bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compliance with the clinical laboratory quality protocol in public primary healthcare centres
Authors: Romero-Arana Adolfo , Gómez-Salgado Juan , Fagundo-Rivera Javier , Cruz-Salgado Óscar , Ortega-Moreno Mónica , Romero-Martín Macarena , Romero Adolfo 
Published: August 2022

The clinical and economic relevance of the clinical laboratories procedures in Andalusia (Spain) have led the Regional Department of Health to focus attention on their improvement. A unified laboratory protocol was implemented that consisted of the unification of criteria in the handling and processing of samples, and report of results.
The objective of this study is to describe the degree of compliance with the clinical laboratory protocol in the preanalytical phase, which includes the analytical request and up to the delivery in the laboratory, as well as the influencing factors.
Cross-sectional descriptive study with a sample of 214 healthcare professionals involved in the preanalytical phase of laboratory procedures in primary care. A self-reported questionnaire with 11 items was used for data collection. Each item was assessed separately with a scale from 0 to 10. A 5 points score was considered as the cutoff point. Descriptive analysis was conducted and Mann–Whitney U test was used to determine differences between subgroups. Internal consistency of the questionnaire was considered.
The best rated item was verifying the correspondence between the request form and identity of the patient. Each item scored from 3 to 10, and the mean for each item ranged from 6.40 (standard deviation = 3.06) to 8.57 (standard deviation = 2.00). Values above or equal to 8 were obtained, for 63.6% of them. Statistically significant differences between accredited and nonaccredited centres were found. Differences were not noteworthy regarding centres with a teaching activity or those without it. All the items were measured separately. The compliance with the protocol was adequate among primary healthcare professionals, who have a strategic position in the sample collection and its transport during the preanalytical phase. Being so, standardisation should be a priority to reduce errors and improve clinical safety and results.
Meta of classical chemotherapy compared with high-dose chemotherapy and autologous stem cell rescue in newly diagnosed medulloblastoma after radiotherapy
Authors: Zhang Mengting , Liu Chunmei , Zhou Huandi , Wang Wenyan , Wang Lixin , Shi Baojun , Xue Xiaoying 
Published: August 2022

Background:
High-dose chemotherapy combined with autologous stem cell rescue (HDCT + ASCR) has been used to treat newly diagnosed medulloblastoma, but there was no high-level evidence to support its efficacy.

Methods:
Databases were retrieved, and patients were divided into 2 groups: group A was radiotherapy combined with HCDT + ASCR, and group B was classical radiotherapy and chemotherapy. The clinical benefit rate, progression-free survival (PFS), overall survival (OS) and toxicities data were extracted.

Results:
22 clinical trials met the inclusion criteria, 416 in group A and 2331 in group B. There was no difference in CBR between 2 groups (80.0% vs 71.5%, P.262). The 3-year PFS (3-y PFS) of group A was significantly better than group B (79.0% vs 69.5%, P = .004). The analysis found that there was no difference between the 2 groups of the standard risk group or the high-risk group. In the standard risk group, the 5-y PFS of group A was significantly better than group B (83.6% vs75.6%, P = .004). Comparison of 3-y OS and 5-y OS between 2 groups of all MB patients showed no difference (P = .086; P = .507), stratified analysis was the same result. The gastrointestinal toxicity in group A was significantly higher than that in group B (P = .016), and the level 3/4 ototoxicity in high-risk group A was higher than that in group B (P = .001).

Conclusions:
HDCT + ASCR can prolong 3-year PFS significantly, and prolong 5-y PFS significantly in the standard risk group, but increase gastrointestinal toxicity significantly for newly diagnosed medulloblastoma.
Predicting article citations using data from 100 top-cited publications in the field of Psoriasis Vulgaris and biological agents (PVBA) since 1991: A bibliometric analysis
Authors: Chen Chieh-Hsun , Chien Tsair-Wei , Yu-Chieh Ho Sam , Lai Feng-Jie 
Published: August 2022

Background:
Psoriasis Vulgaris is a chronic inflammatory disease characterized by keratinocyte hyperproliferation. Bibliometric analysis helps determine the most influential article on the topic of “Psoriasis Vulgaris and biological agents (PVBAs)”, and what factors affect article citation remain unclear. This study aims (1) to identify the top 100 most cited articles in PVBA (PVBA100 for short) from 1991 to 2020, (2) to visualize dominant entities on one diagram using data in PVBA100, and (3) to investigate whether medical subject headings (MeSH terms) can be used to predict article citations.

Methods:
The top 100 most cited articles relevant to PVBA (1991–2020) were downloaded by searching the PubMed database. Citation analysis was applied to compare the dominant roles in article types and topic categories using pyramid plots. Social network analysis (SNA) and Sankey diagrams were applied to highlight prominent entities. We examined the MeSH prediction effect on article citations using its correlation coefficients.

Results:
The most frequent article types and topic categories were research support by institutes (46%) and drug therapy (88%), respectively. The most productive countries were the United States (38%), followed by Germany (13%) and Japan (12%). Most articles were published in Br J Dermatol (13%) and J Invest Dermatol (11%). MeSH terms were evident in the prediction power of the number of article citations (correlation coefficient=0.45, t=4.99).

Conclusions:
The breakthrough was made by developing one dashboard to display PVBA100. MeSH terms can be used for predicting article citations in PVBA100. These visualizations of PVBA100 could be applied to future academic pursuits and applications in other academic disciplines.
Incidence of acute kidney injury during pregnancy and its prognostic value for adverse clinical outcomes: A systematic review and meta-analysis
Authors: Trakarnvanich Thananda , Ngamvichchukorn Tanun , Susantitaphong Paweena 
Published: August 2022

Background:
Acute kidney injury (AKI) that develops during pregnancy results from pregnancy-induced hypertension, hemorrhage, and sepsis, associated with morbidity and mortality in the fetus and mother. This meta-analysis was conducted to evaluate the incidence of pregnancy-related AKI (PR-AKI) and adverse clinical outcomes.

Methods:
PubMed and Scopus were systematically searched for studies published between 1980 and 2021. We included cross-sectional, retrospective, and prospective cohort studies that reported the incidence of PR-AKI as well as adverse fetal and maternal clinical outcomes. A random-effects model meta-analysis was performed to generate summary estimates.

Results:
The meta-analysis included 31 studies (57,529,841 participants). The pooled incidence of PR-AKI was 2.0% (95% confidence interval [CI] 1.0–3.7). Only 49.3% of patients received antenatal care. The most common cause of PR-AKI was preeclampsia (36.6%, 95% CI 29.1–44.7). The proportion of patients requiring hemodialysis was 37.2% (95% CI 26.0–49.9). More than 70% of patients had complete recovery of renal function, while 8.5% (95% CI 4.7–14.8) remained dependent on dialysis. The pooled mortality rate of PR-AKI was 12.7% (95% CI 9.0–17.7). In addition, fetal outcomes were favorable, with an alive birth rate of 70.0% (95% CI 61.2–77.4). However, the rate of abortion and/or stillbirth was approximately 25.4% (95% CI 18.1–34.4), and the rate of intrauterine death was 18.6% (95% CI 12.8–26.2).

Conclusions:
Although the incidence of PR-AKI is not high, this condition has a high impact on morbidity and mortality in both fetal and maternal outcomes. Early prevention and treatment from health care professionals are needed in PR-AKI, especially in the form of antenatal care and preeclampsia medication.
Incidence of immediate allergic reactions to mRNA COVID-19 vaccines in adults with drug allergies and other allergic disorders
Authors: Marković Ivan , Božan Marina , Perković Tomislav , Paušek Katarina , Nedeljković Vanja , Perković Marina , Kelava Tomislav , Artuković Marinko , Stipić Marković Asja 
Published: August 2022

Concerns have been raised about allergic reactions to messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccines. A history of allergic reactions, including anaphylaxis to drugs, has been frequently reported in individuals with anaphylaxis to mRNA vaccines.
To estimate the rate of immediate allergic reactions in patients with a history of drug allergy or other allergic disorders.
We included adult patients who had received at least 1 dose of an mRNA COVID-19 vaccine at the Special Hospital for Pulmonary Diseases between March 1, 2021, and October 1, 2021, and who reported a history of drug allergy or other allergic diseases (asthma, allergic rhinitis, atopic dermatitis, food or insect venom allergy, mastocytosis, idiopathic anaphylaxis, acute or chronic urticaria, and/or angioedema). Immediate allergic reactions, including anaphylaxis, occurring within 4 hours of vaccination were recorded.
Six immediate allergic reactions were noted in the cohort of 1679 patients (0.36%). One patient experienced anaphylaxis (0.06%), which resolved after epinephrine administration, and the other reactions were mild and easily treatable.
Most patients with a history of allergies can safely receive an mRNA COVID-19 vaccine, providing adequate observation periods and preparedness to recognize and treat anaphylaxis.
The effectiveness of ARISCAT Risk Index, other scoring systems, and parameters in predicting pulmonary complications after thoracic surgery
Authors: Ülger Gülay , Sazak Hilal , Baldemir Ramazan , Zengin Musa , Kaybal Oya , İncekara Funda , Alagöz Ali 
Published: August 2022

The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index, which is frequently used in nonthoracic surgery, may not be sufficient to predict postoperative pulmonary complications (PPCs). We aimed to evaluate the effectiveness of the ARISCAT risk index, ASA, preoperative albumin level, neutrophil/lymphocyte ratio (NLR), and other parameters in predicting PPCs after thoracic surgery.
Patients undergoing elective thoracic surgery with 1-lung ventilation (OLV) were prospectively analyzed. Demographic data, ARISCAT score, ASA, Nutritional Risk Score-2002, NLR, white blood cell counts, albumin, hemoglobin levels, intraoperative complications, postoperative average visual analogue scale (VAS) score for pain at the 24th-hour, the length of stay in the postoperative intensive care unit, chest tube removal time, postoperative complications, and discharge time were recorded. Patients were assessed for morbidity and mortality on the 90th-day.
120 patients’ data were analyzed. PPCs developed in 26 patients. The development of PPCs was statistically significant in patients with high ARISCAT scores (P = .002), high ARISCAT grades (P = .009), and ASA III (P = .002). The albumin level was statistically significantly lower in patients who had mortality within 3 months (P = .007). When scoring systems and laboratory parameters were evaluated together, patients with high ARISCAT grade, Albumin < 35g/L, and ASA III had significantly higher development of PPCs (P = .004).
ARISCAT risk index and ASA were found to be significant in predicting PPCs after thoracic surgery. They were also valuable when evaluated in combination with preoperative albumin levels. Additionally; age, male gender, duration of surgery, and duration of OLV were also found to be associated with PPCs.
Clinical features and management of trophoblastic epithelioid tumors: A systematic review
Authors: Gorun Florin , Tomescu Larisa , Motoc Andrei , Citu Cosmin , Sas Ioan , Serban Denis Mihai , Forga Marius , Citu Ioana Mihaela , Gorun Oana Maria 
Published: August 2022

Background:
This study aimed to systematically review the existing literature on epithelioid trophoblastic tumors (ETTs), the rarest type of gestational trophoblastic neoplasia.

Methods:
A systematic review according to PRISMA guidelines was performed, using ScienceDirect, Web of Science, and Scopus databases. The only filter used was the English language. Eligibility/inclusion criteria: retrospective observational studies (case reports, case series) including full case description of epithelioid trophoblastic tumor lesions.

Results:
Seventy studies were assessed for synthesis, including 147 cases. 66.7% of patients with ETT presented with irregular vaginal bleeding. Pretreatment β-hCG levels ranged up to 1000 mIU/mL in 58.5% patients. Of most patients, 42.2% had stage I disease, 10.9% stage II, 25.2% stage III, and 21.8% of patients had stage IV. The most common sites of metastatic disease were the lungs, followed by the liver and brain. After treatment, complete remission was achieved in 75.5% of patients, partial remission in 10.2% of patients, and 14.3% of patients died. On univariate and multivariate analyses, stage IV disease was an independent prognostic factor for overall and disease-free survival.

Conclusions:
Hysterectomy and metastatic lesion resection are essential for controlling ETT. Investigational studies on molecules like EGFR, VEGF, PD-1, CD105, and LPCAT1 are potential therapeutic targets for metastatic ETT.
Paediatric cannabinoid hyperemesis
Authors: Lonsdale Hannah , Wilsey Michael J. 
Published: August 2022

Purpose of review
The prevalence of adolescent cannabinoid hyperemesis syndrome (CHS) continues to grow, as clinicians increasingly recognize the presenting features of cyclical nausea, emesis, abdominal pain and relief of symptoms with hot showers, in the setting of chronic cannabinoid use.

Recent findings
Our understanding of the contributory mechanisms continues to grow, but high-quality evidence of effective treatment in adolescents remains lacking. Current best evidence in the treatment of acute paediatric CHS suggests intravenous rehydration and electrolyte correction, followed by 0.05 mg/kg haloperidol with or without a benzodiazepine. The only long-term treatment remains complete cessation of cannabinoid use.

Summary
This article reviews our growing knowledge of adolescent CHS and provides practical guidance for diagnosis, treatment and understanding the underlying mechanisms of the condition.
Pediatric Emergency Medicine Fellowship Program Directors' Viewpoint
Authors: Hsu Deborah C. , Baghdassarian Aline , Caglar Derya , Rose Jerri A. , Herman Bruce E. , Schwartz Alan , Mink Richard , Langhan Melissa L. 
Published: August 2022

ObjectivesEntrustable Professional Activities (EPAs) are essential tasks physicians perform within their professions. Entrustment levels that pediatric emergency medicine (PEM) fellowship program directors (FPDs) expect graduating fellows to achieve for PEM-specific and common pediatric subspecialty EPAs remain unreported. This study aims to determine minimum entrustment levels FPDs require fellows to achieve to graduate from fellowship and to compare FPD expectations for fellows versus practicing PEM physicians.MethodsSecondary analysis of PEM-specific data from a national multispecialty cross-sectional survey of pediatric subspecialty FPDs. For 6 PEM-specific and 7 common pediatric subspecialty EPAs, PEM FPDs indicated (1) minimum entrustment levels fellows should achieve by training completion, (2) whether they would allow a fellow to graduate below these minimum levels, and (3) minimum levels for safe and effective practice by PEM physicians. Minimum levels were defined as the level that more than 80% of FPDs would not drop below.ResultsSixty of 77 PEM FPDs (78%) completed the survey. Most respondents did not require fellows to achieve the highest level (level 5—no supervision) by graduation for any PEM-specific EPAs. The median level FPDs expected for practicing PEM physicians was 5 (trusted to perform without supervision) for EPAs 1 and 4 and level 4 (indirect supervision for complex cases) for the remaining PEM-specific EPAs. Minimum levels expected by FPDs for common subspecialty pediatric EPAs were lower for both groups.ConclusionsMost PEM FPDs indicated that they would graduate fellows before their achievement of the highest entrustment level for all EPAs. Most also indicated that they do not expect practicing PEM physicians to perform all EPAs without supervision. These findings indicate need for stakeholders to evaluate current structure and outcomes of PEM fellowship programs and for institutions and organizations to ensure adequate support in time and resources for ongoing learning for practicing PEM physicians.
Change in Body Mass Index and Attributable Risk of New-Onset Hypertension Among Obese Living Kidney Donors
Authors: Reed Rhiannon D. , McLeod M. Chandler , MacLennan Paul A. , Kumar Vineeta , Pittman Sydney E. , Maynor Andrew G. , Stanford Luke A. , Baker Gavin A. , Schinstock Carrie A. , Silkensen John R. , Roll Garrett R. , Segev Dorry L. , Orandi Babak J. , Lewis Cora E. , Locke Jayme E. 
Published: August 2022

Objective:
To examine whether body mass index (BMI) changes modify the association between kidney donation and incident hypertension.

Background:
Obesity increases hypertension risk in both general and living kidney donor (LKD) populations. Donation-attributable risk in the context of obesity, and whether weight change modifies that risk, is unknown.

Methods:
Nested case-control study among 1558 adult LKDs (1976–2020) with obesity (median follow-up: 3.6 years; interquartile range: 2.0–9.4) and 3783 adults with obesity in the Coronary Artery Risk Development in Young Adults (CARDIA) and Atherosclerosis Risk in Communities (ARIC) studies (9.2 y; interquartile range: 5.3–15.8). Hypertension incidence was compared by donor status using conditional logistic regression, with BMI change investigated for effect modification.

Results:
Overall, LKDs and nondonors had similar hypertension incidence [incidence rate ratio (IRR): 1.16, 95% confidence interval (95% CI): 0.94–1.43, P=0.16], even after adjusting for BMI change (IRR: 1.25, 95% CI: 0.99–1.58, P=0.05). Although LKDs and nondonors who lost >5% BMI had comparable hypertension incidence (IRR: 0.78, 95% CI: 0.46–1.34, P=0.36), there was a significant interaction between donor and >5% BMI gain (multiplicative interaction IRR: 1.62, 95% CI: 1.15–2.29, P=0.006; relative excess risk due to interaction: 0.90, 95% CI: 0.24–1.56, P=0.007), such that LKDs who gained weight had higher hypertension incidence than similar nondonors (IRR: 1.83, 95% CI: 1.32–2.53, P<0.001).

Conclusions:
Overall, LKDs and nondonors with obesity had similar hypertension incidence. Weight stability and loss were associated with similar hypertension incidence by donor status. However, LKDs who gained >5% saw increased hypertension incidence versus similar nondonors, providing support for counseling potential LKDs with obesity on weight management postdonation.
Temporal Slant Recession of the Inferior Rectus Muscle: A Simple Surgical Treatment for Diplopia Caused by Small Vertical Deviations
Authors: Brodsky Michael C. 
Published: August 2022

Background:
To evaluate the therapeutic effect of temporal slant recession of the inferior rectus muscle (TSRIRM) for the treatment of small vertical deviations in patients with vertical diplopia, with consideration of the theoretical additive effects of this procedure on ocular torsion and horizontal incomitance.

Methods:
Retrospective review of 11 patients who were treated with TSRIRM. Eight patients with vertical diplopia and small hyperdeviations (up to 6 prism diopters (PDs)) were treated with isolated TSRIRMs. Three patients with vertical diplopia from unilateral superior oblique palsies with large hyperdeviations (>15 PDs) were treated with TSRIRMs in conjunction with contralateral inferior oblique recessions.

Results:
Six of the 8 patients with small vertical deviations had successful vertical realignment with elimination of symptomatic diplopia after an isolated TSRIRM. Two of the eight patients had residual hypertropia with symptomatic diplopia. Three additional patients with unilateral superior oblique palsy had successful vertical realignment with elimination of symptomatic diplopia after ipsilateral inferior oblique recession and contralateral TSRIRM. In total, 9 of 11 patients had successful surgical results after TSRIRM.

Conclusions:
TSRIRM provides an effective and reliable treatment for small angle vertical strabismus. Its ease of surgical access renders it useful for implementation in an outpatient neuro-ophthalmology setting.
Preventing nipple pain/trauma in breastfeeding women: a best practice implementation project at the Marqués de Valdecilla University Hospital (Spain)
Authors: Cornejo-del Río Elsa , Cobo-Sánchez José Luis , Mateo-Sota Sonia , Lasarte-Oria Lorena , Sáez de Adana-Herrero María , Gortázar-Arias Pilar , Gómez-Pérez Tamara , Sainz-Gómez Gema , Lechosa-Muñiz Carolina 
Published: August 2022

Objectives:
To assess compliance with recommendations to alleviate nipple pain and/or trauma (NPT) and to reduce the rate of breastfeeding abandonment for this reason.

Introduction:
As a fundamental priority, health programmes encourage mothers to breastfeed exclusively for the first 6 months of the baby's life and to supplement breast milk with other foods up to the age of 2 years. However, the presence of NPT can reduce or prevent compliance with this recommendation.

Methods:
The project was designed and carried out using a framework based on the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES). Six audit criteria were used in preaudits and postaudits to observe any changes in compliance with the recommendations. Between audits, the Getting Research into Practice (GRiP) tool was used to identify stakeholders, barriers and facilitators of the project.

Results:
Two hundred and sixty-seven breastfeeding women were studied in the baseline phase and 275 during follow-up. Compliance in four criteria improved, and the rates of NPT decreased (pain: from 63.3 to 53.5%; P = 0.02; trauma: from 37.8 to 24.7%; P = 0.01). The proportion of women advised by qualified personnel increased from 63 to 88% whereas those who cited pain as the reason for abandoning exclusive breastfeeding decreased from 1.5 to 1.1%.

Conclusion:
The evidence-based implementation project we describe significantly improved compliance rates in most of the evidence-based criteria considered. In consequence, the prevalence of NPT fell significantly. Nevertheless, there was no significant impact on the proportion of mothers abandoning breastfeeding for this reason.