bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy-based interventions for genitourinary syndrome of menopause: a systematic review of randomized controlled trials and prospective observational studies
Authors: Zerzan Nicholas L. , Greer Nancy , Ullman Kristen E. , Sowerby Catherine , Diem Susan , Ensrud Kristine , Forte Mary L. , Anthony Maylen C. , Landsteiner Adrienne , Butler Mary , Wilt Timothy J. , Danan Elisheva R. 
Published: January 2025

Abstract

Importance
Hormone treatments for genitourinary syndrome of menopause (GSM) symptoms have limitations. There is interest in nonhormone therapies, including energy-based interventions. Benefits and harms of energy-based interventions are not currently well known.

Objective
The aim of this study was to assess the benefits and harms of energy-based therapies (eg, CO2 laser, Er:YAG laser, and radiofrequency) for GSM. Outcomes of interest are the eight “Core Outcomes in Menopause” and include the following: dyspareunia, vulvovaginal dryness, vulvovaginal discomfort/irritation, dysuria, change in most bothersome symptom, quality of life, treatment satisfaction, and treatment adverse effects.

Evidence Review
Eligible studies included English language randomized controlled trials (RCT) or prospective observational studies of energy-based treatments with ≥8 weeks follow-up in postmenopausal women with ≥1 GSM symptom and studies of any design reporting adverse effects ≥12 months postintervention. Ovid/MEDLINE, Embase, and CINAHL were searched from inception to December 11, 2023 using vocabulary and natural language terms, along with free-text words. Two authors extracted data and assessed the quality of included studies.

Findings
We identified 32 unique studies (16 RCT; 1 quasi-RCT; 15 nonrandomized). Ten RCT and the quasi-RCT were rated low to moderate risk of bias (RoB) and underwent data extraction. Included studies evaluated CO2 laser (k = 7), Er:YAG laser (k = 3), or radiofrequency and CO2 laser (k = 1). CO2 laser compared with sham (k = 4) may result in little to no difference in dysuria, dyspareunia, or quality of life (low certainty of evidence [COE]). CO2 laser compared with vaginal conjugated estrogens cream (k = 2) may result in little to no difference in dyspareunia, dryness, discomfort/irritation, dysuria, or quality of life (low COE). Treatment effects on all other outcomes and effects of Er:YAG laser or radiofrequency on any outcome are very uncertain (very low COE). Studies noted few adverse events and no serious adverse events.

Conclusions and Relevance
CO2 laser resulted in little to no difference in outcomes compared with sham or vaginal estrogen; the evidence is very uncertain on the effect of energy-based interventions versus all other comparators for all other outcomes. Adverse event reporting was limited. There is a need for further evidence assessing energy-based interventions.
Hsa_circ_0109623 regulates the progression of autoimmune liver disease through Hsa_miR_146b-3p/Sortilin 1–mediated activation of CD4+ T cells
Authors: Lv Xinliang , Zhu Li , Feng Shijie , Yang Siyu , Li Guohua , Zhan Jinqin , Tan Yuchun , Liu Yuquan , Zhang Jinliang , Wang Yujin , Cheng Yucheng , Fu Ping , Xu Yushan , Zheng Chenhong 
Published: January 2025

Background:
Autoimmune hepatitis (AIH) is a chronic liver disease characterized by immune-mediated liver inflammation. Despite its global prevalence, the pathogenesis of AIH remains poorly understood, and there is a lack of specific biomarkers and targeted treatments. This study aimed to investigate the role of hsa_circ_0109623, hsa-miR-146b-3p, and Sortilin 1 (SORT1) in AIH and their potential as therapeutic targets.

Methods:
We collected liver tissue samples and peripheral blood mononuclear cells from patients with AIH and healthy controls and performed RT-PCR, western blotting, flow cytometry, and other molecular biology techniques to analyze the expression of hsa_circ_0109623, hsa-miR-146b-3p, and SORT1. We also used bioinformatics tools to predict the interaction between these molecules and conducted luciferase reporter assays to confirm their binding.

Results:
hsa_circ_0109623 was significantly upregulated in patients with AIH and positively correlated with inflammatory activity. We also found that hsa_circ_0109623 could enhance CD4+ T-cell activation and promote the expression of proinflammatory cytokines. Conversely, hsa-miR-146b-3p was downregulated in patients with AIH and negatively correlated with the expression of hsa_circ_0109623 and SORT1. In addition, hsa-miR-146b-3p acted as a sponge for hsa_circ_0109623, inhibiting CD4+ Th1 cell polarization and cytokine production. SORT1 was also upregulated in patients with AIH and acted as a sponge for hsa-miR-146b-3p, promoting CD4+ Th1 cell polarization and cytokine expression. Furthermore, hsa_miR_146b-3p/SORT1 can regulate the STAT1/STAT4 signaling pathway mediating the progression of AIH.

Conclusions:
The hsa_circ_0109623/hsa-miR-146b-3p/SORT1 axis plays a crucial role in the pathogenesis of AIH by regulating CD4+ T-cell activation and cytokine production. These molecules may serve as potential biomarkers and therapeutic targets for AIH. Further research is needed to validate these findings and explore their clinical applications.
Survival benefit associated with liver transplantation for hepatocellular carcinoma based on tumor burden scores at listing
Authors: Liu Hao , Zhang Wei , Di Mengyang , Lee Hang , Shi Liuhua , Wang Xixi , Xingyu Zhang , Powers Colin A. , Sethi Vrishketan , Li Xingjie , Xiao Yao , Crane Andrew , Kaltenmeier Christof , Alberola Ramon Bataller , Behari Jaideep , Duarte-Rojo Andres , Hughes Dempsey , Malik Shahid , Jonassaint Naudia , Geller David , Tohme Samer , Gunabushanam Vikraman , Tevar Amit , Cruz Ruy , Hughes Christopher , Dharmayan Stalin , Ayloo Subhashini , Humar Abhinav , Molinari Michele 
Published: January 2025

Introduction:
Liver transplantation (LT) provides significant survival benefits to patients with unresectable HCC. In the United States, organ allocation policies for HCCs within the United Network for Organ Sharing criteria do not prioritize patients based on their differences in oncological characteristics. This study assessed whether transplant-associated survival benefits (TASBs) vary among patients with different tumor burden scores (TBS) measured at the time of listing.

Methods:
We analyzed data from adults applying for HCC MELD exception points between 2002 and 2019, with follow-up until December 2023, using the Scientific Registry of Transplant Recipients. TBS was determined based on the largest tumor diameter and number of HCCs. Patients were categorized into low (≤3), intermediate (3.1–5), and high (>5) TBS groups. TASB was measured as the difference in 5-year survival with and without LT.

Results:
This study included 36,634 LT candidates. High-TBS patients had higher waitlist dropout rates and marginally lower post-transplant survival, resulting in a significantly greater TASB. The 5-year TASB for the low, intermediate, and high TBS groups were 15.7, 22.1, and 25.0 months, respectively. The adjusted survival benefit expressed in 5-year survival differences was 21.9%, 34.5%, and 39.4% in the low, intermediate, and high TBS groups, respectively (p<0.001).

Conclusions:
Higher TBS during listing correlates with greater LT benefits for patients with unresectable HCC within UNOS criteria. We conclude that organ allocation policies in the United States should prioritize patients with high TBS due to their increased risk of dropout and comparable post-transplant survival when compared to patients with less advanced tumors.
End-procedural adherence to recommended hemodynamic targets does not improve the outcome of elective TIPS in patients with cirrhosis
Authors: Roccarina Davide , Saltini Dario , Adotti Valentina , Rosi Martina , Senzolo Marco , Nardelli Silvia , Bianchini Marcello , Biribin Lara , Caporali Cristian , Margherita Falcini , Ragozzino Lucia , Guasconi Tomas , Casari Federico , Gioia Stefania , Campani Claudia , Prampolini Francesco , Ingravallo Angelica , Gitto Stefano , Aspite Silvia , Arena Umberto , Citone Michele , Gaggini Melania , Ridola Lorenzo , Barbiero Giulio , De Masi Salvatore , Riggio Oliviero , Merli Manuela , Fanelli Fabrizio , Montagnese Sara , Marra Fabio , Schepis Filippo , Vizzutti Francesco 
Published: January 2025

Background and Aims:
In clinical practice, the reduction of portocaval pressure gradient (PCPG) following TIPS does not always meet the recommendation of current guidance. We evaluated the impact of different degrees of PCPG reduction, measured at the end of an elective TIPS, on ascites control, recurrence of portal hypertension–related bleeding (PHRB), and survival.

Approach and Results:
Patients with cirrhosis receiving TIPS for refractory ascites (RA) or for the secondary prophylaxis of PHRB were consecutively enrolled. Reduction in PCPG was defined as inadequate hemodynamic response (IHR) ﻿in patients not achieving a PCPG <12 mm Hg for both secondary prophylaxis of PHRB and RA, or a reduction of at least 50% only for PHRB. Four hundred fifteen patients were analyzed. An adequate hemodynamic response (AHR) was achieved in 66%. Fifty percent of patients received an under-dilated (≤7 mm) endoprosthesis. No significant differences between patients with IHR and AHR were observed in rebleeding rate and ascites control, while overt HE was higher in AHR. Regardless of TIPS indication, survival was not significantly different between IHR and AHR, while advanced age and liver function before TIPS were significantly associated with a higher cumulative incidence of liver-related death. Notably, in patients with RA ﻿the cumulative incidence of liver-related mortality was higher when AHR was defined as a post-TIPS PCPG <12 mm Hg or a reduction ≥50%.

Conclusions:
AHR measured at the end of an elective TIPS may not be essential to define the eventual outcome, while a marked drop in PCPG could negatively affect the prognosis of patients with RA.
Nurse practitioner and physician associate mentorship: Improving retention and employment experiences
Authors: Yun Boyon , Gilbert Adam C. , Li Hsin-Fang , Scanlan James M. , Coleman Andrea L. 
Published: January 2025

ABSTRACT

Background:
Clinician turnover is costly for health care organizations.

Local problem:
A retention strategy for newly hired nurse practitioners (NPs) and physician associates (PAs) was needed at our organization.

Methods:
A quality improvement project was conducted to determine whether a mentorship program could improve retention and employment experiences of newly hired NPs and PAs.

Interventions:
A one-to-one mentorship program was implemented for newly hired NPs and PAs. (a) Retention and productivity data were compared for mentee participants vs. nonparticipants. (b) Mentee and mentor participants completed two program evaluation surveys to examine the program's impact on their employment experiences.

Results:
Sixty-eight mentee–mentor pairs completed their mentoring relationship during the first 3 years of the program. Retention was higher among mentee participants vs. nonparticipants during their first (96% vs. 85%, p = .0332) and second year of employment (83% vs. 65%, p = .0480). Productivity during the first year was similar for mentee participants and nonparticipants (38th percentile vs. 37th percentile, p = .84). Most participants (≥69%) believed the program improved onboarding, personal and professional growth, work environment, and NP and PA community connection.

Conclusions:
The mentorship program improved first- and second-year retention of newly hired NPs and PAs and employment experiences of program participants. By our estimates, the program helped retain 15 NPs and PAs who would have otherwise left the organization, yielding potential organizational savings of $1.29M–$1.72M. A mentorship program can be an effective retention strategy for reducing health care turnover and related costs.
A case report of Henoch–Schönlein purpura in the elderly complicated by multisystem involvement
Authors: Na Song , Zhang Lei , Kou Luxin , Xu Jinquan , Gang Li 
Published: January 2025

Rationale:
Henoch–Schönlein purpura (HSP), a vasculitis caused predominantly by immunoglobulin A vasculitis deposition in the blood vessel wall. It frequently affects multiple organs, however, intussusception and cardiac involvement in the elderly is extremely rare. Currently, the diagnosis of patients with atypical HSP is very difficult. Drugs and treatments lack adequate evidence-based medical proof to improve patients’ long-term outcomes. We report a case of an elderly patient with allergic purpura involving the intestines, kidneys and heart, and discuss the diagnosis and treatment of patients with atypical clinical symptoms.

Patient concerns:
A 72-year-old woman whose initial symptoms were unusual, and the progression of the disease is irregular.

Diagnoses:
The patient with HSP gradually developed intussusception, renal failure and cardiac involvement.

Interventions and outcomes:
The patient developed kidney injury and intussusception, we sequentially administered surgical intervention, glucocorticoids, hemofiltration and hemoperfusion, and her condition showed improvement. Unfortunately, by the time cardiac complications develop, the patient’s condition deteriorated rapidly. At last, the patient died.

Lessons:
HSP with renal failure, intussusception, and cardiac complication is extremely rare. When patients with atypical HSP, we should always be alerted to changes in their condition. And take into account factors such as the severity of symptoms, patient preferences and complications in order to determine the most suitable therapies.
Thread fragrant moxibustion for a young women with atypical hand herpes zoster: A case report
Authors: Zhang Yi-Mei , Wang Yong-Cheng , Han Xing-Jun , Xu Zhi-Wei , Zhao Xing-Lin , Yuan Xiao-Fen , Wang Wen-Xiu , Jia Hong-Ling 
Published: January 2025

Rationale:
Hand herpes zoster (HHZ) is a very rare skin disease in clinical practice. Due to the lack of specificity in its early clinical manifestations, HHZ is easily misdiagnosed as hand eczema or other lesions. Herein, we present a case with atypical HHZ.

Patient concerns:
A 25-year-old woman experienced left palm pain accompanied by upper limb stabbing pain, general weakness, and low-grade fever after staying up late. At first, she was diagnosed with peripheral nerve compression and hand eczema, and received relevant symptomatic treatment, but her condition did not improve. Diagnosed with herpes zoster on the hand after skin biopsy, treated with thread fragrant moxibustion (TFM).

Diagnoses:
The HHZ diagnosis was established based on clinical appearance and dermatological findings eventually.

Interventions:
The intervention project was TFM treatment once a day in the acupuncture and moxibustion department, and the whole treatment period lasted for 10 days.

Outcomes:
After 3 more TFM treatments were given, the burning sensation and itching in her palms as well as the pulsatility of the finger blood vessels had significantly reduction, the visual analog scale scores significantly decreased. After 10 treatments, the patient’s herpes gradually falls off, revealing pink new skin without any discomfort.

Lessons:
Herpes zoster can appear in any part of the human body with different clinical manifestations. Herpes zoster in the hands is very rare in clinical practice, and it is often misdiagnosed as hand eczema or other lesions in the early stages of the disease. The case is not only highlights the challenging diagnosis in the absence of a characteristic rash at the initial stage but also confirmed the definite therapeutic effect of TFM on herpes zoster.
Treatment of intra-bony defect and periodontal phenotype modification therapy (PhMT): A one-year follow-up case report
Authors: Alqahtani Ali Fahed 
Published: January 2025

Rationale:
The treatment of a patient with an intrabony defect using periodontal phenotype modification therapy (PhMT) is alternative approach in correcting intrabony defects and changing periodontal phenotypes.

Patient concerns:
A 27-year-old male patient arrived with a severe intrabony defect and a poor periodontal phenotype. The patient received PhMT, which includes nonsurgical periodontal therapy, bone grafting, and orthodontic treatment. After 1 year, there were considerable changes in the intrabony defect, periodontal phenotype, and general oral health.

Diagnoses:
A 27-year-old male patient had a profound intrabony defect (10 mm) and a poor periodontal phenotype (thin gingiva, high frenum attachment).

Interventions:
The patient received PhMT, which includes nonsurgical periodontal therapy (scaling and root planing), bone grafting (allograft), and orthodontic treatment (correcting tooth placement). After 1 year, there were considerable improvements: Intrabony defect reduction (from 10 to 3 mm), improved periodontal phenotype (thickened gingiva, decreased frenum attachment), and improved dental health (lower pocket depths, increased attachment levels). PhMT successfully repaired the intrabony deficiency and altered the patient’s periodontal phenotype.

Outcomes:
Improved dental health and aesthetics were the result of the comprehensive treatment, which addressed the problem as well as the patient’s underlying periodontal features.

Lessons:
The efficacy of PhMT in correcting intrabony abnormalities and altering periodontal phenotypes is demonstrated in this case study. This strategy presents a viable remedy for patients with intricate periodontal requirements.
MicroRNA-204 may predict the renal function in patients with chronic kidney disease
Authors: Xiaoyun Guo , Hongjun Li , Cuijing Meng , Li Rong , Mei Zhang 
Published: January 2025

Background:
Chronic kidney disease significantly affects human health by loss of excretory kidney function. MicroRNAs have potential predictive and therapeutic significance for chronic kidney disease and fibrosis-related kidney diseases. This study aimed to investigate expression profiling and clinical significance of microRNA-204 (miR-204) expression in patients with chronic kidney disease.

Methods:
A total of 126 patients with chronic kidney disease and age-matched 126 healthy controls were enrolled in this study. Blood samples were collected from participants and expression levels of miR-204 were detected using reverse transcription quantitative polymerase chain reaction. Expression of inflammatory cytokines in glomerular cells was measured using reverse transcription quantitative polymerase chain reaction. Inflammatory cytokines in serum were analyzed using enzyme-linked immunosorbent assay in all participants. Multivariate Cox-regression analysis was used to analyze the association between serum level of miR-204 and inflammation, renal fibrosis, and degree of chronic kidney disease.

Results:
Chronic kidney disease patients had higher inflammatory cytokines including IL-1β, IL-6, TNF-α, IL-10, and IL-17 than healthy volunteers. Expression levels of inflammatory cytokines (IL-1β, IL-6, TNF-α, IL-10, and IL-17) were upregulated in patients with chronic kidney disease compared to healthy volunteers. Serum level of miR-204 was lower in chronic kidney disease patients than healthy patients. Expression of miR-204 was higher in healthy volunteers than patients with chronic kidney disease. In addition, expression of miR-204 was lower in glomerular cells in chronic kidney disease patients than those in the healthy volunteers. Furthermore, higher serum level of miR-204 was associated with better renal function in chronic kidney disease patients than patients who had lower serum level of miR-204. High serum levels of miR-204 were associated with degree of renal fibrosis and injury of chronic kidney disease patients. Multivariate Cox-regression analysis identified expression of miR-204 was positively correlated with inflammation in patients with chronic kidney disease.

Conclusion:
Outcomes indicate that serum levels of miR-204 are downregulated in serum in patients with chronic kidney disease. Data suggest that serum levels of miR-204 can be used to evaluate the renal function in patients with chronic kidney disease.
Fluoroscopic balloon dilation is effective for anastomotic leakage caused by compression due to intraperitoneal hematoma after ileostomy closure: A case report
Authors: Kamada Teppei , Ohdaira Hironori , Aida Takashi , Yamagishi Daisuke , Takahashi Junji , Nakashima Keigo , Ito Eisaku , Suzuki Norihiko , Hata Taigo , Yoshida Masashi , Yamanouchi Eigoro , Suzuki Yutaka 
Published: January 2025

Rationale:
There have been no reports of delayed anastomotic leakage of the ileum caused by compression of an intra-abdominal hematoma due to postoperative bleeding after ileostomy closure.

Patient concerns:
We report the case of a 44-year-old man with delayed anastomotic leakage after ileostomy closure caused by the compression of an intra-abdominal hematoma that healed quickly after fluoroscopic balloon dilatation of the bowel stenosis area.

Diagnoses:
Postoperative bleeding and hemorrhagic shock occurred on postoperative day 1 after ileostomy closure. Vital signs stabilized after blood transfusion, and computerized tomography-guided drainage was successfully performed to reduce the hematoma volume. However, residual hematoma compressed the ileum on the anal side of the anastomosis, leading to delayed anastomotic leakage.

Interventions/outcomes:
Fluoroscopic balloon dilation of the stenotic area through the drain was successfully performed, and the anastomotic leakage healed quickly.

Lessons:
In cases of small intestinal anastomotic leakage after postoperative bleeding, compression of the intestinal tract due to a hematoma should be considered. Fluoroscopic balloon dilation through a drain is an effective procedure.
Building Health Policy Advocacy Expertise in Pediatric Nurse Practitioners Through Civic-Based Experiential Learning
Authors: Schindler Christine A. , Kuester Jill C. , Pfister Jennifer K. , McDermott Katie L. 
Published: January 2025

Background:
Many nurses work largely as policy implementers rather than policy developers. The literature posits several multifaceted reasons for this lack of policy acumen including interprofessional power dynamics, marginalization of nurses in policy making, and lack of formal training in public policy advocacy.

Purpose:
To evaluate the impact of a targeted teaching strategy on increasing political astuteness, perceived skill, and comfort in health policy advocacy among a cohort of acute care pediatric nurse practitioner students.

Methods:
Curriculum assessment data were collected using the Political Astuteness Inventory, pre- and postclass discussions, and written reflections.

Results:
This curriculum evaluation suggests that specific policy and advocacy training coupled with civic-based experiential learning increased graduate nursing students’ political astuteness as well as increased their perceived skill and comfort with health policy advocacy.

Conclusions:
Targeted training is an important step in giving nurses the needed tools to work for equitable health care policies.