bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Online Model for Central Lymph Node Metastases in Papillary Thyroid Carcinoma With BRAF V600E Mutation
Authors: Chen Hao , Pan Wen-kai , Ren Si-yan , Zhou Yi-li 
Published: April 2024

Background:
To construct a predictive model to direct the dissection of the central lymph nodes in papillary thyroid cancer (PTC) with BRAF V600E mutation by identifying the risk variables for central lymph node metastases (CLNM).

Methods:
Data from 466 PTC patients with BRAF V600E mutations underwent thyroid surgery was collected and analyzed retrospectively. For these patients, we conducted univariate and multivariate logistic regression analysis to find risk variables for CLNM. To construct a nomogram, the independent predictors were chosen. The calibration, discrimination, and clinical utility of the predictive model were assessed by training and validation data.

Results:
CLNM was present in 323/466 PTC patients with BRAF V600E mutations. By using univariate and multivariate logistic regression, we discovered that gender, age, tumor size, multifocality, and pathological subtype were all independent predictors of CLNM in PTC patients with BRAF V600E mutations. A predictive nomogram was created by combining these variables. In both training and validation groups, the nomogram demonstrated great calibration capacities. The training and validation groups’ areas under the curve (AUC) were 0.772 (specificity 0.694, sensitivity 0.728, 95% CI: 0.7195-0.8247) and 0.731 (specificity 0.778, sensitivity 0.653, 95% CI: 0.6386-0.8232) respectively. According to the nomogram’s decision curve analysis (DCA), the nomogram might be beneficial. As well, an online dynamic calculator was developed to make the application of this nomogram easier in the clinic.

Conclusion:
An online nomogram model based on the 5 predictors included gender, age, pathological subtype, multifocality, and tumor size was confirmed to predict CLNM and guide the central lymph nodes dissection in PTC patients with BRAF V600E mutations.
Population Pharmacokinetics of Lamotrigine and Its N2-Glucuronide Metabolite in Chinese Patients With Epilepsy
Authors: Yang Hua , Zhang Dongjie , Wei Shifeng , Zhao Zhigang , Mei Shenghui 
Published: April 2024

Background:
Lamotrigine is a new antiepileptic drug with substantial interindividual variability in its pharmacokinetics and therapeutic responses. This study aimed to develop population pharmacokinetic (PPK) models of lamotrigine and its N2-glucuronide metabolites for model-informed individualized therapy.

Methods:
A total of 353 plasma concentrations from Chinese patients with epilepsy receiving oral lamotrigine were used to develop a population PPK model using a nonlinear mixed effects modeling method. One- and two-compartment models were applied to the nonmetabolite and metabolite model, respectively. Forward addition and backward elimination were used to establish the final model. Model validation was performed using standard goodness-of-fit, bootstrap, visual predictive checks, and normalized prediction distribution errors. Finally, simulations were performed to propose lamotrigine dosages in different situations to achieve trough concentrations within the reference interval (2.5–15 mg/L).

Results:
For both final population PPK models, coadministration with valproic acid (VPA) or enzyme inducer, and body weight significantly affected lamotrigine clearance. The final models for lamotrigine clearance were

and

for nonmetabolite and metabolite models, respectively. The precision of the PPK parameters was acceptable, and the models exhibited good predictability. Monte Carlo simulations revealed that the lamotrigine dosage administered to patients combined with an enzyme inducer must be tripled that administered with VPA to reach the target trough concentration.

Conclusions:
Variability in the pharmacokinetics of lamotrigine is large. Coadministration of VPA or an enzyme inducer and body weight are the most important factors in lamotrigine clearance in Chinese patients with epilepsy. The developed population PPK models might support further optimization of lamotrigine dosing regimens.
Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis
Authors: Xu Hong , Liu Jian , Li Peishan , Liang Yujie 
Published: April 2024

Abstract

Importance
The increasing attention to the management of perimenopausal and postmenopausal women parallels the growth of the aging population. Although hormone therapy is commonly used to alleviate menopausal symptoms, it carries a potential risk of cancer. Recently, mind-body exercises have emerged as innovative approaches for improving menopausal symptoms and bone health. However, research findings have needed to be more consistent, highlighting the significance of this study's systematic review of mind-body exercise effects on perimenopausal and postmenopausal women.

Objective
This study aims to evaluate the impact of mind-body exercises, including tai chi, yoga, Pilates, qigong, baduanjin, and mindfulness-based stress reduction, on bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women.

Evidence Review
Four electronic databases—PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science—were systematically searched from inception until July 2023. The search focused exclusively on randomized controlled trials to examine the impact of mind-body exercise interventions on perimenopausal and postmenopausal women. The methodological quality of the included studies was evaluated using the Cochrane Bias Risk Assessment tool.

Findings
A total of 11 randomized controlled trials, comprising 1,005 participants, were included in the analysis. Traditional meta-analysis indicated that mind-body exercise significantly enhanced bone mineral density in perimenopausal and postmenopausal women compared with control groups, with a standardized mean difference (SMD) of 0.41 (95% CI, 0.17 to 0.66; P = 0.001, I
2 = 7%). In addition, significant improvements were observed in sleep quality (SMD, −0.48; 95% CI, −0.78 to −0.17; P = 0.002, I
2 = 76%), anxiety reduction (SMD, −0.80; 95% CI, −1.23 to −0.38; P = 0.0002, I
2 = 84%), depressive mood (SMD, −0.80; 95% CI, −1.17 to −0.44; P < 0.0001, I
2 = 79%), and fatigue (SMD, −0.67; 95% CI, −0.97 to −0.37; P < 0.0001, I
2 = 0%).

Conclusions and Relevance
The findings of this meta-analysis demonstrate that mind-body exercise positively influences bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women.
Impact of Prior COVID-19 Infections on Cardiac Rehabilitation Completion Rates and Outcomes
Authors: Taylor Matthew A. , Berkowitz Julia L. , Chen Kevin , DeAngelis Julianne , Wu Wen-Chih 
Published: April 2024

Purpose:
This is a retrospective cohort study designed to evaluate the impact of having a prior COVID-19 infection on cardiac rehabilitation (CR) completion rates and outcomes.

Methods:
Participants enrolled into the CR program from June 1, 2020, to March 30, 2022. They completed both physical and mental health assessments prior to enrollment and upon completion of the program. The cohort was divided into (–) COVID and (+) COVID based on whether they self-reported a prior COVID-19 infection. Outcome measures included General Anxiety Disorder-7, Patient Health Questionnaire-9, Mental Composite Score (Short Form Health Survey-36), Physical Composite Score (Short Form Health Survey-36), and exercise capacity (reported in METs). Program completion rates and outcome measures were compared between (–) COVID and (+) COVID cohorts.

Results:
A total of 806 participants were enrolled in the study. Program completion rates were 58.7% in the (–) COVID group and 67.2% in the (+) COVID group (P = .072). African Americans (P = .017), diabetics (P = .017), and current smokers (P = .003) were less likely to complete the program. Both (–) COVID and (+) COVID groups showed significant improvement in all outcome measures after completing the CR program. However, there was no difference in outcomes between groups.

Conclusions:
Having a prior COVID-19 infection did not negatively impact the mental and physical health benefits obtained by completing the CR program, regardless of the American Association of Cardiovascular and Pulmonary Rehabilitation risk category.
Early feeding and nutritional status of Portuguese children in the first 36 months of life: EPACI Portugal 2012–a national representative cross-sectional study
Authors: Nazareth Margarida , Pinto Elisabete , Severo Milton , Graça Pedro , Lopes Carla , Rêgo Carla 
Published: April 2024

Abstract

Background:
Early feeding practices have a critical role in the future not only in health but also in modulating eating habits. This study aimed to assess breastfeeding and complementary feeding practices and the nutritional status of Portuguese toddlers aged 0–36 months.

Methods:
EPACI Portugal 2012 is a cross-sectional study of a national representative sample. Trained interviewers collected data about early feeding practices and anthropometrics. Body mass index was classified according to World Health Organization criteria. Frequencies and survival analysis were used to characterize variables.

Results:
More than 90% of children were initiated breastfeeding, around 20% were exclusively breastfed for six months, and about 20% were breastfed at 12 months while complementary feeding was taking place. Exclusive breastfeeding was determined by maternal prepregnancy body mass index (HR 1.01; 95% CI 1.00, 1.03, P=.03) and low birth weight (HR 1.61; IC 95% 1.21, 2.15, P=.001) of the infants. About 90% were initiated complementary feeding between four and six months, and almost 10% were introduced to cow's milk before 12 months. In the second year of life, 83.2% and 61.6% of toddlers have already consumed nectars and sweet desserts, respectively. About one-third of Portuguese toddlers showed a body mass index z-score >1, and 6.6% were overweight/obese (z-score >2). No association was found between the duration of breastfeeding or timing of complementary feeding and the body mass index z-score in children.

Conclusions:
Despite the low prevalence of exclusive breastfeeding at six months, Portuguese infants effectively comply with dietary recommendations during the first year of life. The transition to the family diet must be carefully made. There is a high prevalence of Portuguese toddlers at least at overweight risk. The duration of breastfeeding or timing of complementary feeding was not associated with the expression of overweight/obesity.
Effect of COVID-19 Infection on Presenteeism
Authors: Miyaji Chikara , Kobayashi Tomoko , Habu Hiroshi , Hagiyama Akikazu , Horie Yoshiharu , Takao Soshi 
Published: April 2024

Objective
Presenteeism occurs when employees attend work despite experiencing problems and ill-health that require sick leave. This study examined whether presenteeism worsened following COVID-19 infection.

Methods
We used the DeSC, a large health insurance claims database. Participants were 9241 individuals who responded to questionnaires at baseline (June 2020) and 6 months later, had been continuously insured for at least 6 months prior to baseline, and reported being employed. Propensity score matching was performed. Adjusted multiple logistic regression was used to estimate odds ratios and 95% confidence intervals of worsening presenteeism from baseline according to COVID-19 infection compared with noninfection.

Results
Conditional logistic regression analysis showed that the adjusted OR for presenteeism in the COVID-19-infected group was 1.555 (95% confidence interval, 1.086–2.225).

Conclusions
The findings suggest that COVID-19 infection affected worsening of presenteeism.
Do You Bleed? A 1-Year FOBT Case-Series Study
Authors: Zouridis Spyridon , Sofia Daniel , Alshakhatreh Osama , Cleary Madeline , Daghstani Omar , Feustel Paul J , Sangha Maheep , Richter Seth 
Published: April 2024

Goals:
The goal of this study is to investigate fecal occult blood test’s (FOBT) usage in cases of suspected gastrointestinal bleeding and how it may affect hospitalization length and inpatient endoscopy procedures.

Background:
FOBT is an approved modality used in colorectal cancer screening but is often used inappropriately for the investigation of suspected gastrointestinal bleeding (GIB) in the hospital setting. The efficiency of FOBT when used for this purpose is questionable.

Study:
This study was performed at a 766-bed tertiary academic medical center. All FOBT performed during a 12-month period were identified and 678 cases were analyzed. The results of FOBT were collected along with information regarding patients’ hemoglobin levels, rectal examination frequency, performance of endoscopy, length of hospital stay, and presence/absence of gastrointestinal lesions.

Results:
There were no findings on endoscopy in 13.5% of cases with positive FOBT, demonstrating weak test sensitivity. Low percentage (14.6%) of patients having negative FOBT results underwent endoscopy, even with negative FOBT results, whereas less than 50% of positive FOBT patients were offered procedural evaluation, demonstrating the inefficiency of FOBT in guiding management. Patients with positive FOBT had longer hospitalization periods. Even in the absence of GIB symptoms, critically anemic patients would still undergo endoscopy for GIB investigation even without FOBT being performed.

Conclusions:
FOBT is inappropriately used in the hospital setting for GIB investigation. This study shows the inefficiency of FOBT to guide management and the high frequency of positive inpatient FOBT tests leading to unnecessary endoscopic investigation, longer hospitalizations, and delays in care. FOBT should be limited to the outpatient setting and be avoided while investigating GIB, anemia, etc. in the hospital.
The effects of common-sense model interventions on cancer patients: A systematic review
Authors: Gu Xue , Shen Xia , Zhou Jun-Rui , Chu Jiang-Hui , Jiang Lei 
Published: April 2024

Background:
From the time of new diagnosis to treatment, cancer patients experience a variety of health problems that can affect the patient’s health outcomes. Individuals with cancer are being given increasing responsibility for the self-management of their health and illness. The self-regulating common-sense model (CSM) is effective in patients’ disease management. This article briefly introduces the common-sense model intervention, in which patients with cancer are affected by these interventions, what they are about, and what effects they have.

Methods:
The authors systematically review evidence for the common-sense model of self-regulation for cancer using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Based on a comprehensive literature search, we searched the Cochrane Library, PsycINFO, Embase, PubMed, Medline, CINAHL, CNKI, and WanFang databases. The included studies underwent a quality assessment using the Effective Public Health Practice Project (EPHPP).

Results:
Eleven empirical studies illustrated the aspects of common-sense model interventions for cancer patients. It is concluded that common-sense model intervention has an effect on symptoms in cancer treatment, behavior, and quality of life, but more studies are needed to verify the use of common-sense model intervention to explore in patients with different cancers. The systematic review summarized a four-point paradigm about intervention content, including assessing the current situation, setting goals, having a disease education and psychological adjustment, and getting feedback for further response. However, the application of intervention requires specific analysis of patient behavior and outcomes.

Conclusion:
Common-sense model interventions are beneficial for the self-management of cancer patients; however, more intervention studies are needed to specify the cognitive, emotional, and coping styles of people with a particular cancer.
Treatment of abdominal pain due to deficiency syndrome of the spleen and stomach with Bian stone plus TCM iontophoresis: A case report
Authors: Guo Huan-Li , Zhao Jing , Feng Wen-Ying , Tian Xiao-Dong , Huang Yan-Ping 
Published: April 2024

Rationale:
Bian stone ironing and rubbing traditional Chinese medicine penetration method is based on the theory of regulating the middle and restoring balance. By using Bian stone to heat, ironing, and rubbing, pushing and rubbing in the epigastric area can regulate the spleen and stomach, restore the normal function of the middle jiao qi movement and the functions of the five organs. Bian stone hot ironing can harmonize stomach qi, nourish qi and assist yang, clear the internal organs and clear turbidity, regulate intestinal qi circulation, and promote qi stagnation.

Patient concerns:
The VAS score for stomach pain is 6 points, and the SAS score is moderate anxiety, which seriously affects sleep and daily life.

Diagnoses:
epigastric pain, spleen, and stomach deficiency cold syndrome.

Interventions:
Easy to digest diet, Western medicine provides famotidine acid inhibiting and protecting gastric mucosa, and mosapride promoting gastrointestinal peristalsis medication treatment; Traditional Chinese Medicine provides oral administration of Huangqi Jianzhong Tang and traditional Chinese medicine techniques such as Bianchi Ironing and Moxibustion for treatment.

Outcomes:
The patient’s symptoms of stomach pain have significantly improved, with a decrease in the epigastric pain score to 0, improved anxiety, reduced fatigue, improved sleep, improved epigastric fullness, unobstructed bowel movements, and improved quality of life. The patient is very satisfied.

Lessons:
The method of using Bian stone ironing and rubbing traditional Chinese medicine to treat stomach pain caused by the spleen and stomach deficiency cold can alleviate the symptoms of stomach pain in patients, and the improvement of symptoms shows a gradual increase, with significant effects. At the same time, it significantly improves patient anxiety and fatigue symptoms and can increase the sample size in future work to further clarify its clinical effects.
Erdheim-Chester disease as complex clinical presentation and diagnosis: A case report and concise review of literature
Authors: Gagliardo Carola M. , Giammanco Antonina , Vaglio Augusto , Pegoraro Francesco , Cefalù Angelo B. , Averna Maurizio , Noto Davide 
Published: April 2024

Rationale:
Erdheim-Chester disease (ECD) is a rare multisystemic disease characterized by the infiltration of multiple organs by foamy CD68 + CD1a-histiocytes. The genetic background consists of gain-of-function somatic mutations in the mitogen-activated protein kinase pathway. The purpose of the present paper is to make a contribution to the scientific literature on ECD by reporting our experience with a complex clinical case report, along with a concise review of the literature. We discussed the unusual clinical presentation, the complex diagnostic process and the comparison with other published cases.

Patient concerns:
A 70-year-old man presented with arthralgia due to multiple bone areas of sclerosis, first diagnosed with metastases of a prostatic neoplasm. Sequential thorax-abdomen, femoral and homer contrast-enhanced computed tomography (CT) showed pericardial effusion, pulmonary fibrosis, and perirenal fibrous tissue as “hairy kidneys.” He underwent. Three bone biopsies were unsuccessful to reach diagnosis.

Diagnoses:
A xanthelasma biopsy showed histopathological signs compatible with ECD; genetic analysis showed the mutation BRAFV600E.

Interventions:
The patient underwent targeted therapy with vemurafenib (BRAF-inhibitor), discontinued 2 weeks later due to the onset of a diffuse erythematous papular rash on the trunk and limbs.

Outcomes:
At the 1-year follow-up, there was only progression of chronic kidney disease (CKD).

Lessons:
The present case report describes how ECD diagnosis could represent a challenge for clinicians, owing to its heterogeneous clinical presentation. Early diagnosis followed by prompt therapy is essential for modifying the natural history of the disease.
Surgical treatment of patellar tendon rupture after total knee arthroplasty with a double-row repair method using the hamstring tendons: A novel technique with functional results
Authors: Akgun Erkan , Emet Abdulsamet , Tepedelenlioglu Emre , Sibar Kemal , Gok Halil , Firat Ahmet 
Published: April 2024

Background:
Patellar tendon rupture (PTR) is extremely rare but serious complication after primary or revision total knee arthroplasty. Due to the serious failure rates of end-to-end repair techniques, various augmentation techniques have been described. In this study, the results of patients with PTR after reconstruction using our own technique with semitendinosus (ST) and gracilis tendons taken from the affected side were evaluated retrospectively.

Methods:
A total of 14 patients, whose diagnosis was made based on physical examination and clinical findings, and supported radiologically (ultrasonography), were included in the study. In these patients, reconstruction was performed using double-row repair technique with the ST and gracilis tendons. Active-passive knee joint range of motion, active knee extension loss, and the Caton-Deschamps index at preoperative and final follow-up visits were compared. Tegner-Lysholm knee score and Kujala score were used to evaluate functional results.

Results:
In 14 patients (8 women and 6 men) with a mean age of 68.1 years, the median time between injury and surgery was 6.6 weeks. In all patients, the rupture was in the distal part of the patellar tendon. While the median preoperative Caton-Deschamps index was 1.8, the postoperative median value was found to be 1.25 after an average follow-up of 3.8 years (P = .014). The median preoperative knee extension loss decreased from 25° to 5° postoperatively. Tegner-Lysholm knee score and Kujala score of the patients at their last follow-up were significantly increased (P < .01).

Conclusion:
For PTR developing after total knee arthroplasty, the double-row reconstruction technique with ST and gracilis tendons is effective.
Robotic exoskeletons and total knee arthroplasty: The future of knee rehabilitation and replacement – A meta-analysis
Authors: Wu Karl , Pan Hsiang Hung , Lin Chun Hung 
Published: April 2024

Objective:
Exoskeletons can play a crucial role in post-TKA rehabilitation by accelerating recovery, improving mobility, and reducing further injury risk. This meta-analysis evaluated the effectiveness of exoskeletons in post-total knee replacement (TKR) rehabilitation.

Design:
Comprehensive searches were conducted on PubMed, OVID Medline, Cochrane Collaboration Library, and Embase (period: database inception to March 2023). Randomized controlled trials enrolling patients who underwent TKR and studies examining the effect of robot-assisted rehabilitation on physical function and pain outcomes were eligible for inclusion. Eight studies (302 patients) were thus included.

Results:
Exoskeletons significantly improved active range of motion (ROM) (SMD: 10.98, 95% confidence interval (CI): 7.81–14.16, P < .001), passive ROM (SMD: 4.11, 95% CI: 1.02–7.20, P = .009), Hospital for Special Surgery scores (SMD: 7.78, 95% CI: 5.87–9.68, P < .00001), and hospital stay length (SMD: −3.19, 95% CI: −4 to −2.38, P < .00001) compared with conventional rehabilitation. Active and passive ROM improvements suggest that exoskeletons aid knee function restoration and mobility post-TKR, whereas Hospital for Special Surgery score improvements support exoskeleton use in TKR rehabilitation. A shorter hospital stay was an important finding which could potentially reduce healthcare costs and improve outcomes.

Conclusion:
Despite the inclusion of a limited number of studies, our findings suggest that exoskeletons can enhance post-TKR rehabilitation outcomes and improve quality of life. Robot-assisted rehabilitation may be effective following TKR. Further research should confirm these findings.