bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acellular Fish Skin Grafts for Treatment of Periocular Skin Defects
Authors: Wang Diane , Maliakkal Janice , Sadat Omar , Codrea Vlad , Nguyen John 
Published: May 2024

Purpose:
To describe the outcomes of acellular fish skin grafts for repair of periocular anterior lamella skin defects after Mohs surgery for skin cancers.

Methods:
Following the institutional review board approval, the authors conducted a retrospective chart review of patients treated with acellular fish skin grafts between January 2022 and December 2023. Indication was to repair defects after Mohs excision of basal cell carcinoma and squamous cell carcinoma. Demographics, smoking and diabetes status, diagnosis, defect location, graft size, and complications were evaluated. Outcomes were analyzed using the scar cosmesis assessment and rating scale.

Results:
Six patients (3 females and 3 males) with a mean age of 60.8 (range 44–80) had Mohs surgery for basal cell carcinoma (4) and squamous cell carcinoma (2). Location of defects included eyebrow (3 cases), lateral nasal wall (1 case), lower eyelid (1 case), and medial lower eyelid/nasal wall (1 case). Defect size ranged from 8 × 10 mm to 30 × 40 mm. Two patients had more than 1 application of xenograft. One patient developed a mild cicatricial ectropion. No other postoperative complications were seen, and all had good wound healing and cosmetically acceptable results.

Conclusions:
In this pilot study, acellular fish skin xenografts are shown to be promising skin graft substitutes in patients with Mohs defects and decrease the need for autologous skin harvesting or allogenic skin donation.
Physiological profiling of cannabidiol reveals profound inhibition of sensory neurons
Authors: Chahyadinata Gracesenia , Nam Joo Hyun , Battenberg Ashley , Wainger Brian J. 
Published: May 2024

Abstract
Cannabidiol (CBD), the main nonpsychoactive cannabinoid of cannabis, holds promise for nonaddictive treatment of pain. Although preclinical studies have been encouraging, well-controlled human trials have been largely unsuccessful. To investigate this dichotomy and better understand the actions of CBD, we used high-content calcium imaging with automated liquid handling and observed broad inhibition of neuronal activation by a host of ionotropic and metabotropic receptors, including transient receptor potential (Trp) and purinergic receptors, as well as mediators of intracellular calcium cycling. To assess the effect of CBD on overall nociceptor electrical activity, we combined the light-activated ion channel channelrhodposin in TRPV1-positive nociceptors and a red-shifted calcium indicator and found that 1 µM CBD profoundly increased the optical threshold for calcium flux activation. Experiments using traditional whole-cell patch-clamp showed increase of nociceptor activation threshold at submicromolar concentrations, but with unusually slow kinetics, as well as block of voltage-activated currents. To address a more integrated capacity of CBD to influence nociceptor sensitization, a process implicated in multiple pain states, we found that submicromolar concentrations of CBD inhibited sensitization by the chemotherapeutic drug vincristine. Taken together, these results demonstrate that CBD can reduce neuronal activity evoked by a strikingly wide range of stimuli implicated in pain signaling. The extensive effects underscore the need for further studies at substantially lower drug concentrations, which are more likely to reflect physiologically relevant mechanisms. The slow kinetics and block raise biophysical questions regarding the lipophilic properties of CBD and its action on channels and receptors within membranes.
Relationship Between Unit Characteristics and Fall Incidence: A Cross-Sectional Survey Using Administrative Data in Japan
Authors: MORIWAKI Mutsuko , TANAKA Michiko , TOBA Mikayo , OZASA Yuka , OGATA Yasuko , OBAYASHI Satoshi 
Published: May 2024

ABSTRACT

Background
Falls are the most frequent accident experienced by inpatients in hospitals. As falls affect patient outcomes, high fall risk factors should be studied to prevent falls and improve patient safety. However, the relationship between hospital unit characteristics and fall risk has never been assessed.

Purpose
This study was designed to identify the unit characteristics significantly related to fall risk.

Methods
A cross-sectional study was conducted on the medical records of patients hospitalized in a Japanese academic hospital between 2018 and 2019. This study quantified unit activities and utilized Diagnosis Procedure Combination data to examine unit characteristics related to falls based on unit day.

Results
Data on 16,307 patients were included in the analysis, and 355 unit days were certified as fall events. Based on patient condition and medical treatment, the results identified antineoplastic injections, radiation therapy, aseptic treatment room, and functional status of partly assisted transfers, meals, and oral care as unit characteristics associated with increased fall events. Decreased nursing time per patient at night (odds ratio [OR] = 0.75, p = .04) and higher numbers of partially assisted transfer patients were also identified as unit characteristics associated with higher fall incidence rates (OR = 5.56, p = .01).

Conclusions
The results of this study are expected to assist nurses to predict falls based on unit characteristics; reducing nursing time in the units was found to be a factor associated with higher fall risk. Nurse managers must understand the unit-related fall risk factors, appropriately assign nurse staffing numbers, and demonstrate nursing leadership to prevent falls in their units.
Nomogram for predicting intolerable postoperative early enteral nutrition following definitive surgery for small intestinal fistula: a cohort study
Authors: Tian Weiliang , Luo Lei , Xu Xin , Zhao Risheng , Tian Tao , Li Wuhan , Zhao Yunzhao , Yao Zheng 
Published: May 2024

Background:
This study was designed to develop and validate a nomogram for predicting intolerable early enteral nutrition (EEN) following definitive surgery (DS) for small intestinal fistula.

Methods:
A total of 377 patients, recruited from January 2016 to September 2023, was randomly allocated into development (n=251) and validation (n=126) groups in a 2:1 ratio. Risk factors were identified using the nomogram. Its performance was assessed based on calibration, discrimination, and clinical utility, with validation confirming its effectiveness.

Results:
Of the 377 patients, 87 (23.1%) were intolerant to EEN, including 59 (23.1%) in the development cohort and 28 (22.1%) in the validation cohort (P=0.84). Four factors were identified as predictive of intolerable EEN: severe abdominal adhesion, deciliter of blood loss during DS, human serum albumin (Alb) input >40 g during and within 48 h post-DS, and the visceral fat area (VFA)/total abdominal muscle area index (TAMAI) ratio. The model demonstrated excellent discrimination, with a C-index of 0.79 (95% CI: 0.74–0.87, including internal validation) and robust calibration. In the validation cohort, the nomogram showed strong discrimination (C-index=0.77; 95% CI: 0.64–0.87) and solid calibration. Decision curve analysis affirmed the nomogram’s clinical utility.

Conclusion:
This research introduces a nomogram that enables the individualized prediction of intolerable EEN following DS for small intestinal fistula, demonstrating a possible clinical utility.
Short-term (1–3 months) versus standard (12 months) dual antiplatelet therapy following new-generation drug-eluting stent implantation: A meta-analysis of randomized controlled trials
Authors: Xiong Penghui , Zheng Chunhua , Fan Jianfeng , Zhang Hongyu , Li Can 
Published: May 2024

Background:
Patients undergoing percutaneous coronary intervention mainly receive antiplatelet therapy. However, limited data are available regarding the optimal dual antiplatelet therapy (DAPT) following the implantation of new-generation drug-eluting stent (DES).

Objective:
This study aimed to compare the clinical outcomes of short-term (1–3 months) DAPT and standard (12 months) DAPT after the implantation of a new-generation of DES.

Methods:
We systematically searched PubMed, The Cochrane Library Database, Embase for trials that compared short-term (1–3 months) and standard DAPT after the implantation of next-generation DES were retrieved from all published studies in English until December 31, 2021. The primary endpoint was major bleeding. The secondary endpoints included all-cause mortality, cardiac death, myocardial infarction, stroke, stent thrombosis, and all bleeding.

Results:
This study included a total of 7 randomized controlled trials, comprising 28,344 subjects. Regarding primary endpoints, short-term DAPT exhibited a significantly lower incidence of major bleeding compared with standard DAPT [relative risk (RR): 0.66, 95% confidence interval (CI): (0.54, 0.81), P < .0001]. For secondary endpoints, there were significant differences between short-term and standard DAPT in all bleeding [RR: 0.59, 95% CI: (0.50, 0.69), P < .00001]. However, no significant differences were identified in all-cause mortality [RR: 0.96, 95% CI: (0.77, 1.18), P = .27], myocardial infarction [RR: 0.98, 95% CI: (0.82, 1.18), P = .86], cardiac death [RR: 0.83, 95% CI: (0.63, 1.10), P = .20], stroke [RR: 1.08, 95% CI: (0.79, 1.47), P = .63], cerebrovascular [RR: 1.08, 95% CI: (0.79, 1.47), P = .63], and stent thrombosis [RR: 1.13, 95% CI: (0.80, 1.57), P = .49] between the 2 groups.

Conclusion:
In patients undergoing implantation of a new-generation of DES, short-term (1–3 months) DAPT exhibited no inferiority compared with standard (12 months) DAPT in terms of all-cause mortality, cardiac death, myocardial infarction, stroke, and definite or probable stent thrombosis compared with standard (12 months) DAPT. However, short-term DAPT appeared superior to standard DAPT in terms of major bleeding and all bleeding.
Visual training for the treatment of retinal photoreceptor inner and outer segment connection (IS/OS) fracture: A case report
Authors: Jiang Peng-Fei , Xu Shan , Chen Qing , Pan Bing-Xin 
Published: May 2024

Background:
The inner segments and outer segments (IS/OS) of the retinal photoreceptors are the areas that receive light signals and are the most initial sites for generating visual impulses, and the integrity of the IS/OS has a direct impact on visual sensitivity.

Methods:
We performed OCT on a 6-year-old child with vision loss and found that the cause of his vision loss was a retinal IS/OS fracture, and the child underwent some treatments to improve microcirculation and nourish the retina at a higher-level hospital, but his vision never improved. Our examination of this child revealed that this child not only had decreased visual acuity, but also hypermetropia, but his near stereopsis was normal. The symptoms were similar to those of amblyopia, so we tried to use visual training as a treatment.

Results:
First, 6 sessions of fine visual stimulation were given, followed by 3 sessions of accommodation training, and we followed the 4 stages of accommodation training: perception of accommodation, amplitude of accommodation, sensitivity of accommodation, and autonomic accommodation. After 9 consecutive visual training sessions, the child’s visual acuity was stabilized at 0.6, and then we added eye movement training, and after the child’s visual acuity was improved to 0.7, we suppressed the visual acuity of the left eye to 0.6, so as to make the visual acuity of both eyes similar, which would promote the establishment of binocular stereo vision, and then we carried out 9 more visual training sessions, and the patient’s visual acuity was stabilized at 0.8 gradually. OCT review showed that the child’s retinal IS/OS fracture was basically closed.

Conclusion subsections:
In conclusion, our study found that visual training can restore visual acuity in children with monocular IS/OS fracture and also promote repair of IS/OS fracture, which increases our understanding and knowledge of the treatment of retinal IS/OS fracture, and this case may provide some lessons for the treatment of retinal IS/OS fracture in children. We hope to have more samples of retinal IS/OS fracture in the future to evaluate the efficacy of visual training for retinal IS/OS fracture.
Smoking cessation and risk of metabolic syndrome: A meta-analysis
Authors: Kim Hyun Ji , Cho Yoon Jeong 
Published: May 2024

Background:
Smoking is an important risk factor for various metabolic and cardiovascular disorders, and smoking cessation reduces the risk of these conditions. However, weight gain is commonly observed when individuals quit smoking, which often leads to hesitation in pursuing smoking cessation. Weight gain increases the risk of metabolic syndrome (MS). However, previous studies that investigated the relationship between smoking cessation and MS have yielded inconsistent results. Therefore, we conducted a meta-analysis to evaluate the association between smoking cessation and MS.

Methods:
Medline, Embase, Cochrane Library and CINAHL databases, were comprehensively searched from inception to April 2023, to identify relevant studies examining the relationship between smoking cessation and MS, comparing such relationship to that with active smoking. The methodological quality of the selected studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. A random-effects model was used for meta-analysis.

Results:
Of 495 identified studies, 24 were reviewed. The risk of selection bias was identified in all the studies. The overall analysis of 14 studies, including data of combined results for both men and women, revealed an increased risk of MS among ex-smokers compared with that among active smokers (pooled relative risk [RR] 1.18, 95% confidence interval [CI]: 1.08–1.29). From the selected studies, 13 studies analyzing men were extracted for subgroup analysis. Among men, no significant difference in the risk of developing MS was observed between ex-smokers and smokers (pooled RR: 1.05, 95% CI: 0.95–1.17). In men, the risk of MS increased if the cessation period was ≤15 years in men (pooled RR 1.26, 95% CI: 1.01–1.56) and slightly decreased if the cessation period was > 15 years (RR 0.84, 95% CI: 0.70–1.00) in ex-smokers compared with that in current smokers.

Conclusion:
An increased risk of MS was observed in the early stages of smoking cessation compared with current smoking. As the longer duration of smoking cessation, the risk of MS becomes less significant.
A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by Chelidonium Majus L.: Report of Two Cases of Herb-Induced Liver Injury and Literature Review
Authors: Ciornolutchii Vera , Ismaiel Abdulrahman , Sabo Cristina Maria , Al Hajjar Nadim , Seicean Andrada , Dumitrascu Dan L. 
Published: May 2024

Background:
In instances where individuals manifest elevated transaminase levels without a clearly discernible cause, a comprehensive patient history proves invaluable in unveiling latent triggers. In this report, we present 2 cases of herb-induced liver injury (HILI) characterized by severe hypertransaminasemia attributed to the consumption of Chelidonium majus L. (also known as greater celandine [GC]), an agent considered an alternative therapeutic remedy.

Areas of Uncertainty:
Exploring the occurrence and range of clinical manifestations in HILI linked to Chelidonium majus L., while also investigating the potential triggers and predisposing factors for hepatotoxic reactions post Chelidonium majus L. usage, remains challenging due to the absence of definitive laboratory tests to identify the causative agent.

Data Sources:
Two case reports were detailed, and a systematic literature review using PubMed was conducted including published literature till March 2023. Moreover, a manual search of reference lists of pertinent articles was performed to identify any additional relevant missed publications.

Results:
In the first case, a 64-year-old woman presented with jaundice, revealing a 1-month history of using GC capsules to manage gallstones. Diagnostic assessment identified HILI, gallstones, and choledocolithiasis, with transaminase levels exceeding 1000 IU/L. After discontinuing GC and receiving intravenous therapy with amino acids and phospholipids, the patient's condition significantly improved. Subsequently, she underwent endoscopic common bile duct stone removal and cholecystectomy. In the second case, a 66-year-old woman presented with elevated liver function test results discovered incidentally during musculoskeletal pain evaluation. Upon further questioning, the patient disclosed regular consumption of GC tea for "health promotion." Following intravenous therapy using amino acids and phospholipids, her transaminase levels returned to normal. The literature review identified 38 cases of HILI associated with GC preparations, primarily in adult women aged 27–77 years, with a predominant reporting location in Germany. Various forms of GC were used, with treatment durations ranging from 1 week to a year. Discontinuation of GC generally led to recovery in these cases.

Conclusion:

Chelidonium majus L., a potent herb often used in alternative medicine, has significant hepatotoxic potential, requiring physicians to be vigilant in cases of unexplained liver injury.
Sustainable practices in hospital and operating theaters
Authors: Anract Julien , Pradere Benjamin , Pinar Ugo 
Published: May 2024

Purpose of review
This review aims to provide an update on the results of studies published in the last two years involving the development of sustainable practices in hospital and operating theaters (OT)

Recent findings
Recently, many studies evaluated various initiatives to better understand the environmental impact of the OT but also to minimize its environmental impact. Many trials evidenced the positive impact of the instrument's reuse using an appropriate reprocessing procedure. Better waste segregation is associated with a reduction of produced waste and contributes to a significant reduction in CO2 equivalent emissions. Regarding anaesthetic gas, Desflurane is known to have the worst environmental impact and the majority of the study evidenced that its reduction permits to drastically reduce greenhouse gas emission of the OT.

Summary
Greening the OT necessitates climate-smart actions such as waste reduction, the improvement of reusable instruments, recycling of our waste and better anaesthetic gas management. Within the last two years, many efforts have been made to reduce and better segregate waste produced in the OT and also to better understand the environmental impact of disposable and reusable devices.
Self-injurious unnatural death among Veterans with HIV
Authors: Smith Alexandria C. , Goulet Joseph L. , Vlahov David , Justice Amy C. , Womack Julie A. 
Published: May 2024

Objective:
People with HIV (PWH) are at an increased risk of suicide and death from unintentional causes compared with people living without HIV. Broadening the categorization of death from suicide to self-injurious unnatural death (SIUD) may better identify a more complete set of modifiable risk factors that could be targeted for prevention efforts among PWH.

Design:
We conducted a nested case–control study using data from the Veterans Aging Cohort Study (VACS), a longitudinal, observational cohort of Veterans from 2006–2015. A total of 5036 Veterans with HIV, of whom 461 died by SIUD, were included in the sample.

Methods:
SIUD was defined using the International Classification of Disease 10th revision cause of death codes. Cases (n = 461) included individuals who died by SIUD (intentional, unintentional, and undetermined causes of death). Controls (n = 4575) were selected using incidence density sampling, matching on date of birth ± 1 year, race, sex, and HIV status. SIUD and suicide was estimated using conditional logistic regression.

Results:
A previous suicide attempt, a diagnosis of an affective disorder, recent use of benzodiazepines, psychiatric hospitalization, and living in the western US significantly increased the risk of suicide and SIUD. Risk factors that appear more important for SIUD than for suicide included a drug use disorder, alcohol use disorder, Hepatitis C, VACS Index 2.0, current smoking, and high pain levels (7–10).

Conclusion:
Limiting studies to known suicides obscures the larger public health burden of excess deaths from self-injurious behavior. Our findings demonstrate the benefit of expanding the focus to SIUD for the identification of modifiable risk factors that could be targeted for treatment.
A Radial Approach Combined With a Contralateral Vertebral Retrograde Approach for Stenting and Coil Embolization of a Large Posterior Inferior Cerebellar Artery Aneurysm
Authors: Fan Guangliang , Ma Yonggang , Wang Chao 
Published: May 2024

Background:
Wide-neck aneurysm embolism is a technically demanding procedure. Stent device deployment is challenging intraoperatively, especially in parent arteries with acute angles.

Case description:
The authors describe the case of a 74-year female with an unruptured right posterior inferior cerebellar artery aneurysm. The acute angle of the arteries proximal to the posterior inferior cerebellar artery complicated the condition, and the distal end of the guidewire failed to enter the posterior inferior cerebellar artery despite several maneuvers. The wide neck of the aneurysm was located in the posterior inferior cerebellar artery, so a stent was needed. The stent was deployed from the left vertebral artery retrograde to the right vertebral artery.

Conclusions:
The authors report the successful application of a rare strategy, the radial approach combined with a contralateral vertebral retrograde approach, for stent deployment.