bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantified versus willful handgrip exercises for the prevention of PICC-related thrombosis: A meta-analysis and systematic review
Authors: Luo Hongliang , Jin Cheng , Li Xiaohong , Jiang Yinzhu , Zhou Jing 
Published: March 2023

Background:
Thrombosis is a common yet serious complication in patients with peripherally inserted central venous catheter (PICC), the prevention of thrombosis is very important to the prognosis of PICC patients. We aimed to evaluate the effects of quantified versus willful grip exercises for the prevention of PICC-related thrombosis, to provide evidence to the clinical nursing care of PICC patients.

Methods:
Two authors searched PubMed et al databases for randomized controlled trials (RCTs) comparing the effects of quantified versus willful grip exercises in PICC patients up to August 31, 2022. Quality assessment and data extraction were independently performed by 2 researchers, and meta-analysis was performed using RevMan 5.3 software.

Results:
15 RCTs involving 1741 PICC patients were finally included in this meta-analysis. Synthesized outcomes indicated that compared with willful grip exercises, quantified grip exercises reduced the incidence of PICC-related thrombosis (odds ratio = 0.19, 95% confidence interval [CI]: 0.12–0.31) and infection (odds ratio = 0.30, 95% CI: 0.15–0.60) in PICC patients, increased the maximum venous velocity (mean difference = 3.02, 95% CI: 1.87–4.17) and mean blood flow (mean difference = 3.10, 95%CI: 1.57–4.62) in PICC patients (all P < .05). There were no publication biases amongst the synthesized outcomes (all P > .05).

Conclusion:
Quantified grip exercises can effectively reduce the occurrence of PICC-related thrombosis and infection, improve the venous hemodynamics. Limited by study population and regions, large-sample, and high-quality RCTs are still needed in the future to further evaluate the effects and safety of quantified grip exercises in PICC patients.
CPR quality with rotation of every 1 versus 2 minutes as characteristics of rescuers: A randomized crossover simulation study
Authors: Kim Dong Hun , Seo Young Woo , Jang Tae Chang 
Published: March 2023

Background:
Fatigue and rotation time are key factors affecting the quality of cardiopulmonary resuscitation (CPR). This study aimed to investigate the effects of rotation time on CPR duration, and sex on chest compression quality.

Methods:
In this randomized crossover simulation study, we enrolled 100 paramedic students stratified by sex and randomly grouped into 28 male and 22 female pairs. In the 2- and 1-minute scenarios, 2 participants performed CPR for 20 minutes with a rotation cycle of 2 minutes and 1 minute, respectively. After taking a break, they changed over and performed CPR again for 20 minutes. The switching of roles was performed with the students positioned on opposite sides of the mannequin. For chest compression quality, a set was defined as CPR performed by 1 pair in a 2-minute scenario for 4 minutes. The quality of CPR in each set was compared between the 2 groups.

Results:
The 1-minute group showed significantly higher chest compression depth than the 2-minute group (54.0 [51.5–57.0] vs 52.5 [48.5–56.5] mm, P = .001, respectively). The female 2-minute group showed decreased chest compression depth over time, and the 1-minute group showed significantly increased chest compression depth during all sets except the 2nd set (54.0 [51.9–55.1] vs 50.5 [48.5–53.8] mm [P = .030], 52.3 [49.4–54.5] vs 50.8 [47.0–53.1] mm [P = .080], 52.8 [49.8–54.5] vs 48.8 [45.4–51.6] mm [P = .002], 51.5 [48.5–53.3] vs 48.3 [44.5–50.6] mm [P = .004], and 50.8 [48.9–54.1] vs 47.5 [44.6–50.1] mm [P = .001], respectively). The fatigue scores in the 2-minute group were significantly higher during sets 4 and 5 than those in the 1-minute group.

Conclusion:
When rescuer fatigue increases during prolonged CPR owing to their physical strength and skill levels, the rotation of rescuers every minute would be helpful in maintaining high-quality CPR.
Efficacy of intradiscal injection of platelet-rich plasma in the treatment of discogenic low back pain: A single-arm meta-analysis
Authors: Peng Bing , Xu Baoshan , Wu Weiyong , Du Lilong , Zhang Tongxing , Zhang Jianqiang 
Published: March 2023

Background:
Discogenic low back pain (DLBP) has been influencing people’s quality of life. Research on platelet-rich plasma (PRP) for DLBP has increased in recent years, but systematic summaries are lacking. This study analyzes all published studies related to the use of intradiscal injection of PRP for the treatment of DLBP and summarizes evidence-based medicine for the efficacy of this biologic treatment for DLBP.

Methods:
Articles published from the inception of the database to April 2022 were retrieved from PubMed, the Cochrane Library, Embase, ClinicalTrial, the Chinese National Knowledge Infrastructure, Wanfang, Chongqing VIP Chinese Scientific Journals, and the Chinese Biomedicine databases. After the rigorous screening of all studies on PRP for DLBP, a meta-analysis was performed.

Results:
Six studies, including 3 randomized controlled trials and 3 prospective single-arm trials, were included. According to this meta-analysis, pain scores decreased by >30% and >50% from baseline, with incidence rates of 57.3%, 50.7%, and 65.6%, and 51.0%, 53.1%, and 51.9%, respectively, after 1, 2, and 6 months of treatment. The Oswestry Disability Index scores decreased by >30% with an incidence rate of 40.2% and by >50% with an incidence rate of 53.9% from baseline after 2 and 6 months, respectively. Pain scores decreased significantly after 1, 2, and 6 months of treatment (standardized mean difference: 1 month, −1.04, P = .02; 2 months, −1.33, P = .003; and 6 months, −1.42, P = .0008). There was no significant change (P > .05) in the pain scores and the incidence rate when pain scores decreased by >30% and >50% from baseline between 1 and 2 months, 1 and 6 months, and 2 and 6 months after treatment. No significant adverse reactions occurred in any of the 6 included studies.

Conclusion:
Intradiscal injection of PRP is effective and safe in the treatment of DLBP, and there was no significant change in the patient’s pain 1, 2, and 6 months after PRP treatment. However, confirmation is required by additional high-quality studies due to the limitations of the quantity and quality of the included studies.
Magnetic resonance imaging in screening women at high risk of breast cancer: A meta-analysis
Authors: Ding Wu , Fan Zaiwei , Xu Yuehuai , Wei Chunshou , Li Zhian , Lin Yingli , Zhu Jianming , Ruan Guodong 
Published: March 2023

Background:
Magnetic resonance imaging (MRI) is more accurate than mammography in screening for breast cancer. Exposure to ionizing radiation from repeated diagnostic X-rays may be a cause of breast cancer.

Methods:
We conducted systematic searches on PubMed, Cochrane and Embase to identify studies on women who underwent mammography or MRI screening. A meta-analysis was performed to compare the detection rate of breast cancer by mammography, MRI or both.

Results:
A total of 18 diagnostic publications were identified and included in the meta-analysis. Among the 1000 screened women, MRI alone increased the detection rate of breast cancer by 8 compared with mammography alone (RR 0.48, 95% CI 0.42–0.54), and MRI plus mammography increased the detection rate of breast cancer by 1 compared with MRI alone (RR 0.86, 95% CI 0.78–0.96). Subgroup analysis demonstrated that the diagnostic efficacy of MRI plus mammography in breast was obviously better than that of MRI alone or mammography alone.

Conclusions:
Screening with MRI alone might be the best choice for women at high risk of breast cancer.
Biomarkers in gastroenteropancreatic neuroendocrine neoplasms
Authors: Jacoba Isa Mulingbayan , Weber H. Christian 
Published: March 2023

Purpose of review
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) represent a heterogenous group of rare tumors emanating from neuroendocrine cells that are clinically silent for prolonged periods of time without detection. Traditional biomarkers lack sufficiently high enough specificity and sensitivity for these tumors and their secreted products. New molecules are sought to improve accuracy of detection and monitoring of GEP-NENs. The purpose of this review is to highlight recent advances in the discovery of novel biomarkers and their potential characteristics and utility as markers of GEP-NENs.

Recent findings
Several recent GEP-NEN investigations regarding NETest demonstrate superior sensitivity and specificity in diagnosis and disease monitoring as compared with chromogranin A. Among several tissue-based emergent candidate molecules as biomarkers for GEP-NEN INSM1 has demonstrated consistently excellent characteristics when compared with traditional markers including chromogranin A, synaptophysin, and CD56.

Summary
For the diagnosis and clinical monitoring of NEN, there still exists a considerable need for better biomarkers. Novel technology has resulted in a promising liquid biopsy for the detection and monitoring of GEP-NENs. The search for improved tissue biomarkers has resulted in identification of one potential candidate whereas several others remain in the investigatory phase.
Effects of point spread function correction and time-of-flight on visual contrast level and pixel values in brain PET images
Authors: Kamikawa Yohei , Yoshida Yukito , Kawahara Yasuhiro 
Published: March 2023

Objectives
Point spread function (PSF) correction and time-of-flight (TOF) can improve the quality of PET images. None have directly assessed the visual effects of these methods in brain PET images and evaluated the image quality from these methods based on the relationship between the number of updates and noise level. The present study aimed to clarify the effects of PSF and TOF on the visual contrast level and pixel values of brain PET images using an experimental phantom.

Materials and methods
The visual contrast level was evaluated based on the sum of edge strengths. In addition, the effects of PSF, TOF, and a combination of them on pixel values were evaluated after anatomical standardization of brain images, in which the whole brain was divided into 18 segments. These were evaluated using images reconstructed with the number of updates set to achieve the same noise level.

Results
Combined application of the point spread function and TOF resulted in the greatest increase in the sum of edge strengths (32%), followed by PSF (21%) and TOF (6%). The maximum increase in pixel values occurred in the thalamic area (17%).

Conclusion
Although PSF and TOF can increase the visual contrast level by increasing the sum of edge strengths, they may affect the results of software-based analysis using pixel values. Nonetheless, using these methods may improve the ability to visualize areas of hypoaccumulation, such as epileptic foci.
Next Steps: Survivor Healthcare Passport — A Novel Form of Survivorship Care Plan in the Pediatric Population
Authors: Valencia M. Clarise , Hang Lindsay , Schmidt Deb , Nichols Julie , Zhang Jian , Yan Ke , Gonzalez Alyssa , Schwartz Cindy L. , Phelan Rachel 
Published: March 2023

Purpose:
Survivorship care plans (SCPs) have been instrumental in aiding transition from cancer treatment to survivorship care, which contains the diagnosis, treatment, potential late effects, and recommended follow-up. There has been paucity of research on its efficacy and lack of guidelines on development and delivery of SCPs. The Next Steps Survivorship Clinic at Children’s Wisconsin uses a Survivorship Healthcare Passport (SHP), a SCP pocket-sized card. This study aims to improve understanding of patient and parent use of the SHP at a single institution.

Materials and Methods:
An electronic survey was distributed to cancer survivors (14 to 28 y old) and parents/guardians who received the SCP. Data was analyzed with descriptive and correlation statistics.

Results:
Older survivors were reliable in carrying their SHP, and endorsed greater confidence in understanding its contents leading to a notion of improved ability to coordinate care. Younger survivors tend to rely on their parents. A preference for a smartphone application as another platform was noted.

Conclusions:
This form of SCP has shown to benefit older survivors which directly impacts the notion of efficacy in care coordination.

Implication for Cancer Survivors:
Providing easy-to-access information may encourage survivors to advocate for their health and to facilitate transition of care.
Clinical Significance of Plasma Soluble MICB in Children With EBV-associated Hemophagocytic Lymphohistiocytosis
Authors: Wei Ang , Zhang Liping , Ma Honghao , Cui Lei , Zhang Qing , Wang Dong , Chen Sitong , Du Junye , Zhao Xiaoxi , Wang Tianyou , Zhang Rui , Zheng Huyong , Li Zhigang 
Published: March 2023

Background:
Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal systemic inflammation disease in children. The most common cause is Epstein-Barr virus (EBV) infection. MHC class I polypeptide-related sequence B (MICB) is a membrane protein inducibly expressed upon cellular stress, viral infection, or malignant transformation, thus marking these cells for clearance through natural killer group 2 member D-positive lymphocytes. MICB can be released into plasma through several mechanisms, reducing NK cell cytotoxicity.

Methods:
We conducted clinical research on HLH patients and cell research in vitro. In the retrospective clinical part, 112 HLH patients (including EBV-HLH group and non-EBV-HLH group), 7 infectious mononucleosis patients, and 7 chronic active EBV infection patients were treated in Beijing Children’s Hospital, affiliated with Capital Medical University, from January 2014 to December 2020, were enrolled in this study. Real-time quantitative polymerase chain reaction, standard enzyme-linked immunosorbent assay methods, and lactate dehydrogenase release tests were used to examine the expression of MICB mRNA, the soluble MICB (sMICB) levels, and the activity of NK cells in those patients. In vitro research, MICB overexpression-vector virus, MICB knockdown-vector virus, and empty-vector virus were transfected into two kinds of target cells, such as K562 and MCF7. The level of sMICB and NK cell killing activity between other groups was compared. Finally, we compared NK92 cell killing activity in different concentrations of sMICB.

Results:
In clinical studies, compared with the non-EBV-HLH group, the EBV-HLH group had lower NK cell killing activity (P < 0.05). The level of sMICB in the EBV-HLH group was significantly higher than in non-EBV-HLH, infectious mononucleosis, and chronic active EBV infection patients (P＜0.05). A high level of sMICB was associated with poor treatment response and poor prognosis (P＜0. 05). Cellular studies showed that an increased level of membrane MICB could positively correlate with the killing activity of NK92 cells (P＜0. 05), and a high level of sMICB (1250 to 5000pg/ml) could reduce the killing activity of NK92 cells (P < 0.05). A high level of sMICB (2500pg/ml) could increase the release of cytokines from NK92 cells.

Conclusion:
The expression level of sMICB in EBV-HLH patients increased, and a high level of sMICB at the initial onset indicated a poor treatment response. The killing activity of NK cells in EBV-HLH patients decreased more significantly. The high level of sMICB may inhibit the killing activity but increase the release of cytokines of NK92 cells.
Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis
Authors: Pauwels Sara , Casters Laura , Lemkens Nele , Lemmens Winde , Meijer Kenneth , Meyns Pieter , van de Berg Raymond , Spildooren Joke 
Published: March 2023

Background and Purpose:
Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders, and is treated effectively with particle repositioning maneuvers (PRM). The aim of this study was to assess the influence of BPPV and treatment effects of PRM on gait, falls, and fear of falling.

Methods:
Three databases and the reference lists of included articles were systematically searched for studies comparing gait and/or falls between (1) people with BPPV (pwBPPV) and controls and (2) pre- and posttreatment with PRM. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias.

Results:
Twenty of the 25 included studies were suitable for meta-analysis. Quality assessment resulted in 2 studies with high risk of bias, 13 with moderate risk, and 10 with low risk. PwBPPV walked slower and demonstrated more sway during tandem walking compared with controls. PwBPPV also walked slower during head rotations. After PRM, gait velocity during level walking increased significantly, and gait became safer according to gait assessment scales. Impairments during tandem walking and walking with head rotations did not improve. The number of fallers was significantly higher for pwBPPV than for controls. After treatment, the number of falls, number of pwBPPV who fell, and fear of falling decreased.

Discussion and Conclusions:
BPPV increases the odds of falls and negatively impacts spatiotemporal parameters of gait. PRM improves falls, fear of falling, and gait during level walking. Additional rehabilitation might be necessary to improve gait while walking with head movements or tandem walking.

Video Abstract available for more insights from the authors (see the Supplemental Digital Content Video, available at: http://links.lww.com/JNPT/A421).
Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children
Authors: Güven Deniz , Sarıcı Dilek 
Published: March 2023

Objectives
Carbon monoxide poisoning (COP) is extremely common throughout the world. The purpose of this study was to assess the demographic, clinical, and laboratory characteristics predicting the severity COP in children.

Methods
The study included 380 children diagnosed with COP between January 2017 and January 2021 and 380 healthy controls. Carbon monoxide poisoning was diagnosed based on the medical history and a carboxyhemoglobin (COHb) level of more than 5%. The patients were classified as mild (COHb 10%), moderate (COHb 10%–25%), or severely (COHb > 25%) poisoned.

Results
The mean age of the severe group was 8.60 ± 6.30, for the moderate group was 9.50 ± 5.81, for the mild group was 8.79 ± 5.94, and for the control group was 8.95 ± 5.98. The most common place of exposure was at home and all cases were affected accidentally. The coal stove was the most common source of exposure, followed by natural gas. The most common symptoms were nausea/vomiting, vertigo, and headache. Neurologic symptoms such as syncope, confusion, dyspnea, and seizures were more common in the severe group. A total of 91.3% of the children had hyperbaric oxygen therapy, 3.8% were intubated, and 3.8% were transferred to intensive care in the severe group, whereas no death or sequela was observed. Mean platelet volume and red cell distribution width had the highest area under the curve in the receiver operating characteristic analysis (0.659; 0.379). A positive and low statistically significant relationship was found between COHb levels and troponin and lactate levels in the severe group (P < 0.05).

Conclusions
Carbon monoxide poisoning progressed more severely in children presented with neurological symptoms and have elevated red cell distribution width and mean platelet volume. Even in severe COP cases, satisfactory results have been obtained with early and appropriate treatment.
The Glymphatic System in Humans: Investigations With Magnetic Resonance Imaging
Authors: Naganawa Shinji , Taoka Toshiaki , Ito Rintaro , Kawamura Mariko 
Published: March 2023

Abstract
The concept of the glymphatic system was proposed more than a decade ago as a mechanism for interstitial fluid flow and waste removal in the central nervous system. The function of the glymphatic system has been shown to be particularly activated during sleep. Dysfunction of the glymphatic system has been implicated in several neurodegenerative diseases. Noninvasive in vivo imaging of the glymphatic system is expected to be useful in elucidating the pathophysiology of these diseases. Currently, magnetic resonance imaging is the most commonly used technique to evaluate the glymphatic system in humans, and a large number of studies have been reported. This review provides a comprehensive overview of investigations of the human glymphatic system function using magnetic resonance imaging. The studies can be divided into 3 categories, including imaging without gadolinium-based contrast agents (GBCAs), imaging with intrathecal administration of GBCAs, and imaging with intravenous administration of GBCAs. The purpose of these studies has been to examine not only the interstitial fluid movement in the brain parenchyma, but also the fluid dynamics in the perivascular and subarachnoid spaces, as well as the parasagittal dura and meningeal lymphatics. Recent research has even extended to include the glymphatic system of the eye and the inner ear. This review serves as an important update and a useful guide for future research directions.
ComBat Harmonization for MRI Radiomics
Authors: Leithner Doris , Nevin Rachel B. , Gibbs Peter , Weber Michael , Otazo Ricardo , Vargas H. Alberto , Mayerhoefer Marius E. 
Published: March 2023

Objectives
The aims of this study were to determine whether ComBat harmonization improves multiclass radiomics-based tissue classification in technically heterogeneous MRI data sets and to compare the performances of 2 ComBat variants.

Materials and Methods
One hundred patients who had undergone T1-weighted 3D gradient echo Dixon MRI (2 scanners/vendors; 50 patients each) were retrospectively included. Volumes of interest (2.5 cm3) were placed in 3 disease-free tissues with visually similar appearance on T1 Dixon water images: liver, spleen, and paraspinal muscle. Gray-level histogram (GLH), gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), and gray-level size-zone matrix (GLSZM) radiomic features were extracted. Tissue classification was performed on pooled data from the 2 centers (1) without harmonization, (2) after ComBat harmonization with empirical Bayes estimation (ComBat-B), and (3) after ComBat harmonization without empirical Bayes estimation (ComBat-NB). Linear discriminant analysis with leave-one-out cross-validation was used to distinguish among the 3 tissue types, using all available radiomic features as input. In addition, a multilayer perceptron neural network with a random 70%:30% split into training and test data sets was used for the same task, but separately for each radiomic feature category.

Results
Linear discriminant analysis–based mean tissue classification accuracies were 52.3% for unharmonized, 66.3% for ComBat-B harmonized, and 92.7% for ComBat-NB harmonized data. For multilayer perceptron neural network, mean classification accuracies for unharmonized, ComBat-B–harmonized, and ComBat-NB–harmonized test data were as follows: 46.8%, 55.1%, and 57.5% for GLH; 42.0%, 65.3%, and 71.0% for GLCM; 45.3%, 78.3%, and 78.0% for GLRLM; and 48.1%, 81.1%, and 89.4% for GLSZM. Accuracies were significantly higher for both ComBat-B– and ComBat-NB–harmonized data than for unharmonized data for all feature categories (at P = 0.005, respectively). For GLCM (P = 0.001) and GLSZM (P = 0.005), ComBat-NB harmonization provided slightly higher accuracies than ComBat-B harmonization.

Conclusions
ComBat harmonization may be useful for multicenter MRI radiomics studies with nonbinary classification tasks. The degree of improvement by ComBat may vary among radiomic feature categories, among classifiers, and among ComBat variants.