bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical Cannabis in Cancer Patients
Authors: Macari David M. , Gbadamosi Bolanle , Jaiyesimi Ishmael , Gaikazian Susanna 
Published: June 2020

Objectives:
Cancer patients are using medical cannabis (MC) to address symptoms; however, little data exist to guide clinicians when counseling patients. We seek to define the patterns of MC use among cancer patients, as well as efficacy and safety of MC.

Materials and Methods:
Cancer patients attending oncology office visits at Beaumont Hospital, Michigan from July to December 2018 were anonymously surveyed. The survey included data regarding demographics, diagnosis, treatment, symptom burden, and MC use. Patients who reported MC use since their cancer diagnosis completed a section on patterns of use, efficacy, and safety.

Results:
The response rate was 188 of 327 (57.5%). MC use was reported by 46 of 188 (24.5%). A median composite baseline symptom score ranging from 8 (best) to 32 (worst) was higher in patients using MC versus nonusers; 17.5 versus 14.4 (P<0.001). Pain was the symptom with the highest frequency of improvement 34/42 (81%), followed by appetite 34/44 (77.3%), and anxiety 32/44 (73%). MC improved the ability to tolerate treatment in 24/44 (54.5%). Cloudy thinking is the symptom that worsened the most 7/42 (16.7%), with decreased energy being experienced by 4/41 (9.8%) of the users.

Conclusions:
MC was utilized by a significant portion of cancer patients in this sample, across age, diagnosis, stage, and treatment. Patients with a higher severity of baseline symptoms were more likely to use MC and report a favorable efficacy profile of MC. Minimal toxicity was reported in this cohort. Prospective studies are needed to define the efficacy and safety of MC.
Power Function Retention of Radionuclides in a Wound
Authors: Goans Ronald E. 
Published: June 2020

Abstract
NCRP Report 156 describes soluble radionuclide retention kinetics in a wound, segregated into four retention categories: weak (W), moderate (M), strong (S), and avid (A). An alternate single-parameter model, the negative power function, t
−γ
, is presented in this paper to describe the time behavior of radionuclide retention. With this mathematical description, γ is a single parameter that can be used to assign the wound retention category rapidly. Using the power function description of wound retention, the various wound categories present as straight lines on log scales with different slopes corresponding to the various retention categories. Regression analysis of average retention values in NCRP 156 shows γ = 0.735 ± 0.132, 0.514 ± 0.015, 0.242 ± 0.016, and 0.053 ± 0.023 for the weak, moderate, strong, and avid categories, respectively. A case study is presented (REAC/TS Registry case 1284) where a power function is shown to fit retention data in a Pu239/Am241 hand wound up to 2,000 d (5.4 y) post-accident.
Tritium Atom Exchange May Be Responsible for Activity Decrease in Plastic Liquid Scintillation Vials
Authors: Wang John , Brandl Alexander 
Published: June 2020

Abstract
Detection and measurement of low-energy beta particles is commonly achieved by liquid scintillation counting, in particular for low-level tritium samples. When samples are contained in plastic scintillation vials for long-term storage, the tritium activity in the vials has been found to decrease faster than expected from its natural radioactive decay. Different explanations for this observation have attributed some of these tritium activity losses to diffusion of the sample, degradation of the LSC cocktail, and the potential long-term changes in quenching effects of the LSC cocktail. An alternative explanation may also be that the tritium organically binds to the carbon chains in the plastic bottle through direct 1H and 3H atom exchange. A study was designed and performed to test this latter hypothesis of 1H and 3H atom exchange in plastic. Deionized water was introduced in a plastic vial that previously contained tritiated water to assess any increase in tritium activity from the reverse atom exchange between the vial material and the deionized water. A greater loss in activity concentration is observed in plastic vials compared to glass vials as a function of storage time for the tritiated water. Furthermore, the tritium activity concentration in the deionized water increased when storage occurred in plastic vials, an effect that is not observed for storage in glass vials. The study results indicate that hydrogen atom exchange may possibly take place in plastic vials.
Fate and Management of Incompletely Excised Solitary Fibrous Tumor of the Orbit: A Case Series and Literature Review
Authors: Jackson Chad H. , Hunt Bryan C. , Harris Gerald J. 
Published: June 2020

Purpose:
There is an imperfect correlation between the histology and behavior of solitary fibrous tumor (SFT). In addition, recurrence is common, and dedifferentiation may occur over time. Preferred primary treatment is intact excision, but friable pseudocapsules and tenacious attachments can thwart this goal in the crowded, visually sensitive orbit. This study addresses the fate and appropriate management of incompletely excised orbital SFT.

Methods:
Among a single surgeon’s 7-case experience with orbital SFT, 3 cases involved incomplete primary excision, either before (2 cases) or after (1 case) referral. We reviewed the clinicopathologic data in these 3 cases, with follow-up intervals of 18, 21, and 52 years after initial presentation. We reviewed the English-language literature on SFT, with special attention to evolving nomenclature, orbital involvement, recurrence, malignant transformation, and management options.

Results:
Benign versus malignant designations of SFT vary with histological and behavioral criteria. Approximately 150 orbital cases have been reported. Published rates of primary malignancy and recurrence across all histologic categories are 6% to 12% and 30% to 37%, respectively. We identified 43 well-documented recurrences (range, 6 months–33 years; median, 3 years) and 10 cases of histological dedifferentiation (range, 14 months–33 years). Because of SFT’s rarity and needed follow-up intervals, the value of adjuvant therapy is not yet proven. In follow up of 18, 21, and 52 years after initial presentation, our 3 cases with incomplete excision showed either no recurrence (Case 1) or no morphological dedifferentiation (Cases 2, 3).

Conclusion:
A treatment algorithm is predicated on the completeness of surgical excision and histological features. However, we recommend case-by-case multidisciplinary decisions in a tumor-board setting.
Evaluation of lumbar fusion using the anterior to psoas approach for the treatment of L5/S1 spondylolisthesis
Authors: He Wei , He Da , Tian Wei 
Published: June 2020

Abstract
To date, no studies have evaluated the outcomes of lumbar interbody fusion using the anterior to psoas (ATP) approach in patients with spondylolisthesis at L5/S1. We; therefore, aimed to evaluate short-term surgical outcomes of interbody fusion using the ATP approach combined with posterior fixation in these patients.
We performed a retrospective analysis of 9 patients with grade I spondylolisthesis at L5/S1 who were treated with fusion and posterior fixation using the ATP approach at our hospital from April to July 2018. The recorded parameters included operation time, intraoperative blood loss, complications, intervertebral fusion rate, radiological intervertebral height, intervertebral foramen height, intervertebral foramen width, pain, visual analog scale, and Oswestry disability index.
Four men and 5 women at an average age of 57.8 years (range: 46–71 years) were enrolled in the study. The average operation time was 152.8 ± 22.9 minutes, and the average blood loss during surgery was 165 ± 27.5 mL. All patients confirmed the relief of their low back pain, and there were no serious complications. The follow-up time was more than 6 months. The visual analog scale and Oswestry disability index scores 3 days postoperatively and at the last follow-up were significantly lower than those before surgery (P < .05). At the last follow-up, the intervertebral space of the surgical segment showed bony fusion in all patients, and the intervertebral height and intervertebral foramen height and width were significantly increased compared with those before surgery (P < .05).
The ATP approach was safe and effective for the treatment of spondylolisthesis at L5/S1. It showed low vascular injury and cage shift rates and was technically easy to perform. We recommended that surgeons identify the vessels in the surgical field preoperatively so that they can be secured or safely ligated during surgery.
Efficacy and safety of Lian-Hua Qing-Wen granule for COVID-2019
Authors: Hu Zhipeng , Yang Maoyi , Xie Chunguang 
Published: June 2020

Abstract

Background:
Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Since the outbreak, the disease has caused more than 60,502 deaths worldwide. Lian-Hua Qing-Wen Granule (LHQWG) is widely used in treating COVID-19 in China. However, there is no evidence that LHQWG is effective for COVID-19.

Methods and analysis:
A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane X2 and I

2
tests. Publication bias assessment will be conducted by funnel plot analysis and Egger test.

Results:
The results of our research will be published in a peer-reviewed journal.

Conclusion:
Our study aims to systematically present the clinical evidence of LHQWG in treating COVID-19, which will be of significant meaning for further research and clinical practice.

OSF registration number:
10.17605/OSF.IO/27SBU.
Influences of different dose of tirofiban for acute ST elevation myocardial infarction patients underwent percutaneous coronary intervention
Authors: Wang Haixia , Feng Meiqin 
Published: June 2020

Abstract
Tirofiban is widely used in patients with acute ST elevation myocardial infarction (STEMI) underwent percutaneous coronary intervention (PCI). This drug can efficiently improve myocardial perfusion and cardiac function, but its dose still remains controversial. We here investigated the effects of different dose of tirofiban on myocardial reperfusion and heart function in patients with STEMI. A total of 312 STEMI patients who underwent PCI in our hospital from March 2017 to March 2018 were enrolled and randomly divided into control group (75 cases, 0 μg/kg), low-dose group (79 cases, 5 μg/kg), medium-dose group (81 cases, 10 μg/kg) and high-dose group (77 cases, 20 μg/kg). The infarction-targeted artery flow grade evaluated by thrombolysis in myocardial infarction (TIMI), corrected TIMI frame count (CTFC) and sum-ST-segment resolution were recorded. At Day 7 and Day 30 after PCI, the left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter, left ventricular end systolic diameter, major adverse cardiovascular events and the hemorrhage and thrombocytopenia were also evaluated. After PCI, the rate of TIMI grade 3, CTFC and incidence of sum-ST-segment resolution > 50% of high-dose group were significantly higher than those of control group, low-dose group and medium-dose group (P < .05), and the CTFC of medium -dose group were significantly higher than that of control group, low-dose group (P < .05). Moreover, the LVEF, left ventricular end diastolic diameter and left ventricular end systolic diameter of high-dose group were significantly improved than those of other groups, and the LVEF of medium-dose group was significantly superior to that of low-dose group (P < .05). However, the incidence of major adverse cardiac events in high-dose group was significantly decreased, while the hemorrhage and incidence of thrombocytopenia of high-dose group were significantly higher than those of other 3 groups (P < .05). The tirofiban can effectively alleviate the myocardial ischemia-reperfusion injury and promote the recovery of cardiac function in STEMI patients underwent PCI. Although the high-dose can enhance the clinical effects, it also increased the hemorrhagic risk. Therefore, the rational dosage application of tirofiban become much indispensable in view of patient's conditions and hemorrhagic risk, and a medium dose of 10 μg/kg may be appropriate for patients without high hemorrhagic risk.
Efficacy and safety of high-viscosity cement in percutaneous vertebroplasty for treatment of Osteoporotic vertebral compression fractures
Authors: Li Kunpeng , Feng Hongyong , Luo Dawei , Zhang Wen , Yang Keshi , Ji Changbin , Liu Jinlong , Xu Hui 
Published: June 2020

Abstract
To evaluate the efficacy and safety of high viscosity bone cement in the percutaneous vertebroplasty (PVP) for treatment of single-level osteoporotic vertebral compression fractures.
Eighty patients were enrolled in this study. All patients were received PVP, and they were divided into 2 groups according to the viscosity of bone cement, either high viscosity bone cement (HV group) or low viscosity cement (LV group). Oswestry Disability Index questionnaire and visual analog scale as clinical assessments were quantified. The operative time and injected bone cement volume were recorded. The anterior vertebral height (AVH) and bone cement leakage were evaluated in the radiograph.
No significant difference was observed in the operative time. Both groups showed significant improvements in pain relief and functional capacity status (visual analog scale and Oswestry disability index scores) after surgery. Less bone cement volume was injected into the the injured vertebra in the HV group and statistical significance was found between both groups. In the HV group, there was lower leakage rate and less patients of severe leakage compared with the LV group. However, the correction of AVH showed no significant differences between the 2 groups and no significant loss of AVH was observed in 2 groups.
High-viscosity and low-viscosity PVP have the similar effects in improving quality of life and relieving pain. There were lower cement leakage rate and less patients of severe leakage in the PVP with high-viscosity bone cement.
Mechanisms of traumatic cardiac arrest in Kuwait
Authors: Alhasan Dalal , Yaseen Ameen 
Published: June 2020

Abstract
The objective of this study is to describe the epidemiology and causes of traumatic cardiac arrest (TCA) in Kuwait aiming to provide a preliminary background to update the current guidelines and improve patients’ management.
This is a retrospective analysis of TCA cases retrieved from emergency medical services archived data between 1 January and 31 December 2017. The TCA cases were sub-grouped based on mechanism of injury then compared in terms of patient demographics, vital signs, patterns of injuries, resuscitation practices, and outcomes.
Outcomes; On scene mortality rate and pre-hospital return of spontaneous circulation.
Among the 204 TCA patients, 140 patients met the inclusion criteria. This whole group was then divided in to 4 subgroups: road traffic accident (RTA) 76% (n=106), fall from height (FFH) 13% (n = 18), slip/fall 4% (n = 6), and assaults 7% (n = 10). There was significant difference between the four mechanisms in: mean age (P
=  < .001), type of injury (P
= .005), head injury (P
= .005), chest injury (P
= .003), GCS score < 9 (P
= .004) and initial hypertension (P
=  < .001). Initial hypertension and GCS score < 9 were only documented in head injuries of RTA and slip/fall groups. Significant difference was also seen in cardiopulmonary resuscitation (P
= .006), airway management (P
= .035) and on scene mortality rate (P
= .003). All patients who had isolated head injury in FFH were pronounced dead on scene, 60%.
Not all TCA incidents are the same, there are different pattern of injuries in each TCA mechanism. Head injuries are predominantly seen in RTA, FFH, slip /falls and chest injuries are seen in assaults. This can influence emergency medical services personals resuscitation plan. Further research is required to address the resuscitation of TCA of different mechanisms.
Red cell distribution width-to-lymphocyte ratio
Authors: Zhang Xueyan , Wang Dawei , Chen Zhongming , Guo Naizhou , Wang Wei , Xiong Cunquan , Liu Jun , Yue Yinhong , Sun Mingzhong 
Published: June 2020

Abstract
To evaluate the diagnostic power of red cell distribution width-to-lymphocyte ratio (RLR) for HBV-related liver cirrhosis via a retrospective cohort study.
Seven hundred fifty healthy controls, 327 chronic hepatitis B (CHB) patients, and 410 patients with HBV-related liver cirrhosis (HBV-LC) were enrolled in this study. RLR, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), AST to platelet ratio index (APRI), and fibrosis index based on the 4 factors (FIB-4) were compared between the 3 groups. The predictive powers of RLR and RDW for HBV-related liver cirrhosis and patient prognosis were evaluated using AUROC.
Patients with HBV-related liver cirrhosis had higher RLR, FIB-4, NLR, RDW, APRI, and lower LMR compared with the control and CHB groups. RLR in the HBV-LC group was significantly higher than both CHB and control groups (both P < .05). While RLR in the CHB group was also higher than the control group, the difference was not statistically significant (P > .05). The AUROC of RLR for predicting HBV-related liver cirrhosis was 0.87, and was superior to RDW (0.81), FIB-4 (0.79), and APRI (0.60). With an optimized cut-off value (10.87), RLR had the highest sensitivity (0.88) and specificity (0.72), and was superior to RDW (0.86, 0.64), FIB-4 (0.80, 0.65), and APRI (0.85, 0.48) as a biomarker. For all 3 groups, RLR was negatively correlated (all P < .05) with serum platelet (PLT) and was positively correlated (all P < .05) with FIB-4 and APRI. There was no significant statistical difference in RLR for patients in HBV-LC group who had different prognosis (P > .05).
The RLR, a routinely available, inexpensive, and easily calculated measure, can be used as a predictor of HBV-related liver cirrhosis, but not as a predictor of prognosis for patients with liver cirrhosis. Use of RLR may reduce the need for frequent liver biopsies in CHB patients.
Computer-aided diagnosis system of thyroid nodules ultrasonography
Authors: Li Tingting , Jiang Zirui , Lu Man , Zou Shibin , Wu Minggang , Wei Ting , Wang Lu , Li Juan , Hu Ziyue , Cheng Xueqing , Liao Jifen 
Published: June 2020

Abstract
To evaluate the diagnostic efficiency of computer-aided diagnosis (CAD) system and 111 radiologists with different experience in identifying benign and malignant thyroid nodules, and to summarize the ultrasound features that may affect the diagnostic of CAD and radiologists.
Fifty thyroid nodules and 111 radiologists were enrolled in this study. All the 50 nodules were diagnosed by the 111 radiologists and the CAD system simultaneously. The diagnostic performance of the CAD system, senior and junior radiologists with the maximum accuracy were calculated and compared. Interobserver agreement for different ultrasound characteristics between the CAD and senior radiologist were analyzed.
CAD system showed a higher specificity than junior radiologist (87.5% vs 70.4%, P = .03), and a lower sensitivity than the senior radiologist and junior radiologist but the statistics were not significant (76.9% vs 86.9%, P > .5; 76.9% vs 82.6%, P > .5). The CAD system and senior radiologist got larger AUC than junior radiologist but the differences were not statistically significant (0.82 vs 0.76, respectively; P = .5). The interobserver agreement for the US characteristics between the CAD system and senior radiologist were: substantial agreement for hypoechoic and taller than wide (kappa value = 0.66, 0.78), and moderate agreement for irregular margin and micro-calcifications (kappa value = 0.52, 0.42).
The CAD system achieved equal diagnostic accuracy to the senior radiologists and higher accuracy than the junior radiologists. The interobserver agreements in the US features between the CAD system and senior radiologist were substantial agreement for hypoechoic and taller than wide; moderate agreement for irregular margin and micro-calcifications. The location of a thyroid nodule and the feature of macrocalcification with wide acoustic shadow may influence the analysis of the CAD system.
Prognosis Value of Early Veno Arterial PCO2 Difference in Patients Under Peripheral Veno Arterial Extracorporeal Membrane Oxygenation
Authors: Ellouze Omar , Nguyen Maxime , Missaoui Anis , Berthoud Vivien , Aho Serge , Bouchot Olivier , Guinot Pierre Grégoire , Bouhemad Belaid 
Published: June 2020

ABSTRACT

Introduction:
Veno arterial membrane oxygenation (VA ECMO) is increasingly used for cardiogenic failure. However, hemodynamic targets for adequate resuscitation remain a challenge. The PCO2 gap and the ratio between PCO2 gap and the arteriovenous difference in oxygen (PCO2 gap/Da–vO2) are marker of peripheral hypoperfusion. We hypothesized that the PCO2 gap and the PCO2 gap/Da–vO2 ratio might be useful parameters in VA ECMO patients.

Patients and Methods:
We conducted an observational prospective study between September 2015 and February 2017. All consecutive patients >18 years of age who had been treated with peripheral VA ECMO for cardiac failure were included. We compared two groups of patients: patients who died of any cause under VA ECMO or in the 72 h following VA ECMO weaning (early death group)—and patients who survived VA ECMO weaning more than 72 h (surviving group). Blood samples were drawn from arterial and venous VA ECMO cannulas at H0, H6, and H24. The ability of PCO2 gap and PCO2 gap/Da–vO2 to discriminate between early mortality and surviving was studied using receiver operating characteristic curves analysis.

Results:
We included 20 patients in surviving group and 29 in early death group. The PCO2 gap was higher in the early death group at H6 (7.4 mm Hg [5.7–10.1] vs. 5.9 mm Hg [3.8–9.2], P < 0.01). AUC for PCO2 gap at H6 was 0.76 (0.61–0.92), with a cutoff of 6.2 mm Hg. The PCO2 gap/Da–vO2 was higher in the early death group at H0 (2.1 [1.5–2.6] vs. 1.2 [0.9–2.4], P < 0.01) and at H6 (2.1 [1.3–2.6] vs. 1.0 [0.8–1.7], P < 0.01). AUC for PCO2 gap/Da–vO2 at H0 and H6 were 0.79 and 0.73 respectively; the cut-off value was 1.4.

Conclusions:
Early PCO2 gap and PCO2 gap/Da–vO2 ratio are higher in the early death group in patients under VA ECMO.