bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early double-balloon enteroscopy was not related to better clinical outcomes in patients with suspected overt small bowel bleeding
Authors: Ye Yong-Cheng , Sung Kuan-Yi , Chang Tien-En , Wu Pei-Shan , Wang Yen-Po , Luo Jiing-Chyuan , Hou Ming-Chih , Lu Ching-Liang 
Published: February 2024

Background:
Device-assisted enteroscopy has been used for over 20 years for the management of patients with suspected small bowel bleeding. Unlike esophagogastroduodenoscopy and colonoscopy, the appropriate timing of enteroscopy is still unknown. In recent guidelines, early enteroscopy is suggested to maximize diagnostic yield and therapeutic yield in patients with suspected small bowel bleeding. However, few studies have identified its influence on clinical outcomes, including mortality or rebleeding rate. We conducted this study to evaluate the influence of the timing of double-balloon enteroscopy on clinical outcomes in patients with suspected small bowel bleeding.

Methods:
Patients with overt small bowel bleeding who underwent double-balloon enteroscopy from January 2013 to February 2021 were retrospectively reviewed. Patients were categorized into an early enteroscopy group (≤14 days) and a nonearly enteroscopy group (>14 days). Clinical outcomes, including short-term mortality and rebleeding rate, long-term mortality and rebleeding rate, diagnostic yield, and therapeutic yield, were analyzed.

Results:
A total of 100 patients (mean age, 66.2 years; 53% male) were included, and 44 patients were stratified into the early enteroscopy group. The diagnostic yield, therapeutic yield, mortality, and rebleeding rate were similar between two groups. In multivariate conditional logistic regression analysis, there were no significant differences between two groups regarding the 30-day rebleeding rate (adjusted odds ratio [aOR], 1.43; 95% CI, 0.47-4.33), 90-day rebleeding rate (aOR, 1.18; 95% CI, 0.47-2.94), 30-day mortality rate (aOR, 1.29; 95% CI, 0.21-8.13), 90-day mortality rate (aOR, 1.94; 95% CI, 0.48-7.87), and 90-day bleeding-related mortality (aOR, 2.18; 95% CI, 0.24-19.52). The Kaplan-Meier survival curve analysis showed that the timing of DBE was not associated with the long-term rebleeding rate or mortality rate (p = 0.57 and 0.83, respectively).

Conclusion:
The timing of enteroscopy did not influence the clinical outcomes, including the short-term mortality rate, short-term rebleeding rate, long-term mortality rate, and rebleeding rate, in patients with suspected overt small bowel bleeding.
Successful utilization of nirmatrelvir/ritonavir and dexamethasone in a patient with total artificial heart and COVID-19: A case report
Authors: Alowais Shuroug A. , Bosaeed Mohammed , Saleh Khalid Bin , AlQahtani Hajar , Selimovic Nedim , Ahmed Husnat , Alghamdi Abdullah A. , Hussain Arif , Badreldin Hisham A. 
Published: February 2024

Rationale:
Management of coronavirus disease 2019 (COVID-19) has been the subject of extensive research and study, leading to the development of strategies and treatments. Nonetheless, there remains a dearth of information concerning patients who require mechanical circulatory system support. This case report presents one of the first documented cases of successful utilization of nirmatrelvir/ritonavir (Paxlovid) and dexamethasone in the treatment of a patient with a total artificial heart.

Patient concerns:
The patient in this case study was a 28-year-old male who had been experiencing severe heart failure. In need of a heart transplant, he underwent a procedure for implantation of a total artificial heart as a bridge to transplantation.

Diagnoses:
Unfortunately, after the surgical intervention, the patient contracted COVID-19, as confirmed by polymerase chain reaction.

Interventions:
The therapeutic approach involved a 5-day regimen of nirmatrelvir/ritonavir at a dosage of 300/100 mg administered twice daily, along with a daily dosage of 6 mg of dexamethasone.

Outcomes:
Remarkably, the patient oxygenation level improved on the second day of therapy. Consequently, he was transferred from the intensive care unit to the general floor. After 71 days with the total artificial heart, the patient successfully underwent heart transplantation.

Lessons:
This case report provides a compelling example of the successful application of nirmatrelvir/ritonavir and dexamethasone in the treatment of a COVID-19 patient with a total artificial heart. The positive outcome observed in this case underscores the potential use of these therapeutic agents in this specific patient population. However, it is imperative to conduct further research to corroborate and validate these initial findings. This study lays the foundation for further exploration of the efficacy of these drugs in patients with mechanical circulatory support systems.
HIV-related neurocognitive disorders: Diagnosis, Treatment, and Mental Health Implications: A Review
Authors: Elendu Chukwuka , Aguocha Chinyere Mirian , Okeke Chinelo V. , Okoro Chinonso B. , Peterson Jesse C. 
Published: February 2024

HIV-related neurocognitive disorders (HAND) have emerged as a significant concern in the context of HIV infection. This article provides a comprehensive overview of the diagnosis, treatment, and mental health implications associated with HAND.
Diagnosis of HAND involves a multifaceted approach, combining clinical assessments, neurocognitive testing, and neuroimaging techniques. Various screening tools and standardized assessments have been developed to aid in the early detection and monitoring of HAND. Timely diagnosis allows for appropriate interventions and personalized treatment strategies. Treatment for HAND encompasses a multidisciplinary approach targeting different aspects of cognitive impairment. Antiretroviral therapy (ART) remains the cornerstone of treatment, effectively reducing viral load and preventing further neurocognitive decline. Adjunctive therapies, including cognitive rehabilitation, pharmacological interventions, and psychosocial support, play crucial roles in managing cognitive symptoms and enhancing overall quality of life. Mental health implications associated with HAND are profound and require special attention. Individuals with HAND are at higher risk of experiencing psychological distress, depression, anxiety, and reduced social functioning. Integrated care models that address physical and mental health aspects are vital in optimizing treatment outcomes and promoting mental well-being in this population. Furthermore, this paper highlights the need for ongoing research to unravel the underlying mechanisms of HAND and develop targeted interventions. Identifying risk factors, understanding the impact of HIV on the brain, and exploring novel treatment modalities are essential areas of focus. Additionally, living with HAND social and cultural aspects must be considered to ensure equitable access to care and support for all affected individuals.
Diagnosis and therapy of giant epidermoid double cysts with infection on the buttock: A case report and literature review
Authors: Wu Peiliang , Wang Cong , Jiang Yiran , Zhang Zhi , Gao Junlan , Fan Zhe 
Published: February 2024

Rationale:Epidermoid cyst (EC) is a common clinical condition and it can be filled with keratinized material. EC often represents painless, slow progressive growth, and single cyst. The cyst is usually 1 to 5 cm in size. Giant epidermoid cysts on the buttock area are extremely rare, and reports of giant epidermoid double cysts on the buttock are even rarer.Patient concerns:This paper reports a patient with a painless mass was on the left buttock.Diagnosis:A giant epidermoid double cysts with infection in a left buttock paranal location.Interventions:The mass was surgically removed.Outcomes:The patient recovered well after surgical treatment and currently has no recurrence.Conclusion:For patients with EC, MRI is recommended as a routine examination before surgery in order to detect the variation and extent of the cyst early. This lays a foundation for the complete resection of the lesion during the operation. The review of relevant literature will hopefully be helpful to clinicians.
A Bibliometric Analysis of the 36-Year History of Cancer Nursing (1987-2023)
Authors: Kaya Ayla , Tuzcu Ayla 
Published: February 2024

Background
Bibliometric analysis is an effective method for evaluating the publication characteristics and development of a journal. To our knowledge, this study is the first such analysis of the publications in Cancer Nursing.

Objective
This study aimed to analyze the publication characteristics and evolution of Cancer Nursing over a period of 36 years since its inception.

Methods
Bibliometric analysis was carried out on 3095 publications. Data were collected from the Web of Science Core Collection database on September 15, 2023. Data analysis was conducted with Web of Science Core Collection, VOSviewer, and Bibliometrix package in R software.

Results
The results showed a steady increase in the citation and publication structure of Cancer Nursing. “Quality of life” was at the center of the studies, and “quality of life,” “women,” and “breast cancer” were identified as trend topics. The United States was both at the center of the cooperation network and was the country that contributed the most publications to the journal.

Conclusion

Cancer Nursing has had an increasing contribution to and impact on cancer nursing in terms of the quality and citations of published articles. It was noted that the journal’s network of collaboration has expanded globally and that its thematic diversity is high. Although quality of life, women, and breast cancer have been reported extensively, more studies addressing the concepts of “children,” “support,” and “needs” are needed in the journal.

Implications for Practice
This study not only enriches global readers in the field of cancer nursing but may also be beneficial in providing input to guide future research.
Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Ulrich Emma H. , Bedi Prabhjot K. , Alobaidi Rashid , Morgan Catherine J. , Paulden Mike , Zappitelli Michael , Bagshaw Sean M. 
Published: February 2024

OBJECTIVES:
The objective of this Prospective Register of Systematic Reviews (CRD42022384192) registered systematic review and meta-analysis was to determine whether prophylactic peritoneal dialysis (PD) catheter insertion at the time of pediatric cardiac surgery is associated with improved short-term outcomes.

DATA SOURCES:
Databases search of the MEDLINE, EMBASE, CINAHL, and Cochrane Library completed in April 2021 and updated October 2023.

STUDY SELECTION:
Two reviewers independently completed study selection, data extraction, and bias assessment. Inclusion criteria were randomized controlled trials (RCTs) and observational studies of children (≤ 18 yr) undergoing cardiac surgery with cardiopulmonary bypass. We evaluated use of prophylactic PD catheter versus not.

DATA EXTRACTION:
The primary outcome was in-hospital mortality, as well as secondary short-term outcomes. Pooled random-effect meta-analysis odds ratio with 95% CI are reported.

DATA SYNTHESIS:
Seventeen studies met inclusion criteria, including four RCTs. The non-PD catheter group received supportive care that included diuretics and late placement of PD catheters in the ICU. Most study populations included children younger than 1 year and weight less than 10 kg. Cardiac surgery was most commonly used for arterial switch operation. In-hospital mortality was reported in 13 studies; pooled analysis showed no association between prophylactic PD catheter placement and in-hospital mortality. There were mixed results for ICU length of stay and time to negative fluid balance, with some studies showing shortened duration associated with use of prophylactic PD catheter insertion and others showing no difference. Overall, the studies had high risk for bias, mainly due to small sample size and lack of generalizability.

CONCLUSIONS:
In this meta-analysis, we have failed to demonstrate an association between prophylactic PD catheter insertion in children and infants undergoing cardiac surgery and reduced in-hospital mortality. Other relevant short-term outcomes, including markers of fluid overload, require further study.
A Quality Improvement Initiative to Transform Seasonal Immunization Processes Using Learning from the Coronavirus 2019 Pandemic
Authors: Robinette Eric D. , Nelly Pamela M. , Engler Laurie J. , Bigham Michael T. 
Published: February 2024

Background:
Surge demands for annual influenza vaccines challenge healthcare systems. Mass immunizations differ from the traditional care model. The coronavirus 2019 (COVID-19) pandemic challenged current care models with amplified demand and infection risks while challenging the organization to create new and improve existing processes.

Methods:
Using the Model for Improvement, the team set out to (1) safely meet a surge in vaccination demand and (2) adopt pandemic-driven innovations into routine immunization practice.

Results:
This free-standing pediatric system delivered 87,000 COVID-19 vaccines (~1.3% state total). It administered over 50% of COVID-19 vaccines using new mass immunization processes, including 37,000 adult vaccines before pediatric authorization. In the 2021–2022 influenza season, it used the new or improved immunization processes to deliver 22% of influenza vaccines.

Conclusions:
Pandemic-driven adaptation for the COVID-19 vaccine substantially increased the efficiency of influenza vaccination processes but did not result in a clear increase in influenza vaccine administration rates.
Outcomes of Flap Reconstruction for Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis of Clinical Studies
Authors: Reed Alistair J. M. , Lim Nicole T. Y. , Yip Sharon W. L. , Thurley Neal , Wormald Justin C. R. , Rodrigues Jeremy N. , Shirley Rebecca Anna , Chan James K. K. 
Published: February 2024

Background:
People with diabetic foot ulcers (DFUs) are at risk of major amputation, which is associated with a high mortality rate (exceeding 50% at 5 years) and reduced quality of life. The authors hypothesized that flap reconstruction of DFUs improves patient outcomes in comparison with standard treatment modalities, including major amputation.

Methods:
MEDLINE, Embase, the Cochrane Library, and gray literature were searched on February 9, 2022. Comparative and single-arm studies reporting outcomes of DFUs treated with local, regional, or free flaps that included function, limb loss, mortality rates, and flap failure rates were included. Risk of bias was assessed, and meta-analysis of proportions was performed.

Results:
A total of 3878 records were retrieved, of which 45 met the inclusion criteria, including the records of 1681 patients who underwent flap reconstruction of DFUs. Free flaps were most commonly performed (n = 1257 [72%]). Only one study used a verified functional outcome measure. At 12 months, the mortality rate was 6.35% (95% CI, 3.89% to 10.20%), the limb loss rate was 11.39% (95% CI, 7.02% to 17.96%), and the free flap failure rate was 9.95% (95% CI, 8.19% to 12.05%). All studies were at high risk of bias. A comparative meta-analysis of interventions was not performed because of study method and outcome heterogeneity.

Conclusions:
There is short-term evidence that flap reconstruction (including microsurgical transfer) has low mortality, limb loss, and flap failure rates. However, there are limited high-quality comparative studies, and uncertainty remains regarding the outcome of DFU flap reconstruction in comparison to other treatments.
Sex-specific genetic determinants of right ventricular structure and function
Authors: Harbaum Lars , Hennigs Jan K , Pott Julian , Ostermann Jonna , Sinning Christoph R , Sau Arunashis , Sieliwonczyk Ewa , Ng Fu Siong , Rhodes Christopher J , Tello Khodr , Klose Hans , Gräf Stefan , Wilkins Martin R 
Published: February 2024

ABSTRACTBackgroundWhile sex differences in right heart phenotypes have been observed, the molecular drivers remain unknown. We used common genetic variation to provide biological insights into sex differences in the structure and function of the right ventricle (RV).MethodsRV phenotypes were obtained from cardiac magnetic resonance imaging in 18,156 women and 16,171 men from the UK Biobank, based on a deep-learning approach, including end-diastolic, end-systolic, and stroke volumes, as well as ejection fraction. Observational analyses and sex-stratified genome-wide association studies were performed. Candidate female-specific loci were evaluated against invasively measured hemodynamics in 479 female patients with idiopathic or heritable pulmonary arterial hypertension (PAH), recruited to the UK National Institute for Health Research BioResource Rare Diseases study.ResultsSex was associated with differences in RV volumes and ejection fraction in models adjusting for left heart counterparts and lung function. Six genome-wide significant loci (13%) revealed heterogeneity of allelic effects between women and men. These included two sex-specific candidate loci present in women only; namely, a locus for RV ejection fraction inBMPR1Aand a locus for RV end-systolic volume nearDMRT2. Epigenetic data indicate that variation at theBMPR1Alocus likely alters transcriptional regulation in RV tissue. In female patients with PAH, a variant located in the promoter ofBMPR1Awas significantly associated with cardiac index (effect size 0.16 l/min/m2), despite similar RV afterload among genotypic groups.ConclusionsWe report sex-specific genetic loci for RV structure and function.BMPR1Ahas emerged as a biologically plausible candidate gene for female-specific genetic determination of RV function, showing associations with cardiac performance under chronically increased afterload in female patients with PAH. Further studies are needed to explore the underlying biological pathways.
Development of the ADFICE_IT clinical decision support system to assist deprescribing of fall-risk increasing drugs: A user-centered design approach
Authors: Groos Sara S. , de Wildt Kelly K. , van de Loo Bob , Linn Annemiek J. , Medlock Stephanie , Shaw Kendrick M. , Herman Eric K. , Seppala Lotta J. , Ploegmakers Kim J. , van Schoor Natasja M. , van Weert Julia C. M. , van der Velde Nathalie 
Published: February 2024

AbstractIntroductionDeprescribing fall-risk increasing drugs (FRIDs) is a promising intervention for reducing the risk of falling in older adults. Applying appropriate deprescribing in practice can be difficult due to the outcome uncertainties associated with stopping the use of FRIDs. The ADFICE_IT study addresses this complexity with a clinical decision support system (CDSS) that facilitates optimum deprescribing of FRIDs through use of a fall-risk prediction model, aggregation of deprescribing guidelines, and joint medication management. The development process of the CDSS is described in this paper.MethodsDevelopment followed a user-centered design approach in which users and experts were involved throughout each phase. In phase I, a prototype of the CDSS was developed which involved a scoping and systematic literature review, European survey (n= 581), and semi-structured interviews with physicians (n= 19), as well as the aggregation and testing of deprescribing guidelines and the development of the fall-risk prediction model. In phase II, the feasibility of the CDSS was tested by means of two usability testing rounds with end users (n= 11).ResultsThe final CDSS consists of five web pages. A connection between the Electronic Health Record allows for the retrieval of patient data into the CDSS. Key design requirements for the CDSS include easy-to-use features for fast-paced clinical practice environments, actionable deprescribing recommendations, information transparency, and visualization of the patient’s fall-risk estimation. Key elements for the software include a modular architecture, open source, and good security.ConclusionThe ADFICE_IT CDSS supports physicians in deprescribing FRIDs optimally to prevent falls in older patients. Due to continuous user and expert involvement, each new feedback round led to an improved version of the system. Currently, a multicenter, cluster-randomized controlled trial with process evaluation at hospitals in the Netherlands is being conducted to test the effect of the CDSS on falls.
Peptide-based capture-and-release purification of extracellular vesicles and statistical algorithm enabled quality assessment
Authors: Greenberg Zachary F. , Ali Samantha , Schmittgen Thomas D. , Han Song , Hughes Steven J. , Graim Kiley S. , He Mei 
Published: February 2024

AbstractCirculating extracellular vesicles (EVs) have gained significant attention for discovering tumor biomarkers. However, isolating EVs with well-defined homogeneous populations from complex biological samples is challenging. Different isolation methods have been found to derive different EV populations carrying different molecular contents, which confounds current investigations and hinders subsequent clinical translation. Therefore, standardizing and building a rigorous assessment of isolated EV quality associated with downstream molecular analysis is essential. To address this need, we introduce a statistical algorithm (ExoQuality Index, EQI) by integrating multiple EV characterizations (size, particle concentration, zeta potential, total protein, and RNA), enabling direct EV quality assessment and comparisons between different isolation methods. We also introduced a novel capture-release isolation approach using a pH-responsive peptide conjugated with NanoPom magnetic beads (ExCy) for simple, fast, and homogeneous EV isolation from various biological fluids. Bioinformatic analysis of next-generation sequencing (NGS) data of EV total RNAs from pancreatic cancer patient plasma samples using our novel EV isolation approach and quality index strategy illuminates how this approach improves the identification of tumor associated molecular markers. Results showed higher human mRNA coverage compared to existing isolation approaches in terms of both pancreatic cancer pathways and EV cellular component pathways using gProfiler pathway analysis. This study provides a valuable resource for researchers, establishing a workflow to prepare and analyze EV samples carefully and contributing to the advancement of reliable and rigorous EV quality assessment and clinical translation.