bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Bakri balloon tamponade combined with different suture methods on preventing postpartum hemorrhage in women with pregnancy-induced hypertension undergoing cesarean delivery
Authors: Liu Yeting , Wu Yanying , Li Fengjiao , Song Xiaocui , Zhao Jingjing 
Published: March 2024

Objective:
To investigate the effect of Bakri balloon tamponade (BBT) combined with different suture methods on preventing postpartum hemorrhage in women with pregnancy-induced hypertension (PIH) undergoing cesarean delivery (CD).

Methods:
This randomized, double-blind, controlled trial was conducted at The First Affiliated Hospital of Xingtai Medical College from October 2020 to June 2023. Patients with PIH who had persistent bleeding after CD and were unresponsive to uterine contractions, sutures, or uterine disconnection procedures were eligible participants. Eligible participants were randomly assigned to control and study groups, with 50 patients in each group. The control group used BBT combined with B-lynch uterine compression sutures, while the study group used BBT combined with modified Hayman suture. Intraoperative and postoperative bleeding and changes in vital signs were compared between the 2 groups. Moreover, changes in inflammation levels, coagulation function, and sex hormone levels were compared between the 2 groups before and after surgery.

Results:
A total of 122 patients with persistent bleeding after CD were recruited, of whom 22 were excluded (16 cases of uterine contractions and/or local uterine myometrial sutures for hemostasis, 4 cases of preoperative uterine artery embolization, and 2 cases of uterine malformations). The intraoperative blood loss, postoperative blood loss at 2 hours, postoperative blood loss at 24 hours, and decrease in red blood cell and hemoglobin in the study group were significantly lower than those in the control group (P < .05). After surgery, the levels of inflammation, coagulation function, and sex hormone in both groups improved compared to before surgery, and the study group was significantly better than the control group (P < .05). In addition, the incidence of postoperative adverse events in the study group was significantly lower than that in the control group (P < .05).

Conclusions:
The hemostatic effect of BBT combined with B-lynch uterine compression sutures is comparable to that of BBT combined with modified Hayman suture for postpartum hemorrhage in pregnant women with PIH undergoing CD, but the latter has less blood loss, attenuated inflammatory response, reduced impact on coagulation function and ovarian function, and a lower incidence of adverse events.
Treating adolescent pseudomyopia and elevated intraocular pressure using chiropractic and moxibustion: A CARE-compliant case report
Authors: Fang Yiyan , Li Zengtu , Hu Hantong , Ye Ziyu 
Published: March 2024

Rationale:
This case report aims to provide clinical evidence on the effectiveness of integrating chiropractic and moxibustion techniques for treating pseudomyopia accompanied by elevated intraocular pressure resulting from cervical spine issues because the application of complementary medicine modalities for managing such vision disorders currently lacks adequate investigations.

Patient concerns:
A 6-year-old patient presented with blurred vision, intermittent ocular discomfort, and upper cervical discomfort.

Diagnoses:
Spine-related increased intraocular pressure and pseudomyopia.

Interventions:
The patient received integrative treatment of chiropractic and walnut-shell moxibustion 3 times a week for a total of 10 treatment sessions.

Outcomes:
The patient exhibited progressive improvements in visual acuity and reductions in intraocular pressure over the treatment period, with unaided vision exceeding 2 lines of improvement in visual acuity charts and normalized intraocular pressure after 10 treatment sessions. These therapeutic effects were sustained at 3-month follow-up.

Lessons:
The integrative use of chiropractic and walnut-shell moxibustion demonstrates considerable potential in alleviating symptoms of pseudomyopia, reducing intraocular pressure, and restoring visual function in spine-related pseudomyopia cases.
Idiopathic mesenteric phlebosclerosis occurring in a patient with liver cirrhosis: A case report
Authors: Zhang Congjie , Huang Haijun , Guo Beibei 
Published: March 2024

Background:
Idiopathic mesenteric phlebosclerosis (IMP) is a rare gastrointestinal disease with unclear etiology and pathogenesis. IMP occurring in a patient with liver cirrhosis is more scarcely reported than independent IMP. In this study, we reported a case of IMP occurring in a patient with liver cirrhosis, so as to provide a reference for understanding liver cirrhosis with IMP.

Method:
A 63-year-old man with liver cirrhosis was admitted in the hospital’s department of infectious disease because of fatigue and constipation for 1 month. The patient had an irregular medical history of antivirus drug and Chinese herbal medicine intake because of the hepatitis B virus infection. No other abnormalities were found in the functions of the liver, coagulation, renal, or complete blood count. Fecal occult blood tests were all positive in 5 detections. Contrast-enhanced computed tomography revealed liver cirrhosis and showed thickening of the wall of the right hemicolon and multiple calcifications of the mesenteric veins. Mesenteric vein computed tomography venography displayed diffuse colon mural thickening of the right colon and tortuous linear calcification line in the right colic veins. Colonoscopy revealed a purple-blue, swollen, rough, and vanished vascular texture mucosa. He was finically diagnosed as liver cirrhosis with IMP by a series of examinations during hospitalization.

Results:
His symptoms of fatigue and constipation subsided after conservative treatment and withdraw from Chinese herbal medicine. The patient experienced no obvious discomfort during the follow-up period.

Conclusion:
A comprehensive medical diagnosis is necessary for the discovery of IMP, especially IMP with liver cirrhosis. Liver cirrhosis maybe play a key role in the development of IMP. The regulatory mechanism of liver cirrhosis contributing to IMP needs to be further studied based on more clinical cases.
Relation between non-alcoholic fatty liver disease and carotid artery intimal media thickness as a surrogate for atherosclerosis: a systematic review and meta-analysis
Authors: Abosheaishaa Hazem , Nassar Mahmoud , Abdelhalim Omar , Bahbah Ammar Ayman , Abbas Sharif , Morsi Samah M. , Ghallab Muhammad , Alagha Zakaria , Omran Ahmed , Elfert Khaled , Bandaru Praneeth , Forlemu Arnold Nongmoh , Reddy Madhavi 
Published: March 2024

Background and objective
Non-alcoholic fatty liver disease (NAFLD), characterized by hepatic steatosis without heavy alcohol consumption or other chronic conditions, encompasses a spectrum from non-alcoholic fatty liver to non-alcoholic steatohepatitis leading to cirrhosis. This analysis aimed to investigate the correlation between NAFLD and carotid intimal media thickness (C-IMT), a non-invasive surrogate for atherosclerosis.

Methodology
Database searches, including PubMed, EMBASE and Cochrane Library, yielded studies up to April 2023. Included were studies exploring the NAFLD-C-IMT relationship in populations aged >18 years. Exclusions comprised non-English papers, those involving animals or pediatric populations and studies lacking control groups.

Results
No statistical significance was noted between mild and moderate NAFLD compared to the control group regarding C-IMT [95% confidence intervals (CI): −0.03, 0.12] and (95% CI: −0.03, 0.21), respectively. There was a statistically significant difference only in the Severe NAFLD group (P value 0.03). NAFLD with and without metabolic syndrome showed statistically significant differences compared to control regarding C-IMT (95% CI: 0.04, 0.12) and (95% CI: 0.01, 0.07), respectively. Fifty-nine studies were mentioned without classification of NAFLD severity and revealed a high statistically significant difference between NAFLD and controls regarding C-IMT with (95% CI: 0.09, 0.12, P < 0.00001). Stratified analysis according to sex was done in two studies and revealed statistical differences between NAFLD and control regarding C-IMT in both groups.

Conclusion
This meta-analysis underscores a significant association between NAFLD and increased C-IMT, emphasizing the importance of assessing C-IMT in NAFLD patients to identify cardiovascular risk and tailor therapeutic interventions for improved patient outcomes.
Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus: a clinical trial.
Authors: Vejdan SA , Danesh HA , Amirian F. , Amirian Z. 
Published: March 2024

Background:
The most important step in treating a pilonidal sinus is eradication by surgical excision. Over the years, various surgical techniques have been reported for wound closure, yet their management still poses a challenge. The current study compares the results of two different methods of wound management: secondary wound healing versus the Z-plasty surgical technique.

Material and method:
The current clinical trial recruited 84 uncomplicated pilonidal sinus patients who were to undergo complete surgical excision of the pilonidal sinus. For wound healing, the 84 subjects were equally divided into two groups of 42 patients each. One group was selected for Z-plasty surgical wound closure and the other for the secondary healing mechanism. Outcomes measured consisted of demographic data, length of operation, complications, severity of pain, number of dressings, recurrence, and complete healing time.

Result:
Age or sex distribution and the median BMI (kg/m²) did not significantly differ between the two groups. The length of the operation for Z-plasty subjects was significantly longer (P <0.0001). The median number of dressing changes for secondary wound healing patients was 38.69, which was significantly higher than the 4.95 dressing changes for the Z-plasty group. The total time recorded for complete wound healing was 21.61±4.27 days in the Z-plasty group and 41.23±24.28 days for secondary wound healing subjects, which was statistically significant. Twenty-four hours postoperation, patients in the secondary wound healing group had significantly more pain, and the Visual Analogue Scale scores of the Z-plasty and secondary wound healing groups were 3.42±0.76 and 6.09±1.2, respectively. Concerning the recurrence rate, there were no significant differences between the two groups. SPSS version 22 performed the analyses, and the independent t-test compared the continuous variables. A P value less than 0.05 was considered statistically significant.

Conclusion:
Z-plasty is a safe and effective procedure in terms of wound complications and recurrence rate. This method is also cost-effective and better received by patients.
Poorly differentiated thyroid carcinoma arising from substernal goiter: a case report
Authors: Apelian Shant , Ismail Sawsan , Roumieh Dommar , Saad Bassam , Alshehabi Zuheir 
Published: March 2024

Introduction and importance:
Poorly differentiated thyroid carcinomas represent a rare heterogeneous group of malignant tumors that constitute ~2–4% of all thyroid neoplasms. Substernal goiter (SG) is defined as an enlargement of the thyroid gland that is located below the thoracic inlet. Malignant neoplasms arising from a SG were reported in only 2–3% of cases.
This case report has been reported in line with the Surgical CAse REport (SCARE) Criteria.
21

Case presentation:
This article presents a 54-year-old Syrian female who presented at our institution due to dysphagia, dyspnea, cervical swelling, and loss of appetite. Following clinical and radiological examinations, total thyroidectomy with lymph node dissection was performed. Microscopic examination revealed an infiltrative growth pattern of insular, trabecular, and solid formations of epithelial cells with scant eosinophilic cytoplasm, hyperchromatic nuclei, and bizarre mitotic figures with areas of necrosis. Subsequently, the final diagnosis was confirmed as a multifocal poorly differentiated thyroid carcinoma arising from a SG.

Clinical discussion:
The heterogeneity of histologic features of poorly differentiated thyroid carcinoma represents a diagnostic challenge. Diagnosis of poorly differentiated thyroid carcinomas is based on the Turin Criteria, which highlights histopathological features. Computed tomography plays a major role in SG for further evaluation.

Conclusion:
In this manuscript, the authors aimed to present a unique case report with challenging diagnostic features including the rapid development of an infiltrative poorly differentiated thyroid carcinoma from a SG highlighting the importance of a detailed histopathological examination of thyroid nodules in the absence of significant medical history.
Syrian child carrying multiple pathogenic variants in MBOAT7 and MT-TS1 genes: a case report on neurodevelopmental phenotypes and mitochondrial inheritance
Authors: Kousa Alyamama , Ahmed Reem , Alasmar Pr.Diana 
Published: March 2024

Introduction:
The authors identify two patterns of inheritance in a Syrian child from consanguineous parents. The membrane-bound O-acyltranferase domain-containing7 (MBOAT7) gene encodes Lysophosphatidylinositol acyltranferase (LPIAT1), which is responsible for the neurodevelopment of the brain cortex. Patients with MBOAT7 variants exhibit pathogenic nervous manifestations such as global developmental delays affecting speech and motor function, intellectual disability (ID), poor coordination, and seizures, with or without MRI abnormalities. MT_TS1, the mitochondrial tRNASer(UCN) gene, is a hotspot for pathogenic mutations causing variable mitochondrial phenotypes, including hearing impairment (HI), ataxia and cognitive impairment.

Clinical presentation:
The authors present a case of a 4-year-old child with motor and speech delay, truncal hypotonia, visual tic, poor coordination, autistic features and generalized seizures at 7 months of age. After normal results from lab tests and MRI imaging, along with the family’s history of neurological disorders, genetic analysis was necessary to diagnose and assess the possibility of genetic counselling. Next-generation sequencing (NGS) showed two variable variants in the MBOAT7 and MT-TS1 genes. The first mutation is a homozygous variant of uncertain significance in the MBOAT7 gene, associated with the autosomal recessive Mental retardation type 57. The second variant is a heteroplasmic pathogenic variant in the MT-TS1 gene, indicative of mitochondrial disorders.

Conclusion:
The presence of the MBOAT7 and MT-TS1 gene variants in the same child is noteworthy. The authors must keep genetic mutations of MBOAT7 and MT-TS1 gene in mind as a differential diagnosis for intellectual disability, seizures and autistic features in children, especially in consanguineous families.
Wandering spleen in a postpartum female: a case report
Authors: Rasheed Omeed , Wassouf Ali , Abo Al Shamat Aiman , Daoud Raghad , Knaj Duaa , Ahmad Ghanem 
Published: March 2024

Introduction and importance:
Wandering spleen (WS) is a rare condition that occurs when the spleen is not in its normal anatomical location, but in the abdominal or pelvic cavity. The mechanism of this condition may be due to dysfunction of ligaments that fixate the spleen in its position. Female hormonal alterations during pregnancy and other unknown causes in children may also play role in an ectopic spleen.

Case presentation:
The authors report a case of a 34-year-old woman who presented to the emergency department with intermittent abdominal pain that persisted after childbirth without other symptoms.

Clinical discussion:
Clinically the symptoms are varied and abdominal pain is the most common presentation. Radiological investigation of WS include ultrasound, MRI, and CT, which is the most preferred tool. Treatments after the diagnosis include splenectomy or splenopexy either through laparoscopy or laparotomy.

Conclusion:
Physicians should include ectopic spleen as a differential diagnosis in a multiparous woman with the presentation of acute or chronic abdominal pain.
Public Health Nurses’ Proficiencies and Training Needs in an Emergency Response: A Cross-Sectional Observational Study
Authors: Kett Paula M. , Shahrir Shahida , Bekemeier Betty 
Published: March 2024

Objective:
To address gaps in understanding the public health nursing workforce regarding competencies recognized as critical during an emergency response.

Design, Setting, and Participants:
A cross-sectional observational study using data with information on local health department staff- and organizational-level characteristics collected from across the United States in 2021. We used logistic regression to estimate the association between 2 binary nurse-specific predictors—(1) whether the staff person was a nurse and (2) whether the staff worked in a local health department that was “nurse-led” (directed by a nurse)—and reported proficiencies important to the COVID-19 response. Models controlled for relevant local health department and community characteristics.

Results:
In the sample, 19% were nurses and 37% were at nurse-led health departments. Nurse versus nonnurse staff had higher odds of reporting proficiencies in skills related to Justice, Equity, Diversity, and Inclusion and in the skill “identifying/applying evidence-based approaches to address public health issues.” However, nurses, compared with their nonnurse peers, had higher odds of reporting training needs in domains related to community engagement, policy engagement, and cross-sectoral collaboration. Conversely, staff at nurse-led health departments, compared with non–nurse-led staff, had higher odds of reporting proficiencies in many of these same areas, including “collaborating across the public health system” and “influencing policies external to the organization that affect community health.” There were no areas in which nurse-led staff had lower odds of reporting proficiencies or higher odds of identifying training needs.

Conclusions:
Findings from this study highlight areas of strength for public health nurses, particularly strengths related to diversity, equity, and inclusion, as well as areas where more training is needed. Such findings can help guide future public health nurse workforce development as well as underscore the value of public health nursing leadership and staff at local health departments for supporting community health.
What are relevant predictors of physical activity in older adults with lower limb loss (LLL)? Results of a retrospective analysis
Authors: Rash Isabelle , Miller William C. , Tao Gordon , Payne Michael W. 
Published: March 2024

Background:
People with lower limb loss (LLL) have reduced physical activity (PA). There is evidence of physical and psychosocial predictors of PA in older adults with limb loss. However, these 2 areas (physical/psychosocial) have not been evaluated in the same analysis.

Objectives:
To describe and identify predictors of PA in individuals with LLL.

Study design:
Cross-sectional study.

Methods:
Secondary analysis of data from a multisite Canadian randomized control trial involving community-dwelling prosthetic ambulators with unilateral transtibial or transfemoral amputation (N = 72). The dependent variable was the Physical Activity Scale for the Elderly. Potential predictors were four step square test, 2-minute walk test, Short Physical Performance Battery, Life Space Assessment, walking while talking test, and Activities-specific Balance Confidence scale.

Results:
Seventy-two community-dwelling lower limb prosthesis users were enrolled. The sample included 62 male participants (86%), and 58 participants (81%) had transtibial amputation. The average age of participants was 65 (8.9) years, and for 49 participants (70%), the amputation was over 24 months ago. The total mean Standard Deviation (SD) Physical Activity Scale for the Elderly score was 153.2 (88.3), with scores of 148.1 (11.4) and 184.5 (24.7) for male and female participants, respectively. Regression analysis identified Life Space Assessment (β = 1.15, p = 0.007) and Short Physical Performance Battery (β = 3.51, p = 0.043) as statistically significant predictors accounting for 25% of the variance in PA.

Conclusions:
Community mobility and physical performance are the most meaningful predictors of PA. Future research should examine additional factors (e.g., environment, motivation). Understanding the predictors for PA after LLL would improve clinical practice as clinicians would have increased knowledge to modify and improve training.
Impact of antiretroviral therapy during acute or early HIV infection on virologic and immunologic outcomes: results from a multinational clinical trial
Authors: Crowell Trevor A. , Ritz Justin , Zheng Lu , Naqvi Asma , Cyktor Joshua C. , Puleo Joseph , Clagett Brian , Lama Javier R. , Kanyama Cecilia , Little Susan J. , Cohn Susan E. , Riddler Sharon A. , Collier Ann C. , Heath Sonya L. , Tantivitayakul Pornphen , Grinsztejn Beatriz , Arduino Roberto C. , Rooney James F. , van Zyl Gert U. , Coombs Robert W. , Fox Lawrence , Ananworanich Jintanat , Eron Joseph J. , Sieg Scott F. , Mellors John W. , Daar Eric S. ,   for the AIDS Clinical Trials Group (ACTG) A5354/EARLIER Study Team
Published: March 2024

Objective:
To assess how antiretroviral therapy (ART) initiation during acute or early HIV infection (AEHI) affects the viral reservoir and host immune responses.

Design:
Single-arm trial of ART initiation during AEHI at 30 sites in the Americas, Africa, and Asia.

Methods:
HIV DNA was measured at week 48 of ART in 5 million CD4+ T cells by sensitive qPCR assays targeting HIV gag and pol. Peripheral blood mononuclear cells were stimulated with potential HIV T cell epitope peptide pools consisting of env, gag, nef, and pol peptides and stained for expression of CD3, CD4, CD8, and intracellular cytokines/chemokines.

Results:
From 2017 to 2019, 188 participants initiated ART during Fiebig stages I (n = 6), II (n = 43), III (n = 56), IV (n = 23), and V (n = 60). Median age was 27 years (interquartile range 23–38), 27 (14%) participants were female, and 180 (97%) cisgender. Among 154 virally suppressed participants at week 48, 100% had detectable HIV gag or pol DNA. Participants treated during Fiebig I had the lowest HIV DNA levels (P < 0.001). Week 48 HIV DNA mostly did not correlate with concurrent CD4+ or CD8+ T cell HIV-specific immune responses (rho range -0.11 to +0.19, all P > 0.025). At week 48, the magnitude, but not polyfunctionality, of HIV-specific T cell responses was moderately reduced among participants who initiated ART earliest.

Conclusion:
Earlier ART initiation during AEHI reduced but did not eliminate the persistence of HIV-infected cells in blood. These findings explain the rapid viral rebound observed after ART cessation in early-treated individuals with undetectable HIV DNA by less sensitive methods.