bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing the Clinical Courses of Children With Human Rhinovirus/Enterovirus to Children With Other Respiratory Viruses in the Outpatient Setting
Authors: Jones Milissa U. , Montgomery Agnes S. , Coskun Jennifer D. , Marcelo Raymundo Z. , Sutton Alyssa B. , Raiciulescu Sorana 
Published: September 2023

Background:
While infections caused by rhinoviruses and enteroviruses are common among children, the entirety of their clinical impact remains elusive. We compared the clinical outcomes of children with rhinovirus/enterovirus infections to other common respiratory viruses in outpatient settings.

Methods:
We conducted a retrospective analysis of nasopharyngeal samples singly positive for human rhinovirus/enterovirus (HRV/ENT), influenza A/B (FLU) or respiratory syncytial virus (RSV) from patients ≤17 years submitted for clinical testing via multiplex polymerase chain reaction between 2016 and 2019. We evaluated the following outpatient outcomes: days of respiratory symptoms before testing; visits for respiratory symptoms; receipt of a breathing treatment; receipt of antibiotics and hospital admission. Statistical analyses were conducted controlling for age and comorbid conditions.

Results:
There were 1355 positive samples included in this analysis (HRV/ENT: n = 743, FLU: n = 303 and RSV: n = 309). Compared to HRV/ENT, children with FLU had 28% fewer days of respiratory symptoms (β: −0.32; 95% confidence interval: −0.46 to −0.18; P < 0.001), fewer visits for respiratory symptoms, and significantly decreased odds of receiving a breathing treatment or antibiotics, and admission to the hospital. Children with RSV had a similar number of days of respiratory symptoms, outpatient visits and odds of hospital admission, but significantly increased odds of receiving a breathing treatment and antibiotics compared to those with HRV/ENT.

Conclusion:
Clinicians should have a high level of vigilance when managing children with positive respiratory viral testing for HRV/ENT given the potential for clinical outcomes similar to and, in some instances, worse than known highly pathogenic viruses.
The impact and utility of very low-calorie diets: the role of exercise and protein in preserving skeletal muscle mass
Authors: Janssen Tom Anthonius Hubertus , Van Every Derrick W. , Phillips Stuart M. 
Published: September 2023

Purpose of reviewVery low-calorie diets (VLCD) are used as a weight loss intervention, but concerns have been raised about their potential negative impact on lean mass. Here, we review the available evidence regarding the effects of VLCD on lean mass and explore their utility and strategies to mitigate reductions in skeletal muscle.Recent findingsWe observed that VLCD, despite their effects on lean mass, may be suitable in certain populations but have a risk in reducing lean mass. The extent of the reduction in lean mass may depend on various factors, such as the duration and degree of energy deficit of the diet, as well as the individual's starting weight and overall health.SummaryVLCD may be a viable option in certain populations; however, priority needs to be given to resistance exercise training, and secondarily to adequate protein intake should be part of this dietary regime to mitigate losing muscle mass.
Using mindfulness-based stress reduction to relieve loneliness, anxiety, and depression in cancer patients: A systematic review and meta-analysis
Authors: Yu Junye , Han Mingyue , Miao Fengru , Hua Dan 
Published: September 2023

Background:
Mindfulness-based stress reduction (MBSR) has been suggested as an effective mind-body approach for relieving stress in patients with chronic diseases. As of yet, there is no conclusive research on MBSR’s role in reducing affective disorders among cancer patients. A systematic review and meta-analysis was conducted to determine whether MBSR has an impact on loneliness, anxiety, and depression in cancer patients.

Methods:
Systematic searches were conducted in PubMed, Embase, and the Cochrane Library from the start of these databases to January 2nd, 2022 to identify relevant randomized controlled trials. Two authors independently conducted the literature search, collected the data, and performed the statistical analysis. In order to account for potential between-study heterogeneity, a random-effect model was used in the meta-analysis.

Results:
The meta-analysis included 16 studies with 2072 cancer patients. Among the 16 studies, 13 included patients with breast cancer, and the follow-up duration ranged from 6 to 53 weeks. Compared to controls receiving standard cancer care, interventions of MBSR with sessions for 6 to 8 weeks significantly improved loneliness (standard mean difference [SMD]: −0.35, 95% confidence interval [CI]: −0.59 to −0.12, P = .003, I
2 = 46%), anxiety (SMD: −0.51, 95% CI: −0.73 to −0.30, P < .001, I
2 = 77%), and depression (SMD: −0.61, 95% CI: −1.02 to −0.20, P = .004, I
2 = 94%) in patients with cancer.

Conclusion:
According to recent research, MBSR may be beneficial to patients diagnosed with cancer who are feeling lonely, anxious, or depressed.
The efficacy of statins in the treatment of rheumatoid arthritis: A systematic review and meta-analysis
Authors: Ren Conglin , Li Mingshuang 
Published: September 2023

Background:
A large body of research has investigated the use of statins in rheumatoid arthritis (RA); however, the therapeutic effects of statins remain uncertain. Thus, we designed a systematic review and meta-analysis to evaluate the role of statins in patients with RA.

Methods:
Databases searched to detect clinical randomized controlled trials or clinical controlled trials on the interaction between statins and RA before January 2020 included PubMed, Web of Sciences, Embase, Cochrane Library, CNKI, Wan Fang Database. Efficacy was measured by Disease Activity Score in 28 Joints (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tenderness of the joint (TJ), swelling of the joint (SJ), and interleukin-6. The level of blood lipid was also evaluated. STATA 12.0 was used for the meta-analysis. The Cochrane method was used for quality assessment. Heterogeneity was considered to determine fixed effects or random effects models.

Results:
Nineteen clinical trials with a total of 22,906 subjects were included in the meta-analysis. Sixteen studies reported a change in DAS28 after statin treatment. The pooled analysis showed that statins reduced DAS28 in RA patients. Change in ESR after statin treatment was reported in 9 studies. The summary analysis showed that statins lowered ESR in RA patients. Twelve studies reported a change in CRP after statin treatment. The results of the entire analysis showed that statins lowered CRP in RA patients. Seven studies reported a change in TJ after statin treatment. The combined analysis showed that statins reduced TJ at RA patients. Six studies reported changes in IL6 after statin therapy. The results showed that statins failed to reduce IL6 in RA patients. Seven studies reported changes in SJ after statin therapy, which showed that statins failed to reduce SJ in RA patients. We also found that statins can reduce blood lipid levels in RA patients.

Conclusion:
In conclusion, statins were able to reduce DAS28, ESR, CRP, TJ, and blood lipids. It indicated that stains can benefit patients with RA by inhibiting the expression of inflammatory factors and reducing the levels of lipids in the blood. Our study may offer a new perspective on the treatment of RA and provide research ideas for future larger multi-center clinical trials.
Effect of sacral erector spinae plane block on post-hemorrhoidectomy pain: A randomized controlled trial
Authors: Mermer Aydin , Simsek Gurcan , Mermer Hasan Alp , Tire Yasin , Kozanhan Betül 
Published: September 2023

Background:
Hemorrhoidectomy is a common surgical procedure associated with significant postoperative pain. The conventional analgesic methods used for hemorrhoidectomy often have adverse effects and may not provide adequate pain relief. The sacral erector spinae plane block (ESPB) is a newly introduced technique that has shown promise in various surgical procedures. This prospective, randomized, controlled trial aimed to evaluate the analgesic effects of sacral ESPB following hemorrhoidectomy.

Methods:
Seventy patients undergoing hemorrhoidectomy were divided into 2 groups: the control group and the sacral ESPB group. Bilateral sacral ESPB was performed in the sacral ESPB group, whereas no intervention was performed in the control group. The numeric rating scale at rest and during the active period (mobilizing) was used as the primary outcome measure. Secondary outcome measures were the cumulative doses of tramadol, the number of patients who required rescue analgesia postoperatively, and quality of recovery-15 Turkish version patient recovery quality.

Results:
The sacral ESPB group had significantly low numeric rating scale scores at various time points (P < .05). More patients in the control group needed rescue analgesia during the postoperative period (P < .001). The dosages of tramadol consumption after the first 24 hours postoperatively were significantly lower in the sacral ESPB group compared with the control group (P < .001). Furthermore, quality of recovery-15 Turkish version scores were high in the sacral ESPB group (P < .001).

Conclusion:
The results suggest that sacral ESPB is an effective method for post-hemorrhoidectomy pain management, reducing the need for additional analgesics and improving patient recovery.
HBOT has a better cognitive outcome than NBH for patients with mild traumatic brain injury: A randomized controlled clinical trial
Authors: Liu Zhiguo , Wang Xirui , Wu Zhiyou , Yin Gangfeng , Chu Haibin , Zhao Pengyue 
Published: September 2023

Background:
Normobaric hyperoxia (NBH) and hyperbaric oxygen therapy (HBOT) are effective treatment plan for traumatic brain injury (TBI). The aim of this study was to compare cognitive outcome after mild TBI between NBH and HBOT so as to provide a more suitable treatment strategy for patients with mild TBI.

Methods:
A prospective research was conducted between October 2017 and March 2023, enrolling patients with mild TBI (Glasgow coma scale score: 13–15 points) within 24 hours of injury in Cangzhou Central Hospital. Patients were randomized into 3 groups: group control (C), group NBH and group HBOT. The patients in HBOT group received hyperbaric oxygen therapy in high pressure oxygen chamber and patients in NBH group received hyperbaric oxygen therapy. at 0 minute before NBH or HBOT (T1), 0 minute after NBH or HBOT (T2) and 30 days after NBH or HBOT (T3), level of S100β, NSE, GFAP, HIF-1α, and MDA were determined by ELISA. At the same time, the detection was performed for MoCA and MMSE scores, along with rSO2.

Results:
The results showed both NBH and HBOT could improve the score of MoCA and MMSE, as well as the decrease the level of S100β, NSE, GFAP, HIF-1α, MDA, and rSO2 compared with group C. Furthermore, the patients in group HBOT have higher score of MoCA and MMSE and lower level of S100β, NSE, GFAP, HIF-1α, MDA, and rSO2.

Conclusion:
Both NBH and HBOT can effectively improve cognitive outcome for patients with mild TBI by improving cerebral hypoxia and alleviating brain injury, while HBOT exert better effect than NBH.
Epidemiology of liver transplantation and post-LT complications in Germany: nationwide study (2005–2018)
Authors: Gu Wenyi , Schaaf Louisa , Hortlik Hannah , Zeleke Yasmin , Brol Maximilian J. , Schnitzbauer Andreas A. , Bechstein Wolf O. , Zeuzem Stefan , Queck Alexander , Peiffer Kai-Henrik , Tischendorf Michael , Pascher Andreas , Laleman Wim , Praktiknjo Michael , Schulz Martin S. , Uschner Frank E. , Rennebaum Florian , Trebicka Jonel 
Published: September 2023

Background
To date, liver transplantation (LT) is the only curative treatment for cirrhosis and early-diagnosed progressive acute liver failure (ALF). However, LT results in morbidities and mortality even post-LT. Different comorbidities may follow and further increase mortality and morbidity. In this study, we investigated the outcomes and their trends over a period of 14 years among hospitalized patients evaluated for LT, transplant and post-LT in Germany.

Methods
This German nationwide study investigated the number of admissions of patients hospitalized for evaluation of LT and post-LT on related comorbidities and complications between 2005 and 2018 based on the DRG system with ICD-10/OPS codes. 14 745 patients were put on the LT waiting list and 12 836 underwent LT during the observational period.

Results
The LT number decreased by 2.3% over time, while the waiting list mortality rate increased by 5%. By contrast, the in-hospital mortality rate decreased by 3%, especially in ALF patients (decrease of 16%). Interestingly, admissions of post-LT patients for complications almost doubled, driven mainly by complications of immunosuppression (tripled). Importantly, post-LT patients with acute kidney injury (20.2%) and biliodigestive anastomosis (18.4%) showed the highest in-hospital mortality rate of all complications.

Conclusion
In conclusion, the decrease in LT leads most probably to the increased in-hospital mortality of patients on the waiting list. Interestingly, in-hospital mortality decreased in LT patients. Post-LT comorbidities requiring hospitalization increased in the observational period and management of patients post-LT with AKI or biliodigestive anastomosis should be addressed.
Potential missed diagnoses of Crohn’s disease in tertiary care: impact on drug utilization and healthcare facilities use
Authors: Ferraro Sara , Cappello Emiliano , Bartolini Claudia , Convertino Irma , Bertani Lorenzo , Lucenteforte Ersilia , Costa Francesco , Paoletti Olga , Giometto Sabrina , Gini Rosa , Tuccori Marco 
Published: September 2023

Background
A missed diagnosis of Crohn’s disease (CD) can delay treatment initiation with consequences on disease course.

Aims
To measure the possible impact of missed diagnoses on drug utilization and access to healthcare facilities in a real-world cohort of CD patients.

Methods
This retrospective observational study has been conducted on the regional administrative databases of Tuscany (Italy). We included patients with a first record of CD diagnosis between 06/11/2011 and 06/30/2016. Possible missed diagnosis (exposure) was defined by hospital presentation for gastrointestinal symptoms consistent with CD diagnosis that occurred in the 7–60 months preceding CD diagnosis. We compared exposed and non-exposed patients by assessing time-free from biologic drugs and from Emergency Department (ED) or hospital access. Hazard ratio (HR) was calculated using Cox models.

Results
Among 3342 CD patients, 584 (17.5%) had a possible missed diagnosis. A risk of being treated with biologic drugs [adjusted HR (aHR): 2.17, 95% CI: 1.75–2.71] and of access to ED or hospitalization (aHR: 1.59, 95% CI: 1.44–1.75) was observed in patients with a possible missed diagnosis as compared to those without.

Conclusion
Tertiary care caregivers should be trained in the identification of early CD symptoms, to timely identify CD diagnosis and optimize pharmacological treatment and disease management.
Climate change and kidney stones
Authors: Maline Grace E. , Goldfarb David S. 
Published: September 2023

Purpose of review
Kidney stones affect an increasing proportion of the population. We suggest that these trends are in part influenced by exposure to higher temperatures as a result of climate change and urbanization. The changing epidemiology of kidney stones is a topic worthy of discussion due to the economic and healthcare burden the condition poses as well as the quality-of-life disruption faced by individuals with kidney stones.

Recent findings
The relationship between heat and kidney stones is well supported. Exposure to high temperatures has been shown to increase risk for stone development within a short time frame. Effects are modified by factors such as sex, comorbid conditions, and population vulnerability and adaptability. Urban heat islands (UHIs) likely exaggerate the effect of increasing global surface temperature. The concentration of UHIs often coincides with historic redlining practices in the United States, potentially contributing to observed disparities in kidney health among minoritized populations. As global surface temperature increases and urbanization trends continue, a greater proportion of the world's population is exposed to significant temperature extremes each year, leading to the expectation that kidney stone prevalence will continue to increase.

Summary
This work describes the effect of increasing global surface temperature as a result of climate change on kidney stone disease and kidney health. These effects may result in further perpetuation of significant kidney stone related social disparities. We suggest strategies to mitigate the effects of heat exposure on stone formation.
Cervical Cerclage: A Comprehensive Review of Major Guidelines
Authors: Giouleka Sonia , Boureka Eirini , Tsakiridis Ioannis , Siargkas Antonios , Mamopoulos Apostolos , Kalogiannidis Ioannis , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: September 2023

Importance
Cervical cerclage (CC) represents one of the few effective measures currently available for the prevention of preterm delivery caused by cervical insufficiency, thus contributing in the reduction of neonatal morbidity and mortality rates.

Objective
The aim of this study was to review and compare the most recently published major guidelines on the indications, contraindications, techniques, and timing of placing and removal of CC.

Evidence Acquisition
A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetricians and Gynaecologists of Canada (SOGC), and the International Federation of Gynecology and Obstetrics (FIGO) on CC was carried out.

Results
There is a consensus among the reviewed guidelines regarding the recommended techniques, the indications for rescue CC, the contraindications, as well as the optimal timing of CC placement and removal. All medical societies also agree that ultrasound-indicated CC is justified in women with history of prior spontaneous PTD or mid-trimester miscarriage and a short cervical length detected on ultrasound. In addition, after CC, serial sonographic measurement of the cervical length, bed rest, and routine use of antibiotics, tocolysis, and progesterone are unanimously discouraged. In case of established preterm labor, CC should be removed, according to ACOG, RCOG, and SOGC. Furthermore, RCOG and SOGC agree on the prerequisites that should be met before attempting CC. These 2 guidelines along with FIGO recommend history-indicated CC for women with 3 or more previous preterm deliveries and/or second trimester pregnancy miscarriages, whereas the ACOG suggests the use of CC in singleton pregnancies with 1 or more previous second trimester miscarriages related to painless cervical dilation or prior CC due to painless cervical dilation in the second trimester. The role of amniocentesis in ruling out intra-amniotic infection before rescue CC remains a matter of debate.

Conclusions
Cervical cerclage is an obstetric intervention used to prevent miscarriage and preterm delivery in women considered as high-risk for these common pregnancy complications. The development of universal international practice protocols for the placement of CC seems of paramount importance and will hopefully improve the outcomes of such pregnancies.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, the learner should be able to identify the indications and contraindications of cervical cerclage; evaluate the prerequisites before cervical cerclage placement; and explain the strategies for perioperative and postoperative care after cervical cerclage placement.
Pediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab’)₂ Antivenom
Authors: Seltzer Justin A. , Winkler Garret A. , Friedman Nathan A. , Galust Henrik , Hardin Jeremy , Srihari Priya , Ontiveros Sam , Corbett Bryan , Clark Richard F. 
Published: September 2023

Objectives
Rattlesnake envenomations are uncommon, and the majority occur in adults. Although Crotalidae equine immune F(ab’)₂ antivenom (F(ab’)₂AV; trade name ANAVIP) was introduced in 2018, no pediatric specific studies of F(ab’)₂AV have been reported to date. The objective of this study was to evaluate the clinical performance and adverse effects of F(ab’)₂AV in children.

Methods
A single-center, retrospective chart review was performed on patients with rattlesnake envenomation presenting to a children's hospital between October 2018 and August 2022. Inclusion criteria were age younger than 18 years and F(ab’)₂AV use. Exclusion criteria were other antivenom use at any time and presentation beyond 24 hours postenvenomation.
Demographic characteristics, hemoglobin, platelet count, fibrinogen, international normalized ratio, number of F(ab’)₂AV vials used, infusion-related complications, and clinical outcomes were collected.

Results
Twenty-six patients, 19 males and 7 females, with a mean age of 7.7 years (0.67 to 16 years) met inclusion criteria. Fourteen (54%) were treated with only the initial 10 vial F(ab’)₂AV doses. Twelve patients were given additional doses with a median additional vials of 10 (4–34 vials; interquartile range, 8.75–12 vials). The median total vials given for all patients was 10 (10–44 vials; interquartile range, 10–20 vials).
Two patients developed acute infusion reactions. Both were treated by slowing the infusion rate and with medications (diphenhydramine, corticosteroids). No delayed reactions were noted. No patients required blood products or surgical interventions.
After discharge, no complications, recurrent symptoms, return visits, or readmissions were reported. Follow-up by chart review or phone was obtained for 18 patients, and no postdischarge complications were noted. Seven patients had postdischarge hematologic laboratory evaluations and all were normal.

Conclusions
Although limited by small sample size and postdischarge follow-up, F(ab’)₂AV was well tolerated in our series of pediatric patients, consistent with prior studies of all age groups.