bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progressive muscle relaxation exercises in patients with COVID-19: Systematic review and meta-analysis
Authors: Seid Abubeker Alebachew , Mohammed Ahmed Adem , Hasen Aragaw Asfaw 
Published: April 2023

Background:
Patients with COVID-19 will experience high levels of anxiety and depression and poor levels of sleep and quality of life (QoL) due to isolation treatment and uncertain outcomes. Progressive muscle relaxation (PMR) exercises show promising treatment effects on mental health and sleep problems and overall QoL in COVID-19 patients. This study aimed to evaluate the efficacy and safety of PMR exercises in patients with COVID-19.

Methods:
Both experimental and non-experimental studies related to PMR and COVID-19 were systematically searched in the PubMed, Cochrane Library, PEDro and HINARI databases for studies published from the occurrence of the pandemic to December 2022. Study selection, methodological quality assessment and data extraction were carried out by 2 independent authors. Efficacy outcomes were evaluated for sleep quality, anxiety, depression, and QoL. The safety outcomes were evaluated based on adverse events reported. Review manager (RevMan 5.4, Cochrane collaboration) was used for the data analysis.

Results:
Four studies with 227 subjects were included in this systematic review. The pooled results indicated that PMR interventions improved the sleep quality score standardized mean difference (SMD): −0.23; 95% confidence interval (CI): −0.54, 0.07; P = .13, level of anxiety SMD: −1.35; 95% CI −2.38, −0.32; P = .01 compared to the usual care. Depression level, disease severity and QoL were also improved following PMR interventions. Only 1 study reported worsening of 1 patient clinical status while all other studies did not report any adverse events during the interventions.

Conclusions:
PMR interventions can improve the sleep quality, anxiety, depression, disease severity and QoL in patients with mild to moderate COVID-19 in a short-term period compared to the usual care. However, there was indecision about the safety and long-term effects of PMR.
The efficacy and potential mechanism of Danggui Buxue Decoction in treating diabetic nephropathy: A meta-analysis and network pharmacology
Authors: Zhang Yan , Jiang Lijuan , Xue Jiaojiao , Lv Minglong , Zhang Wenfeng 
Published: April 2023

Background:
To evaluate the efficacy and potential pharmacological mechanisms of Danggui Buxue Decoction (DGBXD) in the treatment of diabetic nephropathy.

Methods:
Meta-analysis was used to conduct a comprehensive search of the literature for randomized controlled trials of DGBXD for diabetic nephropathy, followed by identification of quantitative literature based on inclusion and exclusion criteria, and statistical analysis of the included data using Review Manager. The network pharmacology technique was used to screen the chemical components of DGBXD and their targets, disease targets, shared targets, and other associated information, and then apply bioinformatics technologies to annotate the key pathways. Using AutoDock and PyMol software, the 6 core targets were docked with the 7 main active components of DGBXD.

Results:
DGBXD complementary treatment significantly reduced 24 hours UTP, SCr and BUN levels and lowered blood glucose and lipid levels, improving clinical outcomes and modulating inflammatory factor levels. 22 active ingredients and 209 active targets were obtained for DGBXD, 245 core targets were obtained for diabetic nephropathy. The molecular docking results showed that all 7 components of DGBXD docked with 6 core targets had binding energies below −5.

Conclusions:
The findings suggest that DGBXD affects diabetic nephropathy through a multi-target, multi-component and multi-pathway mechanism.
Ultrasonic diagnosis of delayed hematoma during emergency removal of traumatic intracranial hematoma: A case report and literature review
Authors: Weng Yan , Shang Ziqi , Zhong Qing 
Published: April 2023

Rationale:
It is emergency and vital during neurosurgical procedure in traumatic intracranial when an acute intraoperative brain bulge (AIBB) is occurred. It is important to get a diagnosis quickly.

Patient concerns:
A 44-year-old man was undergone a neurosurgical procedure for the left side of traumatic intracranial hematoma. An AIBB was occurred during the surgery. Computed tomography (CT) is always used in diagnosis when an AIBB is occurred, but more time is needed when CT is conducted.

Diagnoses:
We diagnosed the AIBB through bedside real-time ultrasound, and a delayed hematoma which caused the AIBB was found.

Interventions:
A further neurosurgical procedure of right intracranial hematoma was performed for the patient.

Outcomes:
The surgical effect and the patient’s prognosis were significantly improved.

Lessons:
Through this patient, we should pay more attention to the application of perioperative of real-time ultrasonic monitoring, to provide more convenience for surgical patients, and improve the prognosis of them.
Study on acupuncture improving sleep deprivation comorbid with cognitive dysfunction based on rs-fMRI: A protocol for systematic review and meta-analysis
Authors: Guo Xiaole , Yang Weiwan , Wang Ying , Ma Shiqi , Lu Qi , Wang Hongfeng 
Published: April 2023

Background:
Sleep deprivation often lead to changes in attention, memory, mood, alertness, and metabolism. Especially, it is often accompanied by cognitive impairment of the brain. Acupuncture is safe and effective for improving cognitive function, but its underlying mechanism is not fully understood. Resting-state functional magnetic resonance imaging is an important means to study brain activity changes. However, the results are inconsistent and lack systematic evaluation and analysis.

Methods:
We will search 9 databases, including PubMed, EMBASE, EBSCOhost-Medline, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP Database and Wan-Fang Database, Chinese Biomedical Literature Database, and 2 clinical trials register platforms: Chinese Clinical Trial Registry, ClinicalTrials.gov (www.ClinicalTrials.gov/) from inception to November 1, 2022. We will use the Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.

Results:
This study will analyze the effect of acupuncture on brain activity changes, improvement of sleep duration, and cognitive impairment.

Conclusion:
This meta-analysis aims to investigate the efficacy of acupuncture on brain activity changes in sleep deprivation comorbid with cognitive dysfunction, so as to provide effective evidence for clarifying its pathogenesis.
Association of osteoporosis risk and polymorphisms of osteoprotegerin gene T950C in postmenopausal Chinese women: A PRISMA-compliant meta-analysis
Authors: Xia Yuansheng , Chen Huiyan 
Published: April 2023

Background:
This study aimed to assess the association between the T950C polymorphism and osteoporosis in postmenopausal Chinese women to further reduce the influence of different genetic backgrounds by meta-analysis and subgroup analysis.

Methods:
Through November 2022, a systematic online investigation was performed with the aid of the Cochrane Library, EMBASE, PubMed, Web of Science and the Chinese National Knowledge Infrastructure to find case-control studies looking into the correlation between the osteoprotegerin gene (OPG) T950C polymorphism and postmenopausal osteoporosis susceptibility.

Results:
This study included 6 studies with a total of 1669 postmenopausal osteoporosis cases and 2992 controls. In the recessive model, postmenopausal women with the CC genotype (mutant homozygote at the T950C locus) had a lower risk of osteoporosis, indicating that the CC genotype of OPG T950C might show a preventive effect on osteoporosis after menopause. In a stratified analysis by geographic area, the population from South China had a significantly higher risk under the dominant model [CC + TC (heterozygote at the T950C locus) vs TT (wild-type homozygotes at the T950C locus): odds ratio = 1.34, 95% confidence interval = 1.17–1.54, P < .01], while the population from South China had a significantly lower risk under the recessive model (CC vs TC + TT: odds ratio = 0.79, 95% confidence interval = 0.69–0.95, P = .02).

Conclusions:
Together, the OPG T950C polymorphism may be associated with osteoporosis risk in postmenopausal Chinese women, according to this meta-analysis. Because of the study’s limitations, more large-scale research is needed to corroborate these findings.
Pediatric Intestinal Pseudo-Obstruction: An International Survey on Diagnostic and Management Strategies in the European Reference Network for Rare Inherited and Congenital Anomalies Intestinal Failure Teams
Authors: Mutanen Annika , Demirok Aysenur , Wessel Lucas , Tabbers Merit ,   on behalf of ERNICA IF Working Group
Published: April 2023

Objectives:
Pediatric intestinal pseudo-obstruction (PIPO) management is based on nutritional, medical, and surgical care while available evidence is scarce. The aim of this study was to outline the current diagnostic and management strategies in intestinal failure (IF) teams of the European Reference Network for rare Inherited and Congenital Anomalies (ERNICA) and to compare these practices to the latest PIPO international guidelines.

Methods:
An online survey on institutional diagnostic and management strategies of PIPO was conducted among the ERNICA IF teams.

Results:
In total, 11 of 21 ERNICA IF centers from 8 countries participated. On average, 64% of teams had ≥6 and 36% had 1–5 PIPO patients under active follow-up. In total, 80 of 102 PIPO patients were parenteral nutrition (PN) dependent while each IF team had median 4 (range 0–19) PN dependent PIPO patients under follow-up. On average, each center received 1–2 new PIPO patients per year. Diagnostics mostly followed current guidelines while medical and surgical management strategies were diverse.

Conclusions:
Numbers of PIPO patients are low and management strategies are diverse among ERNICA IF teams. To improve PIPO patient care, regional reference centers with specialized multidisciplinary IF teams and continuous collaboration across centers are needed.
A Qualitative Descriptive Study of Nurse-Patient Relationships Near End of Life
Authors: Walker Suzanne , Zinck Lindsey , Sherry Victoria , Shea Kimberly 
Published: April 2023

Background
The end of life (EOL) period represents a challenging time for patients with cancer as they face disruptions in their relationships with their oncology healthcare providers (HCPs) when moving toward hospice care. Poor communication and severed or altered relationships in physician-patient relationships have been shown to occur near EOL, leading to perceptions of abandonment and other negative consequences for quality EOL care. Little is known, however, about nurse-patient relationships near EOL in the cancer setting.

Objective
The purpose of this qualitative descriptive study was to describe the relationships between patients with cancer and their cancer nurses near EOL.

Methods
A qualitative descriptive methodology was used via semistructured interviews. A total of 9 participants with advanced cancer were enrolled in and completed the study. Data analysis occurred through qualitative content analysis.

Results
The overarching theme woven throughout the narratives was “Good Communication Fosters Nurse-Patient Relationships.” Three additional themes emerged from this main theme: 1) “Valuing Professionalism in the Relationship,” 2) “Embracing Personhood in the Relationship,” and 3) “An Unimaginable Termination.”

Conclusion
Patients with cancer continued to perceive good communication and strong relationships with their cancer nurses even as EOL approached. Themes consistent with negative alterations in these relationships or perceptions of abandonment were not identified.

Implication for Practice
Cancer nurses can foster nurse-patient relationships through patient-centered communication techniques. Spending adequate time engaging with patients as individuals is also recommended. Perhaps most importantly, nurse-patient relationships should continue to be supported as EOL approaches.
Systematic Review of the Effectiveness of Complementary and Alternative Medicine on Nausea and Vomiting in Children With Cancer
Authors: Ho Ka Yan , Lam Katherine Ka Wai , Xia Wei , Liu Qi , Chiu Sau Ying , Chan Godfrey Chi Fung , Li William Ho Cheung 
Published: April 2023

Background
Nausea and vomiting are distressing symptoms reported by pediatric oncology patients during cancer treatment. More than 40% of them experience these symptoms even after receiving antiemetics.

Objective
Given the limitations of pharmacological interventions, this systematic review synthesized the evidence for the effectiveness of complementary and alternative medicine in controlling nausea and vomiting among pediatric oncology patients.

Methods
Ten databases were searched to identify relevant randomized controlled trials. The risk of bias of selected studies was graded using the Cochrane risk-of-bias tool for randomized trials. The primary outcomes were nausea and vomiting. The secondary outcomes were intervention adherence and number of adverse events.

Results
Nineteen papers met the inclusion criteria and were included in the review. Sixteen studies showed high risk of bias. The tested interventions were acupuncture, acupressure, aromatherapy, hypnosis, massage, active cognitive distraction/relaxation techniques, creative arts therapy, psychoeducation, and combined massage and acupressure. Acupuncture, hypnosis, and massage interventions improved nausea and vomiting. Fifteen trials reported intervention adherence; only 7 monitored adverse events. The most common reason for dropout was refusal from patients and/or their guardians. A total of 34 adverse events were noted.

Conclusions
There is insufficient evidence that complementary and alternative medicine is effective, feasible, or safe in controlling nausea and vomiting among pediatric oncology patients due to high risk of bias.

Implications for Practice
Acupuncture, hypnosis, and massage appear to have therapeutic benefits. However, more robust studies are needed to address the identified methodological issues and determine the real value of these 3 interventions.
Use of Complementary Pain Management Strategies in Postoperative Cardiac Surgical Patients
Authors: Grady Kimberly , Vital Cidalia , Crisafi Cheryl 
Published: April 2023

Background:
Complementary pain management strategies are effective at reducing pain in postsurgical patients.

Local Problem:
Cardiac nurses at a large academic hospital reported inconsistent awareness of patient opioid utilization and poor implementation of complementary pain management strategies.

Methods:
A pre/post–quality improvement project was conducted on 2 inpatient cardiac units. Outcomes included nursing staff's perceived knowledge, confidence, and use of complementary pain management strategies and knowledge of patient postsurgical opioid utilization through calculation of morphine milligram equivalence (MME).

Interventions:
A comprehensive education program was implemented that included increased patient access to pain management resources, nurse education about complementary pain management strategies, and nurse education and access to MME calculations using a custom electronic health record application.

Results:
Nursing staff's perceived knowledge, confidence, and use of complementary pain techniques increased. Patient opioid utilization findings were inconclusive.

Conclusions:
Educational programs about complementary pain management offer promise to improve cardiac postsurgical patient care.
In-Hospital Aspirin Dose as a Risk Factor for Hemorrhagic Transformation in Patients Not Treated With Thrombolysis
Authors: Clares de Andrade Joao Brainer , Mohr Jay P. , Lima Fabricio Oliveira , de Carvalho Joao José Freitas , Maia Barros Levi Coelho , Pontes-Neto Octavio Marques , de Abreu Gabriel Queiroz , Silva Gisele Sampaio 
Published: April 2023

Background:
Aspirin is widely used as secondary prophylaxis for acute ischemic stroke. However, its influence on the risk of spontaneous hemorrhagic transformation (HT) is still unclear. Predictive scores of HT have been proposed. We hypothesized that an increased aspirin dose might be harmful in patients at a high risk of HT. This study aimed to analyze the relationship between in-hospital daily aspirin dose (IAD) and HT in patients with acute ischemic stroke.

Methods:
We conducted a retrospective cohort study of patients admitted to our comprehensive stroke center between 2015 and 2017. The attending team defined IAD. All included patients underwent either computed tomography or magnetic resonance imaging within 7 days of admission. The risk of HT was assessed using the predictive score of HT in patients not undergoing reperfusion therapies. Regression models were used to evaluate the correlations between HT and IAD.

Results:
A total of 986 patients were included in the final analysis. The prevalence of HT was 19.2%, and parenchymatous hematomas type-2 (PH-2) represented 10% (n=19) of these cases. IAD was not associated with HT (P=0.09) or PH-2 (P=0.06) among all patients. However, in patients at a higher risk for HT (patients not undergoing reperfusion therapies ≥3), IAD was associated with PH-2 (odds ratio 1.01,95% CI 1.001-1.023,P=0.03) in an adjusted analysis. Taking 200 versus 300 mg aspirin was protective against PH-2 (odds ratio 0.102, 95% CI 0.018-0.563, P=0.009).

Conclusion:
An increased in-hospital aspirin dose is associated with intracerebral hematoma in patients at a high risk of HT. Stratifying the risk of HT may lead to individualized daily aspirin dose choices. However, clinical trials on this topic are required.
Systemic Inflammation Response Index Predicts Clinical Outcomes in Patients With Acute Ischemic Stroke (AIS) After the Treatment of Intravenous Thrombolysis
Authors: Chen Yan-Fang , Qi Shuo , Yu Zi-Jian , Li Jiang-Tao , Qian Ting-Ting , Zeng Ying , Cao Peng 
Published: April 2023

Background:
Intravenous thrombolysis (IVT) is one of the most important means of therapy for patients with acute ischemic stroke (AIS). After cerebral infarction, the inflammatory response fulfills an essential role in the pathobiology of stroke, affecting the process of recanalization. Hence, we evaluated the usefulness of the systemic inflammatory response index (SIRI) for the prognosis of patients with AIS.

Methods:
A total of 161 patients suffering from AIS were retrospectively analyzed. SIRI was introduced and calculated using the absolute neutrophil, monocyte, and lymphocyte numbers from the admission blood work. The study outcomes were determined using a modified Rankin Scale (mRS) at the 3-month timepoint, and a favorable clinical outcome was calculated in the mRS score range of 0 to 2. The analysis of receiver operating characteristic (ROC) curves was performed to determine the values of the optimal cutoff of SIRI for the prediction of clinical outcomes. In addition, multivariate analyses were performed to investigate the association between clinical outcomes and SIRI.

Results:
The ROC curve analysis revealed that the ideal SIRI cutoff was at 2.54 [area under the curve, 78.85%; 95% CI, 71.70% to 86.00%; sensitivity, 70.89%; and specificity, 84.14%]. Multivariate analysis indicated that SIRI ≤2.54 (odds ratio, 1.557, 95% CI, 1.269 to 1.840; P=0.021) was an independent predictor of favorable clinical outcomes in patients suffering from AIS after treatment with IVT.

Conclusions:
We preliminary speculate that SIRI may serve as an independent predictor of clinical outcomes with AIS following IVT.
When a Hypersomnolent Hemodialyzed Patient Actually Has a Rare Stroke
Authors: Oliveira Pinheiro Filipe , Reis Maia Ruben , Duarte Delfim , Monteiro Ana , Almeida Jorge 
Published: April 2023

Introduction:
Artery of Percheron (AOP) is an uncommon anatomic variant of the arterial supply of the medial thalami. Owing to variable clinical presentation, challenging imaging diagnosis, and its rarity, it is difficult to diagnose AOP infarctions. We present a clinical case of a unique presentation of AOP infarction associated with paradoxical embolism and highlight the atypical clinical manifestations and challenging diagnosis of this stroke syndrome.

Case report:
A 58-year-old White female with chronic renal insufficiency on hemodialysis was admitted to our center with a 10-hour course of hypersomnolence and right-sided ataxia. She had normal body temperature, blood pressure, peripheral oxygen saturation, and heart rate and scored 11 points in the Glasgow Coma Scale and 12 points in National Institutes of Health Stroke Scale. Initial brain computerized tomography scan, electrocardiogram, and thoracic radiography were normal; transcranial Doppler ultrasound showed >50% stenosis at the P2 segment of the right posterior cerebral artery, and transthoracic echocardiogram, a patent foramen ovale and thrombus adherent to the hemodialysis catheter. On day 3, she underwent brain magnetic resonance that showed acute ischemic lesions at the paramedian thalami and the superior cerebral peduncles. AOP infarction due to a paradoxical embolism from a patent foramen ovale with a right atrial thrombus was the final diagnosis.

Conclusions:
AOP infarctions are a rare type of stroke with elusive clinical presentations and frequently, initial imaging assessment is normal. Early recognition is crucial, and a high index of suspicion is needed to suspect this diagnosis.
High-Resolution Magnetic Resonance Imaging in Endovascular Treatment of Vertebrobasilar Junction Stenosis
Authors: Huang Rui , Gao Feng , Mo Dapeng , Yang Ming , Hou Zhikai , Liu Yifan , Cui Rongrong , Kang Kaijiang , Gu Weibin , Miao Zhongrong , Ma Ning 
Published: April 2023

Introduction:
Vertebrobasilar junction (VBJ) stenosis is a challenge in endovascular treatment due to structural variants and complexities. The role of high-resolution magnetic resonance imaging (HRMRI) in endovascular treatment for patients with severe VBJ stenosis is uncertain.

Case Report:
Four patients with symptomatic VBJ stenosis underwent HRMRI of the vessel wall before endovascular treatment. In 3 patients, the VBJ could not be visualized on luminal imaging. One of them had a hypoplastic artery and 2 of them had severe stenotic arteries on HRMRI. HRMRI showed an artery with a negative remodeling in a patient with a hypoplastic vertebral artery. One patient had intraplaque hemorrhage and calcification, and 2 patients had calcification in VBJ lesions. Endovascular treatment was performed utilizing HRMRI findings to guide the decision-making process.

Conclusion:
HRMRI provides additional information about the structure and angle of the VBJ, the characteristics and vulnerability of the plaques, and the lesion size, thus helping to improve the operation process and reduce the risk of complications.