bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relevance of blood tumor markers in inpatients with significant involuntary weight loss and elevated levels of inflammation biomarkers
Authors: Gronnier Morgane , Hedhli Kaies , Sauzay Chloé , Salle Valéry , Duhaut Pierre , Schmidt Jean , Dernoncourt Amandine 
Published: April 2024

Abstract
Purpose
To assess the diagnostic performance of a panel of standard tumor markers (TMs) in patients hospitalized with significant involuntary weight loss (IWL) and elevated levels of inflammation biomarkers, and a combination of the TM panel and the finding of the computed tomography (CT) scan.

Methods
We conducted a retrospective study in the internal medicine department at Amiens-Picardie University Medical Center (Amiens, France) between January 1st, 2015, and November 1st, 2021. The inclusion criteria were age 18 or over, significant IWL (≥ 5 kg over 6 months), elevated inflammation biomarkers (e.g. C-reactive protein), and assay data on two or more standard TMs (carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19 − 9, CA 15 − 3, CA 125, neuron-specific enolase (NSE), alpha-fetoprotein (AFP), calcitonin, and prostate-specific antigen (PSA)). The result of each TM assay was interpreted qualitatively (as positive or negative), according to our central laboratory’s usual thresholds.

Results
Cancer was diagnosed in 50 (37.0%) of the 135 patients included. Positivity for one or more TMs had a positive predictive value (PPV) of 0.55 [0.43–0.66], and a negative predictive value (NPV) of 0.84 [0.75–0.93] for cancer diagnosis. When combined with the presence of suspicious CT findings (e.g. a mass, enlarged lymph nodes and/or effusion), positivity for one or more TMs had a PPV of 0.92 [0.08–0.30]. In the absence of suspicious CT findings, a fully negative TM panel had an NPV of 0.96 [0.89-1.00].

Conclusion
A negative TM panel argues against the presence of a cancer, especially in the absence of suspicious CT findings.
The effect of respiratory muscle training on children and adolescents with cystic fibrosis: a systematic review and meta-analysis
Authors: Cai WenQian , Li Meng , Xu Yi , Li Mei , Wang JiaNan , Zuo YaHui , Cao JinJin 
Published: April 2024

Abstract
Background
Cystic fibrosis is a chronic genetic disease that can affect the function of the respiratory system. Previous reviews of the effects of respiratory muscle training in people with cystic fibrosis are uncertain and do not consider the effect of age on disease progression. This systematic review aims to determine the effectiveness of respiratory muscle training in the clinical outcomes of children and adolescents with cystic fibrosis.

Methods
Up to July 2023, electronic databases and clinical trial registries were searched. Controlled clinical trials comparing respiratory muscle training with sham intervention or no intervention in children and adolescents with cystic fibrosis. The primary outcomes were respiratory muscle strength, respiratory muscle endurance, lung function, and cough. Secondary outcomes included exercise capacity, quality of life and adverse events. Two review authors independently extracted data and assessed study quality using the Cochrane Risk of Bias Tool 2. The certainty of the evidence was assessed according to the GRADE approach. Meta-analyses where possible; otherwise, take a qualitative approach.

Results
Six studies with a total of 151 participants met the inclusion criteria for this review. Two of the six included studies were published in abstract form only, limiting the available information. Four studies were parallel studies and two were cross-over designs. There were significant differences in the methods and quality of the methodology included in the studies. The pooled data showed no difference in respiratory muscle strength, lung function, and exercise capacity between the treatment and control groups. However, subgroup analyses suggest that inspiratory muscle training is beneficial in increasing maximal inspiratory pressure, and qualitative analyses suggest that respiratory muscle training may benefit respiratory muscle endurance without any adverse effects.

Conclusions
This systematic review and meta-analysis indicate that although the level of evidence indicating the benefits of respiratory muscle training is low, its clinical significance suggests that we further study the methodological quality to determine the effectiveness of training.

Trial registration
The protocol for this review was recorded in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023441829.
Critically ill children with SARS-COV-2 Omicron infection at a national children medical center, Guangdong, China
Authors: Lin Fen , Jiang Dao-Ju , Zhang Song , Yang Zhe , Zeng Hua-Song , Liu Zhi-Ping , Yang Li-Ye 
Published: April 2024

Abstract
Background
SARS-CoV-2 infection is described as asymptomatic, mild, or moderate disease in most children. SARS-CoV-2 infection related death in children and adolescents is rare according to the current reports. COVID-19 cases increased significantly in China during the omicron surge, clinical data regarding pediatric critical patients infected with the omicron variant is limited. In this study, we aim to provide an overview of the clinical characteristics and outcomes of critically ill children admitted to a national children’s medical center in Guangdong Province, China, during the outbreak of the omicron variant infection.

Methods
We conducted a retrospective study from November 25, 2022, to February 8, 2023, which included 63 critically ill children, under the age of 18, diagnosed with SARS-CoV-2 infection. The patients were referred from medical institutions of Guangdong province. The medical records of these patients were analyzed and summarized.

Results
The median age of patients was 2 years (Interquartile Range, IQR: 1.0–8.0), sex-ratio (male/female) was 1.52. 12 (19%) patients (age ≥ 3 years) were vaccinated. The median length of hospital stay was 14 days (IQR: 6.5–23) in 63 cases, and duration of fever was 5 days (IQR: 3-8.5), pediatric intensive care unit (PICU) stay was 8 days (IQR 4.0–14.0) in 57 cases. 30 (48%) cases had clear contact history with family members who were infected with SARS-CoV-2. Three children who tested positive for SARS-CoV-2 infection did not show any abnormalities on chest imaging examination. Out of the total patients, 33 (52%) had a bacterial co-infection, with Staphylococcus aureus being the most commonly detected bacterial pathogen. Our cohort exhibited respiratory and nervous system involvement as the primary features. Furthermore, fifty (79%) patients required mechanical ventilation, with a median duration of 7 days (IQR 3.75–13.0). Among these patients, 35 (56%) developed respiratory failure, 16 (25%) patients experienced a deteriorating progression of symptoms and ultimately succumbed to the illness, septic shock was the most common condition among these patients (15 cases), followed by multiple organ failure in 12 cases, and encephalopathy identified in 7 cases.

Conclusion
We present a case series of critically ill children infected with the SARS-CoV-2 omicron variant. While there is evidence suggesting that Omicron may cause less severe symptoms, it is important to continue striving for measures that can minimize the pathogenic impact of SARS-CoV-2 infection in children.
Paternal and maternal exposures to adverse childhood experiences and spontaneous fetal loss: a nationwide cross-sectional analysis
Authors: Liu Wen , Sun Weidi , Yang Lili , Huang Yizhou , Zhu Siyu , Xiao Wenhan , Cheng Siqing , Hao Jiajun , Ying Jiayao , Chen Hanlu , Ren Ziyang , Wang Shuhui , Song Peige 
Published: April 2024

Abstract
Background
Adverse childhood experiences (ACEs) might be associated with maternal spontaneous fetal loss, while evidence among Chinese population is limited. This study aims to explore the associations of adverse childhood experiences (ACEs) among women and their spouses with the risk of spontaneous abortion and stillbirth.

Method
Data were from the China Health and Retirement Longitudinal Study (CHARLS) 2014 survey. ACEs were categorized into intra-familial ACEs and extra-familial ACEs. The associations of maternal and paternal ACEs with women’s history of spontaneous abortion and stillbirth were investigated by logistic regression.

Results
7,742 women were included with 9.05% and 2.47% experiencing at least one spontaneous abortion or stillbirth, respectively. Women exposed to 2, 3, and ≥ 4 ACEs were at significantly higher odds of spontaneous abortion, with adjusted odds ratios (ORs) of 1.52 (95% [CI, Confidence Interval] 1.10–2.10), 1.50 (95% CI 1.07–2.09) and 1.68 (95% CI 1.21–2.32), respectively. A significant association between ≥ 4 maternal intra-familial ACEs and stillbirth (OR 2.23, 95% CI 1.12–4.42) was also revealed. Furthermore, paternal exposures to 3 and ≥ 4 overall ACEs were significantly associated with their wives’ history of spontaneous abortion, with adjusted ORs of 1.81 (95% CI 1.01–3.26) and 1.83 (95% CI 1.03–3.25), respectively.

Conclusion
Both maternal and paternal ACEs were associated with spontaneous abortion, and potential mediators might need to be considered to further explore impacts of maternal and paternal ACEs on maternal reproductive health.
Longitudinal association of grip strength with cardiovascular and all-cause mortality in older urban Lithuanian population
Authors: Sileikiene Lolita , Tamosiunas Abdonas , Luksiene Dalia , Radisauskas Ricardas , Kranciukaite-Butylkiniene Daina , Bobak Martin 
Published: April 2024

Abstract
Background
Ageing populations experience greater risks associated with health and survival. It increases the relevance of identifying variables associated with mortality. Grip strength (GS) has been identified as an important biomarker for all cause and cardiovascular mortality, however, its prognostic value has not been studied in Lithuania. The aim of the present study is to evaluate the relationship of GS to vital status in a representative sample of the Lithuanian 45–72-year-old urban population during the period of 12 years of follow-up and to explore associations of GS with all-cause mortality and mortality from cardiovascular diseases (CVD).

Methods
Within the framework of the international study Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) 7,115 men and women 45–72 years of age were examined in the baseline survey (2006 to 2008). Data from the Official Lithuanian Mortality Register were used to evaluate CVD and all-cause mortality from follow-up till 2020. Cox proportional hazards regression was used, and four models for all-cause and CVD mortality were assessed.

Results
The mean GS was significantly higher among survivors’ men and women as compared to individuals deceased from CVD and other causes of death. In survivor men and women groups, minimal values of GS in all terciles were higher as compared to all three deceased groups. In both men and women groups, the lowest GS (1st tercile) was associated with a significantly higher risk of all-cause and CVD mortality as compared to the highest levels of GS (3rd tercile) in three Cox regression models. In both men and women were found to have a 1.34- and 1.35-fold higher risk of all-cause mortality, respectively, at lower GS, but no significant difference in the risk of CVD mortality. When GS was treated in all models as decrement per 1 kg and decrement per 1 SD, in both men and women, the risk of all-cause mortality significantly increased with decreasing of GS.

Conclusions
The mean GS was significantly higher among survivors’ men and women as compared to deceased from CVD and other causes of death. Risk of all-cause mortality significantly increased with decreasing of GS.
Comparison of condylar position after free fibular flap mandibular reconstruction using computer-assisted and traditional techniques
Authors: Wang Yu , Li Bowen , Liao Juankun , Wang Yan 
Published: April 2024

Abstract
Objectives
To compare the changes in condylar position after mandibular reconstruction with free fibular flap(FFF) and the differences between computer-assisted techniques and traditional methods on CT images.

Methods
Thirty-four patients who underwent mandibular reconstruction with free fibular flap were selected according to the inclusion and exclusion criteria. In the 3D group, virtual surgical planning (VSP) with osteotomy cutting plate and placement guiding plate were used, while the traditional group underwent freehand reconstruction. The CT data of 68 temporomandibular joints (TMJs) were recorded before and immediately after surgery. The condylar position was evaluated by measuring the anterior space (AS), posterior space (PS) and superior space (SS), and the ln (PS/AS) was calculated according to the method proposed by Pullinger and Hollender.

Results
In the patients included in the 3D group, the condyle on the ipsilateral side moved slightly backward; however, in the patients in the traditional group, the ipsilateral side moved considerably anteroinferior. No obvious changes on the contralateral side were noted. In the 3D group, 33% of ipsilateral condyles were in the posterior position postoperatively when compared with the preoperative position (13%). In the traditional group, the number of ipsilateral condyles in the anterior position increased from 4 to 10, accounting for 53% postoperatively. Contrary to the traditional group, the 3D group presented less condylar displacement on the ipsilateral side postoperatively.

Conclusions
This study showed a decreased percentage of change in condylar position postoperatively when VSP was used. Virtual surgical planning improved the accuracy of FFF mandibular reconstruction and made the condylar position more stable.
Endoscopically-assisted extraction of broken roots or fragments within the mandibular canal: a retrospective case series study
Authors: Jiang Junqi , Chen Kenan , Wang Enbo , Duan Denghui , Xu Xiangliang 
Published: April 2024

Abstract
Purpose
To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN).

Methods
Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin.

Results
The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters.

Conclusions
All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.
Ethnobotanical survey on herbal remedies for the management of type 2 diabetes in the Casablanca-Settat region, Morocco
Authors: Arraji Maryem , Al Wachami Nadia , Boumendil Karima , Chebabe Milouda , Mochhoury Latifa , Laamiri Fatima Zahra , Barkaoui Mohamed , Chahboune Mohamed 
Published: April 2024

Abstract
Background
Morocco faces a substantial public health challenge due to diabetes mellitus, affecting 12.4% of adults in 2023. The Moroccan population makes extensive use of phytotherapy and traditional medicine to address the difficulties this chronic condition poses. The aim of this study is to document the use of medicinal plants in traditional medicine for managing type 2 diabetes in the provinces of the Casablanca-Settat region.

Methods
The study employed a semi-structured questionnaire for data collection. A study was conducted between August 1st and September 30th, 2023, and 244 individuals diagnosed with diabetes were invited to take part in the research, all of whom used at least one medicinal plant to manage type 2 diabetes, by visiting primary healthcare facilities in Morocco. The analysis included the use of Relative Frequency of Citation (RFC) to scrutinize the data.

Results
A total of 47 plant species belonging to 25 families were documented. Notably, the Apiaceae, Lamiaceae, and Fabaceae families were frequently mentioned in the context of treating type 2 diabetes in Morocco. Prominent among the cited plant species were Sesamum indicum L., Lepidium sativum L., followed by Foeniculum vulgare Mill., and Rosmarinus officinalis L. Seeds emerged as the plant part most commonly mentioned, with infusion being the prevailing preparation method and oral consumption being the most frequently depicted method of administration.

Conclusion
This research underscores the practicality of incorporating traditional medicine into the healthcare framework of the Casablanca-Settat region. The findings not only offer valuable documentation but also have a vital function in safeguarding knowledge regarding the utilization of medicinal plants in this locality. Moreover, they provide opportunities to delve deeper into the phytochemical and pharmacological potential of these plants.
Implementing spiritual care education into the teaching of palliative medicine: an outcome evaluation
Authors: Batzler Yann-Nicolas , Stricker Nicola , Bakus Simone , Schallenburger Manuela , Schwartz Jacqueline , Neukirchen Martin 
Published: April 2024

Abstract
Background
The concept of “total pain” plays an important role in palliative care; it means that pain is not solely experienced on a physical level, but also within a psychological, social and spiritual dimension. Understanding what spirituality entails, however, is a challenge for health care professionals, as is screening for the spiritual needs of patients.

Objective
This is a novel, interprofessional approach in teaching undergraduate medical students about spiritual care in the format of a seminar. The aim of this study is to assess if an increase in knowledge about spiritual care in the clinical context is achievable with this format.

Methods
In a mandatory seminar within the palliative care curriculum at our university, both a physician and a hospital chaplain teach strategies in symptom control from different perspectives (somatic domain – spiritual domain). For evaluation purposes of the content taught on the spiritual domain, we conducted a questionnaire consisting of two parts: specific outcome evaluation making use of the comparative self-assessment (CSA) gain and overall perception of the seminar using Likert scale.

Results
In total, 52 students participated. Regarding specific outcome evaluation, the greatest gain was achieved in the ability to define total pain (84.8%) and in realizing its relevance in clinical settings (77.4%). The lowest, but still fairly high improvement was achieved in the ability to identify patients who might benefit from spiritual counselling (60.9%). The learning benefits were all significant as confirmed by confidence intervals. Overall, students were satisfied with the structure of the seminar. The content was delivered clearly and comprehensibly reaching a mean score of 4.3 on Likert scale (4 = agree). The content was perceived as overall relevant to the later work in medicine (mean 4.3). Most students do not opt for a seminar solely revolving around spiritual care (mean 2.6).

Conclusions
We conclude that implementing spiritual care education following an interprofessional approach into existing medical curricula, e.g. palliative medicine, is feasible and well perceived among medical students. Students do not wish for a seminar which solely revolves around spiritual care but prefer a close link to clinical practice and strategies.
Disadvantaged groups have greater spatial access to pharmacies in New York state
Authors: Suri Abhinav , Quinn James , Balise Raymond R. , Feaster Daniel J. , El-Bassel Nabila , Rundle Andrew G. 
Published: April 2024

Abstract
Background
The accessibility of pharmacies has been associated with overall health and wellbeing. Past studies have suggested that low income and racial minority communities are underserved by pharmacies. However, the literature is inconsistent in finding links between area-level income or racial and ethnic composition and access to pharmacies. Here we aim to assess area-level spatial access to pharmacies across New York State (NYS), hypothesizing that Census Tracts with higher poverty rates and higher percentages of Black and Hispanic residents would have lower spatial access.

Methods
The population weighted mean shortest road network distance (PWMSD) to a pharmacy in 2018 was calculated for each Census Tract in NYS. This statistic was calculated from the shortest road network distance to a pharmacy from the centroid of each Census block within a tract, with the mean across census blocks weighted by the population of the census block. Cross-sectional analyses were conducted to assess links between Tract-level socio demographic characteristics and Tract-level PWMSD to a pharmacy.

Results
Overall the mean PWMSD to a pharmacy across Census tracts in NYS was 2.07 Km (SD = 3.35, median 0.85 Km). Shorter PWMSD to a pharmacy were associated with higher Tract-level % poverty, % Black/African American (AA) residents, and % Hispanic/Latino residents and with lower Tract-level % of residents with a college degree. Compared to tracts in the lowest quartile of % Black/AA residents, tracts in the highest quartile had a 70.7% (95% CI 68.3–72.9%) shorter PWMSD to a pharmacy. Similarly, tracts in the highest quartile of % poverty had a 61.3% (95% CI 58.0-64.4%) shorter PWMSD to a pharmacy than tracts in the lowest quartile.

Conclusion
The analyses show that tracts in NYS with higher racial and ethnic minority populations and higher poverty rates have higher spatial access to pharmacies.