bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personal versus therapist perioperative music intervention: a randomized controlled trial
Authors: Jiang Fan , Wang Tingting , Hu Liqiong , Chen Shangui , Chen Lijian , Liu Xuesheng , Lu Yao , Gu Erwei , Ulloa Luis 
Published: March 2024

Introduction:
Music interventions can alleviate patient anxiety and improve post-surgical satisfaction. However, it remains uncertain whether personal music preferences affect efficacy. The authors tested whether personal music intervention with patient-selected songs played ad libitum is more effective than standard therapist-designed treatment with classical music.

Methods:
A prospective, parallel-group, single-blinded, randomized controlled trial with 229 participants (aged 18–60 years) previously scheduled for elective surgery. Data analyses followed a modified intention-to-treat principle. The patients were randomized into three groups: Standard care without music (Control), therapist-designed classic music treatment (TT), or personal music intervention with patient-selected songs played ad libitum by the patient (PI). All patients received standard post-anaesthesia care, and music intervention was started upon arrival at the post-anaesthesia care unit. Primary outcomes were anxiety and overall satisfaction at discharge. In contrast, secondary outcomes were systolic blood pressure during music intervention, the sleep quality of the night after surgery, and the occurrence of postoperative nausea and vomiting within the first 24 h after surgery.

Results:
Compared with therapist-designed music treatment, personal intervention decreased systolic blood pressure (T0: 124.3±13.7, 95% CI:121–127.7; T20min: 117.6±10.4, 95% CI:115–120.1; T30min: 116.9±10.6, 95% CI:114.3–119.4), prevented postoperative nausea and vomiting (Control: 55.9%, TT: 64.6%, PI: 77.6%), including severe postoperative nausea (VAS score>4; Control: 44.1%; TT: 33.8%; PI: 20.9%) and severe emesis (Frequency≥3, Control: 13.2%; TT: 7.7%; PI: 4.5%). None of the treatments affected sleep quality at night after surgery (Median, Q1–Q3, Control: 3, 1–3; TT: 3, 1–4; PI: 3, 1–3.5). Personal, but not therapist, music intervention significantly prevented anxiety (Control: 36.4±5.9, 95% CI:35.0–37.9; TT: 36.2±7.1, 95% CI: 34.4-37.9; PI: 33.8±5.6, 95% CI: 32.4–35.2) and emesis (Control: 23.9%; TT: 23.4%; PI: 13.2%) and improved patient satisfaction (Median, Q1–Q3, C: 8, 6–8; TT: 8, 7–9; PI: 8, 7–9).

Conclusions:
Personal music intervention improved postoperative systolic blood pressure, anxiety, nausea, emesis, and overall satisfaction, but not sleep quality, as compared to therapist-designed classic intervention.
Outpatient mean arterial pressure: A potentially modifiable risk for acute kidney injury and death among patients with cirrhosis
Authors: Cullaro Giuseppe , Chiou Sy Han , Fenton Cynthia , Ge Jin , McCulloch Charles E. , Rubin Jessica , Shui Amy M. , Yao Frederick , Lai Jennifer C. 
Published: March 2024

Mean arterial blood pressure (MAP), which decreases as portal hypertension progresses, may be a modifiable risk factor among patients with cirrhosis. We included adults enrolled in the Functional Assessment in Liver Transplantation study. We completed latent class trajectory analyses to define MAP trajectories. We completed time-dependent Cox-regression analyses to test the association between outpatient MAP and 3 cirrhosis-related outcomes: (1) stage 2 acute kidney injury (AKI), defined as a ≥200% increase in serum creatinine from baseline; (2) a 5-point increase in the MELD-Na score, defined as the incidence of increase from initial MELD-Na; (3) waitlist mortality, defined as death on the waitlist. For each outcome, we defined MAP cut points by determining the maximally selected Log-rank statistic after univariable Cox-regression analyses. Among the 1786 patients included in this analysis, our latent class trajectory analyses identified 3 specific outpatient MAP trajectories: “stable-low,” “stable-high,” and “increasing-to-decreasing.” However, >80% of patients were in a “stable-low” trajectory. We found in adjusted analyses that outpatient MAP was associated with each of our outcomes: Stage 2 AKI (adjusted hazard ratio 0.88 per 10 mm Hg increase in MAP [95% CI: 0.79–0.99]); 5-point increase in MELD-Na (adjusted hazard ratio: 0.91 [95% CI: 0.86–0.96]; waitlist mortality (adjusted hazard ratio: 0.89 [95% CI: 0.81–0.96]). For each outcome, we found that an outpatient MAP of 82 mm Hg was most associated with outcomes (p<0.05 for all). Our study informs the association between outpatient MAP and cirrhosis-related outcomes. These findings, coupled with the identification of specific thresholds, lay the foundation for the trial of targeted outpatient MAP modulation in patients with cirrhosis.
Serum HSP70 and VEGF Levels Are Effective Predictive Factors of Chemoradiosensitivity and Prognosis of Pancreatic Cancer Patients
Authors: Xiong Liumei , Li Danming , Xiao Gui , Tan Sipin , Wen Jianbo , Wang Guiliang 
Published: March 2024

Aim
The study is to evaluate serum HSP70 and VEGF for predicting the chemoradiosensitivity of the pancreatic cancer patients.

Materials and Methods
255 pancreatic cancer patients and 60 healthy subjects were measured for serum HSP70 and VEGF using ELISA for the pretreatment, during treatment, and postchemoradiotherapy timepoints.

Results
The serum HSP70 and VEGF were found to be elevated in pancreatic cancer patients as compared to healthy subjects. After chemoradiotherapy treatment, 179 patients showed effective clinical response while 76 patients showed ineffective clinical response. Serum HSP70 and VEGF were higher during chemoradiotherapy, and lower posttreatment in the effective group. However, serum HSP70 and VEGF were higher during and after treatment in the ineffective group. At any given timepoint, serum HSP70 and VEGF were higher in the ineffective group compared with the effective group. The overall survival and progression-free survival trends were as follows: HSP70 High/VEGFHigh < HSP70High/VEGFLow or HSP70Low/VEGFHigh < HSP70Low/VEGFLow. Serum HSP70 and VEGF were individually effective, and their combination was even more effective in predicting the chemoradiosensitivity of pancreatic cancer patients. HSP70 and VEGF were independent risk factors for overall survival and progression-free survival of pancreatic cancer patients.

Conclusions
Low levels of serum HSP70 and VEGF were associated with improved radiosensitivity and better prognosis of pancreatic cancer patients.
Lasting Impact of the COVID-19 Pandemic on Care and Prevention of Sexually Transmitted Infections in the Midwest
Authors: Patel Maya , Cardoza Nicholas , Weingarten Lawrence , Kolenchery Nebu , Trolard Anne , Cooper Benjamin , Reno Hilary 
Published: March 2024

BackgroundThe COVID-19 pandemic reduced the general accessibility of health services. Many sexually transmitted infection (STI) testing and treatment sites modified services (e.g., reduced hours, limited walk-in availability, decreased testing capacity), changes that may result in permanent change in STI service availability. At the same time, systems were driven to innovate in ways that could benefit patients. This study aimed to describe how the COVID-19 pandemic changed STI clinical services, with a focus on long-term impacts.MethodsIn July 2022, a phone survey was designed to assess services for STIs at the 105 STI testing and treatment providers in the St. Louis metropolitan statistical area. Sexually transmitted infection testing providers included STI clinics, primary care clinics that cater to a broad population, and community-based organizations, and excluded emergency departments and urgent care centers. In most cases, the survey was completed by a clinic manager, medical director, or nursing staff member.ResultsOf the 75 locations that were interviewed, 12 (16%) had not returned to prepandemic capacity and operations as of July 2022. Five sites had closed completely since the pandemic began, 3 of which are in the northwestern region of the metropolitan statistical area. Most (58.6%) of the open clinics had added telehealth appointments.ConclusionsSexually transmitted infection testing sites decreased during the pandemic with lasting impact in one area of the Midwest. Resources to support STI infrastructure should be expanded. Maintaining updated information on STI care providers in the region can aid future assessments.
Pulmonary Thromboemboli Due to Leiomyoma
Authors: Gongolli Julita , Vanderschaegen Anna , Renfrow Shannon , Collins Kimberly D. , Prahlow Joseph A. 
Published: March 2024

Abstract
Uterine leiomyomas are the most common pelvic tumor in women and the most frequent indication for hysterectomy. Although benign lesions, leiomyomas can cause dysfunctional uterine bleeding, pelvic pain or discomfort, infertility, and spontaneous abortion. Despite the fact that uterine leiomyomas can result in a significant amount of morbidity, it is relatively rare for these common tumors to lead to death. Here we present a case of fatal pulmonary thromboembolism that occurred due to pelvic vein thrombosis in the setting of leiomyomas.
Forecasting the effect of HIV-targeted interventions on the age distribution of people with HIV in Kenya
Authors: Schnure Melissa C. , Kasaie Parastu , Dowdy David W. , Genberg Becky L. , Kendall Emily A. , Fojo Anthony T. 
Published: March 2024

Objectives:To provide accurate forecasts of the age distribution of people with HIV (PWH) in Kenya from 2025 to 2040.Design:Development of a compartmental model of HIV in Kenya, calibrated to historical estimates of HIV epidemiology.Methods:We forecasted changes in population size and age distribution of new HIV infections and PWH under the status quo and under scale-up of HIV services.Results:Without scale-up, new HIV infections were forecasted to fall from 34 000 (28 000–41 000) in 2,025 to 29 000 (15 000–57 000) in 2,040; the percentage of new infections occurring among persons over 30 increased from 33% (20–50%) to 40% (24–62%). The median age of PWH increased from 39 years (38–40) in 2025 to 43 years (39–46) in 2040, and the percentage of PWH over age 50 increased from 26% (23–29%) to 34% (26–43%). Under the full intervention scenario, new infections were forecasted to fall to 6,000 (3,000–12 000) in 2,040. The percentage of new infections occurring in people over age 30 increased to 52% (34–71%) in 2,040, and there was an additional shift in the age structure of PWH [forecasted median age of 46 (43–48) and 40% (33–47%) over age 50].Conclusion:PWH in Kenya are forecasted to age over the next 15 years; improvements to the HIV care continuum are expected to contribute to the growing proportion of older PWH.
Inflammatory and Malignant Uptake Along Crohn Perianal Fistula on 18F-FDG
Authors: McKinley Spencer , Garuba Favour , Itani Malak , Deepak Parakkal , Ballard David H. 
Published: March 2024

Abstract
Inflammatory increased metabolic activity was discovered in the left anal canal on an 18F-FDG PET/CT scan performed for initial staging of anal squamous cell carcinoma in a patient with history of perianal Crohn disease. This increased uptake was due to a complex intersphincteric perianal fistula with supralevator extension, with a secondary, contiguous, superficial focus of squamous cell carcinoma at the anal verge that was identified on an MRI performed on the same day.
Significantly Elevated FDG Activity in Neurothekeoma
Authors: Amiruddin Raisa , Zhuang Hongming 
Published: March 2024

Abstract
Neurothekeoma is a very rare cutaneous lesion affecting mainly young patients. The lesion is generally benign. We report here that intense FDG activity on PET/CT was noted at the site of primary neurothekeoma of the right shoulder in a 16-year-old boy. Abnormal FDG activity was also seen in the metastatic neurothekeoma in the lung in the same patient 2 years later.
Application of System Nursing in the Prevention of Postoperative Nonstructural Scoliosis in Patients With Ear Reconstruction
Authors: Tian Mei , Zhuang Jun , Zhang Huiwen , Hu Jintian , Liu Na 
Published: March 2024

Objective:
To evaluate whether early systematic nursing can reduce the occurrence of postoperative nonstructural scoliosis in patients undergoing ear reconstruction.

Methods:
A total of 136 patients with congenital microtia who underwent ear reconstruction surgery at the Department of Plastic Surgery, Chinese Academy of Medical Sciences from, January 2022 to July 2022 were included as study subjects. They were randomly divided into a routine nursing group and a systematic nursing group. After preoperative and postoperative education, as well as continuous follow-up intervention after surgery, spinal CT three-dimensional imaging examination was performed 6 months later to measure the Cobb angle and observe the occurrence of spinal scoliosis.

Results:
Compared with the routine nursing group, the incidence and severity of postoperative nonstructural scoliosis were significantly reduced in patients who received systematic nursing.

Conclusions:
Systematic nursing intervention for patients undergoing ear reconstruction can help prevent the occurrence of postoperative nonstructural scoliosis and has a positive effect on improving patient prognosis. It is worth promoting in clinical treatment.
Surgical Management of Complex Skull Base Tumor Using Preoperative Multimodal Image Fusion Technology
Authors: Jian zhi-heng , Chen peng , Li yu , Liao chang-chun , Yi xin-feng , Zhan run-gen , Chen gang 
Published: March 2024

Objective:
To review our single-institution experience in the surgical management of complex skull base tumors using multimodal image fusion technology.

Methods:
From October 2019 to January 2022, 7 cases of complex skull base tumors that performed preoperative multimodal image fusion in Zhuhai People’s Hospital neurosurgery department were involved in this study. The image data were uploaded to the GE AW workstation. Corresponding image sequences were opened in the workstation to complete registration fusion and 3D reconstruction. We retrospectively reviewed the clinical and imaging data, and surgical strategy, respectively.

Results:
one case of recurrent C2 schwannoma, 1 case of recurrent spindle cell tumor of the left cranio-orbital communication, 1 case of lobular malignant tumor of the left infratemporal fossa, 1 case of central giant cell repairing granuloma, 1 case of mesenchymal malignant tumor in left pharyngeal process, 1 case of meningioma in jugular foramen, and 1 case of hemangioblastoma with vascular malformation in fourth ventricular. All cases underwent preoperative multimodal image fusion for the surgical plan and all cases had gross total resection. Except for one case of mesenchymal malignant tumor in left pharyngeal process that had dysphagia and one case of hemangioblastoma that had discoordination, others cases were without postoperative complication.

Conclusions:
Preoperative multimodal image fusion and surgical approach simulation benefit complex skull base tumor surgical treatment. Individually multiple image assessment of complex skull base tumors to determine the specific surgical strategy is more rational and should be recommended (Supplemental Digital Content 1, Supplementary Video, http://links.lww.com/SCS/F936).
The Effect of Combined Spinal Epidural Anesthesia on Shoulder Pain in Laparoscopic Extraperitoneal Hernia Surgery
Authors: Guzey Deniz , Donmez Turgut , Karabulut Mehmet , Surek Ahmet , Emir Nalan Saygi , Cayirci Can Ertug , Kandemir Hande , Hatipoglu Engin 
Published: March 2024

Background:
Shoulder pain is a condition that seriously discomforts patients and develops caused by a peritoneal tear in laparoscopic extraperitoneal hernia repair (TEP) surgeries. Although surgeons generally prefer general anesthesia for the TEP technique, many studies have been carried out on the use of regional anesthesia in recent years. In our study, we aimed to investigate the efficacy and safety of the combined spinal/epidural anesthesia (CSEA) method to prevent shoulder pain in the TEP technique.

Methods:
The patients who operated with the TEP procedure were divided into 2 groups; SA (group 1) and CSEA (group 2). The 2 patient groups were compared in terms of sex, age, body mass index, duration of surgery, total operation time, patient satisfaction, pain scores, length of hospital stay, adverse effects, intraoperative, and postoperative complications.

Results:
The number of patients in group 1 was 42 and group 2 was 40. The mean operation time was recorded as 55.9 and 80.2 minutes in groups 1 and 2, respectively, which was statistically significantly shorter in group 1 (P<0.001). Postoperative pain was significantly less in group 2 for the 4th hour (P<0.0001) and the 12th hour (P=0.047). There was no difference between the 2 groups in terms of peritoneal tear (P=0.860). Intraoperative and postoperative shoulder pain was significantly less in group 2 (P=0.038, P=0015, respectively).

Conclusion:
CSEA is an effective and safe anesthesia method for preventing shoulder pain that develops after TEP surgeries.
Endotheliopathy of trauma in children: The association of syndecan-1 with injury and poor outcomes
Authors: Morgan Katrina M. , Abou-Khalil Elissa , Gaines Barbara A. , Leeper Christine M. 
Published: March 2024

BACKGROUND
The contribution of the endothelium to trauma-induced coagulopathy has not been thoroughly investigated in injured children.

METHODS
This is a prospective cohort study of children (younger than 18 years) who presented with a potentially severe injury to an academic pediatric trauma center. Syndecan-1 level was collected on arrival and 24 hours following hospital arrival. Children were categorized as injured versus uninjured based on results of trauma evaluation. Demographics, injury characteristics, vital signs, and clinical laboratories were recorded. A composite clinical outcome was defined as death or blood product transfusion within 24 hours of hospital arrival. Statistical tests determined the impact of injury characteristics and therapeutics on syndecan-1 levels and assessed for associations between syndecan-1 level and outcomes.

RESULTS
A total of 121 subjects were included in the analysis: 96 injured (79%) and 25 uninjured (21%). There were no differences between groups in age (median [interquartile range (IQR)], 11 [4–14] years), sex, or race. The injured cohort had a median (IQR) Injury Severity Score of 16 (9–21), 75% had blunt mechanism, 26% were transfused within 6 hours, 3% had 24-hour mortality, and 6% had in-hospital mortality. Median (IQR) syndecan-1 level on admission was significantly higher in injured versus uninjured cohort (44 [21–75] vs. 25 [17–42]; p = 0.04). Admission base deficit was significantly correlated with syndecan-1 level (r = 0.8, p < 0.001); no association with traumatic brain injury or injury mechanism was seen. Children with elevated syndecan-1 on admission had significantly increased odds of poor outcome; every 10 ng/mL increase in syndecan-1 was associated with 10% increased odds of death or transfusion (p < 0.001). Transfusion with any blood product was associated with a significant decrease in syndecan-1 from arrival to 24 hours (Δ syndecan-1, −17 [−64 to −5] vs. −8 [−19 to +2]; p < 0001).

CONCLUSION
Elevated admission syndecan-1 level, suggestive of endotheliopathy, was associated with shock and poor outcomes in pediatric trauma. Larger cohort studies are required to fully describe the complexities of trauma-induced coagulopathy and investigate the benefit of therapies targeting endotheliopathy in children.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Whole blood storage duration alters fibrinogen levels and thrombin formation
Authors: Chae Ryan , Nguyen Christopher , Archdeacon Chad , Wattley Lindsey , Sisak Stephanie , Price Adam , Perez Emma , Schuster Rebecca , Lentsch Alex , Caldwell Charles , Goodman Michael , Pritts Timothy 
Published: March 2024

INTRODUCTION
Whole blood resuscitation for hemorrhagic shock in trauma represents an opportunity to correct coagulopathy in trauma while also supplying red blood cells. The production of microvesicles in stored whole blood and their effect on its hemostatic parameters have not been described in previous literature. We hypothesized that microvesicles in aged stored whole blood are procoagulant and increase thrombin production via phosphatidylserine.

METHODS
Whole blood was obtained from male C57BL/6 male mice and stored in anticoagulant solution for up to 10 days. At intervals, stored whole blood underwent examination with rotational thromboelastography, and platelet-poor plasma was prepared for analysis of thrombin generation. Microvesicles were prepared from 10-day-old whole blood aliquots and added to fresh whole blood or platelet-poor plasma to assess changes in coagulation and thrombin generation. Microvesicles were treated with recombinant mouse lactadherin prior to addition to plasma to inhibit phosphatidylserine's role in thrombin generation.

RESULTS
Aged murine whole blood had decreased fibrin clot formation compared with fresh samples with decreased plasma fibrinogen levels. Thrombin generation in plasma from aged blood increased over time of storage. The addition of microvesicles to fresh plasma resulted in increased thrombin generation compared with controls. When phosphatidylserine on microvesicles was blocked with lactadherin, there was no difference in the endogenous thrombin potential, but the generation of thrombin was blunted with lower peak thrombin levels.

CONCLUSION
Cold storage of murine whole blood results in decreased fibrinogen levels and fibrin clot formation. Aged whole blood demonstrates increased thrombin generation, and this is due in part to microvesicle production in stored whole blood. One mechanism by which microvesicles are procoagulant is by phosphatidylserine expression on their membranes.
Interest of rare autoantibodies in autoimmune encephalitis and paraneoplastic neurological syndromes: the utility (or futility) of rare antibody discovery
Authors: Segal Yahel , Zekeridou Anastasia 
Published: March 2024

Purpose of review
The increasing recognition and diagnosis of autoimmune encephalitis (AE) and paraneoplastic neurological syndromes (PNS) is partly due to neural autoantibody testing and discovery. The past two decades witnessed an exponential growth in the number of identified neural antibodies. This review aims to summarize recent rare antibody discoveries in the context of central nervous system (CNS) autoimmunity and evaluate the ongoing debate about their utility.

Recent findings
In the last 5 years alone 15 novel neural autoantibody specificities were identified. These include rare neural antibody biomarkers of autoimmune encephalitis, cerebellar ataxia or other movement disorders, including multifocal presentations.

Summary
Although the clinical applications of these rare antibody discoveries may be limited by the low number of positive cases, they still provide important diagnostic, prognostic, and therapeutic insights.