bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and risk factors of venous thromboembolism in neurosurgical patients after implementing a screening protocol: a retrospective cohort study of a tertiary center
Authors: Boongird Atthaporn , Songkwamcharoen Thitaporn , Mongkolpech Wipada , Kittitirapong Nutsiri 
Published: February 2024

Introduction:
Venous thromboembolism (VTE) is a common complication in neurosurgical procedures both before and after surgery.

Objective:
To examine the incidence of VTE in neurosurgical patients before surgery and in the postoperative period after implementing a VTE prophylaxis protocol. The authors also aimed to determine VTE risk factors.

Methods:
The authors conducted a retrospective cohort study examining 200 patients admitted to the hospital for cranial and spine neurosurgical procedures between January 2020 and October 2021. All patients were screened for VTE using a protocol combining measurement of D-dimer level and venous duplex ultrasonography. Patients who screened negative for VTE were evaluated for VTE risk using the Caprini risk assessment model; those with Caprini score greater than or equal to 3 (indicating moderate-to-high risk) received VTE prophylaxis using intermittent pneumatic compression devices.

Results:
Preoperative screening demonstrated deep venous thrombosis (DVT) in seven of 200 patients (3.5%). All DVTs were asymptomatic and proximal in location. Univariate logistic regression showed that stroke, neurodegenerative disease, and confinement to bed for more than 72 h were significant predictors of preoperative DVT. Among the patients without DVT on preoperative screening, 179 (93%) had a Caprini score greater than or equal to 3; intermittent pneumatic compression was used for prophylaxis in 173 of these (96.6%). Incidence of postoperative VTE was 2.6% (5/193). Extended length of hospital stay, postoperative hydrocephalus, and infection were significant risk factors for VTE.

Conclusion:
Preoperative VTE screening using D-dimer level and V-DUS and implementation of VTE prophylaxis using IPC can reduce the incidence of VTE and VTE-related mortality in neurosurgical patients.
The risk factors for perioperative blood transfusion in open liver resection: a retrospective cohort study
Authors: Lapisatepun Warangkana , Pipanmekaporn Tanyong , Leurcharusmee Prangmalee , Khorana Jiraporn , Patumanond Jayanton , Lapisatepun Worakitti 
Published: February 2024

Purpose:
Liver resection is the current treatment for hepatic neoplasms but may be associated with intraoperative hemorrhage and the need for blood transfusions. The aim of this study is to identify the risk factors for predicting the requirement of a perioperative blood transfusion in open liver resection.

Methods:
A total of 808 consecutive patients who had undergone elective open liver resection from 2006 to 2017 were retrospectively reviewed using the database. Baseline characteristics and intraoperative data were collected. Perioperative blood transfusion was defined as the transfusion of allogenic packed red cells during surgery and the 48 h following surgery. An analysis of logistic regression was used to determine the independent risk factors for blood transfusion in open liver resection.

Results:
Three hundred and seventy-seven patients (46.7%) received perioperative packed red cell transfusions. The independent risk factors associated with perioperative blood transfusion included ASA classification >2, preoperative anemia (Hb<12 g/dl for women, Hb<13 g/dl for men), thrombocytopenia (platelet count<100×103/mm3), albumin<3.5 g/dl, largest tumor size >4 cm., major liver resection, and surgeon experience performing <50 cases of major open liver resection.

Conclusion:
Preoperative risk factors may be utilized to assess and predict patients who require perioperative blood transfusions following liver resection. Modifiable risk factors may also be treated prior to surgery. Furthermore, patient blood management and methods to minimize blood loss and blood transfusions during surgery should be implemented in patients who require high-risk transfusions.
The effects of Salvia miltiorrhiza and ligustrazine injection combined with ACEI/ARB on diabetic kidney disease: A systematic review and meta-analysis
Authors: Zhang Zixuan , Luo Lei , Li Xueling , Zhong Yifei 
Published: February 2024

Background:
In China, Salvia miltiorrhiza and ligustrazine (SML) injection are widely used as adjunctive therapy for patients with diabetic kidney disease (DKD). However, different studies have reported conflicting results. Therefore, a systematic review and meta-analysis are necessary to assess the efficacy and safety of SML injection for the treatment of DKD.

Methods:
We searched 6 electronic literature databases comparing randomized controlled trials (RCTs) of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), SML injection in combination with ACEIs/ARBs that were conducted from inception until September 5, 2023. Two reviewers extracted data and independently assessed the risk of bias. Using the Cochrane Risk of Bias Tool for Risk Assessment. Mean differences (MD) were combined with random-effects models and the corresponding 95% confidence intervals (CI) were reported. Review Manager 5.4 software was used for meta-analysis. Stata 17.0 software was used for sensitivity analysis and Egger test.

Results:
The combined results show that the use of SML injection along with ACEI/ARB led to better outcomes than the use of controls in terms of enhancing recovery: renal function: Serum creatinine (MD = −14.69, 95% CI (−19.38, −10.00)), Blood urea nitrogen (MD = −1.23, 95% CI (−1.72, −0.74)), Urinary β2-microglobulin (MD = −4.58, 95% CI (−7.72, −1.44)); urinary protein: Urinary albumin excretion rate (MD = −45.74, 95% CI (−58.92, −32.56)), Urine albumin-creatinine ratio (MD = −11.93, 95% CI (−13.89, −9.96)), 24-h urine proteinuria (MD = −0.59, 95% CI (−0.86, −0.32)), Urine microalbumin (MD = −13.50, 95% CI (−20.18, −6.83)). Additionally, adjuvant therapy with SML injection enhanced results in blood glucose, blood pressure, lipids, and inflammatory responses, and no significant variations in adverse events were discovered between the 2 groups.

Conclusions:
In patients with DKD, combining SML injection with ACEI/ARB improves renal function, renal proteinuria, hyperglycemia, blood pressure, dyslipidemia, and inflammatory response.
Ultrasound for monitoring different stages of post-transplant lymphoproliferative disorder in a transplanted kidney: A case report and review of the literature
Authors: Du Zu-Sheng , Xie Xiao-Hong , Hu Jin-Jiao , Fang Ye , Ye Lu 
Published: February 2024

Rationale:
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized, but uncommon complication in patients with kidney transplantation, which poses challenges in diagnosis and poor prognosis due to its low incidence and nonspecific clinical manifestations. As a routine follow-up examination method for kidney transplant patients, ultrasound (US) plays a significant role in the diagnosis of PTLD. Therefore, it is critical to evaluate the ultrasonic characteristics of PTLD in transplanted kidney patients for early detection and diagnosis.

Patient concerns:
A 59-year-old female patient was unexpectedly found with a mass in the hilum of the transplanted kidney 12th month after transplantation, which gradually grew up in the following 4 months. The latest US examination found hydronephrosis. Contrast-enhanced ultrasound (CEUS) demonstrated a hypo-enhancement pattern in arterial and parenchymal phases and showed a new irregular area lacking perceivable intensification within the mass, which was considered necrosis. Meanwhile, the patient developed an acute increase in serum creatinine from 122 to 195 μmol/L.

Diagnosis:
A US-guided biopsy was conducted with the final pathological diagnosis of PTLD (polymorphic).

Interventions:
After receiving 3 times of rituximab and symptomatic treatment, blood creatinine returned to normal but the mass was still progressing in the patient. Therefore, the treatment approach was modified to immune-chemotherapy.

Outcomes:
The patient was in a stable condition to date.

Lessons:
PTLD is a rare complication in a transplanted kidney. US and CEUS are the preferred imaging methods in renal transplant patients due to their good repeatability and no nephrotoxicity. This case demonstrates that continuous dynamic monitoring by using US and CEUS has significant value in the detection and diagnosis of PTLD in a transplanted kidney, suggesting early clinical intervention to avoid further progression.
Efficacy and safety of dorzagliatin, a novel glucokinase activators, in the treatment of T2DM: A meta-analysis of randomized controlled trials
Authors: Wu Yuqian , Wang Kai , Su Jingyang , Liu Xin 
Published: February 2024

Object:
To evaluate the efficacy and safety of dorzagliatin for the treatment of type 2 diabetes (T2DM).

Methods:
Seven databases were systematically searched, spanning the interval from 2016 to August 2023. Randomized controlled trials (RCTS) comparing dorzagliatin with placebo for the treatment of T2DM were applicable for containing this study. The relevant data were extracted, and a meta-analysis was implemented using RevMan 5.4 software.

Results:
A total of 3 studies involving 1332 patients were included. We use glycated hemoglobin (HbA1c) levels as the major indicator of efficacy, FBG, 2h postprandial blood glucose, Homa-β and Homa-IR to be Secondary outcome measures. Compared with placebo group, dorzagliatin significantly reduced blood glucose levels as well as enhanced insulin resistance. In terms of safety, no serious adverse events occurred. However, lipid-related indicators, especially triglycerides levels, and the incidence of hypoglycemia were higher in patients in the dorzagliatin group compared with those in the control group, but the increase from baseline was mild.

Conclusions:
Dorzagliatin exerted favorable effects in hypoglycemic control, effectively reduced the HbA1c, FBG, and 2h postprandial blood glucose levels in T2DM patients, stimulated the secretion of insulin during the initial phase, and exerted a consistent hypoglycemic effect. However, the incidence of adverse events such as elevated blood lipids and cardiovascular risk warrants further investigations through long-term clinical trials.
Functional medicine health coaching improved elimination diet compliance and patient-reported health outcomes: Results from a randomized controlled trial
Authors: D’Adamo Christopher R. , Kaplan Michael B. , Campbell Patricia S. , McLaughlin Kerri , Swartz Jordan S. , Wattles Kalea R. , Lukaczer Dan , Scheinbaum Sandra 
Published: February 2024

Background:
The objective of this study was to determine whether an elimination diet with virtually provided functional medicine health coaching support would be more effective than a typical self-guided elimination diet with respect to dietary compliance and patient-reported health and quality of life.

Methods:
A parallel arm, randomized controlled trial was conducted among a sample of healthcare professionals. Participants were randomized to either an elimination diet with 5 sessions of functional medicine health coaching support (intervention arm) or a self-guided elimination diet (control arm). Outcomes assessed at baseline and at the conclusion of the 10-week study included PROMIS Global Health (GH) and medical symptoms questionnaire (MSQ). Compliance with the elimination diet was assessed at the conclusion of the study. Baseline and end of study outcomes were compared within study arms via paired t tests and between study arms with unpaired t tests. Subgroup analysis of symptomatology at baseline was performed.

Results:
125 randomized participants (n = 64 intervention, n = 61 control) provided baseline outcomes data. There were statistically and clinically significant within-group improvements in patient-reported outcomes in both the intervention arm (PROMIS GH-physical = 4.68, PROMIS GH-mental = 3.53, MSQ = 28.9) and control arm (PROMIS GH-physical = 48.4, PROMIS GH-mental = 3.18, MSQ = 24.1). There were no between-group differences in the primary analysis (P > .1). However, participants with more symptoms at baseline had statistically and clinically significant between-group differences in PROMIS GH-mental health (3.90, P = .0038) and MSQ (12.3, P = .047) scores that favored the functional medicine health coaching arm.

Conclusions:
An elimination diet, whether self-guided or with functional medicine health coaching support, may improve patient-reported health outcomes among relatively healthy healthcare professionals. While studies in more diverse samples are needed, functional medicine health coaching support appears to be superior to a self-guided approach with regard to both dietary compliance and improving health outcomes among those with greater symptomatology.
Pulmonary arterial sarcoma: A case report
Authors: Wang Yin , Rong Chunyan , Liu Jingwei , Liu Xuhan , Zhang Weihua 
Published: February 2024

Rationale:
Pulmonary artery sarcoma (PAS) is a rare malignant tumor primarily originating from the pulmonary artery’s intima or subintima. Approximately one-third of cases are classified as undifferentiated type. Its clinical manifestations lack specificity, dyspnea is the main symptom but can also present with chest pain, cough, hemoptysis, and other discomforts, making it prone to misdiagnosis as pulmonary embolism (PE).

Patient concerns:
A 50-year-old woman was admitted to the hospital with “dyspnea for more than 3 months, aggravated for 2 days,” and computed tomography pulmonary angiography suggesting “bilateral multiple pulmonary embolisms.”

Diagnoses:
The patient was initially misdiagnosed as PE, and was later definitively diagnosed as undifferentiated pleomorphic sarcoma of the pulmonary artery by pathologic biopsy.

Interventions and outcomes:
The patient was initially treated with anticoagulant therapy, but her dyspnea was not relieved. After that, she underwent positron emission computed tomography (PET-CT) and other investigations, which suggested the possibility of PAS, and then she underwent pulmonary endarterectomy to remove the lesion, which relieved her symptoms and was advised to seek further medical attention from the Department of Oncology and Department of Radiotherapy.

Lessons:
PAS can be easily misdiagnosed as PE. If a diagnosis of PE is made, but anticoagulation or even thrombolytic therapy proves ineffective, and there is no presence of PE causative factors such as deep vein thrombosis in the lower extremities, or D-dimer levels are not high, one should be cautious and consider the possibility of PAS.
Emerging trends and patterns in healthcare-seeking behavior: A systematic review
Authors: Li Limin , Fu Li , Li Hui , Liu Tong , Sun Jiangjie 
Published: February 2024

Objectives:
The study of healthcare-seeking behavior is essential for optimizing resource allocation and improving healthcare services. Its complexity and diversity have made it a prominent research area. Understanding factors influencing healthcare-seeking decisions allows targeted interventions and policy development to address barriers and ensure equitable access to quality healthcare for diverse populations. Such research plays a vital role in enhancing healthcare outcomes and overall population health.

Methods:
The study utilized a systematic quantitative literature review approach, employing the Web of Science (WOS) Core Collection and PubMed databases as data sources. Additionally, bibliometric tools such as CiteSpace and VOSviewer were employed for analysis and visualization of the literature.

Results:
A comprehensive statistical analysis and visualization were performed on the annual publication volume, publication countries, journals, keywords, and keyword co-occurrence patterns up until 2023. Through this analysis, a framework was established, identifying the determinants and fundamental elements of healthcare-seeking behavior. These findings contribute to the advancement of research in this field and inform future studies and interventions aimed at improving healthcare-seeking behavior.

Conclusions:
Based on the aforementioned literature review and framework, several conclusions were drawn. The determinants that facilitate healthcare-seeking behavior include improving health education awareness, enhancing healthcare resources, reducing costs, and ensuring system soundness. Additionally, providing social environment support was found to be crucial. Furthermore, the fundamental elements of healthcare-seeking behavior were identified as healthcare demand, healthcare choices, and the process of diagnosis and treatment. These findings provide valuable insights for developing interventions and policies to promote optimal healthcare-seeking behavior.
Comparison of manual chest compression versus mechanical chest compression for out-of-hospital cardiac arrest: A systematic review and meta-analysis
Authors: Larik Muhammad Omar , Ahmed Ayesha , Shiraz Moeez Ibrahim , Shiraz Seemin Afshan , Anjum Muhammad Umair , Bhattarai Pratik 
Published: February 2024

Background:
Out-of-hospital cardiac arrest is a life-threatening condition that requires immediate intervention to increase the prospect of survival. There are various ways to achieve cardiopulmonary resuscitation in such patients, either through manual chest compression or mechanical chest compression. Thus, we performed a systematic review and meta-analysis to investigate the differences between these interventions.

Methods:
PubMed, Cochrane Library, and Scopus were explored from inception to May 2023. Additionally, the bibliographies of relevant studies were searched. The Cochrane Risk of Bias Tool for Randomized Controlled Trials, Newcastle-Ottawa Scale, and the Risk of Bias in Non-Randomized Studies-I tools were utilized to perform quality and risk of bias assessments.

Results:
There were 24 studies included within this quantitative synthesis, featuring a total of 111,681 cardiac arrest patients. Overall, no statistically significant differences were observed between the return of spontaneous circulation, survival to hospital discharge, short-term survival, and long-term survival. However, manual chest compression was associated with a significantly superior favorability of neurological outcomes (OR: 1.41; 95% CI: 1.07, 1.84; P = .01).

Conclusion:
Although there were no major differences between the strategies, the poorer post-resuscitation neurological outcomes observed in mechanical chest compression indicate the need for further innovation and advancements within the current array of mechanical devices. However, future high-quality studies are necessary in order to arrive at a valid conclusion.
Efficacy and safety of electroacupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis
Authors: Chen Ruixue , Huang Huiyuan , Zhan Sheng , Yi Lizhen , Huang Linxing , Yue Zenghui 
Published: February 2024

Background:
This study aimed to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of benign prostatic hyperplasia.

Methods:
Seven databases were searched from the inception of each database to March 31, 2023, including PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang, and China Biology Medicine. The modified Jadad scale was used to assess literature quality, and literature inclusion and exclusion were conducted in strict accordance with the criteria of a score of ≥4. The risk of bias was evaluated using the Cochrane risk of bias tool. The pooled effect size of the binary data was measured by odds ratio (OR) and 95% confidence interval (CI), and the pooled effect size of the continuous data was presented as weighted mean difference (WMD) and 95% CI. If I² was larger than 50%, a random effects model was adopted, and otherwise, a fixed effects model was used. Additionally, publication bias assessment and sensitivity analysis were conducted.

Results:
A total of 325 records were retrieved, and finally 9 randomized controlled trial studies were included, involving 1045 patients. Meta-analysis revealed that the EA group had better improvement than the control group in terms of clinical effective rate (odds ratio = 3.92, 95% CI = 2.38 to 6.47, I² = 0%, P < .001), International Prostate Symptom Score (WMD = −4.99, 95% CI = −6.15 to −3.84, I² = 76.9%, P < .001), maximum urinary flow rate (WMD = −4.99, 95% CI = −6.15 to −3.84, I² = 87.4%, P < .001), and post-void residual volume (WMD = −17.12, 95% CI = −29.49 to −4.75, I² = 89.1%, P < .01). There was no statistical significance in prostate volume and adverse events between the EA group and the control group (P > .05).

Conclusion:
EA is effective in the treatment of benign prostatic hyperplasia with acceptable overall safety.
Mast cell activation and nutritional disorders in patients with hypermobility
Authors: Penny Hugo A. , Aziz Imran , Lam Ching 
Published: February 2024

Purpose of review
Individuals with joint hypermobility disorders are increasingly referred to gastroenterology services for support with the investigation and management of gastrointestinal complaints. Individuals can present with a myriad of complex coexisting diagnoses, the inter-relationship of which is unclear. This review discusses the proposed association between hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD) with disorders of mast cell activation and provides an overview of gastrointestinal symptoms and nutritional outcomes in this patient cohort.

Recent findings
It is unclear whether a true association between hEDS/HSD and mast cell activation disorders exists. There is a high prevalence of nonspecific gastrointestinal symptoms in individuals with hEDS/HSD and patients may be at risk of macro-nutrient and micro-nutrient deficiencies, although the current evidence base is limited.

Summary
We advocate a pragmatic approach to the investigation and management of gastrointestinal symptoms in patients with hEDS/HSD. This centres on excluding organic pathology, discussing the overlap with disorders of gut-brain interactions, trialling evidence-based therapies targeting individual symptoms, and supporting nutritional deficiencies where present via the least invasive approach. Engagement with a broad multidisciplinary team is also important to support the holistic needs of this patient cohort.