bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point-of-care, goal-directed management of bleeding in trauma patients
Authors: Zipperle Johannes , Schmitt Felix C.F. , Schöchl Herbert 
Published: October 2023

Purpose of review
The purpose of this review is to consider the clinical value of point-of-care (POC) testing in coagulopathic trauma patients with traumatic brain injury (TBI) and trauma-induced coagulopathy (TIC).

Recent findings
Patients suffering from severe TBI or TIC are at risk of developing pronounced haemostatic disorders. Standard coagulation tests (SCTs) are insufficient to reflect the complexity of these coagulopathies. Recent evidence has shown that viscoelastic tests (VETs) identify haemostatic disorders more rapidly and in more detail than SCTs. Moreover, VET results can guide coagulation therapy, allowing individualised treatment, which decreases transfusion requirements. However, the impact of VET on mortality remains uncertain. In contrast to VETs, the clinical impact of POC platelet function testing is still unproven.

Summary
POC SCTs are not able to characterise the complexity of trauma-associated coagulopathy. VETs provide a rapid estimation of underlying haemostatic disorders, thereby providing guidance for haemostatic therapy, which impacts allogenic blood transfusion requirements. The value of POC platelet function testing to identify platelet dysfunction and guide platelet transfusion is still uncertain.
Acupuncture or moxibustion adjuvant chemotherapy for advanced non-small cell lung cancer: Systematic review and network meta-analysis
Authors: Wang Shiheng , Mu Chaochao , Zhang Fengxia , Tang Hanqing , Ning Wanling 
Published: October 2023

Background:
To compare the advantages and disadvantages of different acupuncture and moxibustion methods by network meta-analysis, in order to find out the best acupuncture and moxibustion adjuvant chemotherapy scheme of non-small cell lung cancer (NSCLC).

Methods:
Randomized controlled trials of acupuncture and moxibustion adjuvant chemotherapy in the treatment of NSCLC were searched in PubMed, Cochrane Library, Web of science, EMbase, China National Knowledge Infrastructure, Wanfang, VIP database and SinoMed. The retrieval time was up to December 03, 2022. ROB2 was used to evaluate publication bias, and Stata16 was used for network meta-analysis.

Results:
A total of 14 studies involving 921 patients were included. The results of network Meta-analysis showed that the effect of acupuncture combined with chemotherapy was better than that of chemotherapy (RR = 1.28, 95%CI (1.04,1.58), P < .0001). The effect of acupuncture combined with chemotherapy was better than that of chemotherapy in improving KPS score (MD = 9.01, 95%CI (3.35,14.67), P < .0001). The safety of acupuncture combined with chemotherapy (RR = 0.35, 95%CI (0.15,0.83), P < .0001) was better than that of chemotherapy.

Conclusion:
Acupuncture combined with chemotherapy has the best comprehensive effect.
Association between diabetes and venous thromboembolism: A systematic review and meta-analysis
Authors: Ding Chaowei , Guo Chang , Du Dan , Gong Xiaowei , Yuan Yadong 
Published: October 2023

Background:
Diabetes mellitus (DM) plays a vital role in the development of cardiovascular disease. However, its association with venous thromboembolism (VTE) remains unclear, for the published study results are conflicting. We performed a meta-analysis of published cohort studies and case–control studies to assess the role of DM in the formation and prognosis of VTE.

Methods:
PubMed and EMBASE databases were searched for articles from the database’s establishment until September 15, 2022. Of the 15,754 publications retrieved, 50 studies were identified that met the selection criteria. The New castle-Ottawa Scale was used to evaluate the quality of the literature. Pooled odds ratios (ORs) and 95% confidence intervals were calculated using fixed- or random-effect models.

Results:
We combined OR using a random-effects or fixed-effects model: patients with DM had an increased risk of VTE (OR 1.27, 95% confidence interval [CI]: 1.15–1.41), which still showed a partial association in studies adjusted by confounding factors (OR 1.20, 95% CI: 1.07–1.35). DM was not significantly associated with VTE when analyzed in studies adjusted by body mass index (OR 1.04, 95% CI: 0.94–1.15). VTE patients with DM had a higher risk of short-term and long-term mortality than those without DM (OR 1.58 [95% CI: 1.26–1.99] for long-term mortality and OR 1.20 [95% CI: 1.19–1.21] for short-term mortality).

Conclusion:
There was no significant association between DM and VTE risk, and body mass index may be a significant confounding factor between DM and VTE risk. However, DM can still lead to an increased risk of long-term and short-term mortality in patients with VTE.
Uterine giant cell tumor of soft tissue: A case report
Authors: Jiang Yao , Chen Kaiyan , Yu Mengting , Qin Juan , Wang Juntao 
Published: October 2023

Introduction:
Giant cell tumor of soft tissue (GCT-ST) is a rare primary soft tissue tumor. GCT-ST mainly occurs in the trunk and extremities. There is no standard treatment for GCT-ST. This paper reports a rare case of primary uterine GCT-ST.

Case presentation:
A 48-year-old female patient underwent a transabdominal subhysterectomy for uterine leiomyoma. Postoperative pathological examination showed GCT-ST with unclear tissue boundary (10.0 × 6.0 × 5.0 cm). A small amount of GCT-ST tissue could be seen on the local edge of the leiomyoma. Residual tumor tissue was found around the uterine cavity. The patient reported persistent lower abdominal distension pain 3 months after the operation. Pelvic and abdominal imaging showed a huge tumor and multiple pelvic and abdominal organ metastasis. No pulmonary metastasis was found. Exploratory surgery revealed widespread metastases in the abdominal and peritoneal cavities, involving both ovaries, right tubal serous membrane, appendix serous membrane, bladder, pelvic peritoneum, and abdominal wall incision. After surgery, the patient had 6 cycles of docetaxel and carboplatin but stopped treatments due to economic reasons. The patient died 3 months later because of multiple organs failure.

Conclusion:
GCT-ST is generally benign but has unpredictable behavior. A massive recurrence with wide invasion is possible after subtotal resection.
Black necrosis of the glans penis associated with calciphylaxis: A case report
Authors: Yu Youwei , Chen Yangxi , Yang Fan , Song Qitai 
Published: October 2023

Rationale:
Calciphylaxis, known as calcific uremic arteriolopathy, is a rare cause of dry gangrene. Despite an increase in the clinical recognition of demographic characteristics and risk factors associated with calciphylaxis, it remains a poorly understood disease with high mortality.

Patient concerns and diagnoses:
We present a 45-year-old man, who was diagnosed with calciphylaxis disease, with a history of diabetes mellitus, end-stage renal disease and cirrhosis with a half-month evolution of painful dry gangrene on his glans penis and scrotum. The patient also presented with gangrene of fingers.

Interventions and outcomes:
The patient and his family opted for palliative care. However, he died eventually.

Lessons:
This case contributed to the current understanding of calciphylaxis. Since no standard treatment is available and the prognosis remained poor, early, and accurate diagnosis of calciphylaxis is important. We here report the current case and provide data for the diagnosis and treatment of this kind of disease.
Anesthesia management of a patient with claustrophobia undergoing surgery for rhegmatogenous retinal detachment: A case report
Authors: Li Xiang , Zhou Qiaomei , Zhang Xingan , Xu Bo 
Published: October 2023

Introduction:
Claustrophobia is a form of phobic anxiety disorder characterized by panic attacks. Anesthesia in patients with claustrophobia poses a challenge because these patients reject all treatments in an enclosed space. When such patients are treated in uncomfortably enclosed environments, it can cause mental distress and even sudden psychiatric death.

Case presentation:
We report the case of a 55-year-old man with severe anxiety disorder and claustrophobia who required anesthesia for the surgical treatment of rhegmatogenous retinal detachment. This patient had a history of severe anxiety and claustrophobia for more than 40 years, without having received any treatment for the condition. The patient had failed to tolerate multiple chamber surgeries. Following multidisciplinary discussion, the patient’s surgery was performed under general anesthesia in the operating room after the patient underwent induction of anesthesia outside the operating room.

Conclusions:
This case report shows that patients with claustrophobia need to be provided a comfortable environment for induction and awakening from anesthesia.
The effect of vitamin D supplementation on some metabolic parameters in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis of 8 RCTs
Authors: Chen Xuemeng , Zhao Ye , Zhang Ran , Zhao Yan , Dai Liheng 
Published: October 2023

Background:
To systematically evaluate the effects of vitamin D supplementation in patients with nonalcoholic fatty liver disease (NAFLD).

Methods:
National Library of Medicine, Cochrane Library, Elsevier, China National Knowledge Infrastructure, Web of Science, WANFANG databases, and Google Scholar were retrieved to collect relevant randomized controlled trials, which are published from the earliest records the time the database was created to April 2023. Meta-analysis was conducted by using Review Manager 5.4 software after evaluating in terms of inclusion and exclusion criteria. The outcome indicators include 25-hydroxyvitamin D [25(OH)D] levels, insulin resistance index (homeostasis model assessment of insulin resistance), fasting blood glucose, and fasting insulin levels (FINS).

Results:
Eight randomized controlled trials with a total of 657 patients are included. Vitamin D supplementation increased 25(OH)D levels significantly (mean difference [MD] = 2.01, 95% confidence intervals [CI]: 0.94 to 3.08, P < .05) and vitamin D supplementation had a significant effect on insulin resistance index (MD = −0.54, 95% CI: −1.28 to 0.20, P = .16), fasting glucose (MD = −0.59, 95% CI: −1.50 to 0.32, P = .20), and FINS levels (MD = −0.30, 95% CI: −0.77 to 0.17, P = .21) had no significant effect.

Conclusion:
Vitamin D supplementation improves 25(OH)D levels in patients with nonalcoholic fatty liver disease, but there is no effect on homeostasis model assessment of insulin resistance, fasting blood glucose, or FINS.
The effect of acupressure on sleep quality in patients with leukemia: a single-center, randomized controlled trial
Authors: Molaee Hanieh , Goli Rasoul , Faraji Navid , Najafali Dizaji Niloofar , Bagheri Mojde , Shakorzadeh Sina , Hassanpour Amireh , Imanzadeh Fatemeh , Lameei Raheleh 
Published: October 2023

Background:
Sleep disturbances are a common problem among patients with leukemia, adversely impacting their quality of life and overall well-being. Acupressure has been suggested as a non-pharmacological intervention for improving sleep quality. Therefore, the present study aimed to determine the effect of acupressure on sleep quality in patients with leukemia.

Methods:
This is a single-blinded randomized controlled trial with a pretest-posttest design in which a total of 68 participants were randomly allocated into two groups: an intervention group receiving acupressure therapy on the SP6 point for 10 minutes twice a day, in the morning and evening, and a control group receiving routine care. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline and after a 4-week intervention period. To evaluate the obtained data, coded research units were used and the results were analyzed by statistical software SPSS version 25 and by chi-square, Fisher, and t-tests.

Results:
The results revealed a significant improvement in sleep quality among participants in the intervention group compared to the control group after the acupressure therapy on the SP6 point (P<0.001). The mean PSQI score decreased from 16.39±1.32 to 12.27±1.84 in the intervention group, whereas it only decreased from 16.78±1.38 to 16.21±1.40 in the control group.

Conclusion:
Acupressure appears to be an effective non-pharmacological intervention for improving sleep quality in patients with leukemia. The findings of this study could contribute to developing comprehensive supportive care strategies in the management of leukemia, ultimately enhancing the overall well-being and quality of life of these patients.
The mean platelet volume (MPV) in patients with systemic lupus erythematosus (SLE) and its correlation with disease activity: a cross-sectional/case–control study
Authors: Khadra Mariam , Drie Tasneem S. , Kudsi Maysoun 
Published: October 2023

Introduction:Systemic lupus erythematosus (SLE) is a systemic disease, with unknown etiology. The authors aimed in this study to determine the connection between mean platelet volume (MPV) and disease activity of SLE. Although it has been studied in other rheumatological conditions like rheumatoid arthritis, its role in adult patients with SLE needs to be defined, especially in Syria.Materials and methods:The authors have included in a cross-sectional study, 80 patients with SLE and 80 controls.The SLE group was divided into two groups based on their disease activity index: the active disease group and the non-active disease group.In all groups, MPV and erythrocyte sedimentation rate (ESR) were analyzed. Clinical findings and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were evaluated in all patients.Results:MPV was significantly lower in SLE patients compared to the control group (8.49±1.2 fl and 10.0±0.5 fl, respectively) (P=0.001). A decrease in MPV below the cut-off value (7.2 fl) increased the risk of active disease by an odds ratio of 9.79 (95% CI: 3.4–27.9) (P<0.001).Conclusion:MPV may be a disease activity indicator in patients with SLE. MPV is reduced in patients with active SLE and presents an inverse correlation with SLEDAI.
Gender Differences in Work-Life Integration, Career Satisfaction, and Burnout in Pediatric Emergency Medicine Physicians
Authors: Skotnicki Brielle Stanton , Wilson Paria M. , Kazmerski Traci M. , Manole Mioara D. , Kinnane Janet M. , Lunoe Maren M. 
Published: October 2023

Objective
Women physicians report worse work-life integration, career satisfaction, and burnout than men. No studies have evaluated work-life integration and career satisfaction in pediatric emergency medicine (PEM) or explored gender differences for these outcomes. This study aims to (1) compare work-life integration, career satisfaction, and burnout in women and men PEM physicians and (2) compare associated individual and occupational factors to distinguish modifiable factors.

Methods
We distributed an electronic survey to assess well-being parameters in PEM physicians. We assessed career satisfaction and work-life integration with single-item measures. We used a 2-item screen to measure burnout. We performed descriptive analyses, univariate analysis to compare gender differences, and multivariate logistic regression analysis for each outcome.

Results
Two hundred thirty-nine PEM physicians participated, yielding a response rate of 50% (57% women; age range, 30–80 years). Overall satisfaction with work-life integration was 42.9%, with 34.3% of women reporting appropriate work-life integration, compared with 55.4% of men (P = 0.001). Career satisfaction rate was 77.8%, with 71.6% of women reporting career satisfaction, compared with 86.1% of men (P = 0.008). Burnout rate was 44.5%, with 53.7% of women reporting burnout compared with 33.7% of men (P = 0.002). Modifiable factors identified include perception of unfair compensation, inadequate physical and mental health support provided by organization, feeling unappreciated, inadequate provider staffing, inadequate resources for patient care, lack of advance notice or control of work schedule, and inadequate sleep.

Conclusions
Of PEM physicians, women have worse work-life integration, less career satisfaction, and more burnout than men. The PEM community should devote resources to modifiable occupational factors to improve gender disparities in well-being parameters.
Hepatitis B virus clinical and virologic characteristics in an HIV perinatal transmission study in sub-Saharan Africa
Authors: Bhattacharya Debika , Guo Rong , Tseng Chi-Hong , Emel Lynda , Sun Ren , Zhang Tian-hao , Chiu Shih-Hsin , Stranix-Chibanda Lynda , Chipato Tsungai , Ship Hannah , Mohtashemi Neaka Z. , Kintu Kenneth , Manji Karim P. , Moodley Dhayendre , Maldonado Yvonne , Currier Judith S. , Thio Chloe L. 
Published: October 2023

Objectives:
To describe the clinical and virologic characteristics of HIV−HBV coinfection, including the predictors of high maternal HBV viral load in pregnant women with HIV in sub-Saharan Africa (SSA).

Methods:
HPTN 046 was a HIV perinatal transmission clinical trial evaluating infant nevirapine vs. placebo. Women-infant pairs (n = 2016) were enrolled in SSA from 2007 to 2010; 1579 (78%) received antiretrovirals (ARV). Maternal delivery samples were retrospectively tested for hepatitis B surface antigen (HBsAg), and if positive, were tested for hepatitis B e antigen (HBeAg) and HBV viral load (VL). High HBV VL was defined as ≥106 IU/ml.

Results:
Overall, 4.4% (88/2016) had HBV co-infection, with geographic variability ranging from 2.4% to 8.7% (P < 0.0001); 25% (22/88) were HBeAg positive with prevalence in countries ranging from 10.5% to 39%. Fifty-two percentage (40/77) of those with HBV received ARV, the majority (97%) received 3TC as the only HBV active agent. HBeAg positivity was associated with high maternal HBV VL, odds ratio (OR) 37.0, 95% confidence interval (CI) 5.4−252.4. Of those with high HBV VL, 40% (4/10) were receiving HBV active drugs (HBV-ARV). HBV drug resistance occurred in 7.5% (3/40) receiving HBV-ARV.

Conclusions:
In SSA, HBV co-infection is common in pregnant women with HIV. HBsAg and HBeAg prevalence vary widely by country in this clinical trial cohort. HBeAg is a surrogate for high HBV viral load. HBV drug resistance occurred in 7.5% receiving HBV-ARV with lamivudine as the only HBV active agent. These findings reinforce the importance of HBsAg screening and early treatment with two active agents for HBV.
People with HIV at the end-of-life and their next-of-kin/loved ones are willing to participate in interventional HIV cure-related research
Authors: Ndukwe Samuel O. , Patel Hursch , Shelton Brittany , Concha-Garcia Susanna , Dullano Cheryl , Solso Stephanie , Hendrickx Steven , Riggs Patricia K. , Villa Thomas J. , Kaytes Andy , Taylor Jeff , Little Susan J. , Lessard David , Arora Anish K. , Costiniuk Cecilia T. , Eskaf Shadi , Smith Davey M. , Gianella Sara , Dubé Karine 
Published: October 2023

Introduction:
The Last Gift study at the University of California San Diego (UCSD), United States enrolls terminally ill people with HIV (PWH) in HIV cure research.

Methods:
From 2017 to 2022, we conducted surveys with Last Gift participants and their next-of-kin/loved ones to evaluate willingness to participate in different types of HIV cure research at the end of life (EOL). We analyzed willingness data descriptively.

Results:
We surveyed 17 Last Gift participants and 17 next-of-kin/loved ones. More than half of Last Gift participants (n = 10; 58.8%) expressed willingness to participate in studies involving totally new treatments or approaches (’first-in-human’ studies), a combination of different approaches, the use of unique antibodies, proteins or molecules, or therapeutic vaccines. Under one-quarter of Last Gift participants (n = 4; 23.5%) expressed willingness to participate in research involving interventions that may shorten their life expectancy to benefit medical research. Most Last Gift participants and their next-of-kin/loved ones also expressed high acceptance for various types of donations and biopsies at the EOL (e.g. hair donations and skin, lymph node or gut biopsies).

Discussion:
Knowing whether people would be willing to participate in different types of EOL HIV cure research can help inform the design of future innovative studies. As a research community, we have a duty to design studies with adequate safeguards to preserve the public trust in research and honor PWH's important gift to humanity.
Immune Features of Disparate Liver Transplant Outcomes in Female Hispanics With Nonalcoholic Steatohepatitis
Authors: Sosa Rebecca A. , Terry Allyson Q. , Ito Takahiro , Naini Bita V. , Zheng Ying , Pickering Harry , Nevarez-Mejia Jessica , Busuttil Ronald W. , Gjertson David W. , Kupiec-Weglinski Jerzy W. , Reed Elaine F. , Kaldas Fady M. 
Published: October 2023

Background.
Nonalcoholic steatohepatitis (NASH) is a severe immune-mediated stage of nonalcoholic fatty liver disease that is rapidly becoming the most common etiology requiring liver transplantation (LT), with Hispanics bearing a disproportionate burden. This study aimed to uncover the underlying immune mechanisms of the disparities experienced by Hispanic patients undergoing LT for NASH.

Methods.
We enrolled 164 LT recipients in our institutional review board-approved study, 33 of whom presented with NASH as the primary etiology of LT (20%), with 16 self-reported as Hispanic (48%). We investigated the histopathology of prereperfusion and postreperfusion biopsies, clinical liver function tests, longitudinal soluble cytokines via 38-plex Luminex, and immune cell phenotypes generated by prereperfusion and postreperfusion blood using 14-color flow cytometry and enzyme-linked immunosorbent assay.

Results.
Hispanic LT recipients transplanted for NASH were disproportionately female (81%) and disproportionately suffered poor outcomes in the first year posttransplant, including rejection (26%) and death (38%). Clinically, we observed increased pro-inflammatory and apoptotic histopathological features in biopsies, increased AST/international normalized ratio early posttransplantation, and a higher incidence of presensitization to mismatched HLA antigens expressed by the donor allograft. Experimental investigations revealed that blood from female Hispanic NASH patients showed significantly increased levels of leukocyte-attracting chemokines, innate-to-adaptive switching cytokines and growth factors, HMGB1 release, and TLR4/TLR8/TLR9/NOD1 activation, and produced a pro-inflammatory, pro-apoptotic macrophage phenotype with reduced CD14/CD68/CD66a/TIM-3 and increased CD16/CD11b/HLA-DR/CD80.

Conclusions.
A personalized approach to reducing immunological risk factors is urgently needed for this endotype in Hispanics with NASH requiring LT, particularly in females.