bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Distance Empowerment Program on Self-efficacy Among Multiple Sclerosis Patients
Authors: Arab Farzaneh , Hekmatpou Davood , Saeedi Maryam 
Published: June 2023

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is the most common nontraumatic debilitating disease in young adults. This study aimed to determine the effect of distance empowerment programs on self-efficacy in MS patients. METHODS: Sixty-four MS patients participated in this quasi-experimental study. Patients were first entered into the study using the convenience sampling method and then were randomly allocated to control (32) and intervention (32) groups. The intervention group underwent a distance empowerment program (via WhatsApp, Telegram, and blog) and weekly telephone follow-up for 2 months. Self-efficacy was evaluated before, and immediately after, the empowerment program using the MS Self-Efficacy Scale. RESULTS: Data from 59 participants were analyzed. Before implementation of the empowerment program, the mean scores of self-efficacy in the intervention and control groups were not significantly different. After implementing the empowerment program, the mean score of self-efficacy in the intervention group was higher than that of the control group (P < .05). CONCLUSION: Distance empowerment has an effect on the self-efficacy of patients with MS and may lead to an increase in self-efficacy scores after implementing an empowerment program.
Gender disparities in health-related quality of life (HRQoL) in patients with cutaneous T-cell lymphoma
Authors: Chalaka Christopher W. , Mahurin Heather M. , Tarabadkar Erica , Hippe Daniel S. , Loggers Elizabeth T. , Shinohara Michi M. 
Published: June 2023

Background:
Patients with cutaneous T-cell lymphoma (CTCL) often experience debilitating symptoms that impair health-related quality of life (HRQoL). Existing evidence for HRQoL differences with respect to gender is conflicting.

Objective:
To investigate potential gender differences in HRQoL for patients with CTCL.

Methods:
We performed a cross-sectional study to assess HRQoL in patients with CTCL by partnering with the Cutaneous Lymphoma Foundation to distribute an electronic survey from February to April 2019.

Results:
A total of 292 patient responses (66% women, mean age 57 years) were included in the analysis. Most of the cohort had early-stage (IA–IIA) (74%; 162/203) mycosis fungoides (MFs) (87%; 241/279), followed by Sézary syndrome (SS) (12%; 33/279). Women with CTCL experienced significantly worse HRQoL compared with men (Skindex-16: 51±26 vs. 36±26, P ≤ 0.001; FACT-G: 69±21 vs. 77±16, P = 0.005). This gender difference was present even when controlling for stage of disease. Women experienced worse HRQoL in all three of the Skindex-16 subscales (symptoms: β = 14.0, P ≤ 0.001; emotions: β = 15.1, P ≤ 0.001; functioning: β = 11.3, P = 0.006), but only two of the four FACT-G subscales (physical: β =-2.8, P ≤ 0.001; emotional: β = -2.0, P = 0.004).

Limitations:
Due to the method of distribution of the survey, we were unable to estimate a participant response rate. Participants’ diagnosis and stage were self-reported.

Conclusion:
In this cohort women with CTCL experienced significantly worse HRQoL when compared to men. Additional studies are necessary to determine what factors contribute to this gender disparity.
Use of Mitomycin-C in Laryngotracheal Stenosis
Authors: Di Felice Christopher , Machuzak Michael S. , Shepherd Ray W. 
Published: June 2023

Background:
Therapeutic options for managing laryngotracheal stenosis (LTS) are limited. Endoscopy is a minimally invasive approach to treating LTS, but carries a high risk of stenosis recurrence. Mitomycin C (MMC) is often used as an adjunct therapy to delay the time to symptomatic recurrence of LTS. This review synthesizes the current literature on the topic of MMC as an adjunct treatment strategy for LTS.

Methods:
A focused literature search was carried out from PubMed on June 12, 2022 using the terms “mitomycin c AND stenosis” in all fields with no date limitations. Evidence-based recommendations relevant to the clinical application of MMC as an adjunct therapy for LTS were formulated. Three questions were addressed: 1) efficacy of MMC, 2) single versus multiple application(s) of MMC, and 3) safety of MMC. The evidence rating and recommendation strength were guided by the GRADE system.

Results:
Twenty-nine studies were reviewed. The efficacy of MMC as an adjunct therapy for LTS varied across studies. Randomized controlled trials have not shown an outcome difference with MMC use, although methodologic flaws including underpowering were noted. A meta-analysis of observational studies with a comparator arm found the unadjusted probability of remaining symptom-free for >1 year is greater with versus without MMC application (73% vs. 35%). Single versus multiple application(s) of MMC resulted in similar restenosis rates at long-term follow-up. Complications related to MMC use are rarely reported using conventional doses (0.4 mg/mL). Overall, the quality of evidence was low and the recommendation for intervention was weak.

Conclusion:
The role for MMC as an adjunct therapy in LTS is uncertain. While safe in its application, the efficacy of MMC in reducing stenosis recurrence remains a matter of debate. Large, prospective studies are needed to inform future recommendations.
Choosing Wisely in Gastroenterology: five new recommendations from the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO)
Authors: Venezia Ludovica , Buonocore Matteo Rossano , Barbuscio Ilenia , Bortoluzzi Francesco , Monica Fabio , Manfredi Guido , Anderloni Andrea , Stasi Elisa ,   on behalf of Association of Hospital Gastroenterologists and Endoscopists (AIGO) Young Committee
Published: June 2023

Background
‘Choosing Wisely’ is an international campaign against inappropriateness in medical practices that aims to promote a rational and evidence-based use of resources. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) joined the Campaign in 2017 releasing five recommendations.

Aims
To identify five new recommendations for a correct, evidence-based approach to the management of gastrointestinal diseases.

Methods
All AIGO members were asked to identify practices or interventions that, even though diffuse in clinical practice, do not provide benefit for patients. The proposed items were then revised, divided by topic and ranked. After a systematic review of the literature for each item, five new recommendations were identified.

Results
The five recommendations are: do not request surveillance investigations for patients with pancreatic cysts who are poor surgical candidates, irrespective of cysts nature and characteristics; do not request esophagogastroduodenoscopy in patients with recent onset of upper gastrointestinal symptoms younger than 50 years, without alarm features; do not request surveillance colonoscopy for asymptomatic colonic diverticular disease without changes in symptoms; do not perform food intolerance tests except for those scientifically validated; do not prescribe proton pump inhibitors to patients with liver cirrhosis, outside of established indications.

Conclusion
The Choosing Wisely recommendations will reduce unnecessary testing and treatments, increasing patient safety and overall healthcare quality.
Application of the birthrate plus (BR+) methodology to identify midwifery workforce shortages in China: a retrospective multisite study
Authors: He Hongxiao , Lu Hong , Wang Yan , Pang Ruyan , Qiu Liqian , Yao Jiasi , Zhou Hong , Zhu Xiu 
Published: June 2023

Abstract

Objective:
The goal of this study is to apply Birthrate Plus (BR+) methodology in Chinese midwifery settings to assess the midwifery workforce status and to calculate the potential demand for more midwives.

Methods:
This was a retrospective multisite study using 12,443 maternal medical records from 49 midwifery settings in Zhejiang Province, China. Data needed in the BR+, including the types of childbearing women and the number of midwifery service hours, were extracted and then calculated to assess the estimated demand and shortage of midwives.

Results:
The study included 599 midwives across 49 settings, with a range of 1–35 full-time equivalent midwives per setting, totaling 465 full-time equivalent midwives. Using BR+ methodology, the analysis revealed a shortage of midwives in 61.2% of the surveyed settings and a surplus in 22.4%. The shortage varied significantly across different levels of settings (H=6.505, P<0.05).

Conclusions:
Overall, the midwifery services provided were significantly insufficient in the surveyed regions, and workforce allocation was unbalanced among different areas.
A Systematic Review of Multisensory Stimulation on Procedural Pain Among Preterm Neonates
Authors: Sharma Neha , Samuel Asir John 
Published: June 2023

Purpose:
This systematic review aims to evaluate the quality of studies and synthesize the literature on multisensory stimulation (MSS) on procedural pain among hospitalized preterm neonates.

Summary of Key Points:
Search strategies were applied to PubMed/Medline, CINAHL, SCOPUS, and PEDro. A total of 414 studies were identified, 104 were screened, and 4 were included. Two independent reviewers extracted data from identified studies that were synthesized qualitatively and quantitatively.

Conclusion and Recommendations for Clinical Practice:
There is strong evidence of MSS in decreasing procedural pain, but additional research is needed to identify the beneficial effects of MSS with a standardized protocol to promote good clinical practice in neonatal intensive care settings.

What This Adds to the Evidence:
High-quality evidence supports beneficial effects of MSS, but standardization of the MSS protocol and its administration needs to be established.
High Specificity of HPV Cell-Free DNA Tests in Persons With HIV for the Detection of HPV-Related Cancer
Authors: Ellsworth Grant , Shen Roger , Marcelin Kinge-Ann , Majumdar Rahul , Bazil Maximillian , Moore Grace , Nelson Meredith , Alland Isabel , Sepulveda Gustavo , Wilkin Timothy , Higginson Daniel S. 
Published: June 2023

Introduction:Persons with HIV (PWH) experience high rates of human papillomavirus (HPV)–associated cancers compared with the general population. Plasma HPV cell-free DNA (cfDNA) tests are sensitive in patients with known HPV-associated cancers. It is not known whether these tests can screen for invasive cancers in populations with high burdens of nonmalignant HPV disease such as PWH. It was not known whether HPV infection and/or noninvasive anal high-grade squamous intraepithelial lesions (HSIL) alone in this population would result in detectable HPV cfDNA, which would result in a high number of false positives if HPV cfDNA is used to screen for invasive cancers.Methods:We conducted a prospective study of PWH in 2 cohorts: 20 without anal HSIL and 20 with anal HSIL. We tested anal and vaginal swabs for HPV infection, and HPV genotyped the biopsies of anal HSIL. Finally, we performed HPV cfDNA droplet digital polymerase chain reaction to test for HPV16/18/33 from plasma samples.Results:In the combined cohorts, the median age was 56 years, 12.5% were cisgender women, and none had detectable HIV. In total, 84.6% had prevalent anovaginal HPV infection, including 10 participants with HPV16, 13 with HPV18, and 2 with HPV33 infections. Five and 2 participants had HPV16 and HPV33 detected in anal HSIL, respectively. Despite the high prevalence of HPV infection and anal HSIL, no participant had HPV16/18/33 detectable cfDNA by droplet digital polymerase chain reaction.Conclusions:These results provide a strong rationale for investigating the use of HPV cfDNA in a screening setting for suspected HPV-related invasive cancers in PWH.
A Case of Pancreatic Cancer With Rare Cutaneous and Muscle Metastases on 18F-FDG PET/CT Imaging
Authors: Zhang Zeyu , Guo Shiwei , Zuo Changjing , Cheng Chao 
Published: June 2023

Abstract
A 46-year-old man underwent PET/CT for metastatic survey 6 years after radical resection of pancreatic cancer. In addition to the increased uptake observed in the operative area, increased FDG uptake was also observed in the left external abdominal oblique muscle and the left frontal scalp. Both intramuscular and subcutaneous lesions were surgically excised and diagnosed as metastases from pancreatic cancer.
Pneumatic Compression–Assisted Lymphoscintigraphy for Quantitative Evaluation of Breast Cancer–Related Lymphedema
Authors: Min Ingi , Lim Sung Joon , Cheon Gi Jeong , Suh Minseok , Seo Kwan Sik 
Published: June 2023

Objectives
Acquired lymphedema of upper extremity is a chronic pathologic status that frequently occurs after breast cancer treatment. Reliable and quantitative evaluation of lymphedema is crucial for successful management of patients. Although lymphoscintigraphy is the primary investigation for the confirmation and evaluation of lymphedema, the specific protocol of stress intervention is not well established. This study aims to introduce intermittent pneumatic compression (IPC) as a part of stress lymphoscintigraphy and compare the effectiveness of conventional stress lymphoscintigraphy (CSL) and pneumatic compression–assisted lymphoscintigraphy (PCAL).

Methods
Our study was designed as a retrospective analysis of 85 breast cancer patients with lymphedema who underwent lymphoscintigraphy utilizing either IPC device or conventional stress maneuver and received complex decongestive therapy. The flow extent of the lymphatic fluid (FE) was evaluated using a 0- to 4-point scale based on lymphoscintigraphic images. The visualization of lymph nodes was also assessed. The clinical outcomes were evaluated by changes in side-to-side circumferential and volume differences of upper extremities and compared between groups.

Results
Of 85 patients, 47 underwent CSL, and 38 underwent PCAL. Participants with relatively preserved flow extent of the lymphatic fluid (FE 3) showed a significant difference in percentage reduction of volume (PRV) between CSL and PCAL groups (P = 0.036). In the other groups, CSL and PCAL demonstrated comparable differences in PRV without statistical significance.

Conclusion
Our study suggests that participants in the PCAL group with relatively preserved lymphatic flow extent (FE 3) had better PRV compared with those in the CSL group. The use of IPC devices in lymphoscintigraphy with the novel stress maneuver can help in the quantitative description of lymphedema status and the selection of an appropriate treatment method.
Comparison of the Efficacy of Subosseous Window Neuro-Endoscopy and Minimally Invasive Craniotomy in the Treatment of Basal Ganglia Hypertensive Intracerebral Hemorrhage
Authors: Lv Kun , Wang Yuhang , Chao Honglu , Cao Shengwu , Cao Wenping 
Published: June 2023

Objective:
To compare the perioperative indexes and long-term effects of craniotomy and neuro-endoscopic hematoma removal in patients with hypertensive intracerebral hemorrhage (HICH) in the basal ganglia region.

Methods:
This study involved 128 patients with HICH in the basal ganglia region who were admitted to our hospital from February 2020 to June 2022. They were divided into 2 groups according to the random number table method. The craniotomy group (n = 70) underwent microsurgery with small bone window craniotomy with a side cleft, and the neuro-endoscopy group (n = 58) underwent small bone window neuro-endoscopic surgery. A 3-dimensional Slicer was used to calculate the hematoma volume and clearance rate and the postoperative brain tissue edema volume. The operation time, intraoperative blood loss, postoperative intracranial pressure, complications, mortality, and improvement in the modified Rankin scale score at 6 months postoperatively were compared between the two groups.

Results:
The clearance rate was significantly higher in the neuro-endoscopy group than in the craniotomy group (94.16% ± 1.86% versus 90.87% ± 1.89%, P < 0.0001). The operation time was significantly lower in the neuro-endoscopy group than in the craniotomy group (89.9 ± 11.7 versus 203.7 ± 57.6 min, P < 0.0001). Intraoperative blood loss was significantly higher in the craniotomy group (248.31 ± 94.65 versus 78.66 ± 28.96 mL, P < 0.0001). The postoperative length of stay in the intensive care unit was 12.6 days in the neuro-endoscopy group and 14.0 days in the craniotomy group with no significant difference (P = 0.196). Intracranial pressure monitoring showed no significant difference between the two groups on postoperative days 1 and 7. Intracranial pressure was significantly higher in the craniotomy group than in the neuro-endoscopy group on postoperative day 3 (15.1 ± 6.8 versus 12.5 ± 6.8 mm Hg, P = 0.029). There was no significant difference in the mortality or outcome rate at 6 months postoperatively between the two groups.

Conclusions:
In patients with HICH in the basal ganglia region, neuro-endoscopy can significantly improve the hematoma clearance rate, reduce intraoperative hemorrhage and postoperative cerebral tissue edema, and improve surgical efficiency. However, the long-term prognosis of patients who undergo craniotomy through the lateral fissure is similar to that of patients who undergo neuro-endoscopic surgery.
Vitamin D is a potential treatment for the management of gastrointestinal mucositis
Authors: Munem Fizza , Thianhlun Phir C.K. , Anderson Paul H. , Stringer Andrea M. 
Published: June 2023

Purpose of the review
Gastrointestinal mucositis (GM) is a severe side effect of cancer treatments, negatively impacting the patient’s quality of life, and has limited treatment. GM consists of complex biological processes involving apoptosis and inflammation, leading to damage and ulceration of the gastrointestinal system. Recently, vitamin D has been shown to have multiple roles in the gut, including immunomodulation, epithelial barrier regulation and microbiome regulation. Hence, this review aims to put forth vitamin D as a potential therapeutic due to its protective role in the intestine.

Recent findings
Recent studies have shown that vitamin D can reduce intestinal inflammation by reducing NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) activation. Vitamin D also targets and maintains the intestinal epithelial barrier via the tight junction protein expression and the inhibition of microbiome translocation. Significant evidence also suggests that vitamin D exerts multiple therapeutic effects through binding to vitamin D receptors (VDRs), and the downregulation of VDR has been associated with the severity of the disease. Additionally, vitamin D deficiency is reported in cancer patients.

Summary
There is a dire need for effective treatment for GM, and recent animal and human studies show that vitamin D may be a potential therapy to prevent or treat GM.
Clinical practice guideline recommendations for pediatric solid organ injury care: A Systematic Review
Authors: Yanchar Natalie , Tardif Pier-Alexandre , Freire Gabrielle , Bérubé Mélanie , Stelfox Henry T. , Beaudin Marianne , Stang Antonia , Beno Suzanne , Weiss Matthew , Labrosse Melanie , Zemek Roger , Gagnon Isabelle J. , Beaulieu Emilie , Berthelot Simon , Turgeon Alexis F. , Lauzier François , Gabbe Belinda , Moore Lynne 
Published: June 2023

BACKGROUND
Observed variations in the management of pediatric solid organ injuries (SOIs) may be due to difficulty in finding and integrating recommendations from multiple clinical practice guidelines (CPGs) with heterogeneous methodological approaches. We aimed to systematically review CPG recommendations for pediatric SOIs.

METHODS
We conducted a systematic review of CPGs including at least one recommendation targeting pediatric SOI populations, using Medical Analysis and Retrieval System Online, Excerpta Medica dataBASE, Web of Science, and websites of clinical organizations. Pairs of reviewers independently assessed eligibility, extracted data, and evaluated the quality of CPGs using the Appraisal of Guidelines Research and Evaluation II tool. We synthesized recommendations from moderate to high-quality CPGs using a recommendations matrix based on Grades of Recommendation, Assessment, Development, and Evaluation criteria.

RESULTS
We identified eight CPGs, including three rated moderate or high quality. Methodological weaknesses included lack of stakeholder involvement beyond surgeons, consideration of applicability (e.g., implementation tools), and clarity around the definition of pediatric populations. Five of the 15 recommendations from moderate to high-quality CPGs were based on moderate quality evidence or were rated as strong; these reflected nonoperative management and angioembolization for renal injuries and required length of stay for liver and spleen injuries.

CONCLUSION
We identified 15 recommendations on pediatric SOI management from 3 moderate or high-quality CPGs, but only one third were based on at least moderate-quality evidence or were rated as strong. Our results prompt the following recommendations for future CPG development or updates: (1) include all types of clinicians involved in the care of pediatric SOIs and patient and family representatives in the process, (2) develop clear definitions of the target population, and (3) provide advice and tools to promote implementation. Results also underline the urgent need for more rigorous research to support strong evidence-based recommendations in this population.

LEVEL OF EVIDENCE
Systematic Review/Meta-analysis; Level III.
Searching and visualizing genetic associations of pregnancy traits by using GnuMoM2b
Authors: Yan Qi , Guerrero Rafael F. , Khan Raiyan R. , Surujnarine Andy A. , Wapner Ronald J. , Hahn Matthew W. , Raja Anita , SallebAouissi Ansaf , Grobman William A. , Simhan Hyagriv , Blue Nathan R. , Silver Robert , Chung Judith H. , Reddy Uma M. , Radivojac Predrag , Pe’er Itsik , Haas David M. 
Published: June 2023

AbstractAdverse pregnancy outcomes (APOs) are major risk factors for women’s health during pregnancy and even in the years after pregnancy. Due to the heterogeneity of APOs, only few genetic associations have been identified. In this report, we conducted genome-wide association studies (GWAS) of 479 traits that are possibly related to APOs using a large and racially diverse study, Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b). To display the extensive results, we developed a web-based tool GnuMoM2b (https://gnumom2b.cumcobgyn.org/) for searching, visualizing, and sharing results from GWAS of 479 pregnancy traits as well as phenome-wide association studies (PheWAS) of more than 17 million single nucleotide polymorphisms (SNPs). The genetic results from three ancestries (Europeans, Africans, and Admixed Americans) and meta-analyses are populated in GnuMoM2b. In conclusion, GnuMoM2b is a valuable resource for extraction of pregnancy-related genetic results and shows the potential to facilitate meaningful discoveries.