bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccinal effect of HIV-1 antibody therapy: dream or reality?
Authors: Naranjo-Gomez Mar , Pelegrin Mireia 
Published: May 2023

Purpose of review
This review summarizes recent studies reporting the induction of vaccinal effects by human immunodeficiency virus (HIV-1) antibody therapy. It also puts into perspective preclinical studies that have identified mechanisms involved in the immunomodulatory properties of antiviral antibodies. Finally, it discusses potential therapeutic interventions to enhance host adaptive immune responses in people living with HIV (PLWH) treated with broadly neutralizing antibodies (bNAbs).

Recent findings
Recent studies in promising clinical trials have shown that, in addition to controlling viremia, anti-HIV-1 bNAbs are able to enhance the host's humoral and cellular immune response. Such vaccinal effects, in particular the induction of HIV-1-specific CD8+ T-cell responses, have been observed upon treatment with two potent bNAbs (3BNC117 and 10–1074) alone or in combination with latency-reversing agents (LRA). While these studies reinforce the idea that bNAbs can induce protective immunity, the induction of vaccinal effects is not systematic and might depend on both the virological status of the patient as well as the therapeutic strategy chosen.

Summary
HIV-1 bNAbs can enhance adaptive host immune responses in PLWH. The challenge now is to exploit these immunomodulatory properties to design optimized therapeutic interventions to promote and enhance the induction of protective immunity against HIV-1 infection during bNAbs therapy.
Noninvasive preimplantation genetic testing using the embryo spent culture medium: an update
Authors: Lledo Belen , Morales Ruth , Antonio Ortiz Jose , Bernabeu Andrea , Bernabeu Rafael 
Published: May 2023

Purpose of review
The presence of cell-free DNA (cf-DNA) in the embryo spent culture medium allows to develop a noninvasive PGT-A (niPGTA). Noninvasive PGT-A may provide a simpler, safer and less costly approach to preimplantation genetic testing of aneuploidy (PGT-A). Furthermore, niPGTA would provide wider access to embryo genetic analysis and circumvent many legal and ethical considerations. However, the concordance rate between the results obtained by PGT-A and niPGTA varies among studies and, their clinical utility has not been already demonstrated. This review evaluates the niPGTA reliability based on SCM and adds new knowledge about the clinical relevance of SCM for noninvasive PGT-A.

Recent findings
The most recent concordance studies evaluating the accuracy of niPGTA using SCM showed a high variation in the informativity rate of SCM and the diagnostic concordance. Also, sensitivity and specificity showed similar heterogeneous results. Therefore, these results do not support the clinical utility of niPGTA. Regarding clinical outcome, the data are initial and further research, including randomized and nonselection studies are needed.

Summary
Further research, including randomized and nonselection studies, as well as optimization of embryo culture conditions and medium retrieval, are needed to improve the reliability and clinical utility of niPGTA.
Impact of COVID-19 on medical care conduct and psychological burden among patients with psoriasis: real-world data from a tertiary hospital in China
Authors: Zhang Ying , Guo Jin-Zhu , Zhang Chun-Lei 
Published: May 2023

Objective:
The ongoing coronavirus disease 2019 (COVID-19) epidemic has caused extensive damage worldwide. We explored whether the medical care conduct of patients with psoriasis has changed and whether the COVID-19 epidemic has placed more psychological pressure on these patients.

Methods:
A questionnaire survey was administered to patients with psoriasis in the Dermatology Department of Peking University Third Hospital in July 2022. Information about the patients’ general demographics, psoriasis condition, mental state of anxiety [Generalized Anxiety Disorder-7 (GAD-7) score], changes in medical care conduct, and Concerns about COVID-19-Related Risk Score for Psoriasis (CCRSP, a self-designed questionnaire) was collected. Univariate analysis with the Mann–Whitney U test for continuous variables was used in the estimation of statistical differences.

Results:
A total of 112 patients with psoriasis completed the survey. Purchasing medicine was the factor that added difficulty for most participants (32.1%). Fewer participants (26.8%) encountered medical registration difficulties than economic and transportation difficulties. Nearly three-quarters of participants (73.2%) reported at least one medical care conduct change resulting from the COVID-19 epidemic. A small proportion of participants (12.5%) thought that COVID-19 prevented them from seeking medical services for psoriasis. The top three items that caused the most concern were psoriasis aggravation resulting from drug reduction and withdrawal because of COVID-19 (44.7%), psoriasis aggravation after infection with COVID-19 (38.4%), and psoriasis-related side effects of the COVID-19 vaccine (35.7%). The GAD-7 score of patients with a high CCRSP (score of >10) was significantly higher than that of patients with a low CCRSP (score of ≤10) (non-parametric test, P = 0.047).

Conclusion:
COVID-19 poses challenges and places a mental burden on patients with psoriasis. Doctors should regulate the medical behavior of patients with psoriasis according to their specific COVID-19 situation and help patients ease their anxiety to maintain the stability of their psoriasis condition.
Predicting Complicated Mild Traumatic Brain Injury in Adolescent Trauma to Enhance Clinical Decisions in Imaging
Authors: Rhodes Heather X. , Berg Gina , Shadiack Anthony L. , Thomas Kevin D. , Horawski Jennifer L. , Boyer Geoff , Kleist Sara M. , Worthley Aaron I. , Rosenberg David I. , Gutovitz Scott B. , Helmrich George A. , Biswas Saptarshi , Pepe Antonio P. 
Published: May 2023

BACKGROUND:
The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury algorithm is used to identify children at low risk of clinically significant traumatic brain injuries to reduce computed tomography (CT) exposure. Adapting PECARN rules based on population-specific risk stratification has been suggested to improve diagnostic accuracy.

OBJECTIVE:
This study sought to identify center-specific patient variables, beyond PECARN rules, that may enhance the identification of patients requiring neuroimaging.

METHODS:
This single-center, retrospective cohort study was conducted from July 1, 2016, to July 1, 2020, in a Southwestern U.S. Level II pediatric trauma center. The inclusion criteria were adolescents (10–15 years), Glasgow Coma Scale (13–15), with a confirmed mechanical blow to the head. Patients without a head CT were excluded. Logistic regression was performed to identify additional complicated mild traumatic brain injury predictor variables beyond the PECARN.

RESULTS:
There were 136 patients studied; 21 (15%) presented with a complicated mild traumatic brain injury. Relative to motorcycle collision or all-terrain vehicle trauma (odds ratio [OR] 211.75, 95% confidence interval, CI [4.51, 9931.41], p < .001), an unspecified mechanism (OR 42.0, 95% CI [1.30, 1350.97], p = .03) and consult activation (OR 17.44, 95% CI [1.75, 173.31], p = .01) were significantly associated with complicated mild traumatic brain injury.

CONCLUSIONS:
We identified additional factors associated with complex mild traumatic brain injury, including motorcycle collision and all-terrain vehicle trauma, unspecified mechanism, and consult activation that are not in the PECARN imaging decision rule. Adding these variables may aid in determining the need for appropriate CT scanning.
Under the Lens: Team Perception of Trauma Video Review
Authors: Scrushy Marinda G. , Nagaraj Madhuri , Burke Kristen , Kuhlenschmidt Kali , Jeter Shannon , Johnson Della , Brown Kristie , Edwards Courtney , Marinica Alexander , Vella Michael A. , Holena Daniel N. , Park Caroline , Dumas Ryan P. 
Published: May 2023

BACKGROUND:
Video-based assessment and review are becoming increasingly common, and trauma video review (TVR) has been shown to be an effective educational, quality improvement, and research tool. Yet, trauma team perception of TVR remains incompletely understood.

OBJECTIVE:
We evaluated positive and negative perceptions of TVR across multiple team member groups. We hypothesized that members of the trauma team would find TVR educational and that anxiety would be low across all groups.

METHODS:
An anonymous electronic survey was provided to nurses, trainees, and faculty during weekly multidisciplinary trauma performance improvement conference following each TVR activity. Surveys assessed perception of performance improvement and anxiety or apprehension (Likert scale: 1 “strongly disagree” to 5 “strongly agree”). We report individual and normalized cumulative scores (average of responses for each positive [n = 6] and negative [n = 4] question stem).

RESULTS:
We analyzed 146 surveys over 8 months, with 100% completion rate. Respondents were trainees (58%), faculty (29%), and nurses (13%). Of the trainees, 73% were postgraduate year (PGY) 1–3 and 27% were PGY 4–9. Of all respondents, 84% had participated previously in a TVR conference. Respondents reported an improved perception of resuscitation education quality and personal leadership skills development. Participants found TVR to be more educational than punitive overall. Analysis of team member types showed lower scores for faculty for all positive stemmed questions. Trainees were more likely to agree with negative stemmed questions if they were a lower PGY, and nurses were least likely to agree with negative stemmed questions.

CONCLUSIONS:
TVR improves trauma resuscitation education in a conference setting, with trainees and nurses reporting the greatest benefit. Nurses were noted to be the least apprehensive about TVR.
Standardizing Child Passenger Safety Screening in the Emergency Department: A Quality Improvement Study
Authors: Almodovar Heidi L. , Thorson Chad M. , Cardy Christina R. 
Published: May 2023

Background:
Motor vehicle collisions remain a leading cause of death and injury in children in the United States. Our Level I trauma center found that 53% of children ages 1–19 years are improperly restrained or unrestrained. Our center employs a Pediatric Injury Prevention Coalition with nationally certified child passenger safety technicians who are active in the community yet remain underutilized in the clinical setting.

Objective:
The purpose of the quality improvement project was to standardize child passenger safety screening in the emergency department to increase referrals to a Pediatric Injury Prevention Coalition.

Methods:
This quality improvement project utilized a pre-/postdesign of data collected before and after implementing the child passenger safety bundle. Using the Plan–Do–Study–Act model, organizational change processes were identified, and quality improvement interventions implemented from March to May 2022.

Results:
The total number of families referred was 199, representing 230 children, which was 3.8% of the eligible population. A significant relationship was found between child passenger safety screening and referral to the Pediatric Injury Prevention Coalition in 2019 and 2021, χ2 (1, n = 230) = 239.98, p < .001, and χ2 (1, n = 230) = 240.78, p < .001, respectively. Forty-one percent of the referred families established contact with the Pediatric Injury Prevention Coalition.

Conclusion:
Standardizing child passenger safety screening in the emergency department increased referrals to a Pediatric Injury Prevention Coalition and resulted in improved child safety seat distribution and child passenger safety education.
Virtual Rural Trauma Team Development Course: Trying to Zoom in on a Solution
Authors: Koontz Jennifer , Causer Thomas , Zipf Jami , Dillman-Stull Jill , Dumire Russell 
Published: May 2023

BACKGROUND:
The COVID-19 pandemic prevented centers from providing in-person interactive training programs such as the Rural Trauma Team Development Course. Adapting the course to a virtual platform is an option, yet little is known regarding the feasibility of using this format.

OBJECTIVE:
This study aimed to evaluate the feasibility of providing a virtual rural trauma development course during COVID-19.

METHODS:
This is a descriptive study of emergency medical technicians, nurses, emergency department technicians, and physicians from four rural community health care facilities and local emergency medical services who participated in a virtual Rural Trauma Team Development Course held in November 2021 which was transformed into a virtual platform using live remote interactive lectures, recorded case-based scenarios, and interactive virtual-based questions. The course was evaluated by the changes instituted at the centers based on program recommendations and a participant survey.

RESULTS:
A total of 41 participants were studied, of whom 31 (75%) returned the emailed postprogram survey. The majority (>75%) of respondents rated the activity as very good, with course objectives met. All four facilities instituted changes following the program, including enhancing policy and procedures, guidelines, advancing performance improvement triggers, and equipment acquisition. Individual-reported participant satisfaction was very high.

CONCLUSION:
The Rural Trauma Team Development Course can be provided virtually and is a feasible option for trauma centers to provide initial trauma management in the rural community in a safe pandemic-restrictive atmosphere.
The role of the absence of Hyrtl’s anastomosis in monochorionic pregnancy: Friend or foe?: A case report
Authors: Liu Ziling , Ruan Jie 
Published: May 2023

Introduction:
Hyrtl’s anastomosis, an intra-arterial shunt, plays a protective role when the placental territories supplied by the umbilical arteries are different in size. Its absence is associated with an increased risk of poor outcomes in singleton pregnancy. However, the literature and studies on the effect of absent Hyrtl’s anastomosis in twin placentas are rare.

Case presentation:
We present a case of a monochorionic diamniotic twin pregnancy complicated with type I selective fetal growth restriction (SFGR). Despite discordance in placental territory and cord insertion sites, the patient had an overall good pregnancy process, suggesting that the absence of Hyrtl’s anastomosis may have played a benign role.

Conclusions:
The absence of Hyrtl’s anastomosis in our case seemed to show a favorable effect, representing a finding of opposite effects in monochorionic placentas compared with singleton placentas.
Lymphocytic interstitial pneumonia presenting with a ground glass nodule: A case report and literature review
Authors: Liu Qi , Chen Zhen , Deng Peng , Wang Jing , Zhang Shengchu , Tang Lihua , Yang Yuxia , Lang Bojuan 
Published: May 2023

Rationale:
Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder, often associated with autoimmune diseases. Most LIPs present with multiple bronchial cysts and diffuse interstitial infiltration. It is histologically characterized by widespread diffuse lymphocytic infiltration of the pulmonary interstitium, and the enlargement and widening of the alveolar septum.

Patient concerns:
A 49-year-old woman was admitted to hospital for finding pulmonary nodules for more than 2 months. 3D imaging chest computed tomography (CT) examination of both lungs showed that there was a middle lobe of the right lung with a size of about 1.5 cm × 1.1 cm ground-glass nodules.

Diagnoses:
A single operating port thoracoscopic wedge resection biopsy of a right middle lung nodule was performed. The pathology showed diffuse lymphocytic infiltration with varying numbers of small lymphocytes, plasma cells, macrophages and histiocytes infiltrating the alveolar septa, widened and enlarged alveolar septa, and scattered lymphoid follicles. Immunohistochemically, CD20 positive in follicular area, CD3 positive in interfollicular area. LIP was considered.

Interventions:
The patient was regularly followed without any specific treatment.

Outcomes:
Follow-up chest CT showed no significant abnormalities in the lungs 6 months after surgery.

Lessons:
To the best of our knowledge, our case may be the second reported case of a patient with LIP presenting with a ground glass nodule on chest CT, and it is speculated that the ground glass nodule may be an early manifestation of idiopathic LIP.
Improving quality of life for a patient with fibromyalgia and their caregiver: A protocol for the application of the integrative medical service model
Authors: Cheong Moon Joo , Chung Chong Hyuk , Lee Chang Hoon , Lee Myeung Su , Ha Won Bae , Lee Jung Han , Kang Hyung Won 
Published: May 2023

Objectives:
Patients with incurable diseases experience difficulty carrying out activities of daily living and rely on caregivers. Caregivers of patients with fibromyalgia (FM) are unable to understand the extent of the patients’ suffering because the pain sites are invisible. To address this problem, this study will apply an integrative healthcare service model to a single FM case to manage pain and enhance the quality of life and, subsequently, gather feedback from different sources regarding the treatment. This paper presents the study protocol.

Methods:
We will conduct an observational study to gather quantitative and qualitative feedback from various perspectives regarding the application of an integrative healthcare service program for FM patients developed in Korea for an FM patient–caregiver pair. The program will comprise eight 100-minute weekly sessions, during which integrative services that combine Western and Oriental medicines (Korean traditional medicine) will be provided to enhance pain management and quality of life. The feedback collected after each session will be reflected in the next session’ content.

Results:
The results will comprise the feedback from the patient and caregiver in accordance with revisions made to the program.

Conclusions:
The results will provide basic data for optimizing an integrative healthcare service system in Korea for patients suffering from chronic pain owing to diseases such as FM.
Small bowel neuroendocrine tumours – casting the net wide
Authors: Chetcuti Zammit Stefania , Sidhu Reena 
Published: May 2023

Purpose of review
Our aim is to provide an overview of small bowel neuroendocrine tumours (NETs), clinical presentation, diagnosis algorithm and management options. We also highlight the latest evidence on management and suggest areas for future research.

Recent findings
Dodecanetetraacetic acid (DOTATATE) scan can detect NETs with an improved sensitivity than when compared with an Octreotide scan. It is complimentary to small bowel endoscopy that provides mucosal views and allows the delineation of small lesions undetectable on imaging. Surgical resection is the best management modality even in metastatic disease. Prognosis can be improved with the administration of somatostatin analogues and Evarolimus as second-line therapies.

Summary
NETs are heterogenous tumours affecting most commonly the distal small bowel as single or multiple lesions. Their secretary behaviour can lead to symptoms, most commonly diarrhoea and weight loss. Metastases to the liver are associated with carcinoid syndrome.
Cleaning up alpha-1 antitrypsin deficiency related liver disease
Authors: Rademacher Laura , Fromme Malin , Strnad Pavel 
Published: May 2023

Purpose of review
Alpha-1 antitrypsin deficiency (AATD) is one of the most common genetic disorders arising due to mutations in alpha-1 antitrypsin (AAT) gene affecting primarily the lung and the liver. This review summarizes the pathophysiology and clinical manifestation of different AATD genotypes and discusses the recent therapeutic developments. The focus is on the severe, rare homozygous Pi∗ZZ and the common heterozygous Pi∗MZ genotype.

Recent findings
Pi∗ZZ individuals harbor an up to 20 times higher risk of liver fibrosis and cirrhosis than noncarriers and liver transplantation is currently the only available therapeutic option. AATD constitutes a proteotoxic disorder arising from hepatic AAT accumulation and the currently most promising data come from a phase 2, open-label trial of fazirsiran, a hepatocyte-targeted siRNA. Pi∗MZ subjects display an increased risk of advanced liver disease and at the latter stage, a faster deterioration than individuals without AAT mutation.

Summary
Although the fazirsiran data offer a glimpse of hope to AATD patients, a consensus on appropriate study endpoint, a careful patient selection as well as monitoring of long-term safety will be essential for an approval.
Metabolic dysfunction and nonalcoholic fatty liver disease risk in individuals with a normal body mass index
Authors: DiStefano Johanna K. , Gerhard Glenn S. 
Published: May 2023

Purpose of review
Nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity, but is also common in individuals with a normal body mass index (BMI), who also experience the hepatic inflammation, fibrosis, and decompensated cirrhosis associated with NAFLD progression. The clinical evaluation and treatment of NAFLD in this patient population are challenging for the gastroenterologist. A better understanding of the epidemiology, natural history, and outcomes of NAFLD in individuals with normal BMI is emerging. This review examines the relationship between metabolic dysfunction and clinical characteristics associated with NAFLD in normal-weight individuals.

Recent findings
Despite a more favorable metabolic profile, normal-weight NAFLD patients exhibit metabolic dysfunction. Visceral adiposity may be a critical risk factor for NAFLD in normal-weight individuals, and waist circumference may be better than BMI for assessing metabolic risk in these patients. Although screening for NAFLD is not presently recommended, recent guidelines may assist clinicians in the diagnosis, staging, and management of NAFLD in individuals with a normal BMI.

Summary
Individuals with a normal BMI likely develop NAFLD as a result of different etiologies. Subclinical metabolic dysfunction may be a key component of NAFLD in these patients, and efforts to better understand this relationship in this patient population are needed.
The role of artificial intelligence in hepatology research and practice
Authors: Khalifa Ali , Obeid Jihad S. , Erno Jason , Rockey Don C. 
Published: May 2023

Purpose of review
The use of artificial intelligence (AI) in examining large data sets has recently gained considerable attention to evaluate disease epidemiology, management approaches, and disease outcomes. The purpose of this review is to summarize the current role of AI in contemporary hepatology practice.

Recent findings
AI was found to be diagnostically valuable in the evaluation of liver fibrosis, detection of cirrhosis, differentiation between compensated and decompensated cirrhosis, evaluation of portal hypertension, detection and differentiation of particular liver masses, preoperative evaluation of hepatocellular carcinoma as well as response to treatment and estimation of graft survival in patients undergoing liver transplantation. AI additionally holds great promise in examination of structured electronic health records data as well as in examination of clinical text (using various natural language processing approaches). Despite its contributions, AI has several limitations, including the quality of existing data, small cohorts with possible sampling bias and the lack of well validated easily reproducible models.

Summary
AI and deep learning models have extensive applicability in assessing liver disease. However, multicenter randomized controlled trials are indispensable to validate their utility.