bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative pain management after abdominal transplantations
Authors: Tufegdzic Boris , Lobo Clara , Kumar Arun 
Published: June 2024

Purpose of review
The aim of this review article is to present current recommendations as well as knowledge gaps and controversies pertaining to commonly utilized postoperative pain management after solid organ transplantation in the abdominal cavity.

Recent findings
Postsurgical pain has been identified as one of the major challenges in recovery and treatment after solid organ transplants. Many perioperative interventions and management strategies are available for reducing and managing postoperative pain. Management should be tailored to the individual needs, taking an interdisciplinary and holistic approach and following enhanced recovery after surgery guidelines. Many centers currently utilize peripheral and neuraxial blocks during transplantation surgery, but these techniques are far from standardized practices. The utilization of these procedures is often dependent on transplantation centers’ historical methods and perioperative cultures.

Summary
The optimal pain management regimen has not yet been definitively established, and current scientific evidence does not yet support the endorsement of a certain analgesic approach. This objective necessitates the need for high-quality randomized controlled trials.
Substance Use Disorder Care in Skilled Nursing Facilities: Characterizing Resident Experiences
Authors: Parkhideh Arianna , Beiting Kimberly J. , Yang Meredith , Landi A. Justine , Levine Stacie 
Published: June 2024

Objectives
Patients with substance use disorder (SUD) may face many challenges when being cared for in skilled nursing facilities (SNFs), such as stigma and inadequate access to treatment. This study aims to learn from the perspectives of SNF residents with SUD.

Methods
Nineteen semistructured interviews were conducted at 5 SNFs in the Chicago Metropolitan Area. Additionally, Likert-type responses and substance use screening tests were collected. Qualitative data were analyzed using Dedoose version 9.0.107 (Sociocultural Research Consultants, LLC, Los Angeles, CA).

Results
Qualitative analyses identified 4 themes: (1) the SNF can be a positive site for recovery, (2) barriers to recovery in SNFs are variable, (3) lived experiences with SUD care and harm reduction are heterogeneous, and (4) the needs of residents with SUD encompass multiple domains. Results highlighted the variability of access to counseling and SUD treatment, as well as the prevalence of stigma, substance use, and overdose in SNFs. Results revealed the need for access to social work support, activities, counseling services, and improved staff knowledge of treating SUD.

Conclusions
SNF residents living with SUD experience variable quality of care and may have difficulty accessing counseling and medical treatments for SUD, depending on the available resources in the facility to which they were admitted. The quality of care for residents living with SUD requires further study as more patients with SUD require SNF care.
Drug Testing Interpretation in the Peripartum Setting: Results of Clinician Survey
Authors: Kurtz Theresa , Charron Elizabeth , Shakib Julie , Smid Marcela C. 
Published: June 2024

Objectives
The objectives of this study were to (1) survey obstetrical and pediatric clinicians’ experience, confidence, and training in maternal and neonatal drug testing interpretation; (2) determine their proficiency in drug test interpretation; and (3) assess predictors of correct interpretation.

Methods
We conducted a cross-sectional survey of clinicians caring for pregnant people or newborns at an urban academic center. We assessed clinicians’ demographic characteristics, experience, confidence, and prior training in interpretation of maternal and newborn drug tests. We assessed proficiency in interpreting drug tests using 11 clinical vignettes and categorized scores as poor (0–2), fair (3–5), and good (≥6) performance to facilitate data interpretation. We used descriptive statistics to summarize responses. Multinomial logistic regression was used to determine associations of clinician characteristics and score category (reference category: poor performance).

Results
In total, 103 respondents completed the survey including 60 obstetrical clinicians (58.3%), 19 family medicine physicians (18.5%), 21 pediatric clinicians (20.4%), and 3 social workers (2.9%) (response rate, ~40%). The mean correct response was 4.1 (SD, 2.17; range, 0–11). Most respondent scores were fair (n = 47.6%), followed by good (n = 28.2%) and poor (n = 24.3%). Increased frequency, confidence, and training in interpreting maternal screening and confirmatory tests were associated with higher proficiency. Increased confidence and training in interpreting neonatal screening and confirmatory tests, but not frequency, were associated with higher proficiency.

Conclusions
Most clinicians demonstrated fair proficiency in interpreting drug tests. Predictors of proficiency were confidence and prior training for drug test interpretation, suggesting that educational interventions could improve proficiency.
Ectopic Prostatic Tissue in Female Urethral Diverticulum
Authors: Sinha Annika , Cantrell Sarah , Kozman Diana M. , Jelovsek J. Eric 
Published: June 2024

BACKGROUND:
Ectopic prostatic tissue in female patients is rare. It is theorized that the presence of prostatic tissue in female patients is likely a Wolffian remnant or transformation of hormonally mediated tissue of the uterus, cervix, Skene's gland, and, rarely, periurethral tissue. Due to the increase in the use of testosterone and gender-affirming therapies, it is important to understand the role of testosterone in mediating the presence of ectopic prostatic tissue.

CASE:
We present a case of ectopic prostatic tissue in a urethral diverticulum in a female patient with exposure to testosterone hormone therapy and review the literature on this finding.

CONCLUSION:
Although rare, ectopic prostatic tissue should be considered in the differential diagnosis of anterior vaginal cysts, especially in the setting of testosterone supplementation.
Anterior Distal Femoral Hemiepiphysiodesis Using Coronally Oriented 8-plates for the Correction of Fixed Knee Flexion Deformities in Children—Preliminary Results
Authors: Hassanein Mohamed Y. , Khaled Mohamed , Hassanein Mahmoud Yahya , Abol Oyoun Nariman 
Published: June 2024

Introduction:
The original technique for guided growth of the distal femur for correction of pediatric fixed knee flexion deformities (FKFDs) involves the utilization of two 8-plates inserted on either side of the trochlear groove, a technique that has been frequently linked to the development of persistent postoperative knee pain and crepitus. The present study aimed to assess the preliminary results of a novel technique where the two 8-plates are fixed in the coronal plane, one on each of the medial and lateral surfaces, so that they occupy the anterior part of the distal femur.

Methods:
Our study was a prospective case series that included cases with FKFD of >10 degrees in children with at least 12 months of predicted growth remaining. The preoperative knee flexion contracture angle was documented. The surgical procedure entailed the insertion of 2 coronally oriented 8-plates on the medial and lateral surfaces of the distal femur as anterior as possible to the axis of the femur without encroachment on the trochlear groove. The duration of time required to attain full knee extension and any complications encountered were recorded. Wilcoxon signed-rank was used to compare the preoperative and final contracture angles. The level of statistical significance was set at P<0.05.

Results:
Thirteen knees in 8 patients (6 boys and 2 girls) were included. The median age was 11 years (6 to 14). There was a significant improvement in the FKFD for the whole cohort from 25 degrees (14 to 42) to 0 degrees (−9 to 8), P<0.05. The median rate of correction was 2.0 degrees/month (0.9 to 5.8). The time till full correction was 14 months (4 to 25). Postoperative knee pain and metalware-related complications were not reported by any patient during follow-up.

Conclusions:
Guided growth of the distal femur using coronally oriented 8-plates is an effective procedure for the treatment of FKFDs in children. This modified technique may achieve faster correction while minimizing the risk of postoperative knee pain compared with the conventional technique.

Level of Evidence:
Level IV—case series.
Histopathological Confirmation of Axonal Sprouting in Regenerative Peripheral Nerve Interface
Authors: Chang Song Ho , Maenohara Yuji , Hirose Jun , Omata Yasunori , Fujiwara Sayaka , Haga Nobuhiko , Ikemura Masako , Saito Taku , Tanaka Sakae , Matsumoto Takumi 
Published: June 2024

Summary:
Symptomatic neuroma represents a debilitating complication after major limb amputation. The regenerative peripheral nerve interface (RPNI) has emerged as a reproducible and practical surgery aimed at mitigating the formation of painful neuroma. Although previous animal studies revealed axonal sprouting, elongation, and synaptogenesis of proximal nerve stump within the muscle graft in RPNI, there is a lack of reports confirming these physiological reactions at the histopathological level in human samples. This report presents a case of below-knee amputation with RPNI due to foot gangrene resulting from polyarteritis nodosa. Subsequently, an above-knee amputation was necessitated due to the exacerbation of polyarteritis nodosa, providing the opportunity for histopathological examination of the RPNI site. The examination revealed sprouting, elongation, and existence of neuromuscular junction of the tibial nerve within the grafted muscle. To the best of our knowledge, this is the first report demonstrating axonal sprouting, elongation, and possibility of synaptogenesis of the nerve stump within the grafted muscle in a human sample.
Who develops chronic pain after an acute lower limb injury? A longitudinal study of children and adolescents
Authors: Fisher Emma , Monsell Fergal , Clinch Jacqui , Eccleston Christopher 
Published: June 2024

Abstract
Prevention of chronic pain is a major challenge in this area of clinical practice. To do this, we must be able to understand who is most at risk of developing chronic pain after an injury. In this study, we aimed to identify risk factors of chronic pain onset, disability, and pain interference after a lower limb musculoskeletal injury in children and adolescents between 8 to 16 years of age. We assessed biopsychosocial factors including age, sex, pubertal status, anxiety, depression, fear of pain, pain worry, adverse life events, and sleep in children. We also assessed risk factors in parents including parent anxiety, depression, parent pain catastrophising, and protective behaviours. Logistic and hierarchical linear regressions identified risk factors assessed immediately postinjury for outcomes assessed at 3 months postinjury. Fourteen percent (17/118 children) reported chronic pain 3 months after injury. There were significant between-group differences in children with and without chronic pain at baseline. Children with chronic pain reported higher pain intensity, disability, pain interference, child depression, fear of pain, and catastrophic thinking about their pain. Regressions showed child depression and fear of pain at baseline independently predicted chronic pain onset at 3 months, parent protectiveness predicted child pain interference at 3 months, and child depression, poor sleep, parent anxiety and pain catastrophising predicted disability. Most children recover after a lower limb injury, but a minority develop chronic pain predicted by important psychosocial risk factors, which could be addressed to prevent the onset of treatment-resistant chronic pain and disability.
Burden of chronic pain among adult pastoralists in Ethiopia: a cross-sectional household survey
Authors: Baum Eleonore , Abdi Sied , Hattendorf Jan , van Eeuwijk Peter , Tschopp Rea , Vosseler Birgit , Zinsstag Jakob , Probst-Hensch Nicole 
Published: June 2024

Abstract
Chronic pain is a major global health problem. Untreated pain causes particular suffering in marginalized communities. Most studies investigating chronic pain in sub-Saharan Africa stem from South Africa and Nigeria. Pastoralists are particularly underrepresented in pain research. The main objective of this study is to investigate the burden of chronic pain in adult pastoralists in the Somali Regional State of Ethiopia. We conducted a cross-sectional household survey among adult pastoralists (aged 18 years or older, N = 299) by face-to-face interviews. To randomly select households, we applied GPS-based household localization and recruitment. Chronic pain was self-reported by 17.0% (95% CI: 10.8-25.7) of male and 34.7% (95% CI: 28.4-41.5) of female adult pastoralists. The prevalence of chronic pain increased with age from 5.4% (95% CI: 0.8-30.1; 18-34 years) to 27.1% (95% CI: 15.1-43.7; 35-54 years) to 69.1% (95% CI: 53.7-81.1; 55 years and older). The body sites most commonly affected among those with chronic pain were knees (37.2%), followed by lower back (33.7%) and head (23.3%). The data for the first time provide insights into the burden of chronic pain among Somali pastoralists and reveal associated risk factors. The results support the planning of locally adapted health interventions for pastoralist-specific pain management considering the effects of chronic pain on pastoralists' daily lives.
Metabolic support for patients on extra-corporeal membrane oxygenation
Authors: Hileman Bethany Anne , Martucci Gennaro , Subramanian Harikesh 
Published: June 2024

Purpose of reviewThe purpose of the review is to summarize recent research on metabolic support during extracorporeal membrane oxygenation. In this review, we cover the evidence on nutritional supplementation, both the route of supplementation, timing of initiation of supplementation as well as quantities of supplementation needed. In addition, we discuss the recent trend in awake extracorporeal membrane oxygenation (ECMO) and its benefits to patients.Recent findingsAs ECMO use continues to increase over the last few years, for both cardiovascular as well as respiratory failure, the need to optimize the metabolic states of patients has arisen. Increasing evidence has pointed towards this hitherto unexplored domain of patient care having a large impact on outcomes. Additionally, strategies such as awake ECMO for select patients has allowed them to preserve muscle mass which could aid in a faster recovery.SummaryThere is a role of optimal metabolic support in the early recovery of patients on ECMO that is currently under-recognized. Future directions of research that aim to improve post ECMO outcomes must focus on this area.
Light, sleep and circadian rhythm in critical illness
Authors: Perry Heather , Alight Athina , Wilcox M. Elizabeth 
Published: June 2024

Purpose of reviewSleep and circadian disruption (SCD) are associated with worse outcomes in the ICU population. We discuss sleep, circadian physiology, the role of light in circadian entrainment and its possible role in treating SCD, with special attention to the use of light therapies and ICU design.Recent findingsThe American Thoracic Society recently published an official research statement highlighting key areas required to define and treat ICU SCD. Recent literature has been predominantly observational, describing how both critical illness and the ICU environment might impair normal sleep and impact circadian rhythm. Emerging consensus guidance outlines the need for standardized light metrics in clinical trials investigating effects of light therapies. A recent proof-of-concept randomized controlled trial (RCT) showed improvement in delirium incidence and circadian alignment from ICU room redesign that included a dynamic lighting system (DLS).SummaryFurther investigation is needed to define the optimal physical properties of light therapy in the ICU environment as well as timing and duration of light treatments. Work in this area will inform future circadian-promoting design, as well as multicomponent nonpharmacological protocols, to mitigate ICU SCD with the objective of improving patient outcomes.
Research of assisted housing design for the bedridden elderly and their family caregivers
Authors: Shang Tingting , Wang Yue , Yao Yanan , Wang Yu , Wang Xiaomeng 
Published: June 2024

Abstract

Objectives:
To explore the housing design strategies based on the needs of the bedridden elderly and their family caregivers to promote the health of the bedridden elderly and reduce the stress of family caregiving.

Methods:
A descriptive qualitative study, grounded in phenomenological principles, was undertaken to investigate the experiences of 24 bedridden elderly individuals and their respective 24 family caregivers. The interviews were semistructured and supplemented by nonparticipant observations.

Results:
The needs of the bedridden elderly and their family caregivers for the housing environment were mainly focused on safety guarantees, health promotion, and care assistance. Challenges such as spatial barriers, poor environmental quality, and insufficient adaptability in housing components and aids can greatly reduce the assisted role of housing.

Conclusion:
This paper emphasizes the importance of tailoring housing design to the specific physical characteristics, sensory needs, and behavioral habits of the bedridden elderly and their family caregivers. Effective layout and design should consider spatial flow, control and regulation of the physical environment, and the careful selection and configuration of accessories and aids.
Celecoxib enhances the response of tumor cells to cisplatin through upregulating PUMA in non–small cell lung cancer carrying wild-type p53
Authors: Xiao Yuxuan , Wang Ziyu , Gu Meng , Tan Jinjing , Li Weiying 
Published: June 2024

Abstract
Celecoxib, a cyclooxygenase-2 inhibitor, can enhance the efficacy of chemotherapy; however, its effect seems inconsistent. In this study, we investigated whether celecoxib would increase the antiproliferative effects of cisplatin in human lung cancer cells. Our data demonstrated the synergistic effects of celecoxib with cisplatin in wild-type p53 cells and their antagonistic effects in mutated or deleted p53 cells. Combination indices of 0.82 to 0.93 reflected a synergistic effect between celecoxib and cisplatin in lung cancer cells with wild-type p53. Combination indices of 1.63 to 3.00 reflected antagonism between celecoxib and cisplatin in lung cancer cells with mutated or deleted p53. Compared with that in cells with mutated or deleted p53, apoptosis significantly increased with the addition of celecoxib and cisplatin in wild-type p53 cells (P < 0.05). Moreover, the results in vivo were similar to those in vitro: celecoxib combined with cisplatin slowed tumor growth in wild-type p53 groups and not in mutated or deleted p53 groups. In addition, celecoxib promoted p53 translocation into the nucleus and upregulated active p53 expression in wild-type p53 cells. Celecoxib combined with cisplatin upregulated PUMA (PUMA is a downstream gene of p53) after active p53 increased in wild-type p53 cells. In summary, the combination of celecoxib and cisplatin demonstrates clear synergistic effects in wild-type p53 cells and antagonistic effects in mutated or deleted p53 cells. The synergistic effect was achieved by apoptosis, induced by upregulating PUMA. Our results will provide a new treatment strategy for patients carrying wild-type p53, insensitive to cisplatin.
Spontaneous intra-abdominal hematomas in a hepatocellular carcinoma patient treated with lenvatinib: a case report
Authors: Ma Hong , Li Jun-Feng , Wang An-Rong , Tan Yong , Yuan Guang-Jin 
Published: June 2024

Abstract
A 44-year-old patient was admitted with tumor rupture in the left hepatic lateral lobe, and he underwent emergent exploratory laparotomy and proceeded for hepatic left lateral lobectomy on September 19, 2021. The final diagnosis of hepatocellular carcinoma was confirmed by histopathological examination of the surgical specimen. Afterward, the patient received hepatic arterial infusion chemotherapy with FOLFOX (oxaliplatin, fluorouracil, and leucovorin) for 5 cycles. Subsequently, recurrence of the hepatocellular carcinoma was diagnosed in the abdominal cavity. The patient was then treated with lenvatinib. Within less than 1 month of the treatment with lenvatinib, the patient was admitted to the emergency room on June 2, 2022, because of acute intra-abdominal bleeding (hematomas). Percutaneous intra-abdominal angiography found that the bleeding vessels were the right gastroepiploic artery and left gastric artery. The patient was stabilized after arterial embolization using gelatin sponges. The diagnosis and management of spontaneous intra-abdominal hematomas are discussed.
BMI1 overexpression is correlated with a poor prognosis and immune infiltration in hepatocellular carcinoma
Authors: Wang Min-Cong , Yang Peng-Tao , Zhang Yang , Ma Hong-Bing 
Published: June 2024

AbstractBackgroundOwing to the occurrence of primary or secondary tolerance, the efficacy of immunotherapy for hepatocellular carcinoma (HCC) patients is limited. Therefore, the mechanism underlying this tolerance needs to be further investigated. B cell–specific Moloney murine leukemia virus integration site 1 (BMI1) is associated with cancer stem cell tumorigenesis, progression, and the maintenance of the self-renewal. However, the effect of BMI1 expression on immune infiltration and prognosis in HCC is still unclear.MethodsTo assess the relationship between BMI1 expression and HCC prognosis and immune infiltration, the GEPIA database, TIMER database, and K-M plotter were used. TIMER database was used to determine the levels of BMI1 in various tumor tissues and corresponding normal tissues, and examine the association between BMI1 expression and tumor-infiltrating immune cells. GEPIA database was applied to determine BMI1 expression in various tumor tissues and corresponding normal tissues. K-M Plotter was used to study the relationships among BMI1 expression, clinicopathological features, and survival rates.ResultsBMI1 expression was markedly higher in various solid tumors compared with that in the respective normal tissues, including HCC, and high expression led to poor relapse-free survival and overall survival in HCC patients. BMI1 overexpression was also correlated with the infiltration of immune cells (eg, B cells, CD8+T cells, CD4+T cells, dendritic cells, neutrophils, and macrophages) and positively associated with different subsets of T cells, monocytes, and M1 macrophages, among others.ConclusionsThis study demonstrates that high BMI1 expression is strongly correlated with immune infiltration and poor prognosis in HCC. Increased expression of BMI1 might thus be a potential mechanism of immune tolerance in this disease.
Progress and current perspectives of diagnosis and treatment of hepatoid adenocarcinoma of the stomach
Authors: Qin Kai , Zhang Jing , Gong Chen , Cheng Yi 
Published: June 2024

Abstract
Hepatoid adenocarcinoma of the stomach (HAS) is a rare malignant gastric tumor exhibiting both hepatocellular and adenocarcinomatous differentiation. Patients are often diagnosed at an advanced stage, and their clinical symptoms closely resemble those of gastric adenocarcinoma. Because of its rarity, misdiagnosis and missed diagnoses are prevalent. Compared with gastric adenocarcinoma, HAS typically exhibits higher invasiveness and a more unfavorable prognosis. This review aimed to elaborate on the pathological features, potential mechanisms, clinical characteristics, diagnosis, and prognosis of HAS. The insights provided aimed to contribute robust guidance for the clinical management of patients with HAS.