bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer treatment resumption in patients with new-generation drug-eluting stents
Authors: Balanescu Dinu Valentin , Aziz Moez Karim , Donisan Teodora , Palaskas Nicolas , Lopez-Mattei Juan , Hassan Saamir , Kim Peter , Song Juhee , Ntim William , Cilingiroglu Mehmet , Marmagkiolis Konstantinos , Iliescu Cezar 
Published: November 2020

Objective
Percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DESs) may provide survival benefits to the cancer population undergoing PCI by expediting cancer treatment due to improved safety profile. We aimed to assess the safety of starting or resuming cancer treatment within 6 months of DES placement. We also compared the impact of different DES types on the overall survival (OS) in cancer patients and to identify a safe threshold for dual antiplatelet therapy (DAPT) discontinuation.

Methods
Cancer patients at our institution undergoing PCI with DES from December 2014 to June 2017 were included. Baseline demographics, DAPT duration, malignancy type, stage, and treatment were retrospectively analyzed. Univariate Cox regression was used to pinpoint baseline characteristics that correlated with OS. Survivorship was determined by Kaplan–Meier analysis, and the log-rank test was used to compare OS among DES types.

Results
Seventy-five patients were included. Of these, 45 had biodegradable polymer DES (Synergy) and 30 patients had durable polymer DES (Resolute Integrity, Xience, Ion, or Promus). Mean duration of follow-up was 1367 ± 334 days. There were two minor bleeding complications. No statistically significant differences in OS were found among different stent brands. Discontinuation of aspirin, early P2Y12 inhibitor discontinuation, and advanced cancer were significantly associated with OS. DAPT discontinuation <6 months after PCI was not associated with stent thrombosis or in-stent restenosis. There were two major adverse cardiac events: one in-stent restenosis while on DAPT for >12 months (attributed to radiation-induced heart disease) and one myocardial infarction and death. Of patients who resumed or started cancer treatment (chemotherapy, radiation therapy, or surgery) after PCI, all but one did so within 6 months of PCI, and most of them as early as 2 weeks.

Conclusion
Patients may resume cancer treatment <6 months after PCI. We suggest that DAPT may be safely interrupted as early as 6 months, but additional longitudinal studies are needed.
Dietary management of cardiovascular risk including type 2 diabetes
Authors: Nestel Paul J. , Sullivan David R. , Mori Trevor A. 
Published: November 2020

Purpose of review
Recent changes or confirmations linking patterns of eating and specific dietary interventions in the management of cardiovascular risk factors including associations with prevalent and incident type 2 diabetes.

Recent findings
Recently published guidance for dietary management of cardiovascular risk and type 2 diabetes have mostly common features. Major findings include a trend to replace strict quantitative advice on nutrients with qualitative advice on food consumption with exceptions for diabetes, global advice to increase intake of plant foods, confirmation to substitute mono and polyunsaturated oils for saturated and trans fats, new advisory on supplemental omega-3 intake, less limitation on dairy foods and fermented dairy foods encouraged, reduced emphasis on specific cholesterol-rich foods allowing greater consumption of eggs except for people with diabetes, processed meat consumption limited allowing modest intake of lean red meat, distinguishing between ‘healthy’ and ‘unhealthy’ carbohydrates including sugars, and maintaining advice on healthy bodyweight, reducing salt intake and encouraging water as preferred beverage.

Summary
The new guidance for healthier patterns of food consumption supported by evidence is more readily understood by health practitioners and translatable to consumers and patients.
Novel approaches to management of hypertension
Authors: Bosch Agnes , Schmieder Roland E. 
Published: November 2020

Purpose of review
Of the roughly 1.4 billion people with hypertension worldwide, only about one in seven has their blood pressure (BP) successfully treated and adequately controlled. This review will focus on new therapeutic approaches of hypertension.

Recent findings
Several recent clinical studies and guidelines have favoured the assessment of target organ damage and cardiovascular risk scores for the diagnosis and treatment approach of hypertension. Paradigm shifts recommended in the guidelines are the initiation of antihypertensive treatment with combination (not mono) therapy and the recommendation of single-pill combinations (SPC), which improve adherence and result in rapid and effective BP control. In clinical trials with optimized design and renal denervation (RDN) technology, the biological proof of concept has been established. Consistent, durable ambulatory and office BP reductions without procedure associated serious adverse events have been documented. The challenges are now to identify patients who respond best to interventional treatment.

Summary
Major key points in the treatment strategy for hypertension are: individualization of the therapy according to total cardiovascular risk, combination therapy as initial step, recommendation of SPC and RDN as promising interventional therapy.
Novel conservative management of chronic kidney disease via dialysis-free interventions
Authors: Zarantonello Diana , Rhee Connie M. , Kalantar-Zadeh Kamyar , Brunori Giuliano 
Published: November 2020

Purpose of review
In advanced chronic kidney disease (CKD) patients with progressive uremia, dialysis has traditionally been the dominant treatment paradigm. However, there is increasing interest in conservative and preservative management of kidney function as alternative patient-centered treatment approaches in this population.

Recent findings
The primary objectives of conservative nondialytic management include optimization of quality of life and treating symptoms of end-stage renal disease (ESRD). Dietetic-nutritional therapy can be a cornerstone in the conservative management of CKD by reducing glomerular hyperfiltration, uremic toxin generation, metabolic acidosis, and phosphorus burden. Given the high symptom burden of advanced CKD patients, routine symptom assessment using validated tools should be an integral component of their treatment. As dialysis has variable effects in ameliorating symptoms, palliative care may be needed to manage symptoms such as pain, fatigue/lethargy, anorexia, and anxiety/depression. There are also emerging treatments that utilize intestinal (e.g., diarrhea induction, colonic dialysis, oral sorbents, gut microbiota modulation) and dermatologic pathways (e.g., perspiration reduction) to reduce uremic toxin burden.

Summary
As dialysis may not confer better survival nor improved patient-centered outcomes in certain patients, conservative management is a viable treatment option in the advanced CKD population.
Novel approaches to sarcopenic obesity and weight management before and after kidney transplantation
Authors: Tantisattamo Ekamol , Kalantar-Zadeh Kamyar , Halleck Fabian , Duettmann Wiebke , Naik Marcel , Budde Klemens 
Published: November 2020

Purpose of review
Although a widely recognized and complex pathophysiological condition, sarcopenic obesity remains less appreciated and may elude diagnosis and workup in both kidney transplant waitlisted candidates and kidney transplant recipients. The lack of consensus definition, and practical diagnostic tools for evaluating waitlisted candidates and transplant recipients are barriers to early detect and initiate therapeutic management for sarcopenic obesity. Although sarcopenia leads to poor clinical outcomes, posttransplant obesity yields conflicting results. Exercise and nutritional managements are common therapies for sarcopenic obese patients; however, surgery weight loss or bariatric surgery in both transplant candidates and potential living kidney donors shows promising benefits for kidney transplant access in waitlist obese candidates but may require to be selected for appropriate patients.

Recent findings
Pathogenesis and management for sarcopenia and obesity are interconnected. The benefits of exercise to improve muscle mass and function is clear in waitlist kidney transplant candidates and transplant recipients. However, there are several barriers for those to increase exercise and improve physical activity including patient, provider, and healthcare or environmental factors. The advantages of fat mass reduction to lose weight can promote muscle mass and strength. However, epidemiological data regarding the obesity paradox in dialysis-dependent patients when overnutrition provides survival benefits for this population should be taken into account when performing weight loss especially bariatric surgery.

Summary
Barriers in providing optimal care to kidney transplant waitlisted candidates and transplant recipients may partly result from underdiagnosis of sarcopenic obesity; notwithstanding that this entity has increasingly been more recognized. Mechanistic studies to better understand pathogenesis of sarcopenic obesity will help determine pathogenesis and clinical tools for diagnosis of this entity, which can facilitate further studies related to the outcomes and weight management to ultimately improve kidney transplant outcomes.
A primer on single-cell genomics in myeloid biology
Authors: Ferchen Kyle , Song Baobao , Leighton Grimes H. 
Published: November 2020

Purpose of review
Understanding the fast-moving field of single-cell technologies, as applied to myeloid biology, requires an appreciation of basic molecular, informatics, and biological concepts. Here, we highlight both key and recent articles to illustrate basic concepts for those new to molecular single-cell analyses in myeloid hematology.

Recent findings
Recent studies apply single-cell omics to discover novel cell populations, construct relationships between cell populations, reconfigure the organization of hematopoiesis, and study hematopoietic lineage tree and fate choices. Accompanying development of technologies, new informatic tools have emerged, providing exciting new insights.

Summary
Hematopoietic stem and progenitor cells are regulated by complex intrinsic and extrinsic factors to produce blood cell types. In this review, we discuss recent advances in single-cell omics to profile these cells, methods to infer cell type identify, and trajectories from molecular omics data to ultimately derive new insights into hematopoietic stem and progenitor cell biology. We further discuss future applications of these technologies to understand hematopoietic cell interactions, function, and development. The goal is to offer a comprehensive overview of current single-cell technologies and their impact on our understanding of myeloid cell development for those new to single-cell analyses.
Role of Social Networks and Social Norms in Future PrEP Use in a Racially Diverse Sample of At-Risk Women and Members of Their Social Networks
Authors: Johnson Laura M. , Green Harold D. , Koch Brandon , Stockman Jamila K. , Felsher Marisa , Roth Alexis M. , Wagner Karla D. 
Published: November 2020

Objective:Despite the efficacy of pre-exposure prophylaxis (PrEP) in reducing the risk of HIV infection, uptake remains low among many who are most vulnerable to HIV, such as Black and Latinx women. Interventions that target social networks to encourage at-risk women to initiate PrEP are underused.Design:This study used an egocentric network design and sampled Black/African American and Latinx women at risk of HIV as well as people from their social networks (N = 211) in a small, western city.Methods:Multivariable generalized linear mixed effects regression models investigated individual-level and network-level characteristics associated with likely future PrEP use.Results:PrEP awareness was low, but once informed, 36% considered themselves likely to take it in the future. Perceived risk of HIV, perceived barriers to HIV testing, and participation in a 12-step program increased odds of anticipated PrEP use. A higher proportion of friends in one's network decreased odds of future PrEP use, whereas a higher proportion of network members who tested regularly for HIV increased odds of future PrEP use. A marginally significant interaction was detected between proportion of friends in one's network and proportion of the network perceived to test for HIV regularly (ie, testing norms). When HIV testing norms were low, a higher proportion of friends in the network decreased odds of likely PrEP use. However, this effect was reversed in contexts with strong testing norms.Conclusion:Women who are interested in PrEP may be embedded within social and normative contexts that can foster or inhibit PrEP uptake.
Facial Contour Rejuvenation by Reduction Malarplasty Combined With Second-Stage Fat Grafting
Authors: Gao Bowen , Yuan Yukun , Li Ke , Li Zengguang , Yu Lianggang 
Published: November 2020

Background:
With aging, the facial contour shows a double-concave deformity. Conventional facial contouring procedure, including face lifting and fat grafting, cannot yield a smooth facial contour line. This study was the first to propose a combination of reduction malarplasty and 2nd-stage autologous fat grafting so as to achieve the aesthetic goals of facial contour rejuvenation.

Methods:
The study group comprised patients seeking facial contour rejuvenation from January 2017 to May 2018 (28 patients: 28 females and 0 males) at the Department of Plastic Surgery, Tian Tan Pu Hua Hospital. All of the cases underwent bilateral malarplasty with 2nd-stage autologous facial fat grafting. Radiologic and photographic documentation was completed preoperatively. The mean follow-up period was 12 months. Patients’ pre-op photographs and 3 months follow-up pictures were blindly assessed.

Results:
Most of the patients were satisfied with their results after 1-time fat grafting. Eleven patients demanded re-injection after the 1st fat grafting in temporal area, and 6 patients demanded 3rd time fat grafting in temporal area. Eleven patients demanded re-injection insubmalar area, and 8 patients demanded 3rd time fat grafting in submalar area. Meanwhile, 9 of those patients underwent fat grafting in other sites other than temporal and submalar region. The amount of fat injected was also recorded in this study. The appearance of double-concave deformity was greatly improved in all cases. Complications included infection (3.6%), hematoma (7.1%), and malar prominence relapse (7.1%), and so on.

Conclusion:
Reduction malarplasty combined with several times of fat grafting could effectively overcome the malar prominence and soft tissue deflation. Complications were minimal after these procedures. Therefore, this technique is useful to restore the youthful facial contour in Asian patients with aging double-concave deformity.
Reconstruction of Posttraumatic Nasal Defect Through Paramedian Frontal Flap
Authors: Gonçalves Kalyne Kelly Negromonte , Lessa Thayane Celina Silva , Diniz Demóstenes Alves , Silva Ana Fábia dos Santos , Luz Luciano Leal , Filho Dirceu de Oliveira , Vasconcelos Belmiro Cavalcanti do Egito 
Published: November 2020

Abstract
Facial injuries caused by motorcycle accidents represent a challenge for reconstructions. Currently, the most indicated treatment for facial fractures is anatomical reduction and internal fixation, however, this procedure is not exempt from complications, such as infection and exposure of osteosynthesis material, thus requiring a new surgical procedure and repair. In this study, the authors describe a case of a 60-year-old woman who was the victim of a motorcycle accident and developed exposure of osteosynthesis material on the nasal dorsum after treatment of facial fractures. The patient underwent surgical treatment with objective of removing the osteosynthesis material and associated infected tissue, as well as reconstruction using a paramedian frontal flap, which resulted in a harmonic relationship and skin color similar to the recipient area. This case shows the importance of anatomical knowledge and reconstructive techniques for hard and soft tissues.
Network Analysis of Postoperative Surgical Complications in a Cohort of Children Reported to the National Surgical Quality Improvement Program
Authors: Alzubaidi Ahmad N. , Karabayir Ibrahim , Akbilgic Oguz , Langham Max R. 
Published: November 2020

Objective:
To understand the temporal relationships of postoperative complications in children and determine if they are related to each other in a predictable manner.

Summary of Background Data:
Children with multiple postoperative complications have increased suffering and higher risk for mortality. Rigorous analysis of the temporal relations between complications, how complications might cluster, and the implications of such clusters for children have not been published. Herein, we analyze the relationships between postoperative complications in children.

Methods:
Data source: Surgical operations included in the National Surgical Quality Improvement Program Pediatric Participant Use Data File from 2013 to 2017. The main outcomes measure was presence of 1 or more postoperative complications within 30 days of surgery. Operations followed by multiple complications were analyzed using network analysis to study prevalence, timing, and co-occurrences of clusters of complications.

Results:
This study cohort consisted of 432,090 operations; 388,738 (89.97%) had no postoperative complications identified, 36,105 (8.35%) operations resulted in 1 postoperative complication and 7247 (1.68%) operations resulted in 2 or more complications. Patients with multiple complications were more likely to be younger, male, African American, with a higher American Society of Anesthesiologists score, and to undergo nonelective operations (P < 0.001). More patients died with 2 complication versus 1 complication vs no complication (5.3% vs 1.5% vs 0.14%, P < 0.001). Network analysis identified 4 Louvain clusters of complications with dense intracluster relationships.

Conclusions:
Children with multiple postoperative complications are at higher risk of death, than patients with no complication, or a single complication. Multiple complications are grouped into defined clusters and are not independent.
Prophylactic Single-use Negative Pressure Dressing in Closed Surgical Wounds After Incisional Hernia Repair
Authors: Bueno-Lledó José , Franco-Bernal Ascensión , Garcia-Voz-Mediano María Teresa , Torregrosa-Gallud Antonio , Bonafé Santiago 
Published: November 2020

Objective:
A randomized controlled trial (RCT) was undertaken to evaluate whether the prophylactic application of a specific single-use negative pressure (sNPWT) dressing on closed surgical incisions after incisional hernia (IH) repair decreases the risk of surgical site occurrences (SSOs) and the length of stay.

Background:
The sNPWT dressings have been associated to several advantages like cost savings and prevention of SSOs like seroma, hematoma, dehiscence, or wound infection (SSI) in closed surgical incisions. But this beneficious effect has not been previously studied in cases of close wounds after abdominal wall hernia repairs.

Methods:
An RCT was undertaken between May 2017 and January 2020 (ClinicalTrials.gov registration number NCT03576222). Participating patients, with IH type W2 or W3 according to European Hernia Society classification, were randomly assigned to receive intraoperatively either the sNPWT (PICO)(72 patients) or a conventional dressing at the end of the hernia repair (74 patients). The primary endpoint was the development of SSOs during the first 30 days after hernia repair. The secondary endpoint included length of hospital stay. Statistical analysis was performed using IBM SPSS Statistics Version 23.0.

Results:
At 30 days postoperatively, there was significatively higher incidence of SSOs in the control group compared to the treatment group (29.8% vs 16.6%, P < 0.042). There was no SSI in the treatment group and 6 cases in the control group (0% vs 8%, P < 0.002). No significant differences regarding seroma, hematoma, wound dehiscence, and length of stay were observed between the groups.

Conclusion:
The use of prophylactic sNPWT PICO dressing for closed surgical incisions following IH repair reduces significatively the overall incidence of SSOs and the SSI at 30 days postoperatively.
Open Versus Laparoscopic Repair of Perforated Peptic Ulcer Disease
Authors: Coe Peter O. , Lee Matthew J. , Boyd-Carson Hannah , Lockwood Sonia , Saha Arin 
Published: November 2020

Objective:
The aim of this study was to compare open surgery (OS) with laparoscopic surgery (LS) for perforated peptic ulcer (PPU) disease using a National dataset.

Background:
PPU disease is typically treated surgically with an omental patch. This can be performed through OS or a LS. Current evidence in OS versus LS suggests equivalence in mortality and postoperative complications, but a decrease in pain and wound infections with LS.

Methods:
A one-to-one propensity score-matched analysis of patients who underwent PPU repair from December 2013 to December 2017 using data from the National Emergency Laparotomy Audit was performed. Patients with an initially laparoscopic approach were classed as LS even if converted to OS. The primary end-point was 90-day mortality; secondary endpoints were length of stay (LOS), re-operation, and re-admission to critical care. Multivariable logistic and linear models were created to compare the effect of operative approach on binary and continuous outcomes with log-rank tests for time-to-event data.

Results:
A total of 5253 patients underwent surgery in the study period. After propensity-matching, 2 groups of 1158 patients were created. Overall 90-day mortality was 7.5%. There was no difference between the LA and OA for 90-day mortality (7.2% vs 8.5%, OR 0.80, 95% CI 0.56– 1.15, P = 0.23), median LOS (equivalent at 7 days, P = 0.09), reoperation (3.6% vs 4.0%, P = 0.74), or re-admission to critical care (2.8% vs 2.9%, P = 0.92). Across the 4-year study period LS use increased from 20% to 26% and the conversion rate decreased from 40% to 31%.

Conclusions:
Short outcomes from laparoscopic PPU repair appear equivalent to open repair. There is increasing adoption of LS with decreasing conversion rates. LS for PPU appears to be an acceptable approach in this setting.