bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Emergency Call Volume on Occupational Workload and Sleep Quality in Urban Firefighters
Authors: Jelmini Jacob D. , Gribble Phillip A. , Abel Mark G. , Whitehurst Lauren N. , Heebner Nicholas R. 
Published: April 2024

Objective
The aim of the study is to determine the impact of emergency call volume on exertion, autonomic activity, and sleep among urban structural firefighters.

Methods
Thirty-four firefighters wore a wrist-based monitor to track sleep and autonomic parameters and rated their level of perceived exertion (Borg Rating of Perceived Exertion) and subjective sleepiness after a 24-hour shift. Predictive variables included total run time and total run time after 11:59 PM.

Results
Total run time and sleep duration accounted for Borg Rating of Perceived Exertion and subjective sleepiness, while total run time and total run time after 11:59 PM accounted for sleep durations on-duty.

Conclusions
The current results suggest that emergency call volume is associated with indicators of exertion and sleep. As such, call volume tracking is an important consideration for departments to ensure personnel readiness and wellness and provide a method of tracking the occupational demands experienced by firefighters on-duty.
Unmet Mental Health Needs Among California Workers Since the Start of the COVID-19 Pandemic
Authors: Gibb Kathryn , Bui David P. , Cox Jonah , Watmore Nichole , Vergara Ximena P. 
Published: April 2024

Objective
We sought to identify worker groups with high prevalence of unmet mental health needs to inform employer benefits programs and outreach to increase access to care.

Methods
We conducted a repeated cross-sectional study to understand unmet mental health needs among workers since the start of the COVID-19 pandemic using the California Health Interview Survey data from 2013 to 2021.

Results
In 2021, 23.4% (confidence interval: 22.4 to 24.4) reported unmet mental health needs, an absolute increase of 3.9% from 2019. Relative increases were highest among workers in the information industries (prevalence ratio: 1.89, confidence interval: 1.4 to 2.5) and older workers (prevalence ratio: 1.27, CI: 0.9 to 1.8). Increases in needing help were not met with comparable increases in seeking care.

Conclusions
Unmet mental health needs increased for California workers during the pandemic. Employers should dedicate resources and implement strategies to increase access to care and promote worker well-being.
Case report of a novel mutation in the TNC gene in Chinese patients with nonsyndromic hearing loss
Authors: Li Shouxia , Li Shurui , Chen Dingli , Zhao Subin , Liu Cairu , Zhang Ruimin , Chen Yongxue , Guo Xiangrui , Song Xuedong 
Published: April 2024

Rationale:
Hereditary hearing loss is known to exhibit a significant degree of genetic heterogeneity. Herein, we present a case report of a novel mutation in the tenascin-C (TNC) gene in Chinese patients with nonsyndromic hearing loss (NSHL).

Patient concerns:
This includes a young deaf couple and their 2-year-old baby.

Diagnoses:
Based on the clinical information, hearing test, metagenomic next-generation sequencing (mNGS), Sanger sequencing, protein function and structure analysis, and model prediction, in our case, the study results revealed 2 heterozygous mutations in the TNC gene (c.2852C>T, p.Thr951Ile) and the TBC1 domain family member 24 (TBC1D24) gene (c.1570C>T, p.Arg524Trp). These mutations may be responsible for the hearing loss observed in this family. Notably, the heterozygous mutations in the TNC gene (c.2852C>T, p.Thr951Ile) have not been previously reported in the literature.

Interventions:
Avoid taking drugs that can cause deafness, wearing hearing AIDS, and cochlear implants.

Outcomes:
Regular follow-up of family members is ongoing.

Lessons:
The genetic diagnosis of NSHL holds significant importance as it helps in making informed treatment decisions, providing prognostic information, and offering genetic counseling for the patient’s family.
Evaluating the efficacy and safety of Alzheimer’s disease drugs: A meta-analysis and systematic review
Authors: Chen Yan , Lai Min , Tao Ming 
Published: April 2024

Background:
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder. Dementia severity was assessed mainly through cognitive function, psychobehavioral symptoms, and daily living ability. Currently, there are not many drugs that can be selected to treat mild to moderate AD, and the value of drugs remains controversial.

Objective:
The aim of this study is to quantitatively evaluate the efficacy and safety of cholinesterase inhibitors (ChEIs), memantine, and sodium oligomannate (GV-971) in the treatment of patients with AD. Additionally, molecular docking analysis will be used to investigate the binding affinities of donepezil, galantamine, rivastigmine, and memantine with key receptor proteins associated with AD, including beta-amyloid (Abeta), microtubule-associated protein (MAP), apolipoprotein E4 (APOE4), and Mitofusin-2 (MFN2), to further validate the results of the meta-analysis.

Methods:
We obtained clinical trials characterized by randomization, placebo control, and double–blinded methodologies concerning ChEIs, memantine, and GV-971. Statistical analysis was performed using Review Manager Version 5.4 software. Molecular docking was also conducted to evaluate the results.

Results:
All drugs improved the cognitive function, with the effect value ranging from −1.23 (95% CI −2.17 to −0.30) for 20 mg memantine to −3.29 (95% CI −4.14 to −2.45) for 32 mg galantamine. Although 32 mg galanthamine and GV-971 did not improve the clinicians’ Global Impression of Change scale, other drugs showed significant results compared with placebo. On NPI, only 10 mg of donepezil and 24 mg of galantamine had improvement effects. On ADCS/ADL, only 20 mg memantine and 900 mg GV-971 had no significant difference from the placebo. Donepezil 5 mg and GV-971 900 mg did not increase the drug withdrawal rates due to various reasons or adverse reactions when compared to the placebo. Donepezil demonstrated superior binding to the protein and exhibited greater efficacy compared to other drugs.

Conclusion:
ChEIs, memantine, and GV-971 all can slow the progression of AD but have different effects on respective assessments. Donepezil and GV-971 were relatively well tolerated.
Successful treatment of gastric cancer 10 years after heart transplantation: A case report
Authors: Zhao Lin , Wang Ye , Guo Zhenggang 
Published: April 2024

Background:
While survival rates among cardiac allograft recipients have improved, there has been a rise in post-transplant malignancies, with gastric cancer being less commonly reported. This study presented a successful treatment of gastric cancer in an individual 10 years after undergoing a heart transplant.

Case presentation:
A 66-year-old Chinese man presented to the gastrointestinal clinic with a complaint of diagnosis of gastric cancer for 4 months and treated with neoadjuvant therapy for 1 month. He has undergone orthotopic heart transplantation 10 years earlier due to a myocardial infarction. Physical examination and laboratory tests did not reveal any significant abnormalities. Abdominal contrast-enhanced computed tomography (CT) imaging indicated a gastric mass near the greater curvature, with gastroscopy suggesting a carcinoma at the esophagogastric junction, Siewert III. An echocardiogram indicated left atrial enlargement with mild mitral and tricuspid regurgitation. The diagnosis suggested that his gastric cancer at the esophagogastric junction was a consequence of long-term immunosuppressive therapy. A multidisciplinary team (MDT) consultation recommended a proximal radical gastrectomy. Postoperatively, the patient received 4 cycles of adjuvant chemotherapy with XELOX combined with Herceptin, initiated a month after surgery. During the 1-year follow-up, the patient showed commendable recovery, with no signs of tumor recurrence or metastasis.

Conclusion:
This case underscores the potential risk of malignancy from immunosuppressive agents in transplant recipients. The successful management of this complex scenario underscores the indispensable role of an MDT approach in treating such unique and challenging cases.
Fire acupuncture for plaque psoriasis case series
Authors: Chen Rui-Ming , Shi Guo-Ao , Xiong Yong-Qin , Li Zhong-Xian , Ji Xiang , Feng Yan-Yan , Yan Luda , Zhou Xia-Yun , Xu Hai-Yan , Wu Ting , Chen Shi-Yun , Gan Hai-Fang , Zhou Yi-Fu , Peng Min , Zhou Peng , Zeng Jing-Chun , Li Jing-Jing 
Published: April 2024

Objective:
To investigate the clinical efficacy of fire acupuncture (FA) on plaque psoriasis (PP), exploring its suitable syndrome types, in order to achieve better therapeutic effects, accelerate the possibility of psoriasis skin lesion recovery, and provide assistance for clinical treatment.

Methods:
A total of 8 patients with PP aged between 18 and 60 years were recruited and treated with FA once a week, and the lesion area and severity index (PASI), visual analog scale and pruritus were measured before, 2, 4 and 8 weeks after treatment and at the follow-up period (week 12), respectively. Visual analog scale, and dermoscopy were used for assessment.

Results:
All patients showed improvement in pruritus after 1 FA treatment, and lesions were reduced to varying degrees after 2 weeks. Except for patients 5 and 8, who only achieved effective results due to severe disease, all other patients with psoriasis achieved significant results at 8 weeks after treatment.

Conclusion:
FA can significantly control the development of lesions, reduce the symptoms of PP lesions and pruritus, and help prevent psoriasis recurrence.
Efficacy and safety of Buyang Huanwu Decoction in patients with spinal cord injury: A meta-analysis of randomized controlled trials
Authors: He Zhongcheng , Yang Silin , Tan Yuxi , Liao Yulin , Song Shigang 
Published: April 2024

Background:
There has been growing interest in using the traditional Chinese herb Buyang Huanwu Decoction (BHD) as a potential treatment for spinal cord injury (SCI), owing to its long-used treatment for SCI in China. However, the efficacy and safety of BHD treatment for SCI remain widely skeptical. This meta-analysis aims to assess the safety and efficacy of BHD in managing SCI.

Method:
A comprehensive literature search was conducted across several databases, including PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, VIP, and Sinomed, up to January 1, 2024. Randomized controlled clinical trials evaluating the safety or efficacy of BHD in SCI treatment were included. The analysis focused on 8 critical endpoints: Patient-perceived total clinical effective rate, American Spinal Cord Injury Association (ASIA) sensory score, ASIA motor score, somatosensory evoked potential, motor evoked potential, visual analog scale pain score, Japanese Orthopaedic Association score, and adverse events.

Results:
Thirteen studies comprising 815 participants met the inclusion criteria. No significant heterogeneity or publication bias was observed across the trials. The findings revealed significant improvements in the patient-perceived total clinical effective rate (OR = 3.77; 95% confidence interval [CI] = [2.43, 5.86]; P < .001), ASIA sensory score (mean difference [MD] = 8.22; 95% CI = [5.87, 10.56]; P < .001), ASIA motor score (MD = 7.16; 95% CI = [5.15, 9.18]; P < .001), somatosensory evoked potential (MD = 0.25; 95% CI = [0.03, 0.48]; P = .02), motor evoked potential (MD = 0.30; 95% CI = [0.14, 0.46]; P = .0002), and Japanese Orthopaedic Association score (MD = 1.99; 95% CI = [0.39, 3.58]; P = .01) in the BHD combination group compared to the control group. Additionally, there was a significant reduction in visual analog scale pain scores (MD = −0.81; 95% CI = [−1.52, −0.11]; P = .02) with BHD combination treatment, without a significant increase in adverse effects (OR = 0.68; 95% CI = [0.33, 1.41]; P = .3).

Conclusion:
The current evidence suggests that BHD is effective and safe in treating SCI, warranting consideration as a complementary and alternative therapy. However, given the low methodological quality of the included studies, further rigorous research is warranted to validate these findings.
Endovascular treatment of wide-neck bifurcation aneurysms using pCONUS2 HPC bridging device with single antiplatelet: A Case Series
Authors: Ho Jun Kiat , Kee Tze Phei , Lee Wickly 
Published: April 2024

Rationale:
Wide neck bifurcation aneurysms (WNBA) are technically challenging for both surgical and endovascular treatments. Endovascular treatment for WNBA often requires dual antiplatelet therapy (DAPT) post stent insertion. Novel devices such as the pCONUS2 HPC neck bridging device have an HPC coating which reduces the device thrombogenicity. This theoretically allows for use of single antiplatelet therapy (SAPT), which would be advantageous, particularly in treating ruptured aneurysms. This case series aims to evaluate the safety of SAPT regimen only post stent insertion, by presenting our center early clinical experience in using pCONUS2 HPC neck bridging device in patients that are not suitable for DAPT.

Patient concerns:
We report the cases of 3 patients (2 females, 1 male; range: 64–71 years old) who underwent coil embolization for WNBA using the pCONUS2 HPC device (2 unruptured WNBA, and 1 ruptured WNBA). As all 3 patients were allergic to Aspirin, they could only be started on SAPT post endovascular therapy.

Diagnosis:
All 3 patients were diagnosed with WNBA on angiographic studies. Patient 1 had an unruptured left middle cerebral artery aneurysm; Patient 2 had a ruptured basilar tip aneurysm; Patient 3 had an unruptured anterior communicating artery (ACOM) aneurysm.

Interventions:
All 3 WNBA were treated with pCONUS2 HPC neck bridging device.

Outcomes:
There were no immediate complications. The immediate angiographic result of aneurysm treatment in Patient 1 and Patient 2 demonstrated incomplete occlusions, with delayed complete occlusion of aneurysm in Patient 1 and growth of aneurysmal neck in Patient 2 on follow-up angiograms (range: 6–9 months). No major thrombo-embolic or hemorrhagic complications in the first 2 patients. For Patient 3, the immediate angiographic result of the treated aneurysm demonstrated complete occlusion. However, the patient readmitted 11 days post procedure with cerebral infarction, scoring 5 on the modified Rankin scale on discharge.

Lessons:
pCONUS2 HPC as a neck bridging device in treating WNBA has yet to be shown superior to traditional techniques and devices. The theoretical advantage of HPC coating reducing its thrombogenicity requiring only SAPT is yet to be proven safe in clinical practice.
Breast mucosa-associated lymphoid tissue lymphoma: A case report and literature review
Authors: Luo Siyi , Zhang Xinyue , Wang Zhichun 
Published: April 2024

Background:
Mucosa-associated lymphoid tissue (MALT) lymphoma, also known as extranodal marginal zone lymphoma, is more commonly detected in the stomach and rarely in the breast. Our study presented a clinical and pathological examination of a patient diagnosed with breast MALT lymphoma, supplemented with pertinent research, to offer guidance for the diagnosis and treatment of this condition.

People concerns:
The occurrence of breast MALT lymphoma has risen in the past decade, but its etiology, progression and treatment response are less well-studied.

Diagnosis:
Breast MALT lymphoma was diagnosed by excisional biopsy and histopathology.

Interventions:
Following breast MALT lymphoma diagnosis, the patient was transferred to the hematology department for further treatment, and she made the decision to continue observing.

Outcomes:
After 3 months of observation, the patient remained asymptomatic.

Conclusion:
Breast MALT lymphoma is an indolent disease with an asymptomatic presentation, There are no standardized treatment guidelines for breast MALT lymphoma, treatment must be tailored to the patient willingness to treat and the severity of the disease. Hence, in order to give patients a better chance of cure, more research is needed to explore its pathogenesis and more clinical trials are needed investigate the treatment of this disease.
Acute blockage of forearm supination due to flap tear of the triangular fibrocartilage disc: A case report
Authors: HO Ji Woong , Kim Jee Yune , Lee Young-Keun 
Published: April 2024

Rationale:
Acute blockage of forearm supination has been reported in several studies. It is caused by loose bodies in the wrist joint, extensor carpi ulnaris tendon interposition, and distal radioulnar joint (DRUJ) injuries, including forearm bone fractures. Some studies have reported cases of DRUJ injuries caused by triangular fibrocartilage complex (TFCC) tears.
We report a case of acute blockage of forearm supination after minor trauma and suggest a possible TFCC tear when a patient complains of forearm supination blocking. In addition, we present a comparison between our case and other reports on etiology, magnetic resonance imaging (MRI) findings, and arthroscopic findings, and show the specific characteristics of our case.

Patients concerns:
A 22-year-old male presented with left wrist pain as the chief complaint. He was injured 2 months prior to pushing his left hand on the floor during exercise. Physical examination showed a relative limitation of range of motion (ROM) in the left wrist of about 10° in flexion and about 15° in extension compared with the right side. The patient also complained of supination limitation and volar side wrist pain during supination. The patient showed tenderness in the axial compression test.

Diagnoses:
Plain radiographs showing no abnormalities. MRI showed a TFCC tear in the central portion. A torn flap of the TFCC was interposed on the volar side of the DRUJ.

Interventions:
Arthroscopic surgery of the left wrist joint was performed. Arthroscopic examination revealed a tear in the TFCC on the radial side. A torn flap was interposed on the volar side of the DRUJ. We removed the flap from the DRUJ using an arthroscopic grasper and partially resected it.

Outcomes:
Intraoperative tests showed no locking and the forearm was well supinated. Two months after the surgery, the patient had no pain and showed full forearm supination.

Lessons:
DRUJ blocking due to a TFCC tear should be suspected when acute blockage of forearm supination occurs after minor trauma. MRI is helpful for diagnosis; however, we suggest that the diagnosis should be confirmed through arthroscopy. Symptoms can be resolved by surgical treatment using arthroscopy.
Epigenetics of hematopoietic stem cell aging
Authors: Yokomizo Takako , Oshima Motohiko , Iwama Atsushi 
Published: April 2024

Purpose of review
The development of new antiaging medicines is of great interest to the current elderly and aging population. Aging of the hematopoietic system is attributed to the aging of hematopoietic stem cells (HSCs), and epigenetic alterations are the key effectors driving HSC aging. Understanding the epigenetics of HSC aging holds promise of providing new insights for combating HSC aging and age-related hematological malignancies.

Recent findings
Aging is characterized by the progressive loss of physiological integrity, leading to impaired function and increased vulnerability to death. During aging, the HSCs undergo both quantitative and qualitative changes. These functional changes in HSCs cause dysregulated hematopoiesis, resulting in anemia, immune dysfunction, and an increased risk of hematological malignancies. Various cell-intrinsic and cell-extrinsic effectors influencing HSC aging have also been identified. Epigenetic alterations are one such mechanism.

Summary
Cumulative epigenetic alterations in aged HSCs affect their fate, leading to aberrant self-renewal, differentiation, and function of aged HSCs. In turn, these factors provide an opportunity for aged HSCs to expand by modulating their self-renewal and differentiation balance, thereby contributing to the development of hematological malignancies.
Diagnostic Performance of 18F-FDG Positron Emission Tomography/Computed Tomography and Blood Test Parameters for Pulmonary Inflammatory Pseudotumor
Authors: Pan Bo , Wang Yanming , Zhu Zehua , Zhu Xingxing 
Published: April 2024

Purpose:
Pulmonary inflammatory pseudotumor (PIP) is an inflammatory proliferative tumor-like lesion that frequently exhibits hypermetabolism on 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography imaging (PET/CT) and is readily misdiagnosed as a malignant tumor. The purpose of this study was to identify PIP by combining PET/computed tomography metabolic and blood test characteristics with machine learning.

Patients and Methods:
We recruited 27 patients with PIP and 28 patients with lung cancer (LC). The PET metabolic and blood test parameters were collected, and the differences between the groups were evaluated. In addition, we combined the support vector machine (SVM) classifier with the indicators that differed between the groups to classify PIP and LC.

Results:
For PET metabolic parameters, our findings showed that, as compared with the LC group, maximal standardized uptake value (P < 0.001, t = −4.780), Mean standardized uptake value SUVmean, P < 0.001, t = −4.946), and SD40% (P < 0.001, t = −4.893) were considerably reduced in the PIP group, whereas CV40% (P = 0.004, t = 3.012) was significantly greater. For blood test parameters, the total white blood cell count (P < 0.001, t = 6.457) and absolute neutrophil count (P < 0.001, t = 6.992) were substantially higher in the PIP group than in the LC group. Furthermore, the performance of SVM trained solely on PET metabolic parameters (mean area under the curve [AUC] = 0.84) was comparable to that of SVM trained solely on blood test parameters (mean AUC = 0.86). Surprisingly, utilizing the combined parameters increased SVM performance significantly (mean AUC = 0.98).

Conclusion:
PET metabolic and blood test parameters differed significantly between the PIP and LC groups, and the SVM paradigm using these significantly different features has the potential to be used to classify PIP and LC, which has important clinical implications.
Pudendal Block at the Time of Transvaginal Prolapse Repair: A Randomized Controlled Trial
Authors: Torosis Michele , Fullerton Morgan , Kaefer Daniela , Nitti Victor , Ackerman A. Lenore , Grisales Tamara 
Published: April 2024

Importance
The utility of pudendal nerve blocks (PNBs) at the time of transvaginal surgery is mixed in the literature. No published study has evaluated the efficacy of PNB since the widespread adoption of Enhanced Recovery After Surgery (ERAS) pathways.

Objective
This study aimed to determine if PNB, in addition to ERAS measures, at the time of vaginal reconstructive surgery reduces opioid use in the immediate postoperative period.

Study Design
In this randomized, blinded, controlled trial, women scheduled for transvaginal multicompartment prolapse repair were randomized to bilateral PNB before incision with 20 mL of 0.5% bupivacaine versus usual care. Primary outcome was opioid use in morphine milligram equivalents (MME) for the first 24 hours. The study was powered to detect a 5.57-MME difference in opioid use in the first 24 hours between groups.

Results
Forty-four patients were randomized from January 2020 to April 2022. The PNB and control groups were well matched in demographic and surgical data. There was no difference in opioid use in first 24 hours between the control and PNB groups (8 [0–20] vs 6.7 [0–15]; P = 0.8). Median pain scores at 24 and 48 hours did not differ between groups (4 ± 2 vs 3 ± 3; P = 0.44) and 90% of participants were satisfied with pain control across both groups. Time to return to normal activities (median, 10 days) was also not different between the groups.

Conclusions
Because pain satisfaction after transvaginal surgery in the era of ERAS is high, with overall low opioid requirements, PNB provides no additional benefit.