bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of family centered nursing model on children with primary nephrotic syndrome: A systematic review and meta-analysis
Authors: Yu Miaolei , Zhu Shuzhen 
Published: August 2023

Background:
Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS.

Methods:
The electronic databases included China National Knowledge Internet, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, Cochrane Library, and Embase, were searched to collect randomized controlled trials on family-centered nursing model in the treatment of children with PNS. Fixed effect models or fixed effect models were used to analyze the outcomes. The primary outcomes were length of hospital stay and nursing satisfaction, and the second outcomes were quality of life (QoL) and behavioral problems.

Results:
A total of 12 studies involving 996 pediatric patients were included, of which 500 children received family centered care and 496 children received routine care. The results showed that family centered nursing model could significantly improve the QoL of children with PNS (P < .05), increase the nursing satisfaction of family members (P < .0001, SMD = 7.37, 95%CI = 4.15–13.08), reduce the time of hospitalization (P < .0001, standard mean difference [SMD] = −2.30, 95%CI = −2.57 to −2.03), and decrease the scores of psychosomatic disorders and impulsivity hyperactivity in children with PNS (P < .0001, SMD = −3.13, 95%CI = −4.12 to −2.15; P < .0001, SMD = −3.29, 95%CI = −4.29 to −2.28). However, there was no significant statistical difference in the impact on the scores of conduct problems, learning problems, anxiety, and hyperactivity (P > .05).

Conclusion:
Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems.
Acupuncture-adjuvant therapies for treating perimenopausal depression: A network meta-analysis
Authors: Zheng Lifang , Sun Zhanling , Liu Chenghao , Zhang Jiamin , Jin Yabei , Jin Huifang 
Published: August 2023

Background:The issues related to the treatment of perimenopausal depression (PMD) are the side effects of antidepressants and hormone replacement therapy. The aim of this study was to assess the efficiency and safety of acupuncture and moxibustion in PMD patients.Methods:Databases, namely PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, CBM, VIP, and WanFang, were reviewed for related randomized controlled trials dated between database inception and November 22, 2022. The primary outcomes were the efficacy rate and the Hamilton Depression Scale score. The secondary outcomes were the levels of follicle-stimulating hormone, luteinizing hormone, and estradiol and the Kupperman score. Odds ratios (ORs) were generated as the effect size for dichotomous outcomes, while the standard mean difference (SMD) ± standard deviation was used for continuous outcomes. Matrices were developed to demonstrate pairwise comparisons of regimens related to each endpoint. Utilizing Review Manager (RevMan) 5.3, Stata 16.0 and SPSS 21, data were analyzed.Results:In total, 27 studies involving 2269 PMD patients and 8 therapeutic measures were incorporated into the network meta-analysis (NMA). The NMA showed that warm acupuncture (OR = 1.55, 95% CI: 1.00–2.44), electroacupuncture (OR = 1.34, 95% CI: 1.00–1.8), abdominal acupuncture (OR = 1.19, 95% CI: 0.73–1.96), and common acupuncture (OR = 1.4, 95% CI: 0.9–2.17) were more effective than fluoxetine + menopausal hormone treatment in the treatment of PMD. The NMA also showed that, based on the Hamilton Depression Scale score, warm acupuncture was more effective than the other 4 acupuncture-related treatments, i.e., electroacupuncture (SMD = −1.22, 95% CI: −2.34 to −0.09), thread embedding (SMD = −1.31, 95% CI: −2.21 to −0.40), abdominal acupuncture (SMD = −1.33, 95% CI: −2.42 to −0.24), and common acupuncture (SMD = −1.46, 95% CI: −2.26 to −0.66). The cumulative ranking probability (SUCRA) showed that warm acupuncture (99.6%) was the best treatment method.Conclusions:The findings of this network meta-analysis may help patients and therapists choose the best acupuncture therapy for treating perimenopausal depression patients and furnish reliable evidence for guidelines.
Diagnostic value of serum human epididymis protein 4, carbohydrate antigen 125 and their combination in endometrial cancer: A meta-analysis
Authors: Wu Qi , Bai Su-ning , Song Li-yun , Wu Wen-fei , Han Li-na 
Published: August 2023

Background:
To systematically analyze the value of human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) in the diagnosis of endometrial cancer, so as to provide evidence-based medical evidence for the selection of serum tumor markers in the early screening of endometrial cancer.

Methods:
We comprehensively searched relevant literature in the Cochrane Library, EMBASE, PubMed, Web of Science, CNKI, VIP, WanFang, and CBM from the date of establishment to November 31, 2021. Quality assessment of diagnostic accuracy studies 2 was applied to evaluate the quality of the included literature. We used Stata 16.0 to calculate the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) and plot summary receiver operating characteristic curve, as well as to assess diagnostic accuracy using the area under the curve (AUC).

Results:
A total of 25 studies, including 1980 patients and 2345 controls, were included in this meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of HE4 were 0.58 (95% CI 0.52–0.63), 0.95 (95% CI 0.92–0.97), 11.57 (95% CI 6.88–19.48), 0.45 (95% CI 0.39–0.51), 25.92 (95% CI 14.84–45.26), and 0.80 (95% CI 0.76–0.83), respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of CA125 were 0.41 (95% CI 0.34–0.49), 0.91 (95% CI 0.85–0.95), 4.55 (95% CI 2.73–7.58), 0.65 (95% CI 0.57–0.74), 7.03 (95% CI 3.92–12.62), and 0.68 (95% CI 0.64–0.72), respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC of HE4 + CA125 were 0.67 (95% CI 0.60–0.73), 0.92 (95% CI 0.87–0.95), 8.59 (95% CI 5.32–13.86), 0.36 (95% CI 0.30–0.44), 23.80 (95% CI 13.86–40.86), and 0.85 (95% CI 0.82–0.88), respectively.

Conclusion:
This Meta-analysis found that HE4 alone or in combination with CA125 showed better diagnostic efficacy than CA125, regardless of clinical stage and pathological type. HE4 + CA125 had slightly higher diagnostic efficiency than HE4, but did not show significant advantages. While the studies were heterogeneous, the credibility of the findings needs to be further confirmed by more homogeneous, prospective, and large sample size studies.
Investigation of Beclin 1 and TNF-α expressions in preeclampsia placentas: Immunohistochemical study
Authors: Öcal Ece , Toprak Veysel , Akalin Senem Alkan , Aşir Firat , Deveci Engin 
Published: August 2023

Background:
Preeclampsia is a pregnancy complication Aim of this study was to investigate expression of Beclin1 and tumor necrosis factor (TNF)-α in normotensive and preeclamptic placentas of pregnant women patients.

Methods:
Twenty normotensive and 20 preeclamptic patients placentas were dissected for paraffin- wax processing. Placental samples were embedded in parafin blocks. Sections were stained with Hematoxylin-Eosin staining and TNF-α and Beclin1 immunostaining.

Results:
In control group, root and floating villi were normal in histological perspectives, syncytial node number was low, vessels were normal with connective tissue. No hemorrhage was observed in the intervillous area. In preeclampsia group, decidual cell degeneration and fibrinoid accumulation increased. Vascular dilatation and congestion with mononuclear cell infiltration were observed. Beclin1 reaction was generally negative in control group. In preeclampsia group, Beclin1 reaction was increased in decidual cells, syncytial nodes and bridges and in chorionic villi and in some Hoffbauer cells. In control group, TNF-α expression was mainly negative but only in some decidual cells. In preeclampsia, TNF-α reaction was observed in degenerated decidua cells, in leukocytes and in villi.

Conclusion:
In preeclampsia placentas, degenerated decidua cells and inflammation increased. It was thought that Beclin1 and TNF-α signals could be used as a marker in affecting the fetal structure of blood flow in preeclamptic placentas.
Practice Perspectives on Care Coordination in Rural Settings
Authors: Kapp Julie M. , Underwood Beau , Ressel Kristi , Quinn Kathleen 
Published: August 2023

Purpose:
Social needs and nonmedical health determinants are increasingly incorporated into care coordination models. However, little is known about the practice of operationalizing enhanced care coordination, particularly in rural settings. The objective of this study was to determine care coordination practices in rural settings that integrate social services with health care.

Primary Practice Settings:
Staff and administrators in rural Missouri health and health care settings were interviewed about their organization's implementation of enhanced care coordination practices.

Methodology and Sample:
This is a mixed-methods study; 16 key informant structured interviews were conducted across 14 organizations.

Results:
Organizations reported a median care coordination population of 800 (range: 50–21,500) across a median of 11 case managers (range: 3–375). The percentage of organizations reporting social determinants of health services included the following: 100% transportation, 86% mental health, 79% food, 71% housing, and 50% dental. Implementation of the essential indicators of care coordination quality ranged from 41.7% to 100%. We report organizations' innovative solutions to care coordination barriers.

Implications for Case Management Practice:
This study contributes to a very limited literature on the practice of rural care coordination by assessing the quality of care provided compared with a recommended standard. This study also contributes an in-depth reporting on the variety of service models being implemented. Finally, this study uniquely contributes innovative interprofessional examples of enhanced care coordination initiatives. These examples may provide inspiration for rural health care organizations. As the care coordination landscape evolves to include social determinants of health, there remain important fundamental barriers to ensuring quality of care.
Adult attachment in couples facing stage IV lung cancer: associations with patient quality-of-life outcomes and sense of life completion
Authors: Kroll Juliet L. , Jones Morgan , Chen Aileen B. , Yang Chunyi Claire , Carmack Cindy L. , Cohen Lorenzo , Milbury Kathrin 
Published: August 2023

Abstract

Background:
Adult attachment insecurity is associated with poor psychosocial and cancer-related symptom outcomes in patients with cancer; however, there is a paucity of research around the role of the spousal caregivers' attachment in patient quality of life (QOL) at the end of life (EOL). Attachment styles may be particularly relevant for couples coping with prolonged metastatic disease, where the threat of death or disease progression is highly salient.

Methods:
We conducted secondary analyses on a sample of patients with stage IV non–small cell lung cancer and their spouses. Participants separately completed questionnaires of attachment style (ECR-S), relationship closeness (PAIR), illness-related communication (holding back one's fear of death or disease progression), and cancer-related distress (IES). Patients additionally completed questionnaires on sense of life completion and QOL at EOL (QUAL-E Completion Subscale and Overall QOL Item) and symptom burden (MDASI-LC).

Results:
For patients, greater attachment avoidance was associated with lower sense of life completion (r = −0.31, P = .009) and lower overall QOL (r = −0.35, P = .003). Greater patient attachment anxiety was also associated with a lower sense of life completion (r = −0.26, P = .034). Greater caregiver attachment avoidance and attachment anxiety were associated with patient reports of lower overall QOL (r = −0.38, P = .001, r = −0.36, P = .002, respectively). In addition, greater caregiver attachment anxiety was associated with greater patient symptom burden (r = 0.24, P = .048) controlling for patient's own attachment anxiety. For both patients and caregivers, greater attachment anxiety was associated with more “holding back” from communicating their fear of death or disease progression with their spouse (r = 0.25, P = .036; r = 0.31, P = .011, respectively). Dyadic analyses revealed a positive association within the couple for attachment avoidance (r = 0.41, P < .01) and anxiety (r = 0.31, P < .01).

Conclusion:
Both spousal caregiver and patient attachment styles are highly relevant to illness communication patterns and patient QOL outcomes.
Evaluation of Newborn Direct Bilirubin As Screening for Cholestatic Liver Disease
Authors: Lerer Rikah , Barash Lily , Nafday Suhas , Kogan Liberman Debora , Ovchinsky Nadia 
Published: August 2023

Background:
Biliary atresia (BA) remains the most common indication for pediatric liver transplantation. Early diagnosis is essential for a favorable long-term prognosis for patients with BA. Preliminary data suggests that measurement of direct bilirubin (DB) in newborns may be an effective screening tool for neonatal cholestasis, particularly BA, allowing for early referral and diagnosis. The objective of our study was to establish a cutoff DB value to predict diagnosis of cholestatic liver disease (CLD) with high sensitivity and specificity, as well as, to evaluate whether newborns with elevated DB received appropriate follow-up in our health system.

Methods:
Baseline data were collected on infants born between 2016 and 2019 who had serum total bilirubin and DB drawn in the nursery, and who continued to follow in our health system. Sensitivity, specificity, and positive and negative predictive values were examined using cutoff values of 0.5, 0.6, and 0.7 mg/dL for identifying infants at risk for CLD. Patients’ charts were reviewed to note whether they had follow-up levels drawn by their pediatrician or by the hepatology team within 2 months of age and whether they were diagnosed with CLD.

Results:
Serum total bilirubin and DB levels were drawn from 11 965 infants during their hospitalizations. Three infants from this cohort were diagnosed with CLD: 2 with BA and 1 with Alagille syndrome. DB cutoff values of 0.5, 0.6, and 0.7 mg/dL had sensitivity of 100% and specificity of 96.83% (95% confidence interval [CI], 96.69%-97.53%), 99.08% (95% CI, 98.81%-99.30%), and 99.63% (95% CI, 99.4%-99.7%), respectively. Given that a DB of 0.6 mg/dL had a sensitivity of 100% and specificity of 99%, this value was chosen as the cutoff value to monitor for DB follow-up and diagnosis of CLD. Out of 60 infants who met criteria for DB ≥0.6 mg/dL, only 15 (25%) had a repeat level drawn after nursery discharge; 3 (5%) were eventually diagnosed with CLD.

Conclusions:
A DB cutoff value of 0.6 mg/dL yielded high sensitivity and specificity for identifying patients with CLD. All 3 patients diagnosed with CLD had elevated DB at hospital discharge. The data revealed that the majority (75%) of eligible newborns did not receive follow-up for their elevated DB in the outpatient setting.
Association of sleep quality with fatigue in post Covid-19 patients in an Indian population
Authors: Ghosh Srutarshi , Kumar Anjani , Pandey Sanjay Kumar , Kumar Sanyal 
Published: August 2023

AbstractObjectivesTo assess the quality of sleep in recently recovered Covid-19 and long Covid cases, also to determine its associations with fatigue and pain.MethodsPost-Covid cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, Fatigue Severity Scale (FSS) for fatigue, and Numeric Pain Rating Scale (NPRS) for pain in this observational study.ResultsGlobal PSQI score was higher (p = <0.001) among cases (5.7 ± 5.1, 95%CI 5.0, 6.4) than controls (2.1 ± 2.0, 95%CI 1.8, 2.4). Normal sleep latency was observed in 56(27.9%) patients and 164(79.6%) controls (p < 0.001). FSS score higher (p = <0.001) among cases (16.8 ± 10.2, 95%CI 15.4, 18.2) against controls (10.9 ± 4.1, 95%CI10.3, 11.4). The FSS scores in mild, moderate, and severe Covid were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (p < 0.001), and higher in the elderly (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (p ≤ 0.001) cases. The global PSQI score was positively correlated with the FSS (r = 0.755, p < 0.001) and NPRS scores (r = 0.657, p < 0.001). NPRS score correlated with the FSS score (r = 0.710, p < 0.001). FSS and global PSQI scores were higher in the Long Covid group (p < 0.001).ConclusionSignificantly poor sleep quality was observed in post-Covid-19 individuals including Long Covid being positively associated with fatigue and pain.
Association between trauma center type and mortality for injured children with severe traumatic brain injury
Authors: Malhotra Armaan K. , Patel Bhavin , Hoeft Christopher J. , Shakil Husain , Smith Christopher W. , Jaffe Rachael , Kulkarni Abhaya V. , Wilson Jefferson R. , Witiw Christopher D. , Nathens Avery B. 
Published: August 2023

BACKGROUND
There is conflicting evidence regarding the relationship between trauma center type and mortality for children with traumatic brain injuries. Identification of mortality differences following brain injury across differing trauma center types may result in actionable quality improvement initiatives to standardize care for these children.

METHODS
We used Trauma Quality Improvement Program data from 2017 to 2020 to identify children with severe traumatic brain injury (TBI) managed at levels I and II state or American College of Surgeon–verified trauma centers. We used a random intercept multilevel logistic regression model to assess the relationship between exposure (trauma center type either adult, pediatric, or mixed) and outcome (in-hospital mortality). Several secondary analyses were performed to assess the influence of trauma center volume, age strata, and TBI heterogeneity.

RESULTS
There were 10,105 patients identified across 512 trauma centers. Crude mortality was 25.2%, 36.2%, and 28.9% for pediatric, adult, and mixed trauma centers, respectively. After adjustment for confounders, odds of mortality were higher for children managed at adult trauma centers (odds ratio, 1.67; 95% confidence interval, 1.30–2.13) compared with pediatric trauma centers. There were several patient demographic and injury factors associated with greater odds of death; these included male sex, self-pay insurance status, interfacility transfer, non-fall related inury, age-adjusted hypotension, lack of pupil reactivity and midline shift >5 mm. Adjustment for trauma volume and subgroup analysis using a homogenous TBI subgroup did not change the demonstrated associations.

CONCLUSION
Our results suggest that mortality was higher at adult trauma centers compared with mixed and pediatric trauma centers for children with traumatic brain injuries. Importantly, there exists the potential for unmeasured confounding. We aim for these findings to direct continuing quality improvement initiatives to improve outcomes for brain injured children.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
The impact of extreme temperatures on birth outcomes in the Netherlands: a nationwide population-based study
Authors: Burgos Ochoa Lizbeth , Garcia-Gomez Pilar , Steegers Eric AP , Van Ourti Tom , Bertens Loes CM , Been Jasper V 
Published: August 2023

ABSTRACTBackgroundClimate projections predict an increased frequency and intensity of extreme weather events, such as extreme temperatures, prompting concerns about their impact on early-life health and health disparities. This study aimed to investigate the causal impact of in-utero exposure to extreme temperatures on birth outcomes and effect heterogeneity across levels of socioeconomic status (SES).MethodsWe obtained data on singleton births that occurred between 2003 and 2017 from the Dutch perinatal registry (N=2 472 352). Exposure was calculated as the number of days during the gestational period in which the mean temperature fell into each of mutually exclusive bins, with the 8–12 °C bin used as reference. To identify a causal effect, we exploited the unpredictability of daily temperature fluctuations while accounting for seasonal and underlying trends. Effect heterogeneity was assessed across levels of household income, neighbourhood SES, and maternal education.ResultsIn-utero exposure to an additional hot day (mean temperature > 20 °C), relative to the reference range, led to increased odds of low birth weight (LBW) (OR[95%CI]= 1.007 [1.005, 1.009]), small for gestational age (SGA) (OR[95%CI]= 1.004 [1.003, 1.005]), and preterm birth (PTB) (OR[95%CI]= 1.006 [1.005, 1.007]). Exposure during the second trimester to an additional cold day (< -4 °C) led to increased odds of LBW and PTB. The observed effects were the most detrimental for births in low-SES households.ConclusionsIn-utero exposure to extreme temperature has a detrimental impact on birth outcomes in the Netherlands. Projected increases in extreme temperatures may further exacerbate health disparities in early life.