bluuebunny/crossref_metadata_2025_split huggingface dataset:
A meta-analysis of randomized controlled trials of tonifying kidney and strengthen bone therapy on nondialysis patients with chronic kidney disease-mineral and bone disorder
Authors: Wu Guiling , Li Liang , Wu Zijian 
Published: June 2023

Background:
Correction of calcium, phosphorus, and parathyroid hormone disorders is the standard of treatment in nondialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD). However, the side effects and adverse reactions are still the main problems. Moreover, the lack of protection of kidney function in the treatment dramatically affects patients’ health. Although Traditional Chinese Medicine, specifically tonifying kidney and strengthen bone (TKSB) therapy, is wildly applied to patients with CKD-MBD in China, the evidence of TKSB therapy in the treatment of CKD-MBD is limited. Thus, we conducted this meta-analysis to evaluate the efficacy and safety of TKSB therapy combined with Western medicine (WM) for nondialysis patients with CKD-MBD.

Methods:
Two investigators conducted systematic research of randomized controlled trials of TKSB therapy for CKD-MBD from 7 electronic databases. Methodological quality evaluations were performed using the Cochrane collaboration tool, and data analysis was conducted by RevMan v5.3 software and STATA v15.0.

Results:
In total, 8 randomized controlled trials involving 310 patients met the criteria of meta-analysis. The complete results showed that compared with WM alone, TKSB treatment could improve the clinical efficacy rate (risk ratio = 4.49, 95% confidence interval [CI]: [2.64, 7.61], P  .00001), calcium (weighted mean difference [WMD] = 0.11, 95% CI: [0.08, 0.14], P < .00001), serum creatinine (WMD = 45.58, 95% CI: [32.35, 58.8], P < .00001) phosphorus (WMD = 0.11, 95% CI: [0.08, 0.13], P < .00001), parathyroid hormone (WMD = 16.72, 95% CI: [12.89, 20.55], P < .00001), blood urea nitrogen levels (WMD = 0.95, 95% CI: [0.26, 1.64], P = .007) on nondialysis patients with CKD-MBD, which was beneficial to improve the patients’ bone metabolic state and renal function. In addition, evidence shows that, compared with WM alone, TKSB treatment is safe and does not increase side effects.

Conclusion:
The systematic review found that TKSB therapy combined with WM has a positive effect on improving renal function and correcting bone metabolism disorder in nondialysis patients with CKD-MBD, which shows that Traditional Chinese Medicine is effective and safe in treating CKD-MBD. However, more high-quality, large-sample, multicenter clinical trials should be conducted to assess the safety and efficacy of TKSB therapy in treating nondialysis patients with CKD-MBD.
Systematic review registration: INPLASY2020120086
The 10 top-cited authors who published papers in journal medicine since 2000 using the betweenness centrality to identify unique names: Bibliometric analysis
Authors: Chang Chi-Sheng , Chow Julie Chi , Chien Tsair-Wei , Cheng Bor-Wen , Chou Willy 
Published: June 2023

Background:
Numerous studies have explored the most productive and influential authors in a specific field. However, 2 challenges arise when conducting such research. First, some authors may have identical names in the study data, and second, the contributions of coauthors may vary in the article by line, requiring consideration. Failure to address these issues may result in biased research findings. Our objective was to illustrate how the author-weighted scheme (AWS) and betweenness centrality (BC) can be employed to identify the 10 most frequently cited authors in a particular journal and analyze their research themes.

Methods:
We collected 24,058 abstracts from the PubMed library between 2000 and 2020 using the keyword “Medicine [Journal].” Author names, countries/regions, and medical subject headings (MeSH terms) were collected. The AWS to identify the top 10 authors with a higher x-index was applied. To address the issue of authors with identical names affiliated with different research institutes, we utilized the BC method. Social network analysis (SNA) was conducted, and 10 major clusters were identified to highlight authors with a higher x-index within the corresponding clusters. We utilized SNA to analyze the MeSH terms from articles of the 10 top-cited authors to identify their research themes.

Results:
Our findings revealed the following: within the top 10 cited authors, 2 authors from China shared identical names with Jing Li and Tao-Wang; JA Winkelstein from Maryland (US) had the highest x-index (15.58); Chia-Hung Kao from Taiwan was the most prolific author, having published 115 articles in Medicine since 2003; and the 3 primary research themes, namely, complications, etiology, and epidemiology, were identified using MeSH terms from the 10 most frequently cited authors.

Conclusions:
Using AWS and BC, we identified the top 10 most cited authors. The research methods we utilized in this study (BC and AWS) have the potential to be applied to other bibliometric analyses in the future.
Analyzing the number of articles with network meta-analyses using chord diagrams and temporal heatmaps over the past 10 years: Bibliometric analysis
Authors: Liang Yu-Erh , Ho Sam Yu-Chieh , Chien Tsair-Wei , Chou Willy 
Published: June 2023

Background:
Network meta-analyses (NMAs) are statistical techniques used to synthesize data from multiple studies and compare the effectiveness of different interventions for a particular disease or condition. They have gained popularity in recent years as a tool for evidence-based decision making in healthcare. Whether publications in NMAs have an increasing trend is still unclear. This study aimed to investigate the trends in the number of NMA articles over the past 10 years when compared to non-NMA articles.

Methods:
The study utilized data from the Web of Science database, specifically searching for articles containing the term “meta-analysis” published between 2013 and 2022. The analysis examined the annual number of articles, as well as the countries, institutions, departments, and authors associated with the articles and the journals in which they were published. Ten different visualization techniques, including line charts, choropleth maps, chord diagrams, circle packing charts, forest plots, temporal heatmaps, impact beam plots, pyramid plots, 4-quadrant radar plots, and scatter plots, were employed to support the hypothesis that the number of NMA-related articles has increased (or declined) over the past decade when compared to non-NMA articles.

Results:
Our findings indicate that there was no difference in mean citations or publication trends between NMA and non-NMA; the United States, McMaster University (Canada), medical schools, Dan Jackson from the United Kingdom, and the Journal of Medicine (Baltimore) were among the leading entities; NMA ranked highest on the coword analysis, followed by heterogeneity, quality, and protocol, with weighted centrality degrees of 32.51, 30.84, 29.43, and 24.26, respectively; and the number of NMA-related articles had increased prior to 2020 but experienced a decline in the past 3 years, potentially due to being overshadowed by the intense academic focus on COVID-19.

Conclusion:
It is evident that the number of NMA articles increased rapidly between 2013 and 2019 before leveling off in the years following. For researchers, policymakers, and healthcare professionals who are interested in evidence-based decision making, the visualizations used in this study may be useful.
Assessing ChatGPT’s capacity for clinical decision support in pediatrics: A comparative study with pediatricians using KIDMAP of Rasch analysis
Authors: Kao Hsu-Ju , Chien Tsair-Wei , Wang Wen-Chung , Chou Willy , Chow Julie Chi 
Published: June 2023

Background:
The application of large language models in clinical decision support (CDS) is an area that warrants further investigation. ChatGPT, a prominent large language models developed by OpenAI, has shown promising performance across various domains. However, there is limited research evaluating its use specifically in pediatric clinical decision-making. This study aimed to assess ChatGPT’s potential as a CDS tool in pediatrics by evCDSaluating its performance on 8 common clinical symptom prompts. Study objectives were to answer the 2 research questions: the ChatGPT’s overall grade in a range from A (high) to E (low) compared to a normal sample and the difference in assessment of ChatGPT between 2 pediatricians.

Methods:
We compared ChatGPT’s responses to 8 items related to clinical symptoms commonly encountered by pediatricians. Two pediatricians independently assessed the answers provided by ChatGPT in an open-ended format. The scoring system ranged from 0 to 100, which was then transformed into 5 ordinal categories. We simulated 300 virtual students with a normal distribution to provide scores on items based on Rasch rating scale model and their difficulties in a range between −2 to 2.5 logits. Two visual presentations (Wright map and KIDMAP) were generated to answer the 2 research questions outlined in the objectives of the study.

Results:
The 2 pediatricians’ assessments indicated that ChatGPT’s overall performance corresponded to a grade of C in a range from A to E, with average scores of −0.89 logits and 0.90 logits (=log odds), respectively. The assessments revealed a significant difference in performance between the 2 pediatricians (P < .05), with scores of −0.89 (SE = 0.37) and 0.90 (SE = 0.41) in log odds units (logits in Rasch analysis).

Conclusion:
This study demonstrates the feasibility of utilizing ChatGPT as a CDS tool for patients presenting with common pediatric symptoms. The findings suggest that ChatGPT has the potential to enhance clinical workflow and aid in responsible clinical decision-making. Further exploration and refinement of ChatGPT’s capabilities in pediatric care can potentially contribute to improved healthcare outcomes and patient management.
Clinical efficacy of belimumab in central nervous system demyelinating syndromes with systemic lupus erythematosus: A case series
Authors: Liu Ya , Fan Qiuyu , Jia Chao , Wan Qibin , Yang Huiqin 
Published: June 2023

Rationale:
Systemic lupus erythematosus (SLE) is a complex autoimmune disease involving multiple systems. Central nervous system (CNS) demyelinating syndromes are one of the rare neurological manifestations of SLE, whose diagnosis, treatment, and prognosis are rarely reported. Belimumab, an anti-BAFF monoclonal antibody, has been approved by the FDA for the treatment of SLE. We aimed to assess the effects of belimumab on demyelinating syndromes in patients with SLE.

Patient concerns:
Six patients with demyelination in SLE who were managed at Traditional Chinese and Western Medicine Hospital of Wuhan from March 2021 to March 2023, who received belimumab ≥ 5 times, were enrolled. Ten age- and sex-matched SLE patients with noutneuropsychiatric systemic lupus erythematosus (NPSLE) and normal controls were recruited to analyze potential biomarkers.

Diagnoses:
All patients were diagnosed with SLE based on the 2012 Systemic Lupus International Collaborating Clinics (SLICC) SLE classification criteria or the 2019 EULAR/ACR classification criteria. All SLE patients with CNS demyelinating syndromes were diagnosed by rheumatologists, neurologists, and radiologists.

Interventions:
These patients were administered belimumab combined with standard treatment (glucocorticoids and/or antimalarials and/or immunosuppressants [cyclophosphamide, mycophenolate, methotrexate, etc.]).

Outcomes:
Six patients were included in the study (100% female, mean [range] age at first demyelinating episode 42.8 [24–66] years). The most common extra-CNS features in these patients were rash, arthritis, alopecia, leukopenia, and hypocomplementemia. After Belimumab treatment, 3 of 6 (50%) patients achieved complete remission with decreased prednisone, 2 improvements, and 1 relapsed with uterine surgery. Compared with the baseline, 3.5 months post belimumab treatment, the disease activity score SLEDAI (21.5–5.5, P < .001), C3 and C4 increased, and extra-CNS symptoms improved rapidly. Moreover, The expression of lupus susceptibility gene PBX1 in CD19+ B cells was lowest in demyelinating syndromes with lupus patients compared with healthy volunteers and lupus patients without demyelination, and its relative expression negatively correlated with SLE disease activity.

Conclusion:
Belimumab could be an effective and safe option for the treatment of SLE demyelination. In addition, PBX1 might be a potential biomarker for the clinical diagnosis of lupus in patients with demyelinating syndrome.
Microwave ablation versus radiofrequency ablation for treating spinal metastases
Authors: Yao Yuming , Zhu Xiang , Zhang Na , Wang Ping , Liu Zhizheng , Chen Yun , Xu Cong , Ouyang Taohui , Meng Wei 
Published: June 2023

Background:
This study aimed to compare the clinical efficacy and safety of microwave ablation (MWA) and radiofrequency ablation (RFA) for the treatment of spinal metastases.

Methods:
A literature search was performed using the PubMed, Web of Science, and Cochrane Library databases according to the PRISMA statement (as of September 20, 2022). Two independent investigators screened articles based on the inclusion and exclusion criteria and included studies with primary outcomes of pain relief, tumor control, and complications. Article quality was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool.

Results:
Sixteen articles were finally included in this study, including 630 patients with spinal metastases, with ages ranging from 51.4 to 71.3 years. Of these, 393 (62.4%) underwent MWA and 237 (37.6%) underwent RFA. After MWA and RFA treatment, visual analog scale scores significantly decreased, and the local tumor control rates were all above 80%. Complications were reported in 27.4% of patients treated with MWA compared with 10.9% of patients treated with RFA.

Conclusion:
The results of this systematic review suggest that MWA alone or in combination with surgery and RFA in combination with other modalities may improve pain caused by primary tumor metastasis to the spine, and MWA alone or in combination with surgery may have better local tumor control. However, MWA appears to result in more major complications than RFA in combination with other treatment modalities.
Effect of abdominal binder on shoulder pain after laparoscopic gynecologic surgery: A randomized, controlled trial
Authors: Kim Yoon Jung , Hwang So Yeong , Kim Hee-Soo 
Published: June 2023

Background:
To evaluate the impact of abdominal binder (AB) use on postoperative shoulder pain in patients recovering from laparoscopic gynecologic surgery.

Methods:
This was a prospective randomized study conducted in a tertiary teaching hospital. Overall, 144 patients underwent laparoscopic gynecologic surgery. The postoperative use of an AB for 24 hours was added to the pulmonary recruitment maneuver.

Results:
Of 144 consenting patients, 72 patients each were allocated to the AB and control groups, respectively, and 14 patients were excluded. Finally, 130 patients were analyzed, with 68 in the AB group and 62 in the control group. There was no difference in the incidence of postoperative shoulder pain between the 2 groups (55.9% vs 56.5%, P = 1.000). The severity of the worst shoulder pain, measured using a numerical rating scale, did not differ between the 2 groups (Median [interquartile range] 2 [0–5] vs 2 [0–5]; P = .865). The severity of surgical site pain, pain and nausea medications, and the ambulation time were not different in the 2 groups.

Conclusion:
The use of an AB was not beneficial for postoperative shoulder pain following laparoscopic gynecologic surgery. Surgical site pain, ambulation time, and postoperative nausea and vomiting were not improved with the use of an AB.
Ichthyosis: presentation and management
Authors: Butala Sneha , Mazereeuw-Hautier Juliette , Paller Amy S. 
Published: June 2023

Purpose of review
This review focuses on the presentation and management of ichthyoses and highlights recent advances in treatment that hold promise for better targeted therapy.

Recent findings
The ichthyoses are a group of rare genetic diseases with a wide phenotypic spectrum, characterized most often by generalized hyperkeratosis and scaling with variable erythema. The highly visible scaling and frequent itch contribute to decreased quality of life. Management for ichthyosis focuses on symptomatic relief and scale reduction with emollients, keratolytics, and retinoids. Recent advances in immune profiling and genotype-phenotype mapping have increased understanding of ichthyosis and shifted focus to pathogenesis-based targeted therapies with emerging biologics, small molecular inhibitors, and gene therapy.

Summary
This article discusses clinical assessment and genotyping to make the diagnosis of specific forms of ichthyosis, provides guidance for management, and reviews new treatment options with systemic agents.
Stroke and kidney transplantation
Authors: Abreo Adrian P. , Kataria Deepak , Amrutkar Chaitanya , Singh Ayush , Samaniego Millie , Singh Neeraj 
Published: June 2023

Purpose of review
This review will focus on the epidemiological data, risk factors, and management of stroke before and after kidney transplant. Stroke is highly prevalent in waitlisted patients as well as kidney transplant recipients and is associated with impaired transplant outcomes. Multiple traditional, nontraditional, and transplanted risk factors increase the risk of stroke.

Recent findings
Although the risk of stroke is reduced after kidney transplantation compared with remaining on dialysis, the morbidity and mortality from stroke after transplantation remain significant.

Summary
Early screening for risk factors before and after a kidney transplant and following the Kidney Disease Improving Global Outcomes (KDIGO) management guidelines could minimize the incidence of stroke and transplant outcomes.
Longitudinal Effects of Sex, Aging, and Multiple Sclerosis Diagnosis on Function
Authors: Harrison Tracie C. , Blozis Shelley A. , Stuifbergen Alexa K. , Becker Heather 
Published: June 2023

Background
A gap in research about the trajectories of function among men and women aging with functional limitations because of multiple sclerosis (MS) hinders ability to plan for future needs.

Objectives
Using a biopsychosocial model, we characterize how men and women with MS report changes over time in their function and test how person-level differences in age, diagnosis duration, and sex influence perceived function.

Methods
A longitudinal study with multiple waves of surveys was used to collect data on participant perceptions of function, as well as demographic and contextual variables. Self-reported functional limitation was measured over a decade. The study participants were community residing with physician-diagnosed MS.

Results
The people with MS had a diagnosis duration of about 13 years and were around 51 years of age, on average, at the start of the study. They were primarily women and non-Hispanic White. We analyzed the data using mixed-effects models. Subject-specific, functional limitation trajectories were described best with a quadratic growth model. Relative to men, women reported lower functional limitation and greater between-person variation and rates of acceleration in functional limitation scores.

Discussion
Results suggest function progressed through two pathways for over a decade, particularly closer to diagnoses. Variability in trajectories between individuals based on sex and years since diagnosis of disease indicates that men and women with MS may experience perceptions of their function with age differently. This has implications for clinician advice to men and women with MS.
Case Comparison of Preterm Infant Stability During Packed Red Blood Cell Transfusions
Authors: Everhart Kayla C. , Donevant Sarah B. , Iskersky Victor N. , Wirth Michael D. , Dail Robin B. 
Published: June 2023

Background
Very preterm infants (less than 32 weeks gestational age) experience acute morbidity during their stay in a neonatal intensive care unit. Because of their prematurity and frequent laboratory testing, they experience anemia, requiring correction with packed red blood cell (PRBC) transfusion(s). PRBC transfusions have been linked to neonatal morbidity, such as necrotizing enterocolitis, but never signs and symptoms of physiological stability.

Objective
The secondary data analysis aimed to examine very preterm infants’ physiological stability before, during, and after PRBC transfusions.

Methods
A within-case, mixed-methods design was used in a secondary data analysis for 16 transfusion cases from 13 very preterm infants.

Results
The findings showed very preterm infants with physiological variables falling within defined limits based on gestational age during the transfusion. Two contrasting case exemplars will be presented.

Discussion
PRBC transfusions are necessary and prevent morbidity in very preterm infants. Observing instability during transfusions and prospectively studying hypothermia, cardiac instability, and thermal gradients is essential to design interventions to decrease morbidity associated with PRBC transfusions.
Center Volume and Survival Relationship for Neonates With Congenital Diaphragmatic Hernia Treated With Extracorporeal Life Support
Authors: Martino Alice M. , Nguyen Danh V. , Delaplain Patrick T. , Dinh Peter , Jancelewicz Tim , Harting Matthew T. , Yu Peter T. , Di Nardo Matteo , Gowda Sharada , Goodman Laura F. , Yu Yangyang , Guner Yigit S. 
Published: June 2023

OBJECTIVES:
Literature is emerging regarding the role of center volume as an independent variable contributing to improved outcomes. A higher volume of index procedures may be associated with decreased morbidity and mortality. This association has not been examined for the subgroup of infants with congenital diaphragmatic hernia (CDH) receiving extracorporeal life support (ECLS). Our study aims to examine the risk-adjusted association between center volume and outcomes in CDH-ECLS neonates, hypothesizing that higher center volume confers a survival advantage.

DESIGN:
Multicenter, retrospective comparative study using the Extracorporeal Life Support Organization database.

SETTING:
One hundred twenty international pediatric centers.

PATIENTS:
Neonates with CDH managed with ECLS from 2000 to 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The cohort included 4,985 neonates with a mortality rate of 50.6%. For the 120 centers studied, mean center volume was 42.4 ± 34.6 CDH ECLS cases over the 20-year study period. In an adjusted model, higher ECLS volume was associated with lower odds of mortality: odds ratio (OR) 0.995 (95% CI, 0.992–0.999; p = 0.014). For an increase in one sd in volume, that is, 1.75 cases annually, the OR for mortality was lower by 16.7%. Volume was examined as a categorical exposure variable where low-volume centers (fewer than 2 cases/yr) were associated with 54% higher odds of mortality (OR, 1.54; 95% CI, 1.03–2.29) compared with high-volume centers. On-ECLS complications (mechanical, neurologic, cardiac, hematologic metabolic, and renal) were not associated with volume. The likelihood of infectious complications was higher for low- (OR, 1.90; 95% CI, 1.06–3.40) and medium-volume (OR, 1.87; 95% CI, 1.03–3.39) compared with high-volume centers.

CONCLUSIONS:
In this study, a survival advantage directly proportional to center volume was observed for CDH patients managed with ECLS. There was no significant difference in most complication rates. Future studies should aim to identify factors contributing to the higher mortality and morbidity observed at low-volume centers.