bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture for abdominal wall endometriosis: A case report
Authors: Du Xiufan , Tang Jiahao , Zhang Lixia , Yi Wei 
Published: December 2023

Introduction:
Endometriosis refers to a series of symptoms caused by the presence of endometrial-like tissue outside the uterine cavity. In extrapelvic endometriosis, abdominal wall endometriosis (AWE) is very common. Acupuncture therapy has been widely used as an alternative therapy to treat multiple diseases, such as sequelae of stroke, pain, and facial paralysis. To our knowledge, case reports of acupuncture for the treatment of AWE has not been reported. We report a case of acupuncture in the treatment of abdominal endometriosis.

Rationale:
AWE could result in symptoms including pelvic pain, dysmenorrhea, and infertility. Acupuncture might be effective in the treatment of the disease.

Patient concerns:
A 38-year-old woman complained of the aggregation of pain in a mass, which is located in her abdominal wall.

Diagnoses:
The patient was diagnosed with AWE, surgical history (excision of deep abdominal wall mass, repair of abdominal wall defect with patch). According to traditional Chinese medicine theory, traditional Chinese medicine diagnosis is Zhengjia (qi stagnation and blood stasis pattern).

Interventions:
Combined with the theory of disentanglement, we use acupuncture, cupping, and needle therapy to promote qi circulation, activate blood circulation, relieve pain, and dissipate masses.

Outcomes:
After treatment, abdominal ultrasound showed that the mass gradually decreased.

Conclusion:
Acupuncture can effectively relieve the pain caused by abdominal endometriosis and reduce the size of abdominal endometriosis masses.
A systematic review and meta-analysis of moxibustion for chronic prostatitis
Authors: Yu Xi-wen , Wang Cheng-si , Yu Xiao-hong 
Published: December 2023

Background:
Chronic prostatitis (CP) is a common condition that affects many individuals. Previous clinical trials have explored the use of moxibustion as a potential treatment for CP. However, the evidence on the effectiveness of moxibustion for CP remains limited. Therefore, this study aimed to comprehensively assess the effects of moxibustion for CP.

Methods:
In order to gather relevant and up-to-date information, we conducted a systematic literature search of databases including Cochrane Library, PUBMED, EMBASE, CNKI, and Wangfang from inception until June 30, 2023. Only randomized clinical trials (RCTs) that investigated the use of moxibustion for CP were included in this study. The primary outcomes of interest were the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores and the overall response rate. To evaluate the quality of the included studies, we used the Cochrane risk-of-bias tool.

Results:
After analyzing the data from 8 RCTs involving a total of 664 patients, we found significant differences in NIH-CPSI scores between moxibustion and other treatment modalities. Specifically, when compared with herbal medicine, moxibustion was associated with a mean difference (MD) of −1.78 in NIH-CPSI scores (95% confidence interval [CI] [−2.78, −0.78], P < .001), and when compared with western medicine, moxibustion was associated with a MD of −5.24 in NIH-CPSI scores (95% CI [−7.80, −2.67], P < .08). In terms of the overall response rate, moxibustion was found to be superior to herbal medicine, with a MD of 2.36 (95% [19, 4.67], P = .01). Additionally, when moxibustion was combined with herbal medicine, it yielded a higher overall response rate with a MD of 4.07 (95% CI [1.54, 10.74], P = .005) compared to herbal medicine alone. Moxibustion also outperformed western medicine in terms of the overall response rate, with a MD of 4.56 (95% CI [2.24, 9.26], P < .001).

Conclusion:
Based on the findings of this study, moxibustion appears to be a potentially efficacious treatment for CP. The results suggest that moxibustion can improve NIH-CPSI scores and overall response rate in patients with CP. However, further high-quality studies are needed to validate these results and establish the long-term effects of moxibustion as a treatment for CP.
Central Sensitization in Vulvodynia and Endometriosis: What Have We Been Overlooking So Far?
Authors: Cetera Giulia Emily , Merli Camilla Erminia Maria , Boero Veronica , Caia Carlotta , Facchin Federica , Barbara Giussy , Monti Ermelinda , Vercellini Paolo 
Published: December 2023

Importance
Women experience more frequent and greater pain than men, although they receive less adequate treatment and are perceived as more anxious than males. Recent clinical research has lead to hypothesize a common etiology for overlapping chronic pain conditions and mood disorders, namely, central sensitization, which originates from an alteration of pain processing pathways in the central nervous system.

Objective
The aim of this review was to collect all available evidence regarding the potential role of central sensitization in vulvodynia and endometriosis.

Evidence Acquisition
A systematic literature search was performed between July and August 2022 using the electronic database PubMed. The extracted data were summarized using a narrative approach.

Results
Ten articles were chosen for the review. Participants' mean age was 39.2 years (SD = 5.1). Among serum markers of central sensitization, nitric oxide levels were greater in women with endometriosis than in controls, whereas brain-derived neurotrophic factor and S100B levels differed among pain conditions with structural anomalies and those without. Functional magnetic resonance imaging showed different resting state networks between patients with endometriosis and controls. In neurophysiology studies, cases had reduced pain thresholds, compared with healthy controls. Lastly, self-reported questionnaires suggested a central component of pain in women with endometriosis-related dyspareunia and associated bladder/pelvic floor tenderness.

Conclusions and Relevance
The management of vulvodynia and endometriosis may benefit from a new perspective, which considers their possible central etiology. It is compelling that treatment of pain starts to be considered a therapeutic goal in its own right.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to describe central sensitization as a common etiology for vulvodynia and endometriosis; explain how to investigate the presence of central sensitization with various techniques; identify the possible origin of vulvodynia and endometriosis pain; and discuss the importance of considering treatment of pain as a therapeutic goal.
Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature
Authors: Sgayer Inshirah , Dabbah Shirin , Farah Rola Khamisy , Wolf Maya , Ashkar Nadine , Lowenstein Lior , Odeh Marwan 
Published: December 2023

ABSTRACT

Importance
Uterine rupture is defined as a nonsurgical disruption of all layers of the uterus. Most ruptures occur in the presence of a scar, usually secondary to a previous cesarean delivery. Rupture of an unscarred uterus is rare and is associated with severe maternal and neonatal outcomes.

Objective
To outline the literature on potential predisposing factors, clinical findings, and maternal and fetal outcomes of a rupture of an unscarred uterus.

Evidence Acquisition
PubMed was searched for the phrases “uterine rupture,” “unscarred,” and “spontaneous.” Individual case reports, retrospective case series, and review articles in English between 1983 and 2020 were included.

Results
We found 84 case reports in 79 articles. The mean maternal age was 29.3 (SD, 5.7) years; 38 women (45.2%) were nulliparous. Uterine rupture occurred in 37% of the women at term; in 9.9%, the gestational age was ≤12 weeks. The most common clinical presentations were abdominal pain (77.4%), signs of hypovolemic shock (36.9%), fetal distress (31%), and vaginal bleeding (22.6%). The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor and a prior curettage procedure. The most frequently ruptured site was the body of the uterus. Hysterectomy managed 36.9% of the ruptures. Four women died (4.8%). Perinatal mortality was 50.6%. Perinatal death was higher in developing than developed countries.

Conclusions and relevance
Although rare, spontaneous rupture of the unscarred uterus has serious consequences to the mother and the fetus and should be included in the differential diagnosis of acute abdomen in pregnancy.

Target Audience
Obstetrician-gynecologists, family medicine physicians.

Learning Objectives
After completing this activity, the learner will be better able to describe the consequences of spontaneous rupture of the unscarred uterus to the mother and fetus; discuss risk factors for spontaneous rupture of the unscarred uterus and its potential occurrence in nulliparous, antepartum, and the first trimester; and discuss how timely assessment of a pregnant woman presenting with abdominal pain impacts survival of the mother and child.
Prevention of Early-Onset Neonatal Group B Streptococcal Disease: A Comprehensive Review of Major Guidelines
Authors: Boureka Eirini , Krasias Dimitrios , Tsakiridis Ioannis , Karathanasi Anna-Maria , Mamopoulos Apostolos , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: December 2023

ABSTRACT

Importance
Group B Streptococcus (GBS) colonization during pregnancy is associated with significant neonatal morbidity and mortality and represents a major public health concern, often associated with poor screening and management.

Objective
The aim of this study was to review and compare the most recently published influential guidelines on the screening and management of this clinical entity during antenatal and intrapartum periods.

Evidence Acquisition
A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada on the prevention of early-onset neonatal group B streptococcal disease was carried out.

Results
There is a consensus among the reviewed guidelines regarding the optimal screening specimen type, indications for intrapartum antibiotic administration such as bacteriuria during pregnancy, clinical signs of chorioamnionitis or maternal pyrexia, and history of GBS-related neonatal disease. There is also agreement on several conditions where no intervention is recommended, that is, antepartum treatment of GBS and GBS-positive women with planned cesarean delivery and intact membranes. Controversy exists regarding the optimal screening time, with the Royal College of Obstetricians and Gynecologists stating against routine screening and on management strategies related to preterm labor and preterm prelabor rupture of membranes.

Conclusions
The development of consistent international practice protocols for the timely screening of GBS and effective management of this clinical entity both during pregnancy and the intrapartum period seems of paramount importance to safely guide clinical practice and subsequently improve neonatal outcomes.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After participating in this activity, the learner should be better able to explain the aim of screening for group B streptococcal infection in pregnancy; identify cases that should be treated for group B streptococcal infection; and discuss appropriate intrapartum antibiotic prophylaxis for pregnant women positive for GBS.
Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer
Authors: Agrawal Pranjal , Singh Sajya M. , Able Corey , Dumas Kathryn , Kohn Jaden , Kohn Taylor P. , Clifton Marisa 
Published: December 2023

(Abstracted from Obstet Gynecol 2023;142:660–668)
The current 5-year survival rate for female breast cancer patients has risen to 90%, but several breast cancer systemic treatments such as radiotherapy, chemotherapy, and endocrine therapy can all worsen hypoestrogenic states. Genitourinary syndrome of menopause (GSM) can result from lack of circulating estrogen, which can possibly lead to conditions such as sexual dysfunction.
Surgical management and weight-bearing recommendations for geriatric distal femur fractures
Authors: Haller Justin M. , Marchand Lucas S. , Higgins Thomas F. , O'Toole Robert V. , Reider Lisa 
Published: December 2023

Objective:To investigate current practices among orthopaedic trauma surgeons in treating geriatric distal femur fractures and evaluate current postoperative weight-bearing recommendations.Methods:A 26-question survey was emailed to Major Extremity Trauma Research Consortium surgeon members to characterize current practice with different fixation methods for distal femur fractures and the surgeon-directed postoperative weight-bearing recommendations for each approach.Results:Surveys were completed by 123 orthopaedic trauma surgeons with a response rate of 37% (123/332). Retrograde intramedullary nailing (IMN) was commonly performed by 88% of surgeons, and lateral locked plate was commonly performed by 74% of surgeons. Retrograde IMN with a lateral plate was commonly performed by 51% of surgeons. Dual femoral plating was commonly performed by 18% of surgeons and sometimes performed by 39% of surgeons. Surgeons were significantly more likely to allow immediate postoperative weight-bearing for retrograde IMN (P< 0.001), retrograde IMN with lateral plate (P< 0.001), and dual plate (P< 0.001) as compared with locked lateral plate. Most surgeons (79%) would be interested in participating in a randomized controlled trial (RCT) investigating single implant versus dual implant for distal femur fractures and believe that a trial incorporating immediate weight-bearing is important.Conclusion:A variety of implants are commonly used to treat geriatric distal femur fractures. Patients with distal femur fracture commonly have weight-bearing restrictions in the immediate postoperative period. A large proportion of orthopaedic trauma surgeons have clinical equipoise for an RCT to investigate the impact of surgical construct and weight-bearing on geriatric distal femur fracture patient recovery.
Examination of Incidence of Sexually Transmitted Infections in the Ending the HIV Epidemic Priority Counties of the U.S., 2005-2019
Authors: Bunting Samuel R. , Hunt Bijou , Johnson Amy K. , Hazra Aniruddha , Nunez-Garcia Andrea , Glick Nancy 
Published: December 2023

Abstract

Background
The incidence of sexually transmitted infections (STIs) has been increasing in the U.S. and this trend has continued alongside expanding/changing HIV-prevention strategies, moving from reliance solely on behavioral interventions like condoms to biomedical methods like oral and injectable antiretroviral pre-exposure prophylaxis (PrEP). In 2019, the Ending the HIV Epidemic (EHE) initiative was released to prioritize resource allocation to the 50 jurisdictions in the U.S. with the highest HIV incidence, providing an opportunity to monitor STI incidence in a national group of discrete, geographic units and identify trends and differences across jurisdictions.

Objectives & Design
Using existing data from the U.S. CDC and Census Bureau, a retrospective analysis was conducted to examine the incidence of STIs in 49 of the 50 EHE priority counties between 2005-2019. This timeframe was divided into two time periods representing a before and after entry into the biomedical era of HIV-prevention: P1 (2005-2011) and P2 (2012-2019).

Key Results
A total of 49 EHE counties were included in this analysis, representing 27.4% of the total U.S. population. Entry into the biomedical HIV-prevention era was associated with an increase in STI incidence in 28 EHE counties and a decrease in 14 EHE counties. The greatest percent increase in total STI incidence was in the District of Columbia (+12.1%; IRR = 1.121, [1.115, 1.127], p < .001) and the greatest percent decrease was identified in Orleans Parish, LA (-8.7%; IRR = 0.913, [0.908, 0.919], p < .001).

Conclusions
Rising STI rates in the biomedical era of HIV-prevention represent missed opportunities for comprehensive sexual and preventive healthcare. County-level data provide actionable insight for reducing STI incidence. The EHE counties that have experienced decreases in STI incidence while being in the biomedical era may provide models of best practice which may be scaled in other jurisdictions.
Admission Functional Status is Associated With Intensivists Perception of Extracorporeal Membrane Oxygenation Candidacy for Pediatric Acute Respiratory Failure
Authors: McCabe Brenna C. , Morrison Wynne E. , Morgan Ryan W. , Himebauch Adam S. 
Published: December 2023

OBJECTIVES:
To determine the association between admission Functional Status Scale (FSS) category and perceived extracorporeal membrane oxygenation (ECMO) candidacy for pediatric acute respiratory failure.

DESIGN:
Prospective, cross-sectional study.

SETTING:
Single-center, quaternary, and ECMO referral academic children’s hospital between March 2021 and January 2022.

SUBJECTS:
Pediatric intensivists directly caring for patients admitted with acute respiratory failure secondary to shock or respiratory disease.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Pediatric intensivists were surveyed about current patients within 72 hours of initiation or escalation of invasive mechanical ventilation on whether they would offer ECMO should their patient deteriorate. Baseline functional status was assessed using trichotomized admission FSS: 1) normal/mild dysfunction (6–9), 2) moderate dysfunction (10–15), and 3) severe dysfunction (> 16). Multivariable logistic regression clustered by physician was used to assess the association between admission FSS category with perceived ECMO candidacy. Thirty-seven intensivists participated with 76% (137/180) of survey responses by those with less than 10 years of experience. 81% of patients (146/180) were perceived as ECMO candidates and 19% of patients (34/180) were noncandidates. Noncandidates had worse admission FSS scores than candidates (15.5 vs. 9, p < 0.001). After adjustment for age, admission FSS category of severe dysfunction had lower odds of perceived ECMO candidacy compared with normal to mild dysfunction (odds ratio [OR] 0.18 [95% CI, 0.06–0.56], p < 0.003). Patients with an abnormal communication subscore domain had the lowest odds of being considered a candidate (unadjusted OR 0.44 [95% CI, 0.29–0.68], p < 0.0001).

CONCLUSIONS:
In this prospective, single-center, cross-sectional study, admission FSS category indicating worse baseline functional status impacted pediatric intensivists’ perceptions of ECMO candidacy for patients with acute respiratory failure. Abnormal FSS subscores in the neurocognitive domains were the most important considerations. Future studies should better seek to define the decision-making priorities of both parents and medical specialists for the utilization of ECMO in children with acute respiratory failure.
Lifestyle differences between co-twins are associated with decreased similarity in their internal and external exposome profiles
Authors: Drouard Gabin , Wang Zhiyang , Heikkinen Aino , Foraster Maria , Julvez Jordi , Kanninen Katja M. , van Kamp Irene , Pirinen Matti , Ollikainen Miina , Kaprio Jaakko 
Published: December 2023

AbstractWhether differences in lifestyle between co-twins are reflected in differences in their internal or external exposome profiles remains largely underexplored. We therefore investigated whether within-pair differences in lifestyle were associated with within-pair differences in exposome profiles across four domains: the external exposome, proteome, metabolome and epigenetic age acceleration (EAA). For each domain, we assessed the similarity of co-twin profiles using Gaussian similarities in up to 257 young adult same-sex twin pairs (54% monozygotic). We additionally tested whether similarity in one domain translated into greater similarity in another. Results suggest that a lower degree of similarity in co-twins’ exposome profiles was associated with greater differences in their behavior and substance use. The strongest association was identified between excessive drinking behavior and the external exposome. Overall, our study demonstrates how social behavior and especially substance use are connected to the internal and external exposomes, while controlling for familial confounders.
Securin Regulates the Spatiotemporal Dynamics of Separase
Authors: Turpin Christopher G. Sorensen , Sloan Dillon , LaForest Marian , Klebanow Lindsey Uehlein , Mitchell Diana , Severson Aaron F. , Bembenek Joshua N. 
Published: December 2023

AbstractSeparase is a key regulator of the metaphase to anaphase transition with multiple functions. Separase cleaves cohesin to allow chromosome segregation and localizes to vesicles to promote exocytosis in mid-anaphase. The anaphase promoting complex/cyclosome (APC/C) activates separase by ubiquitinating its inhibitory chaperone, securin, triggering its degradation. How this pathway controls the exocytic function of separase has not been investigated. During meiosis I, securin is degraded over several minutes, while separase rapidly relocalizes from kinetochore structures at the spindle and cortex to sites of action on chromosomes and vesicles at anaphase onset. The loss of cohesin coincides with the relocalization of separase to the chromosome midbivalent at anaphase onset. APC/C depletion prevents separase relocalization, while securin depletion causes precocious separase relocalization. Expression of non-degradable securin inhibits chromosome segregation, exocytosis, and separase localization to vesicles but not to the anaphase spindle. We conclude that APC/C mediated securin degradation controls separase localization. This spatiotemporal regulation will impact the effective local concentration of separase for more precise targeting of substrates in anaphase.
A multiplex qRT-PCR assay for detection of Influenza A and H5 subtype targeting new SNPs present in high pathogenicity avian influenza Canadian 2022 outbreak strains
Authors: Lee Tracy D. , Tsang Frankie , Kolehmainen Kathleen , Prystajecky Natalie A. , Jassem Agatha N. , Tyson John R. 
Published: December 2023

AbstractH5N1 is a highly pathogenic avian Influenza A subtype that has been known to also infect mammalian hosts and presents a potential public health risk. To address and mitigate the affects of new SNPs, found in recent Canadian outbreaks, on diagnostic detection we developed two qRT-PCR assays by modifying current probes to match sequences detected in the east and west coast of Canada. These assays were multiplexed with a third qRT-PCR assay targeting the M segment, allowing streamlined detection of Influenza A and subtyping for H5. This three-plex qRT-PCR was validated by assessing analytical specificity, limit-of-detection, precision, and accuracy.