine M. , Flores Megan B. , Wilford Katherine F. 
Published: May 2024

Introduction.
The purpose of this mixed-methods study was to explore perceptions of work–life balance (WLB) of full-time faculty in professional physical therapist (PT) education programs.

Review of Literature.
Studies show that faculty are at risk of diminution of WLB and subsequent burnout due to job expectations and changing educational landscapes. Limited evidence exists to describe perceived WLB of faculty in professional PT education.

Subjects.
Full-time faculty in professional PT education programs (n = 239) responded to an online survey and 16 participated in focus group discussions.

Methods.
The Work/Nonwork Interference and Enhancement Survey (W/NW Scale), faculty characteristic prompts, and open-ended questions were disseminated electronically to all accredited professional PT education programs within the United States. Focus groups were conducted to further explore nuances of WLB. Frequencies and percentages were calculated for survey categorical variables with means and standard deviations for continuous variables. Differences in W/NW Scale and faculty characteristics were analyzed using independent-samples Mann–Whitney U tests. Open coding and an iterative process of thematic analysis was used to analyze the qualitative data.

Results.
Medians for all W/NW Scale dimensions were between 2 and 3 out of 5. W/NW Scale dimension scores differed significantly in each of the faculty characteristics of gender, defined workload, and faculty job searching (Z = −2.399 to −3.517, P ≤ .016). Qualitative data yielded 3 main themes: 1) implicit and explicit job duties; 2) leadership; and 3) individual boundaries. Ebb and flow of WLB emerged as an overarching theme.

Discussion and Conclusion.
This study offers a portrayal of the lived experience of faculty regarding WLB. Results offer useful information about faculty demographics, work-related factors, and personal responsibilities. One limitation was that cultural, community, and religious demands were not explored. Findings may facilitate improved understanding of faculty WLB perceptions and can guide leadership to optimize the balance between faculty's paid work and personal life.
Common contact allergens implicated in frontal fibrosing alopecia found in over-the-counter hair growth serums and solutions
Authors: Verma Kritin K. , Fenner Blayne , Pham Meredith , Tarbox Michelle 
Published: May 2024

Background:
Frontal fibrosing alopecia (FFA) is a form of lichen planopilaris with an undetermined etiopathogenesis, predominantly affecting women. There is conflicting evidence as to whether contact allergens may play a role in the underlying etiology or progression of FFA.

Objective:
The aim of this study is to find the most common products that patients search for online, identify contact allergens present in these advertised over-the-counter hair products, and suggest their role in the development or exacerbation of FFA.

Methods:
We reviewed current research on this topic and then investigated common allergens found in over-the-counter hair products commonly used for hair regrowth.

Results:
FFA’s exact etiopathogenesis remains vastly unknown, however, current literature has reported an association between inflammatory skin conditions and FFA.

Limitations:
The lack of published data on the function of contact allergens in FFA placed restrictions on our study.

Conclusion:
A survey-based analysis with a larger cohort is needed to further interpret the relationship between product use and FFA presentation based on contact allergens. More research on possible etiopathogenesis and the relationship between contact dermatitis and FFA may prevent further progression of a patient’s disease, leading to an improvement in their quality of life.
Semaglutide for management of obesity in adolescents: efficacy, safety, and considerations for clinical practice
Authors: Bensignor Megan O. , Arslanian Silva , Vajravelu Mary Ellen 
Published: May 2024

Purpose of review
The purpose of this review is to describe the existing limited data related to the use of semaglutide in adolescents with obesity, supplementing with findings from adult studies of semaglutide use.

Recent findings
Semaglutide, as a once weekly subcutaneous injection for weight management, effectively reduces body mass index (BMI) while improving hyperglycemia, elevated alanine aminotransferase levels, hyperlipidemia, and quality of life in youth with obesity. As of this review, only one large randomized clinical trial of semaglutide in youth has been completed, with a follow-up duration of 68 weeks. Thus, long-term data on the safety in adolescents is limited, particularly regarding the risks of cholelithiasis, pancreatitis, suicidal ideation, and disordered eating. Due to the cost of semaglutide, particularly in the United States, limited cost effectiveness analyses have demonstrated unfavorable incremental cost-effectiveness ratios for semaglutide relative to phentermine-topiramate as an alternative antiobesity medication in adolescents.

Summary
Semaglutide represents an important advance in the pediatric obesity management, with clear short-term reductions in BMI and improvement in metabolic parameters. However, its long-term safety and efficacy for youth with obesity remain to be demonstrated. Additional research is needed to assess trends in utilization and adherence to minimize the risk of worsening socioeconomic disparities in pediatric obesity.
Diaphragmatic Ultrasound in Children With Asthma Exacerbations
Authors: Chiang Elaine , Kessler David O. , Liebman Melissa , Rabiner Joni E. 
Published: May 2024

Objectives
Asthma is a leading cause of pediatric emergency department visits, yet few tools exist to objectively measure asthma severity. Diaphragmatic ultrasound (DUS) is a novel method of assessing respiratory distress; however, data are lacking for children.
Our primary aim was to determine if diaphragmatic excursion (DE), diaphragmatic thickening (DT), or diaphragmatic thickening fraction (TF) correlated with asthma severity as determined by the Pediatric Respiratory Assessment Measure (PRAM) score. Secondarily, we examined if these parameters correlated with need for respiratory support and evaluated interrater reliability.

Methods
We conducted a prospective study of children 5–18 years presenting to a pediatric emergency department with an asthma exacerbation. Diaphragmatic ultrasound was performed by a trained pediatric emergency medicine sonologist in subcostal (DE) and midaxillary (DT). Thickening fraction was calculated from DT values as previously described in literature. To evaluate interrater reliability, a subset of subjects had DUS performed by a second sonologist.

Results
We enrolled 47 subjects for a total of 51 encounters. The mean age was 9.1 ± 3.7 years. Twenty-five (49%) had mild, 24 (47%) had moderate, and 2 (4%) had severe asthma. There was a significant difference in midaxillary DT and TF between children with mild and moderate asthma (P = 0.02; mean difference, 0.2 mm; 95% confidence interval [CI], 0.03–0.4 and P = 0.02; mean difference, 0.11 mm; 95% CI, 0.02–0.2, respectively). No difference was found in subcostal DE (P = 0.43; mean difference, 1.4 mm; 95% CI, −2.1 to 4.8). No association was found between use of positive pressure and DUS parameters. Fourteen encounters had 2 sonologists perform DUS, with strong interrater reliability found for midaxillary DT (Pearson correlation, 0.56) and poor association for subcostal DE (Pearson correlation, 0.18).

Conclusions
In this pilot study, we conclude that DUS may be helpful in assessing severity of asthma. The midaxillary view assessment for DT and TF had the best correlation with asthma severity and the best interrater reliability. Future studies may benefit from focusing on the midaxillary view for DT and TF.
Clinical Characteristics and Delayed Diagnosis of Pediatric Patients Presenting to the Emergency Department With a Newly Diagnosed Central Nervous System Tumor
Authors: Tamas Vanessa , Hollenbach Kathryn , Saleh Fareed , Crawford John , Gutglass David J. 
Published: May 2024

Background
Due to the varied symptomatology and inconsistent features on neurologic exam, central nervous system (CNS) tumors are difficult to diagnosis in a timely manner.

Objective
To determine the clinical, neurological, and neuroimaging features of newly diagnosed CNS tumors presenting to the emergency department (ED).

Methods
We evaluated a retrospective cohort of 121 consecutive patients presenting to a tertiary care pediatric ED over 7 consecutive years with newly diagnosed CNS tumors. Clinical symptomatology, neurologic findings reported by emergency room and neurology physicians, neuroimaging features, and time to diagnosis were analyzed.

Results
A total of 116 (48 female, median age 8.0 years (interquartile range, 4.4–12.6), 52% Hispanic) presented to the ED (64% self-referred) diagnosed with a brain tumor (54% posterior fossa, 24% embryonal, 24% low-grade glioma, 16% high-grade glioma) resulting in hospital admission in 92% of cases. Five were diagnosed with extradural spinal, clivus, or orbital apex tumors. Symptomatology or duration did not differ when stratified by demographics, location, or histologic subtype. Moderate degree of concordance was observed among neurologic examinations performed by ED physicians and neurologists. Delayed diagnosis (median delay = 3.5 [1–7] months) was seen in 14% of patients, 13 with primary brain tumors (11 hemispheric, 2 brain stem). Six children with delayed diagnosis of low-grade glial tumors had a nonfocal neurologic examination in comparison to 5 patients with abnormal examinations observed with primary spinal or extradural CNS tumors. Four patients with posterior fossa tumors (3 medulloblastoma, 1 ependymoma) had normal/near normal neurologic examination at presentation despite posterior fossa symptomatology related to increased intracranial pressure.

Conclusions
Our series highlights the complexity of symptomology and neurologic findings in children presenting to the ED with newly diagnosed CNS tumors who may have a normal neurologic examination. Standardization of symptom assessment and focused neurologic examinations may lead to earlier neuroimaging and prevent delayed diagnosis.
Effects of dynamic wrist-hand splints for patients with rheumatoid arthritis: A systematic review
Authors: Gilanlıoğulları Nazemin , Soyer Kardem 
Published: May 2024

Background:
Rheumatoid arthritis (RA) results structural changes on wrist-hand joints, which can have negative impact on daily activities. Splints are commonly used to reduce pain and improve function of people with RA. The research shows that usage of dynamic splints improves wrist-hand function of people with other conditions.

Objective:
This systematic review aims to understand impact of dynamic wrist-hand splints on daily activity functioning of people with RA.

Study Design:
A systematic review.

Methods:
Search criteria were applied to PubMed, Web of Science, MEDLINE, CINAHL, Cochrane Library, Physiotherapy Evidence Database, and Scopus electronic databases. Only papers, January 1980 to January 2024, conducted use of dynamic wrist-hand splint for people with RA were included. Quality assessment was completed using the Jovell and Navarro-Rubio classification.

Results:
Five papers that evaluated the use of dynamic wrist-hand splint for people with RA were included. All the papers showed that use of dynamic wrist-hand splints have positive effect on people with RA, but further research is required to show effect of them on daily activity functioning.

Conclusion:
Use of dynamic wrist-hand splints improves function and preferred to be used more commonly by the people with RA; however, there is not enough research to show its effect on daily activities as most of the research conducted had limitations. Therefore, further research is required to show the impact of dynamic wrist-hand splint of daily activities for people with RA.
Immediate Prepectoral Tissue Expander Breast Reconstruction Without Acellular Dermal Matrix Is Equally Safe Following Skin-Sparing and Nipple-Sparing Mastectomy
Authors: Henry Nader , Sebag Victoria , Safran Tyler , Viezel-Mathieu Alex , Dionisopoulos Tassos , Davison Peter , Vorstenbosch Joshua 
Published: May 2024

Background
Prepectoral breast reconstruction has become increasingly popular over the last decade. There is a paucity of data surrounding the impact of mastectomy type on clinical outcomes when comparing prepectoral immediate breast reconstruction without acellular dermal matrix (ADM) using tissue expansion. The purpose of this study was to compare 90-day reconstructive surgical outcomes in immediate prepectoral tissue expander reconstruction between patients with nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM).

Methods
A retrospective review of patient records was carried out on all patients undergoing NSM or SSM with immediate prepectoral tissue expander reconstruction without ADM, in a single institution, from June 2020 to December 2021. All complications were recorded, categorized, and statistically analyzed for significance.

Results
Seventy-nine patients (97 breasts) were studied. The mean age was 51 years old (range, 31–77). Twenty-two patients suffered complications recorded in 22 breasts (22.7%). There was no statistically significant difference in the total complications between the NSM (25.7%) and SSM (21.0%) groups or in the incidence of all major and minor complications.

Conclusions
Breast reconstruction using tissue expanders without ADM has similar reconstructive outcomes in both NSM and SSM. There were no significant differences in complication rates between either groups. Breast reconstruction without ADM can confer institutional cost savings without compromising safety.
Double Z-Rhombic Plasty for Repair of Scalp Defects
Authors: García Sánchez Vicente , Lin Wu Zhan Q. , Barret Juan P. 
Published: May 2024

Background
The closure of scalp wounds presents with reconstructive challenges due to the poor tissue elasticity. It is not uncommon to require skin grafts for definitive closure, even when large flaps are employed. Herein, we present a novel method for the direct closure of small- to medium-sized wounds defects. It is a modified bilateral rhomboid flap, which enables tension-free closure in many areas of scalp.

Methods
All patients treated with this technique between January 2018 and January 2023 were reviewed. Demographics, complications, and outcomes were reviewed.

Results
One hundred forty patients have been operated with this technique. All have been cases of skin tumors. The full flap survival was 97.14%, and they did not present any major local complications, avoiding in all cases the use of skin autografts. Four patients (2.86%) had partial necrosis in the edges of the flap, all managed with topical wound care with good healing and no need of secondary procedures.

Conclusions
This flap is safe and easy to perform when there is skin laxity in the scalp. It can save many skin grafts, simplifying the closure of this area, which can be a first-choice technique on scalp reconstruction.
Increase of Cardiac Autoantibodies Against Beta-2-adrenergic Receptor During Acute Cellular Heart Transplant Rejection
Authors: Salbach Christian , Schlegel Philipp , Stroikova Vera , Helmschrott Matthias , Mueller Anna-Maria , Weiß Christel , Giannitsis Evangelos , Frey Norbert , Raake Philip , Kaya Ziya 
Published: May 2024

Background.
Acute cellular rejection (ACR) in heart transplant (HTx) recipients may be accompanied by cardiac cell damage with subsequent exposure to cardiac autoantigens and the production of cardiac autoantibodies (aABs). This study aimed to evaluate a peptide array screening approach for cardiac aABs in HTx recipients during ACR (ACR-HTx).

Methods.
In this retrospective single-center observational study, sera from 37 HTx recipients, as well as age and sex-matched healthy subjects were screened for a total of 130 cardiac aABs of partially overlapping peptide sequences directed against structural proteins using a peptide array approach.

Results.
In ACR-HTx, troponin I (TnI) serum levels were found to be elevated. Here, we could identify aABs against beta-2-adrenergic receptor (β-2AR: EAINCYANETCCDFFTNQAY) to be upregulated in ACR-HTx (intensities: 0.80 versus 1.31, P = 0.0413). Likewise, patients positive for β-2AR aABs showed higher TnI serum levels during ACR compared with aAB negative patients (10.0 versus 30.0 ng/L, P = 0.0375). Surprisingly, aABs against a sequence of troponin I (TnI: QKIFDLRGKFKRPTLRRV) were found to be downregulated in ACR-HTx (intensities: 3.49 versus 1.13, P = 0.0025). A comparison in healthy subjects showed the same TnI sequence to be upregulated in non-ACR-HTx (intensities: 2.19 versus 3.49, P = 0.0205), whereas the majority of aABs were suppressed in non-ACR-HTx.

Conclusions.
Our study served as a feasibility analysis for a peptide array screening approach in HTx recipients during ACR and identified 2 different regulated aABs in ACR-HTx. Hence, further multicenter studies are needed to evaluate the prognostic implications of aAB testing and diagnostic or therapeutic consequences.
Interleukin-27 Promotes the Generation of Myeloid-derived Suppressor Cells to Alleviate Graft-versus-host Disease
Authors: Zhu Jianmin , Yang Liting , Xia Jing , Zhou Neng , Zhu Jiayao , Zhu Hua , Chen Jing , Qing Kai , Duan Cai-Wen 
Published: May 2024

Background.
Stimulation of myeloid-derived suppressor cell (MDSC) formation represents a potential curative therapeutic approach for graft-versus-host disease (GVHD), which significantly impacts the prognosis of allogeneic hematopoietic stem cell transplantation. However, the lack of an effective strategy for inducing MDSC production in vivo has hindered their clinical application. In our previous study, MDSC expansion was observed in interleukin (IL)-27-treated mice.

Methods.
In this study, we overexpressed exogenous IL-27 in mice using a recombinant adeno-associated virus vector to investigate its therapeutic and exacerbating effects in murine GVHD models.

Results.
In our study, we demonstrated that exogenous administration of IL-27 significantly suppressed GVHD development in a mouse model. We found that IL-27 treatment indirectly inhibited the proliferation and activation of donor T cells by rapidly expanding recipient and donor myeloid cells, which act as MDSCs after irradiation or under inflammatory conditions, rather than through regulatory T-cell expansion. Additionally, IL-27 stimulated MDSC expansion by enhancing granulocyte-monocyte progenitor generation. Notably, we verified that IL-27 signaling in donor T cells exerted an antagonistic effect on GVHD prevention and treatment. Further investigation revealed that combination therapy involving IL-27 and T-cell depletion exhibited remarkable preventive effects on GVHD in both mouse and xenogeneic GVHD models.

Conclusions.
Collectively, these findings suggest that IL-27 promotes MDSC generation to reduce the incidence of GVHD, whereas targeted activation of IL-27 signaling in myeloid progenitors or its combination with T-cell depletion represents a potential strategy for GVHD therapy.