bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal Outcomes After Use of Buprenorphine during Pregnancy
Authors: Krans E.E. 
Published: May 2023

(N Engl J Med. 2022;387:2085–2086)
Opioid use during pregnancy continues to rise and result in adverse maternal and neonatal outcomes. Buprenorphine and methadone are medications used for opioid use disorder (OUD) treatment to help prevent risks such as overdose and preterm birth. While methadone was used for decades to treat perinatal OUD, it suffers from several issues. The primary issue is that it can only be given by federally licensed drug and alcohol treatment programs, which can be a barrier for many women requiring treatment. Another issue is that it is a long-acting drug.
Fetal Reduction From Twin to Singleton Gestation: A Meta-analysis
Authors: Bardin R. , Gupta M. , Greenberg G. , Nandrajog A. , Hadar E. 
Published: May 2023

(Int J Gynaecol Obstet. 2022;158:260–269)
Twin pregnancies have 2 to 3.5 times increased risk of maternal hypertensive and hyperglycemic complications and 2 to 3 times increased risk of perinatal and infant mortality. Approximately 50% of twin pregnancies result in preterm birth <37 weeks gestation, and early preterm birth at <34 weeks gestation occurs in 14%. The outcomes of multifetal reduction in triplets and quadruplets have been studied, but maternal, perinatal, and neonatal results for twins have been inconsistent. This meta-analysis helps to clarify issues around fetal reduction compared with ongoing twin pregnancies.
Liquefied Petroleum Gas or Biomass for Cooking and Effects on Birth Weight
Authors: Clasen T.F. , Chang H.H. , Thompson L.M. , Kirby M.A. , Balakrishnan K. , Rosenthal J.P. , Checkley W. , Peel J.L. ,   HAPIN Investigators
Published: May 2023

(N Engl J Med. 2022;387:1735–1746)
Over the past few decades, 3 billion people continue to use open fires and traditional stoves to cook with using solid biomass fuels (biomass) like charcoal and wood. The resulting air pollution within the home is a concerning health risk for low- to middle-income populations and leads to millions of premature deaths and adverse health outcomes, including lower birth weight neonates. Liquefied petroleum gas (LPG) cookstoves have been shown to decrease air pollution and associated health risks. This study aimed to determine whether replacing biomass cookstoves with LPG cookstoves impacts birth weight.
Parenteral Protein in Extremely Preterm Infants: More Is Not Better
Authors: Martin C.R. 
Published: May 2023

(N Engl J Med. 2022;387:1712–1713)
Adequate nutrient absorption in utero is critical for neonatal health and development. Premature delivery of a baby disrupts the accumulation of vital nutrients, so sufficient nutrient replacement is required to help prevent nutrient deficits and adverse health outcomes. The standard of preterm infant nutritional management is to closely replicate a healthy fetus’s nutrient intake and growth rates. This approach, however, does not take into consideration factors and illnesses preterm infants face in the neonatal intensive care unit such as lung injury, immature metabolism, and hypothermia that may require necessary pivots in treatment. Additional studies are required to determine the best nutrition management of preterm infants that may be different than healthy fetuses to ensure optimal outcomes.
Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-blind Randomized Controlled Trial
Authors: Lee A. , Shatil B. , Landau R. , Menon P. , Smiley R. 
Published: May 2023

(Anesth Analg. 2022;134:634–632)
Cervical cerclage, an operation designed to reduce preterm delivery and improve perinatal outcomes, is often performed under spinal anesthesia. While the benefits of spinal anesthesia are well documented, a short-acting local anesthetic agent, such as 2-chloroprocaine, could shorten postanesthesia care unit (PACU) stay compared with longer acting agents. Currently, bupivacaine is the most used local anesthesia for cerclage because of historical concern regarding 2-chloroprocaine’s safety. This study randomly compared the outcome of 2-chloroprocaine 3% 50 mg and hyperbaric bupivacaine 0.75% 9 mg on dermatomal level, sensory block resolution, ability to ambulate and void, and motor blockade.
Obstetric Comorbidity Index and the Odds of General Versus Neuraxial Anesthesia in Women Undergoing Cesarean Delivery: A Retrospective Cohort Study
Authors: Singh S. , Farber M.K. , Bateman B.T. , Lumbreras-Marquez M.I. , Richey C.J. , Easter S.R. , Fields K.G. , Tsen L.C. 
Published: May 2023

(Int J Obstet Anesth. 2022;51:103546)
General anesthesia (GA) is often related to significant anesthetic exposure, tracheal intubation, risk for pulmonary aspiration, surgical site infection, and severe postpartum depression. As cesarean deliveries (CD) are common in the United States and around the world, many countries view GA during CD as an indicator that improvements could be made. In an effort to persuade more people towards neuraxial anesthesia instead of GA, this study researched the relationship between obstetric comorbidity index (OCI) risk-assessment data, a tool used by the several countries to assess the risk of surgeries and prepare for said risk, and GA, specifically in a nonemergency setting.
Opioids for Cesarean Delivery Under General Anesthesia and Neonatal Outcome: A Historical Cohort Study
Authors: Caissie N. , Héroux J. , Lefebvre M. , Lamarche D. , Dubois M-C. , Rivard G. , D’Aragon F. 
Published: May 2023

(Can J Anesth/J Can Anesth. 2022;69:1017–1024))
While general anesthesia (GA) is not the preferred technique for cesarean delivery (CD), due to the risk of gastric aspiration, it is sometimes used for emergent delivery or in the setting of contraindications to neuraxial anesthesia. Opioids are often used in nonobstetric populations during anesthesia to attenuate the hemodynamic response to laryngoscopy. In pregnant patients with hypertensive disorders of pregnancy, opioids are used to avoid exaggerated sympathetic responses to intubation. However, beta-blockers, vasodilators, or magnesium are considered just as effective in stabilizing blood pressure as opioids in this population. Since opioids are associated with an increased risk of neonatal respiratory depression, their use in GA for cesarean is not common. This study aimed to describe the current use of opioids during GA for CD, find potential predictors of opioid use in pregnant patients, and investigate the association between opioid use and neonatal outcomes.
A Multimodal Approach to Reducing Post-Cesarean Opioid Use: A Quality Improvement Initiative
Authors: Llarena N.C. , Krivanek K. , Yao M. , Kim D.D. , Devarajan J. , Ayad S. , Chiang E. 
Published: May 2023

(BJOG: Int J Obstet Gynaecol. 2022;129:1583–1590)
Opioid administration following cesarean delivery is common in the United States, but the number of opioids prescribed is often higher than needed to control pain. Opioid overdose deaths among reproductive-age women have increased since 1999. Opioids also are associated with adverse effects and outcomes for mothers and neonates. A multi-modal approach using acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) is recommended by American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists. These methods have been shown to reduce opioid use and adequately manage pain but have not been widely adopted by clinicians. This study evaluated a four-part quality improvement initiative, including nursing education, designed to reduce inpatient and outpatient opioid use and prescribing patterns.
Healing Exposed Calvarial Hardware Using Negative-Pressure Wound Therapy and Vashe Wound Solution: Case Report
Authors: Ockerman Kyle M. , Cox Elizabeth A. , Wiesemann Gayle , Nichols D. Spencer , Murad Gregory J. A. , Ching Jessica , Sorice-Virk Sarah 
Published: May 2023

ABSTRACT

OBJECTIVE
The management of cranioplasty infections has historically been explantation followed by delayed reimplantation/reconstruction. This treatment algorithm necessitates surgery, tissue expansion, and prolonged disfigurement. In this report, the authors describe a treatment approach consisting of serial vacuum-assisted closure (VAC) with hypochlorous acid (HOCl) solution (Vashe Wound Solution; URGO Medical) as a salvage strategy.

METHODS
A 35-year-old man who sustained head trauma, neurosurgical complications, and severe syndrome of the trephined (SOT; devastating neurologic decline treated by cranioplasty) underwent titanium cranioplasty with free flap. Three weeks postoperation, he presented with pressure-related wound dehiscence/partial flap necrosis, exposed hardware, and bacterial infection. Given the severity of his precranioplasty SOT, hardware salvage was critical. He was treated with serial VAC with HOCl solution for 11 days followed by VAC for 18 days and definitive split-thickness skin graft placement over resulting granulation tissue. Authors also conducted a literature review of cranial reconstruction infection management.

RESULTS
The patient remained healed 7 months postoperatively without recurrent infection. Importantly, his original hardware was retained, and his SOT remained resolved. Findings from the literature review support the use of conservative modalities to salvage cranial reconstructions without hardware removal.

CONCLUSIONS
This study investigates a new strategy for managing cranioplasty infections. The VAC with HOCl solution regimen was effective in treating the infection and salvaging the cranioplasty, thus obviating the complications associated with explantation, new cranioplasty, and recurrence of SOT. There is limited literature on the management of cranioplasty infections using conservative treatments. A larger study to better determine the efficacy of VAC with HOCl solution is underway.
Toe Web Infections, the Microbiome, and Toe Web Psoriasis: A Review
Authors: Reynolds F. Hall , Tusa Mark G. , Banks Samuel L. 
Published: May 2023

ABSTRACT

OBJECTIVE
To present the toe web space as an anatomically, physiologically, and pathologically unique part of the human body; characterize toe web infections and discuss why they occur; and highlight toe web psoriasis as an uncommon condition that providers should consider if toe web intertrigo does not respond to treatment.

DATA SOURCE
This review encompassed many years of clinical observation and photographs; medical textbooks; and a literature search of MEDLINE, PubMed, and Google Scholar.

STUDY SELECTION
Primary research keywords included intertrigo, toe web intertrigo, toe web infection, tinea pedis, microbiome, skin microbiome, toe web microbiome, ecology, psoriasis, psoriasis microbiome, intertriginous psoriasis, and Wood’s lamp. More than 190 journal articles met the search criteria.

DATA EXTRACTION
The authors sought data relating to what makes for a healthy toe web space and what makes for disease. They extracted and collated relevant information to compare and contrast among sources.

DATA SYNTHESIS
After understanding the normal toe web space and the microorganisms that normally reside there, the authors investigated why infections occur, how they should be treated, what complications may result, and what other diseases occur in the toe web area.

CONCLUSIONS
This review of toe web infection illustrates the effect of the microbiome and reports a rare form of psoriasis that is usually misdiagnosed as athlete’s foot. The toe web space is a unique part of the human body that can be affected by a variety of both common and unusual conditions.
Educational needs of self-care in cachectic cancer patients and caregivers
Authors: Hopkinson Jane B. 
Published: May 2023

Purpose of review
To give an overview of what is known about the educational component of supportive care for people with cancer cachexia and their family caregivers.

Recent findings
The educational needs for self-care by people with cancer cachexia are largely unmet. There is potential for education to enable self-care that mitigates cachexia-related distress with benefit to quality of life and mitigates malnutrition/malnutrition risk with implications for treatment tolerance and outcomes. Theoretically informed approaches to cancer cachexia education for patients and their family members are needed if optimal methods for support of self-care are to be identified. The cancer workforce also needs education to have the confidence and knowledge to play a role in the cancer cachexia education of their patients.

Summary
To address the educational needs of self-care in cachectic cancer patients and their caregivers, there is much work to do. Healthcare professionals need to know the best educational process and methods for cachexia for supporting quality of life and to facilitate improving cancer treatment outcomes including survival.
How to become a Multinational Association of Supportive Care in Cancer-designated center of excellence in supportive care in cancer
Authors: Antonuzzo Andrea , Lucchesi Maurizio , Ripamonti Carla Ida 
Published: May 2023

Purpose of review
Aim of this review is to encourage and involve more doctors to take care of supportive care in cancer patients and to become centers of excellence.

Recent findings
In 2019, MASCC initiated a certification program to recognize oncology centers that demonstrate best practices in supportive cancer care but literature on how to become MASCC-designated center of Excellence in Supportive Care in Cancer is scarce and will be bulleted.

Summary
Becoming centers of excellence means not only the recognition of the clinical and managerial requirements to provide good supportive care but also the creation of a network of centers to participate in multicenter scientific projects and thus improve knowledge in the field of supportive care in cancer patients.
Neoadjuvant and adjuvant approaches in gastroesophageal cancers
Authors: Scheck Magdalena K. , Masetti Michael , Lorenzen Sylvie 
Published: May 2023

Purpose of review
Despite advances in the perioperative treatment of locally advanced (T2-4 and/or N+) gastroesophageal cancer with evolving chemoradiotherapy and chemotherapy regimens, prognosis remains poor. Biomarker-based approaches with targeted therapies and immune checkpoint inhibition present a new opportunity to improve response rate and overall survival. This review aims to shed light on the current treatment strategies and therapy options that are under investigation for the curatively intended perioperative treatment of gastroesophageal cancer.

Recent findings
A major step for patients with advanced esophageal cancer and insufficient response to chemoradiotherapy was the implementation of immune checkpoint inhibition in the adjuvant treatment with positive effects on survival duration and quality of life (CheckMate577). Various studies that seek to further integrate immunotherapy or targeted therapy into (neo-) adjuvant treatment are on their way and show promising results.

Summary
Ongoing clinical research tries to increase the effectivity of standard of care approaches for the perioperative treatment of gastroesophageal cancer. Biomarker based immunotherapy and targeted therapy bear the opportunity to further improve the outcome.
Following your gut: the emerging role of the gut microbiota in predicting and treating immune-related adverse events
Authors: Desilets Antoine , Elkrief Arielle 
Published: May 2023

Purpose of review
Although immune checkpoint inhibition has reshaped the therapeutic landscape leading to improved outcomes across an array of both solid and hematologic malignancies, a significant source of morbidity is caused by immune-related adverse events (irAEs) caused by these agents.

Recent findings
The gut microbiota has emerged as a biomarker of response to these agents, and more recently, also as a key determinant of development of irAEs. Emerging data have revealed that enrichment of certain bacterial genera is associated with an increased risk of irAEs, with the most robust evidence pointing to an intimate connection with the development of immune-related diarrhea and colitis. These bacteria include Bacteroides, Enterobacteriaceae, and Proteobacteria (such as Klebsiella and Proteus). Lachnospiraceae spp. and Streptococcus spp. have been implicated irAE-wide in the context of ipilimumab.

Summary
We review recent lines of evidence pointing to the role of baseline gut microbiota on the development of irAE, and the potentials for therapeutic manipulation of the gut microbiota in order to reduce irAE severity. The connections between gut microbiome signatures of response and toxicity will need to be untangled in further studies.
Treatment of radiation-associated angiosarcoma
Authors: Dufresne Armelle , Meeus Pierre , Sunyach Marie-Pierre 
Published: May 2023

Purpose of review
Radiation-associated angiosarcoma is a cutaneous aggressive tumor that is very rare and it represents a specific entity poorly studied in literature. It requires new therapeutic opportunity.

Recent findings
The complete surgical resection with negative margins is the mainstay treatment of localized treatment, even though it is difficult to reach in case of diffuse cutaneous infiltration. Adjuvant re-irradiation may improve local control with no benefit demonstrated on survival. Many systemic treatments can be efficient not only in metastatic setting but also in neoadjuvant setting in case of diffuse presentation. These treatments have never been compared to each other; the most efficient regimen remains to be determined, and a high heterogeneity of treatment is observed, even between sarcoma reference centers.

Summary
Immune therapy represents the most promising treatment under development. At the time of building clinical trial to assess the efficacy of immune therapy, the lack of randomized studies prevents the identification of a strong and consensual reference arm treatment. Given the rarity of the disease, only international collaborative clinical trials may have a chance to include enough patients to draw any conclusion and so will have to counteract the heterogeneity of management.
Doxorubicin combined with Trabectedin in systemic first-line M+/recurrent leiomyosarcoma patients
Authors: Turinetto Margherita , Meeus Pierre , Ray-Coquard Isabelle 
Published: May 2023

Purpose of review
Currently, the only systemic therapy approved for advanced leiomyosarcoma is Doxorubicin-based monotherapy. Despite disappointing progression-free survival (PFS) and overall survival (OS), no combination therapy has formally ever proven to be more effective. In this clinical setting, selecting the most efficient therapy is key, as most patients become quickly symptomatic with poor performance status.
This review aims to describe the current emerging role of Doxorubicin and Trabectedin in first-line setting, compared with doxorubicin alone the current standard of treatment.

Recent findings
Previous randomized trials focusing on combination therapies (Doxorubicin + ifosfamide, doxorubicin + evofosfamide, doxorubicin + Olaratumab, or Gemcitabine + Docetaxel) never reported positive results on the primary endpoint (OS or PFS). For the first time, the randomized phase III LMS-04 demonstrated that Doxorubicin and Trabectedin have a better PFS and disease control rate (DCR) compared with Doxorubicin, with higher but still manageable toxicities.

Summary
In the first-line setting, the results of this trial were pivotal for numerous reasons; Doxorubicin-Trabectedin is the first combination that has been proven to be more effective in terms of PFS, ORR and trend of OS compared with doxorubicin alone; moreover, it is clear that trials regarding soft tissue sarcoma should strive to be histology-driven.
A Practical Review of the Management of Xanthelasma palpebrarum
Authors: Malekzadeh Hamid , Ormseth Benjamin , Janis Jeffrey E. 
Published: May 2023

Background:

Xanthelasma palpebrarum is the most common type of xanthomatous lesion. Various methods for treating Xanthelasma palpebrarum have been reported. We conducted a systematic review to evaluate the efficacy and associated complications of different treatment methods, and we summarized these findings as a practical review designed to be clinically useful, accessible, and impactful.

Methods:
The PubMed and Embase databases were searched to identify clinical studies that reported on outcomes and complications of different methods of Xanthelasma treatment. The electronic databases were searched from January 1990 to October 2022. Data on study characteristics, lesion clearance, complications, and recurrences were collected.

Results:
Forty-nine articles (including 1329 patients) were reviewed. The studies reported on surgical excision, laser modalities, electrosurgical techniques, chemical peeling, cryotherapy, and intralesional injection. The majority of studies were retrospective (69%) and single-arm (84%). Surgical excision combined with blepharoplasty and skin grafts showed excellent outcomes for large Xanthelasma. CO2 and erbium yttrium aluminum garnet (Er:YAG) were the most commonly studied lasers and showed more than 75% improvement in over 90% and 80% of patients, respectively. Comparative studies reported better efficacy for CO2 laser than both Er:YAG laser and 30%–50% trichloroacetic acid. Dyspigmentation was the most encountered complication.

Conclusions:
Different methods for the treatment of Xanthelasma palpebrarum have been reported in the literature, with moderate to excellent efficacy and safety profiles depending on the size and location of the lesion. Surgery is more appropriate for larger and deeper lesions, whereas laser and electrosurgical techniques can be used in smaller and more superficial contexts. Only a limited number of comparative studies have been conducted, and novel clinical trials are necessary to further augment appropriate treatment selection.
When All Else Fails: Transformational Strategies to Put Not-for-Profit Healthcare on a Sustainable Path
Authors: Majka Dan , Samaris Dawn 
Published: May 2023

SUMMARY
Changes in underlying cost structure, intensifying competition for nonacute healthcare services, heightened costs of capital, and lower investment returns have put many health systems on an unsustainable path forward. Traditional performance improvement efforts remain important but cannot fully remedy the underlying causes that have disrupted operational and financial performance. Health systems must consider a fundamental transformation of their business model. Transformation requires a disciplined assessment of the health system's current portfolio of businesses, services, and markets. The goal of transformative change is to concentrate efforts and resources on ways that can sustain the organization's long-term relevance while supporting its mission. Decisions resulting from this assessment will define new opportunities to optimize lines of business, identify partnerships to fulfill mission, and free up resources for areas where the organization can truly excel.
UChicago Medicine Grows Through Partnership Synergies
Authors: Jackiewicz Thomas E. 
Published: May 2023

SUMMARY
University of Chicago Health System—UChicago Medicine—recently joined forces with AdventHealth's Great Lakes Region to expand access to services, treatment options, and clinical trials to residents in Chicago's western suburbs. Other organizations may want to follow that approach in developing and maintaining a high-quality and integrated healthcare ecosystem—one that not only increases access to care for underserved populations but also responds to changing consumer preferences and behavior. Building partnerships with other systems that possess similar values and complementary strengths is an effective way to provide patients with convenient, high-quality care closer to home. Early results of the joint venture show promising synergies and benefits.