bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustained Hemostasis With the Padlock™ Over-the-scope Clip for Gastric Fundus Dieulafoy’s Lesion in the Setting of Anticoagulation Following Hemorrhagic Shock From Two Dieulafoy’s Lesions
Authors: Cho Jonathan J , Forbes Chelsea M , Fiore Benjamin D , McCarron Joshua D , Padilla Leybelis 
Published: November 2022

ABSTRACT
Dieulafoy’s lesions (DLs) are a rare and difficult-to-identify cause of acute gastrointestinal bleeding that can lead to hemorrhagic shock. We present a case of a 23-year-old previously healthy male presenting with melenic stools and hemorrhagic shock. Computed tomography of abdomen and pelvis with oral and intravenous contrast showed a possible source of hemorrhage as a hyperdense intraluminal material within the stomach. Initial urgent esophagogastroduodenoscopy showed a large, nonbleeding distal esophageal DL, which was treated successfully with 10 mL of 1:10,000 epinephrine and bipolar cauterization with 10 Fr Gold Probe™. Hemorrhage recurred 2 d later, prompting another esophagogastroduodenoscopy, which found another DL within the gastric fundus. Treatment with epinephrine, Gold Probe™, and through-the-scope Hemoclips was unsuccessful because of difficult visualization and positioning. A subsequent attempt was made using the over-the-scope clip (OTSC) Padlock™ Clip Defect Closure System with successful hemostasis and stabilization of the patient. His hospital course was complicated by left lower lobe segmental pulmonary embolism without right heart strain for which he was discharged on 3 months of anticoagulation with apixaban. On follow-up, there was no recurrence of gastrointestinal bleeding (GIB) despite 3 months of anticoagulation. He did not complete the Basic Underwater Demolition/SEAL (BUD/S) Training. This case report demonstrates the evaluation and management of a patient with hemorrhagic shock from two DLs and sustained hemostasis with the Padlock™ OTSC in the setting of apixaban anticoagulation.
Platelet RNA enables accurate detection of ovarian cancer: an intercontinental, biomarker identification study
Authors: Gao Yue , Liu Chun-Jie , Li Hua-Yi , Xiong Xiao-Ming , Li Gui-Ling , In ‘t Veld Sjors G J G , Cai Guang-Yao , Xie Gui-Yan , Zeng Shao-Qing , Wu Yuan , Chi Jian-Hua , Liu Jia-Hao , Zhang Qiong , Jiao Xiao-Fei , Shi Lin-Li , Lu Wan-Rong , Lv Wei-Guo , Yang Xing-Sheng , Piek Jurgen M J , de Kroon Cornelis D , Lok C A R , Supernat Anna , Łapińska-Szumczyk Sylwia , Łojkowska Anna , Żaczek Anna J , Jassem Jacek , Tannous Bakhos A , Sol Nik , Post Edward , Best Myron G , Kong Bei-Hua , Xie Xing , Ma Ding , Wurdinger Thomas , Guo An-Yuan , Gao Qing-Lei 
Published: November 2022

Abstract
Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889–0.948), 0.923 (0.855–0.990), 0.918 (0.872–0.963), and 0.887 (0.813–0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889–0.955) in the combined validation cohort; 0.955 (0.912–0.997) in VC1; 0.939 (0.901–0.977) in VC2; 0.917 (0.824–1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.
Can bee propolis help us fight against methicillin-resistant Staphylococcus aureus (MRSA)?
Authors: Ripari Nicolas , Beatriz Toti Maria , Kenupp Bastos Jairo , Sforcin José Maurício 
Published: November 2022

Abstract

Objectives
Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug-resistant pathogen in nosocomial infections. Since the 1950s, MRSA has acquired several resistance factors including efflux pumps and drug target modifications. Some studies investigated the anti-MRSA capacity of propolis samples collected in different regions and their immunomodulatory action. The aim of this review is to gather the data published up to August 2022 about propolis action on MRSA strains and its modulatory action on phagocytes.

Methods
The PubMed database was used to look for articles containing the keywords ‘propolis’, ‘immunomodulation’, ‘MRSA’ and the name of each compound. As propolis contains a variety of compounds making it impossible to isolate the major bioactive components, we reviewed the main compounds found in several propolis samples and their mechanisms towards the resistance factors displayed by MRSA. Some perspectives for using propolis-based medications and the formulation of new antimicrobial/immunomodulatory agents are discussed.

Key findings
Propolis extracts and active compounds exert antibacterial action over MRSA strains acting on resistance factors. Moreover, propolis modulates pro-inflammatory markers in phagocytes.

Conclusions
Because propolis compounds may act synergistically, it’s crucial to understand how these components interact to synthesize standardized formulations and enhance their bioavailability for clinical applications to combat MRSA.
Effect of altitude and acetazolamide on sleep and nocturnal breathing in healthy lowlanders 40 y of age or older. Data from a randomized trial
Authors: Graf Laura C , Furian Michael , Bitos Konstantinos , Mademilov Maamed , Abdraeva Ainura , Buenzli Jana , Buenzli Simone , Aidaralieva Shaira , Sheraliev Ulan , Mayer Laura C , Schneider Simon R , Sooronbaev Talant M , Ulrich Silvia , Bloch Konrad E 
Published: November 2022

AbstractStudy ObjectivesTo assess altitude-induced sleep and nocturnal breathing disturbances in healthy lowlanders 40 y of age or older and the effects of preventive acetazolamide treatment.MethodsClinical examinations and polysomnography were performed at 760 m and in the first night after ascent to 3100 m in a subsample of participants of a larger trial evaluating altitude illness. Participants were randomized 1:1 to treatment with acetazolamide (375 mg/day) or placebo, starting 24 h before and while staying at 3100 m. The main outcomes were indices of sleep structure, oxygenation, and apnea/hypopnea index (AHI).ResultsPer protocol analysis included 86 participants (mean ± SE 53 ± 7 y old, 66% female). In 43 individuals randomized to placebo, mean nocturnal pulse oximetry (SpO2) was 94.0 ± 0.4% at 760 m and 86.7 ± 0.4% at 3100 m, with mean change (95%CI) −7.3% (−8.0 to −6.5); oxygen desaturation index (ODI) was 5.0 ± 2.3 at 760 m and 29.2 ± 2.3 at 3100 m, change 24.2/h (18.8 to 24.5); AHI was 11.3 ± 2.4/h at 760 m and 23.5 ± 2.4/h at 3100 m, change 12.2/h (7.3 to 17.0). In 43 individuals randomized to acetazolamide, altitude-induced changes were mitigated. Mean differences (Δ, 95%CI) in altitude-induced changes were: ΔSpO2 2.3% (1.3 to 3.4), ΔODI -15.0/h (−22.6 to −7.4), ΔAHI -11.4/h (−18.3 to −4.6). Total sleep time, sleep efficiency, and N3-sleep fraction decreased with an ascent to 3100 m under placebo by 40 min (17 to 60), 5% (2 to 8), and 6% (2 to 11), respectively. Acetazolamide did not significantly change these outcomes.ConclusionsDuring a night at 3100 m, healthy lowlanders aged 40 y or older revealed hypoxemia, sleep apnea, and disturbed sleep. Preventive acetazolamide treatment improved oxygenation and nocturnal breathing but had no effect on sleep duration and structure.Trial registrationThe trial is registered at Clinical Trials, https://clinicaltrials.gov, NCT03561675
Comparison of Pregnancy Outcomes of Previable and Periviable Rupture of Membranes After Laser Photocoagulation for Twin–Twin Transfusion Syndrome
Authors: Forde Braxton , Fresch Robert , Masters Heather , DeFranco Emily A. , McKinney David N. , Tabbah Sammy , Lim Foong , Habli Mounira 
Published: November 2022

OBJECTIVE:
To describe the pregnancy outcomes of patients who experienced previable and periviable prelabor rupture of membranes (PROM) after the treatment of twin–twin transfusion syndrome.

METHODS:
We conducted a retrospective cohort study of patients whose pregnancies were complicated by twin–twin transfusion syndrome who were treated with fetoscopic laser photocoagulation at a single fetal center and subsequently experienced PROM from April 2010 to June 2019. Outcomes were infant survival and latency from PROM to delivery. Patients were grouped by gestational age at PROM (before 26 weeks of gestation and 26 weeks or later). The group with PROM before 26 weeks of gestation was stratified by gestational age at PROM for further description of outcomes.

RESULTS:
Two-hundred fifty of 653 patients (38%) developed PROM, 81 before 26 weeks of gestation and 169 after 26 weeks of gestation. In the setting of PROM before 26 weeks of gestation, the rate of survival of both twins to neonatal intensive care unit (NICU) discharge was 46.3%, compared with 76.9% in the setting of PROM at 26 weeks of gestation or later (P<.001); the survival rate of at least one twin was 61.2% and 98.5%, respectively (P<.001). Fourteen, 22, and 45 patients experienced PROM at 16–19 6/7, 20–22 6/7, and 23–25 6/7 weeks of gestation, respectively. Survival of both twins and at least one twin to NICU discharge was 25.0%, 47.4%, 52.8% (for two) and 33.3%, 47.4%, and 77.8% (for at least one), respectively, among those groups. Fifty-seven of the 81 patients with PROM before 26 weeks of gestation experienced a latency longer than 48 hours. In the setting of PROM before 26 weeks of gestation, when latency lasted longer than 48 hours, overall survival was improved (69.6% vs 53.7%, respectively, P=.017). With latency longer than 48 hours and PROM at 16–19 6/7, 20–22 6/7, and 23–25 6/7 weeks of gestation, survival of both twins to NICU discharge was 60.0%, 61.5%, and 60.7%, respectively, and survival of at least one twin was 80.0%, 61.5%, and 85.7%, respectively.

CONCLUSION:
Earlier gestational age at PROM after laser photocoagulation is associated with longer latency but lower rates of survival. When PROM occurs before 26 weeks of gestation and latency exceeds 48 hours, rates of neonatal survival are significantly improved.
Identifying Components of Autism Friendly Health Care: An Exploratory Study Using a Modified Delphi Method
Authors: O'Hagan Belinda , Krauss Shari B. , Friedman Alexander J. , Bartolotti Lauren , Abubakare Oluwatobi , Broder-Fingert Sarabeth , Augustyn Marilyn 
Published: November 2022

ABSTRACT:

Objectives:
Autistic individuals report lower health care satisfaction. However, there is currently no set of “best practice” standards about caring for autistic individuals. In this exploratory study, we aim to identify features of Autism Friendly practice according to a sample consisting of mainly professionals whose interests include autism using a modified 3-round Delphi—a method that identifies a consensus view across subject participants.

Methods:
Statements about components of an Autism Friendly health care practice were compiled in consultation with the steering committee of an Autism Friendly Initiative at a single, urban academic safety-net hospital. Participants were recruited through our national network of professionals and patients/families mailing list. Examples of invited professionals included researchers, health care workers, and educators. In the first 2 rounds, we distributed electronic surveys to participants, who scored statements from 1 to 9 regarding importance. In round 2, statements that were scored low by all stakeholder groups were eliminated. Seventy-eight participants responded to the first-round survey, and 51 participants responded to the second-round survey. In the third round, 38 participants ranked 16 statements from most to least important. Statements are summarized and presented in the Results section.

Results:
Topics that emerged from highly ranked statements include environmental/operational modifications (e.g., longer appointment times) and staff training to support autistic patients.

Conclusion:
Highly ranked statements represented previously reported barriers, including the need for staff training and inclusive engagement with the autistic community. The findings can help inform health care organizations to determine priorities when building an Autism Friendly health care practice.
Low-dose aspirin as primary prevention for adults without cardiovascular disease
Authors: Klausner Shira 
Published: November 2022

ABSTRACT

Background:
Cardiovascular disease is the leading cause of death in the United States. Patients with cardiovascular disease risk factors are often put on low-dose aspirin to prevent future cardiovascular events and cardiovascular death. However, the evidence supporting this practice is limited.

Objective:
To examine whether adults without a history of cardiovascular disease benefit from taking daily low-dose aspirin as primary prevention for cardiovascular disease and death.

Data sources:
The four databases of PubMed, CINAHL, Scopus, and Ovid were used, and a total of 67 nonduplicate articles were reviewed. After examining those articles, four studies were included. Of the four studies, three were randomized controlled trials, and one was a retrospective cohort study.

Conclusions:
All four studies concluded that daily low-dose aspirin used for primary prevention does not lower the risk of death from cardiovascular disease.

Implications for practice:
Further research needs to be conducted to determine whether daily low-dose aspirin is beneficial in individuals without a history of cardiovascular disease. Nurse practitioners need to know the most current evidence-based practice recommendations to appropriately counsel patients about whether they should be taking low-dose aspirin to prevent cardiovascular disease.
Infection control in the bronchoscopy suite: effective reprocessing and disinfection of reusable bronchoscopes
Authors: Chhabria Mamta S. , Maldonado Fabien , Mehta Atul C. 
Published: November 2022

Purpose of review
With advancements in technology, flexible bronchoscopes have become thinner in diameter and in need of more thorough reprocessing to prevent infection transmission than ever before. Many experienced bronchoscopists are not aware of the critical steps involved in effective bronchoscope reprocessing and we hope to bridge this gap by describing this process in detail.

Recent findings
Bronchoscope reprocessing includes several distinct steps (precleaning, leak testing, manual cleaning, visual inspection, terminal reprocessing, rinsing and drying). Each step is comprehensive and needs to be carried out systematically by trained personnel. Failure of any step can lead to serious downstream events such as outbreaks and pseudo-outbreaks. Some experts now recommend sterilization when feasible, although high-level disinfection remains the minimum standard. We also will review some literature on the utility of borescopes, automated endoscope reprocessors and disposable bronchoscopes.

Summary
Our article will focus on the most recent recommendations for effective reprocessing and disinfection of reusable bronchoscopes.
Shorter durations of antibiotic therapy in organ transplant
Authors: Alegria William , Medvedeva Natalia , Holubar Marisa 
Published: November 2022

Purpose of review
Recent evidence supports shorter courses of antibiotics for several common infections and prophylactic indications. Unfortunately, solid organ transplant patients are often underrepresented or excluded from these studies. As a result, prolonged antibiotic durations are often used in clinical practice despite a lack of demonstrable benefit. This paper reviews recent publications addressing antibiotic duration of therapy in SOT recipients.

Recent findings
Although largely limited to observational studies, longer courses of antibiotics for surgical prophylaxis, urinary tract infections, and bloodstream infections have not demonstrated benefit compared to shorter courses. In some instances, longer courses of therapy have been associated with harm (i.e., adverse drug events and development of resistance).

Summary
Although the data remains limited, findings from retrospective studies evaluating shorter courses of antibiotics in SOT patients is encouraging. More robust research is desperately needed to define the optimal duration of antibiotics for common infections in SOT patients.
Liver transplantation and portal vein tumour thrombus: futile enterprise?
Authors: Bhangui Prashant 
Published: November 2022

Purpose of review
To summarize recent evidence in literature regarding liver transplantation in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT) with no extrahepatic disease. In addition, in this review, we have tried to highlight the advances in downstaging with ablative therapies that have made liver transplantation a possibility, and also the key points to focus on when considering liver transplantation in these patients with locally advanced HCC.

Recent findings
Advances in the understanding of technicalities and effectiveness of ablative therapies, including transarterial chemoembolization, stereotactic body radiotherapy and transarterial radioembolization on PVTT have helped successfully downstage patients with HCC and PVTT to within transplant criteria. This provides the opportunity to offer a curative liver transplantation in these patients who are generally managed with systemic or palliative therapy alone with dismal prognosis. Meticulous patient selection based on tumour biology, documented downstaging based on imaging and decrease in tumour marker levels, an adequate waiting period to demonstrate stable disease, liver transplantation with some technical modifications, and a modified immunosuppression protocol may offer long-term survival in a select group of patients treated with initial downstaging therapies in an intention to treat strategy.

Summary
In patients with HCC, presence of PVTT is generally considered the end of the road by many. A multidisciplinary approach combining ablation and a curative liver transplantation may offer the best hope of long-term survival in a select group of patients with favourable tumour biology. Although promising, current evidence is limited, and future studies with larger number of patients, and longer follow-up may pave the way for an elaborate selection algorithm to choose the ideal candidates for such a curative strategy in patients with locally advanced HCC with PVTT.
“Autophagy Dysfunction in a Diabetic Peripheral Neuropathy Model”
Authors: Choi Su-Jeong , Kim Sena , Lee Won Suk , Kim Dong Woon , Kim Cuk-Seong , Oh Sang-Ha 
Published: November 2022

Background:
The relationship between autophagy and diabetic peripheral neuropathy (DPN) has been highlighted in a only few reports. Using an animal model, we investigated the relationship between autophagy and DPN, and focused particularly on changes in autophagy in Schwann cells.

Methods:
The ultrastructural features of DPN mice were evaluated in vivo using transmission electron microscopy. Dysfunction of autophagy in DPN was evaluated using immunofluorescence microscopy and western blot analysis of autophagy-related proteins, including Beclin1, LC3, and p62. Reactive oxygen species (ROS) levels were measured in vitro in glucose-treated Schwann cells. Dysfunction of autophagy in glucose-treated Schwann cells was examined by immunofluorescence microscopy and western blot analysis.

Results:
Reduced myelin thickness and axonal shrinkage were observed in the sciatic nerves of DPN mice. ROS levels were increased in high glucose-treated Schwann cells (p < 0.05). The expression of Becline1 was increased in DPN mice and high glucose-treated Schwann cells (p < 0.05), whereas the expression of LC3-Ⅱ/LC3-Ⅰ ratio and p62 were decreased in DPN mice and high glucose-treated Schwann cells (p < 0.05).

Conclusions:
Our results suggest that increased levels of ROS induced by high glucose may contribute to autophagy dysfunction in Schwann cells. Autophagy dysfunction especially in Schwann cells may be an underlying cause of DPN.
Ai Chi for Long COVID: Transitioning to a Post-Rehabilitation Community Program
Authors: Pierce Melinda Nygren 
Published: November 2022

Background:
As the COVID-19 pandemic continues to impact lives around the world, long COVID symptoms plague a significant number of survivors in their daily lives. Guidelines are available for individualized rehabilitation during acute and subacute phases; however, safe community options are needed for those with lingering symptoms who are transitioning away from formal rehabilitation. A lack of access or resistance to COVID-19 vaccination worldwide, and the emergence of more aggressive coronavirus variants, is predicted to result in many more positive COVID-19 cases and consequentially in more long haulers, increasing the need for community resources.

Discussion:
Ai Chi is a gentle aquatic body-mind practice employed worldwide by aquatic therapists and trainers to reduce stress, enhance breathing, strengthen core muscles, extend joint range of motion, improve balance, stabilize heart rate, and promote focus and centering. It can address some of the common persisting symptoms in medically stable individuals with long COVID including pain, difficulty breathing, muscle weakness, and stress. While Ai Chi is a promising community aquatic intervention, exercise providers need to be aware of special considerations that may impact this population in community programming, such as postexertional malaise, cardiac impairment, oxygen desaturation, and autonomic nervous system dysfunction when providing exercise programs. Research is needed to validate the effectiveness of Ai Chi with post-rehabilitation COVID long haulers in a community setting.