bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular phylogeny, biogeography, and species delimitation of segmented spider genus Liphistius (Araneae: Liphistiidae) in Thailand
Authors: Sivayyapram Varat , Kunsete Chawakorn , Xu Xin , Smith Deborah R , Traiyasut Prapun , Deowanish Sureerat , Li Daiqin , Warrit Natapot 
Published: November 2023

Abstract
Mesothelae, or primitively segmented trapdoor spiders, form the most basal clade among living spiders. In Southeast Asia, Liphistius is the only genus recognized in the extant family Liphistiidae. Liphistius taxonomy and species identification are based largely on characters of the genitalia; however, the female genitalia show high intraspecific variation, males are rarely collected, and the phylogenetic relationships among the 69 described Liphistius species are unresolved. Here, we focused on the Liphistius of Thailand, including 37 described and numerous undescribed species in four species groups. We generated sequences from five loci (COI, 16S, H3, 28S, and ITS2) for 162 specimens from 52 sites in Thailand and Myanmar to reconstruct phylogenetic relationships, infer historical biogeography, and delimit species. The five-locus data set resolved nearly all species and species group relationships and was mostly congruent with morphology-based classifications. Ancestral area reconstruction suggested that Liphistius originated in Sibumasu (Siam–Burma–Malaysia–Sumatra) and diversified into several species groups, four (birmanicus, bristowei, linang, and trang) of which are found in Thailand. Speciation within Liphistius occurred in the area corresponding to their current distribution. All delimitation methods tested (ASAP, GMYC, PTP, STACEY and BFD) delimited specimens from discrete locations as separate species; variation in the number of species proposed (ranging from 53 to 72) stemmed from variation in delimitation of sympatric cryptic species.
Mobile-Enhanced Family-Integrated Care for Preterm Infants
Authors: Franck Linda S. , Hodgson Christine , Gay Caryl L. , Bisgaard Robin , Cormier Diana M. , Joe Priscilla , Lothe Brittany , Sun Yao 
Published: November 2023

Background:
The mobile-enhanced family-integrated care (mFICare) model addresses inconsistencies in family-centered care (FCC) delivery, with an evidence-based bundle of staff training, parent participation in rounds, parent classes, parent peer mentors, expanded role for parents in infant caregiving, and a parent-designed app.

Purpose:
Our aim was to explore the views of neonatal intensive care unit (NICU) nurses and physicians about mFICare implementation, including what worked well and what could be improved.

Methods:
As part of a larger study to compare mFICare with FCC, we invited registered nurses, nurse practitioners, and fellow and attending physicians at the 3 study sites to participate in a survey about mFICare implementation. Data were analyzed with descriptive statistics and thematic analysis.

Results:
The majority of the 182 respondents with experience delivering mFICare positively rated parent-led rounds, parent classes, parent skills acquisition, and the nurse–family relationship resulting from participation in mFICare. Respondents were less familiar or neutral regarding the parent peer mentor and app components of mFICare. Most respondents agreed that the mFICare program improved parent empowerment, and they shared suggestions for optimizing implementation. Physicians experienced more challenges with parent participation in rounds than nurses. Three themes emerged from the free-text data related to emotional support for parents, communication between staff and parents, and the unique experiences of families receiving mFICare.

Implications for Practice and Research:
The mFICare program was overall acceptable to nurses and physicians, and areas for improvement were identified. With implementation refinement, mFICare can become a sustainable model to enhance delivery of FCC in NICUs.
The Influence of Potential Organ Donors on Standardized Mortality Ratios and ICU Benchmarking*
Authors: Pölkki Anssi , Moser André , Raj Rahul , Takala Jukka , Bendel Stepani , Jakob Stephan M. , Reinikainen Matti 
Published: November 2023

OBJECTIVES:
The standardized mortality ratio (SMR) is a common metric to benchmark ICUs. However, SMR may be artificially distorted by the admission of potential organ donors (POD), who have nearly 100% mortality, although risk prediction models may not identify them as high-risk patients. We aimed to evaluate the impact of PODs on SMR.

DESIGN:
Retrospective registry-based multicenter study.

SETTING:
Twenty ICUs in Finland, Estonia, and Switzerland in 2015–2017.

PATIENTS:
Sixty thousand forty-seven ICU patients.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We used a previously validated mortality risk model to calculate the SMRs. We investigated the impact of PODs on the overall SMR, individual ICU SMR and ICU benchmarking. Of the 60,047 patients admitted to the ICUs, 514 (0.9%) were PODs, and 477 (93%) of them died. POD deaths accounted for 7% of the total 6738 in-hospital deaths. POD admission rates varied from 0.5 to 18.3 per 1000 admissions across ICUs. The risk prediction model predicted a 39% in-hospital mortality for PODs, but the observed mortality was 93%. The ratio of the SMR of the cohort without PODs to the SMR of the cohort with PODs was 0.96 (95% CI, 0.93–0.99). Benchmarking results changed in 70% of ICUs after excluding PODs.

CONCLUSIONS:
Despite their relatively small overall number, PODs make up a large proportion of ICU patients who die. PODs cause bias in SMRs and in ICU benchmarking. We suggest excluding PODs when benchmarking ICUs with SMR.
Irritation, General and Pandemic-Related Demands, and the Importance of Workplace Health Promotion in Long-Term Care—Results From a Survey of Managers in Outpatient and Inpatient Long-Term Care Facilities in Germany
Authors: Schaps Valerie , Hower Kira Isabel , Pfaff Holger , Pförtner Timo-Kolja 
Published: November 2023

Objective
This study examines the association between irritation and demands of long-term care managers during the COVID-19 pandemic, as well as the role of workplace health promotion (WHP).

Methods
Findings were derived from an online survey investigating long-term care managers as part of the employees in the COVID-19 pandemic (N = 207). Data analyses were performed with linear regression and interaction analyses.

Results
For managers in long-term care, there was found a significant positive association between pandemic-related and general demands and irritation. The irritation level was significantly lower among managers in facilities where WHP was offered whereas the association between irritation and demands did not significantly vary by WHP.

Conclusions
The presence of WHP was associated with lower average irritation levels among managers during the COVID-19 pandemic. Thus, the implementation of WHP can contribute to maintain the well-being of long-term care managers.
Combination of an Anti-Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitor and Immunotherapy as a Neoadjuvant Approach in Renal Cell Carcinoma With Associated Inferior Vena Cava Tumor Thrombus: A Single-Center Experience and Review of Literature
Authors: Candelario Nellowe C. , Kafer Ilana , Kim Simon P. , Kessler Elizabeth R. 
Published: November 2023

Introduction:
Renal cell carcinoma (RCC) has a predisposition to vascular invasion that manifest as an inferior vena cava tumor thrombus (IVC TT). Radical nephrectomy with an IVC thrombectomy is associated with high morbidity. We present our single-center experience on the neoadjuvant use of the combination of anti-vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKI) and immune check point inhibitor (IO) for patients with RCC with IVC TT.

Patient and Methods:
Five patients with RCC and associated IVC TT received a neoadjuvant combination anti-VEGF TKI and IO. The IVC TT reduction was evaluated. The extent of tumor thrombus was defined based on the Mayo Classification, and TT volume was measured by the largest anteroposterior diameter. The safety of therapy, perioperative outcome, and number of patients who were able to undergo definitive surgery are described.

Results:
Two (40%) had a reduction in IVC TT based on the Mayo Classification. Tumor thrombus volume reduction was seen in all patients (100%). Four of 5 patients (80%) were able to have surgery.

Conclusion:
The neoadjuvant combination of an anti-VEGF TKI and IO is effective in reducing the extent of IVC TT. Prospective research is needed to characterize the safety, and long-term outcomes of this approach.
Large Intra-abdominal Testicular Neoplasm Involving the Bladder and Ureter in an Adult Male with Bilateral Cryptorchidism
Authors: Beal Pedro Rodrigues , Silva Tiago Aparecido , Buonfiglio Vitor Bonadia , Dal Col Luciana Saboya Brito , Junior Renato Meirelles Mariano Da Costa , Portari FIlho Luiz Henrique Correa , Sadi Marcus Vinicius 
Published: November 2023

Abstract
Cryptorchidism remains as one of the most significant risk factors for the development of testicular cancer (TC). The occurrence of TC in undescended testes can represent challenges to both diagnosis and management because the clinical presentation can delay a definitive diagnosis, and surgical management of intra-abdominal masses can be difficult. We present a case of an adult male with bilateral cryptorchidism diagnosed with a large intra-abdominal TC which was subjected to surgical resection.
Efficacy of cognitive behavioral therapy for reducing pain susceptibility and increasing social engagement in patients with chronic low back pain: A systematic review and meta-analysis
Authors: Zhang Qian , Xu Hongli , Wang Yuqi , Jiang Jiahui , Xue Qing , Qiu Zhengang 
Published: November 2023

Background:
The objective of this study was to evaluate the efficacy of cognitive behavioral therapy in improving social engagement and pain susceptibility in patients with chronic low back pain (≥6 months duration).

Methods:
From the initial to January 2023, 5 databases were searched for randomized controlled trials, literature screening, quality evaluation, and data extraction were performed by 2 independent researchers throughout, Meta-analysis was performed using RevMan 5.4 software, standardized mean difference (SMD) was calculated for different indicators, and the combined experimental and control groups were calculated using random-effects models or fixed-effects models effect sizes, and forest plots were drawn to present the results.

Results:
A total of 16 studies containing 2527 patients with chronic nonspecific low back pain, all of whom had pain lasting longer than 6 months, were included, and after treatment, cognitive behavioral therapy (CBT) was superior to other treatments in improving social participation [SMD = −0.30, 95%CI (−0.60, −0.01), Z = 2.02, P = .04]. There was no significant difference from other treatments in improving patient depression [SMD = −0.07, 95%CI (−0.19, 0.05), Z = 1.11, P = .27] and anxiety [SMD = −0.07, 95%CI (−0.30, 0.16), Z = 0.52, P = .57]. Three papers describe the superiority of CBT over other treatments in improving sleep quality, but the metrics could not be combined due to too little literature.

Conclusion:
CBT can improve patients’ social participation and pain susceptibility to some extent, but it does not show advantages for managing negative emotions (depression, anxiety). Due to the limited number and low quality of included literature, the above findings still need to be validated by conducting a large sample of high-quality RCTs.
One case of recurrent ST-segment elevation myocardial infarction in a patient with antiphospholipid syndrome complicated with severe thrombocytopenia within a short period of time: A case report
Authors: Qiu Zhongjue , Wang Yong , Xu Li , Zhou Zhou , Zhang Jiacheng , Wang Zhen 
Published: November 2023

Introduction:
Acute myocardial infarction is an important arterial thrombotic event in patients with antiphospholipid syndrome (APS). Anticoagulation regimen might greatly affect the prognosis. Due to the lack of sufficient data and large prospective randomized controlled trials, there is no definite consensus among researchers on the optimal antithrombotic therapy for patients with APS after arterial events.

Patient concerns:
A 35-year-old male presented with sustained chest tightness and chest pain for 6 hours, accompanied with palpitation, sweating and headache.

Diagnosis:
The patients was diagnosed with acute ST-segment elevation myocardial infarctions with severe thrombocytopenia. Emergency coronary angiography showed that the posterior descending artery (PDA) was occluded, and a thrombus shadow was visible. An emergency coronary intervention was performed to open the occluded PDA. About 48 hours after hospitalization, the PDA was occluded again and percutaneous coronary intervention was performed again to open the blocked coronary artery. The lupus anticoagulant screen rate were positive during hospitalization and 12 weeks after discharge, meeting the diagnostic criteria of APS.

Interventions:
The patient received coronary intervention twice during hospitalization. After the second coronary intervention, a sequential therapy of bivalirudin, fondaparinux sodium, and warfarin was adopted as the anticoagulant regimen.

Outcomes:
The patient was discharged in stable condition without chest pain. One year later, during her follow-up, a repeat echocardiogram and electrocardiogram showed normal findings.

Conclusion:
It is the first report of severe thrombocytopenia and recurrent coronary thrombosis within a short period of time in an APS patient, and in this report the importance of anticoagulant therapy in thrombus management in patients with APS was present, also the importance of tracking thrombotic factors. This study proposes an anticoagulation regimen for patients suffering from antiphospholipid syndrome, experiencing recurrent atherothrombotic events, and presenting severe thrombocytopenia.
Endomyocardial fibrosis and apical calcification: A case report with unusual presentations of apical hypertrophic cardiomyopathy
Authors: Gao Man , Zhang Feifei , Xie Yuetao , Li Jialin , Hao Xiao , Liu Huiliang , Qi Xiaoyong , Dang Yi 
Published: November 2023

Rationale:
Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of hypertrophic cardiomyopathy. Endomyocardial fibrosis and endocardial calcification are especially rare in ApHCM.

Patient concerns:
The main symptoms was chest tightness, palpitation, shortness of breath, and fatigue. Echocardiography and imaging examinations found apical hypertrophy along with endocardial calcification and endomyocardial fibrosis. Abnormal structural changes led to thrombosis and made the left ventricle a flat shape resembling an “apple.”

Diagnoses:
The typical presentations, hypertrophic apex on echocardiography and an elevated N-terminal pro-brain natriuretic peptide level indicated the diagnosis of ApHCM and heart failure with preserved ejection fraction.

Interventions:
Optimal medical therapy including the administration of ApHCM, heart failure and atrial fibrillation to improve symptoms and life quality.

Outcomes:
Since discharge, the patient could perform normal daily activities and had no discomfort based on the optimal medical therapy.

Lessons:
We report a ApHCM patients with unusual presentations of endomyocardial fibrosis and apical calcification. This case highlights the importance of understanding the specific pathological changes of ApHCM for treatment and prognosis.
Meta-analysis of risk factors for cardiovascular disease in patients with rheumatoid arthritis
Authors: Lyu Qian , Ma Linxiao , Liu Huijie , Wang Jihong 
Published: November 2023

Background:
Cardiovascular disease (CVD) is a common complication of rheumatoid arthritis (RA). We aimed to explore the risk factors for cardiovascular disease in patients with rheumatoid arthritis and provide a scientific basis on effective prevention and treatments for CVD in RA patients.

Methods:
We searched for a combination of the subject words and free words involved arthritis, rheumatoid, CVD, heart disease, vascular disease, risk factors, etc. from China Knowledge Network, Wanfang, Vip, China Biomedical Literature Database, Pubmed, Embase, Web of Science, Cochrane and other databases for documents published in public in 2000-October 2022.RevMan 5.3 and Stata14.0 analysis software was used to perform a meta-analysis of case-control and cohort studies on risk factors of CVDs in patients with RA published from 2000 to 2022.The Egger method was used to determine whether there was publication bias.

Results:
Seventeen pieces of literature were included in this meta-analysis. We explored the associations between CVD and different clinical characters such as DAS28 score, rheumatoid factor, triglyceride, age, sex, C-reactive protein, total cholesterol (TC), hypertension, and D dimer. High serum levels of C-reactive protein, TC, and D-dimer, as well as hypertension, are the main risk factors for CVD in patients with RA. The OR and 95% CI of C-reactive protein were 2.06 (1.91–2.23), RR and 95% CI of TC were 1.7 (1.49–1.93), RR and 95% CI of hypertension were 3.58 (2.37–5.40), as well as OR and 95% CI of D dimer were 2.83 (1.48–5.40).Our results performed by the meta-analysis were reliable, with low publication bias existed.

Conclusion:
C-reactive protein, TC, hypertension, and D dimer are the main risk factors for CVD in patients with RA. No protective factors were found.
Desmoplastic small round cell tumor of the abdomen: A case report
Authors: Li Runze , Liu Weizhen , Ye Lin 
Published: November 2023

Rationale:
Desmoplastic small round cell tumor (DSRCT) is a rare malignant tumor with poor prognosis, usually involving the peritoneum. There are currently no standardized treatment approaches. This study helped to further advance our understanding of DSRCT, and help to guide therapy.

Patient concerns:
The patient, a 19-year-old male, presented with left-sided back pain with no obvious cause and occasional abdominal pain, and underwent abdominal electron computed tomography examination in our hospital suggesting consideration of small bowel mesenchymal tumor with possible multiple implantation metastasis in the abdominopelvic cavity.

Diagnoses:
After surgical treatment, the pathology report suggested a DSRCT, and immunohistochemistry and fluorescence in situ hybridization revealed EWSR1-WT1 gene rearrangement. Lung computer tomography and abdominal magnetic resonance imaging performed half a month later showed multiple solid nodules on the proximal septal surface of the right lung base, right posterior cardiac/right anterior inferior vena cava nodules, and multiple nodules in the abdominopelvic cavity, omenta, peritoneum, and around the liver or liver, all of which were considered as metastatic foci.

Interventions and outcomes:
Patient received 5 cycles of chemotherapy after surgery. The review results showed a smaller size than before. Currently, he continues to receive treatment.

Lessons:
The reported case has raised awareness of the importance of DSRCT in the treatment of chemotherapy, including its role in the differential diagnosis of abdominal tumors.
Laparoscopy with transverse-abdominal extra-fascial hysterectomy for early-stage endometrial carcinoma, obesity, and large uterus: A case report
Authors: Zou Jian , Li Yang , Zhu Changkun 
Published: November 2023

Rationale:
Removal of a large uterus poses a challenge in minimally invasive surgery for patients with early-stage endometrial cancer. This manuscript presents 3 cases performed the improved surgical procedure with minimal trauma.

Patient concerns:
Three patients with obesity (Body Mass Index: 31.93, 30.06, and 51.82 kg/m2) and large uterus (7.3 × 8.0 × 7.6 cm, 8.5 × 8.9 × 8.5 cm, and 8.3 × 10.1 × 6.9 cm) visited our hospital because of vaginal bleeding, and received dilation and curettage. Pathological examination revealed endometrial carcinoma.

Diagnoses:
Endometrial carcinoma, obesity.

Intervention:
Laparoscopy and transverse-abdominal extra-fascial hysterectomy were performed. First, we performed bilateral adnexectomy, pelvic lymph node dissection, and para-aortic lymph node sampling, and exposed and separated the para-uterine tissue and bladder before cutting off the uterus from the vagina through laparoscopy. Second, we made a 10 cm suprapubic transverse incision in the lower abdomen, clamped the vagina using right-angle forceps to follow the principle of tumor-free technique, placed the uterus in a surgical bag for retrieval the uterus immediately from the incision.

Outcome:
All 3 patients underwent intestinal recovery for 24 hours post operation; 50 mL blood was lost during the operation with a well-healing wound and no complication. Till date, there has been no recurrence or metastasis in any of them.

Lessons:
Improving the surgical procedure could enhance safety and ease of operation even in cases of obesity and a large uterus.
Pediatric Sertoli-Leydig Cell Tumors of the Ovary
Authors: Yang Bo , Chour William , Salazar Cristo Guardado , Zamiara Paul , Schmidt Ryan J. , Raca Gordana , Shillingford Nick , Zhou Shengmei , Warren Mikako , Parham David M. , Pawel Bruce , Wang Larry L. 
Published: November 2023

Sertoli-Leydig cell tumors (SLCTs) are currently classified into 3 molecular subtypes: DICER1-mutant (younger patient age), FOXL2-mutant, and DICER1/FOXL2-wildtype. However, it is not clear whether all pediatric SLCTs are DICER1-mutant molecular subtypes and whether other molecular genetic aberrations besides DICER1 are involved in the pathogenesis and prognosis of these tumors. We studied comprehensive data for 8 cases of pediatric SLCTs, including clinicopathological features, pan-cancer–targeted next-generation sequencing/OncoKids panel, and chromosomal microarray analysis, to further analyze the correlation among clinicopathological features, molecular genetic aberrations, and prognosis. The ages of the patients ranged from 4 to 16 years (median, 14 y). Seven cases were moderately differentiated, and one was poorly differentiated with heterologous mesenchymal elements. Two cases had heterologous epithelium or retiform elements. Follow-up was available for all 8 patients (median, 49.5 mo). Seven patients were alive without evidence of recurrence or metastasis, and only case 5 developed metastases (synchronous bilateral pulmonary tumors with rhabdomyosarcomatous differentiation). All 8 tumors were found to harbor somatic hotspot DICER1 mutations, and 5 patients carried germline DICER1 mutations (2 of them had the phenotype of DICER1 syndrome). Together with recent studies, the DICER1 mutation frequency is 100% in pediatric SLCTs (n=27, age≤16 y). Copy number alterations were detected in 3 tumors; the only recurrent copy number alterations was the gain of whole chromosome 6 in case 5 and case 8. This is the first report describing clinicopathological features and molecular alterations in pediatric SLCTs. Our results demonstrate that all pediatric SLCTs belong to the DICER1-mutant molecular subtype, highlighting that somatic hotspot DICER1 mutation detection has high sensitivity (100%) for the auxiliary diagnosis of pediatric SLCTs (age ≤16 y). Some pediatric SLCTs harbor molecular genetic aberrations other than DICER1 mutation, and their significance needs further study.