bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of Laparoscopic Liver Resection for Colorectal Liver Metastasis With Obesity
Authors: Inoue Yoshihiro , Ishii Masatsugu , Fujii Kensuke , Nihei Kentaro , Suzuki Yusuke , Ota Masato , Kitada Kazuya , Kuramoto Toru , Shima Takafumi , Kodama Hiroyuki , Matsuo Kentaro , Miyaoka Yuta , Miyamoto Takahiro , Yokohama Keisuke , Ohama Hideko , Imai Yoshiro , Tanaka Ryo , Sanda Mariko , Osumi Wataru , Tsuchimoto Yusuke , Terazawa Tetsuji , Ogura Takeshi , Masubuchi Shinsuke , Yamamoto Masashi , Asai Akira , Shirai Yasutsugu , Inoue Masaya , Fukunishi Shinya , Nakahata Yoshikatsu , Takii Michiaki , Goto Masahiro , Kimura Fumiharu , Higuchi Kazuhide , Uchiyama Kazuhisa 
Published: December 2020

Introduction Laparoscopic liver resection (LLR) in obese patients has been reported to be particularly challenging owing to technical difficulties and various comorbidities. Methods The safety and efficacy outcomes in 314 patients who underwent laparoscopic or open nonanatomical liver resection for colorectal liver metastases (CRLM) were analyzed retrospectively with respect to the patients’ body mass index (BMI) and visceral fat area (VFA). Results Two hundred and four patients underwent LLR, and 110 patients underwent open liver resection (OLR). The rate of conversion from LLR to OLR was 4.4%, with no significant difference between the BMI and VFA groups ( P = .647 and .136, respectively). In addition, there were no significant differences in terms of operative time and estimated blood loss in LLR ( P = .226 and .368; .772 and .489, respectively). The incidence of Clavien-Dindo grade IIIa or higher complications was not significantly different between the BMI and VFA groups of LLR ( P = .877 and .726, respectively). In obese patients, the operative time and estimated blood loss were significantly shorter and lower, respectively, in LLR than in OLR ( P = .003 and < .001; < .001 and < .001, respectively). There was a significant difference in the incidence of postoperative complications, organ/space surgical site infections, and postoperative bile leakage between the LLR and OLR groups ( P = .017, < .001, and < .001, respectively). Conclusion LLR for obese patients with CRLM can be performed safely using various surgical devices with no major difference in outcomes compared to those in nonobese patients. Moreover, LLR has better safety outcomes than OLR in obese patients.
Breast Cancer Screening in Inner City and County Populations: A Tale of Two Centers
Authors: Castaldi Maria , Smiley Abbas , Butler Jonathan , Latifi Rifat 
Published: December 2020

Background New York’s statewide “Get Screened, No Excuses” campaign has been one of the nation’s most aggressive actions to improve access to breast cancer screening. Inner city and suburban county medical centers’ initiatives were studied to compare outcomes of breast cancer screening and factors that influence access to care. Methods Women delinquent in breast cancer screening one year or greater were offered patient navigator services to aid in timely breast cancer screening. Time-to-event completion rates among different stages of breast cancer screening stages in City and County women were compared. Time-to-event completion rates among different stages of breast cancer screening stages. Results 2505 women aged ≥40 years accepted PN services. Mean (SD) age of patients was 56.2 (10) years. The mean (SD) age of those who completed breast screening vs. those who did not was 56.8 (10) and 52.5 (.9) years, respectively ( P < .01). The rates of screening completion during physical examination, mammography and biopsy stages were 74%, 78% and 100% in City vs. 98%, 85% and 100% in County, respectively ( P < .001). Screening phase was the significant predictor of time to completion for breast cancer screening in Cox regression analysis. Over 85% of women completed the breast cancer screening, 74% in City and 97.6% in County ( P < .001). Discussion Screening phase is an important predictor of time-to complete breast cancer screening. Center location served as the effect modifier of the relationship. The rate of completing the screening was significantly higher and faster among Suburban County compared to Inner City women.
Enhanced Recovery After Surgery Protocols. Does Frailty Play a Role?
Authors: Studniarek Adam , Borsuk Daniel J. , Marecik Slawomir J. , Park John J. , Kochar Kunal 
Published: December 2020

Introduction The 5-modified frailty index (mFI) is a valid predictor of 30-day mortality after surgery. With the wide implementation of enhanced recovery after surgery (ERAS) protocols in colorectal patients, the predictive power of frailty and its contribution to morbidity and length of stay (LOS) can be underestimated. Methods We reviewed all colectomy patients undergoing ERAS protocol at a single, tertiary care institution from January 2016-January 2019. The 5-mFI score was calculated based on the presence of 5 comorbidities: Congestive heart failure (CHF), diabetes mellitus, chronic obstructive pulmonary disease, functional status, and hypertension (HTN). Multivariate analysis was used to assess the impact of 5-mFI score on morbidity, emergency department (ED) visits, readmissions, and LOS. Results 360 patients were evaluated including 163 elderly patients. Frailer patients had a higher rate of ED visits ( P = .024), readmissions ( P = .029), and LOS ( P < .001). Patients with CHF had a higher chance of prolonged LOS, whereas patients with HTN had a higher chance of ED. Elderly patients with an mFI score of 3 and 4 were likely to have longer LOS ( P = .01, P = .07, respectively). Elderly patients with an mFI score of 4 were 15 times more likely to visit ED and 22 times more likely to be readmitted than patients with an mFI score of 0. Discussion An increase in 5-mFI for elderly patients undergoing colorectal procedures increases ED visits or readmissions, and it correlates to a higher LOS, especially in elderly patients. This instrument should be used in the assessment of frail, elderly patients undergoing colorectal procedures.
Predictors of Progression of Appendiceal Mucinous Neoplasm to Pseudomyxoma Peritonei
Authors: Sueda Stefanie , Young Stephanie , Sung Michael , Hotta Mayo , O’Connor Victoria , Leung Anna M. 
Published: December 2020

Appendiceal mucinous neoplasm (AMN) can present with a spectrum of disease. Predicting factors in development of pseudomyxoma peritonei (PMP) from AMN could aid in management and treatment. The aim of this study was to determine factors predictive of PMP from AMN. This was a retrospective multicenter study of all patients diagnosed with AMN from 2006-2017. Diagnosis of PMP was compared by (1) patient demographics, (2) tumor characteristics, and (3) surgery. Secondary end points were disease-specific survival (DSS) and overall survival (OS). One-hundred thirty-eight patients with AMN were identified. Thirty-six patients (26.1%) had a ruptured appendix at presentation, and 12 patients (8.7%) were diagnosed with PMP during the study period. Eight patients presented with PMP at the time of surgery. No demographic factors were predictive of PMP. Operative approach and extent of initial resection did not correlate with PMP. Tumor rupture at presentation was the only factor associated with PMP, though only 14% of patients who presented with simple rupture eventually progressed to PMP. OS was not different between those who were diagnosed with PMP and those who were not. DSS was significantly lower for the group diagnosed with PMP ( P = .007). Tumor rupture at presentation did not influence OS or DSS. The only factor found to be significantly associated with PMP was tumor rupture at presentation. Diagnosis of PMP did not affect OS but did lead to decreased DSS. In conclusion, though a majority of patients who presented with rupture did not go on to develop PMP, tumor rupture at presentation was the only factor significantly associated with PMP. Diagnosis of PMP did not affect OS at 5 years. In patients with AMN who present with a ruptured appendix on final pathology, we recommended continued surveillance, though overall risk of PMP is relatively low.
The Comparison of Physical Fitness, Anthropometric Characteristics, and Visual Acuity of Goalball Players with Their Right Shot Performance
Authors: Kimyon Bulent , Ince Gonca 
Published: December 2020

Introduction: This study investigated the relationship between physical fitness, anthropometric characteristics, visual acuity of athletes with visual impairments, and their right shot performance. Method: The participants of the study involved 34 male athletes with different visual acuities who participated in the 2015 Visually Impaired Schools Goalball Championship in Alanya, Turkey. The means of the participants’ age, body weight, height, and sport age were 14.95 ± 1.28 years, 52.06 ± 8.89 kilograms, 163.58 ± 10.39 centimeters, 02.39 ± 1.50 years, respectively. The participants’ physical fitness, body fat percentage, handgrip (right–left), and spine flexibility were measured. Upper and lower extremity lengths were obtained through anthropometric measurements, and the athletes’ right shot performance was calculated. To analyze the data, the Shapiro–Wilk test was used, and one-way analysis of variance and independent sample t-test were performed, because the data showed a normal distribution ( p = .106). In addition, multivariate regression model analysis was utilized to investigate the relationship between all parameters and the athletes’ right shot performance. Results: A significant difference was found among the groups’ right shot performance ( p = .03), specifically on behalf of the athletes with low vision. When the participants’ anthropometric features, physical fitness values, and their right shot performance were examined, a positive relationship was observed between their dominant (right) handgrip strength and right shot performance (stepwise method; p = .03, R2 = 0.14). However, no significant difference emerged between their anthropometric characteristics and right shot performance. Discussion: It is considered that visual acuity and upper extremity muscle strength are of vital importance in goalball. Implications for practitioners: Whereas the International Blind Sports Federation applies rules according to visual acuity to offer equal conditions for some areas of sport, in goalball such a rule does not exist. It is important to make a change in the regulations for competition groupings according to visual acuities in goalball like in other sports for individuals with visual impairments. More frequent workout oriented to upper extremity muscle strength during right shot performance is suggested in the training sessions.
Effect of Balloon Eustachian Tuboplasty in Adults That Only Have Symptoms of Chronic Eustachian Tube Dysfunction, With a 1-Year Follow-Up: Prospective Clinical Trial
Authors: Formánek Martin , Formánková Debora , Školoudík Lukáš , Zeleník Karol , Chrobok Viktor , Komínek Pavel 
Published: December 2020

Objectives: Balloon eustachian tuboplasty (BET) is a promising therapeutic option for eustachian tube (ET) dysfunction. However, data are lacking on the effect of BET in adults with symptoms of chronic ET dysfunction but without a contributing pathology. This study investigated the effect of BET in adult patients with only symptoms of chronic ET dysfunction. Methods: This prospective clinical trial included adult patients with aerated physiological middle ears and symptoms of ET dysfunction for more than 6 months. Compliance with follow-up was 93.3%. We evaluated the effects of BET with tympanometry, assessment of the Valsalva or Toynbee maneuver with tympanometry verification, a Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and pure-tone audiometry. Data were recorded 1 day before surgery and 2, 6, and 12 months after BET. Therapy was considered successful when the patient exhibited a newly acquired ability to perform the Valsalva or Toynbee maneuver or when the ETDQ-7 score improved by 20% or more. Results: We included 14 ears in the analysis. After 2, 6, and 12 months, therapy was successful, according to the ETDQ-7, in 11/14 (78.6%; 95% CI: 48.8-94.3), 13/14 (92.9%; 95% CI: 64.2-99.6), and 12/14 (85.7%; 95% CI: 56.2-97.5) ears, respectively. These results were statistically significant. The ETDQ-7 scores also significantly decreased at 2, 6, and 12 months after the BET, when any change was observed. All patients experienced improvement. Only 1 patient reported temporary deterioration after 2 months. Treatment was more frequently successful in patients without nasal polyps or pollinosis. Conclusions: Adults with only symptoms of chronic ET dysfunction benefitted more and had longer lasting results from BET, compared to patients with pathologies caused by ET dysfunction. Balloon eustachian tuboplasty could be recommended for these patients.
Topical Refrigerant Spray for IVs: Patient/Provider Responses - Prospective, Double-blind, Randomized Study
Authors: Barbour Tracy , O’Keefe Sharon , Mace Sharon E. 
Published: December 2020

Painful procedures are common. Patients prefer analgesia for painful procedures. Studies indicate that use of a topical refrigerant spray (TRS) prior to needlestick procedures decreases needlestick pain. TRS is easy to apply, inexpensive, has fast onset, and avoids needlestick pain and anxiety, and needlestick injury risk. Patient and health care provider (HCP) acceptance of any technique is essential before it is adopted. This study evaluated the decrease in pain with TRS and the patient and HCP satisfaction and acceptance of TRS for peripheral intravenous (PIV) placement. Adults (N = 300) randomized to placebo or TRS and HCPs (N = 300) placing PIVs answered questionnaires. Patients had significantly less pain than with prior PIVs, and were satisfied with and would use TRS in the future (P < 0.001). HCP felt that patients had significantly (P < 0.001) less pain with TRS than the placebo, and were satisfied with the TRS, and would use TRS in the future. Registered at Clinicaltrials.gov NCT01670487
Predictors of Tracheostomy Decannulation in Adult Laryngotracheal Stenosis
Authors: Snow Grace E. , Shaver Timothy Brandon , Teplitzky Taylor B. , Guardiani Elizabeth 
Published: December 2020

ObjectivePredictors of tracheostomy decannulation in patients with laryngotracheal stenosis are not fully known, making prognosis difficult. The aim was to identify predictors of tracheostomy decannulation in adult patients with acquired stenosis of the larynx and/or trachea who were tracheostomy dependent.Study DesignCase series.SettingAcademic teaching hospital.MethodsA total of 103 consecutive adult patients with laryngotracheal stenosis who were tracheostomy dependent and seen by the otolaryngology clinic from January 1, 2013, to August 2, 2018, were included. Exclusion criteria included age <18 years, history of laryngeal cancer or head and neck radiation, or history of laryngeal fracture. The primary outcome was the presence of tracheostomy at last follow‐up. The patients’ etiology of stenosis, comorbid conditions, and characteristics of the stenosis were analyzed to determine if there was a statistically significant relationship with decannulation.ResultsA total of 103 patients were included: 67% of patients were women and the average age was 53.5 years. Sixty‐four patients (62%) were successfully decannulated. In multivariate analysis, patients who were successfully decannulated presented to the otolaryngology clinic earlier after tracheostomy was performed, were more likely to have been intubated due to trauma, and were less likely to have gastroesophageal reflux disease. In patients with subglottic or tracheal stenosis, those with granulation tissue without firm scar were more likely to be decannulated, and those who underwent rigid dilation were less likely to be decannulated.ConclusionEarly evaluation by an otolaryngologist may increase the likelihood of tracheostomy decannulation in patients with laryngotracheal stenosis. Patient comorbidities may assist in predicting which patients will be successfully decannulated.
Perioperative breathing training to prevent postoperative pulmonary complications in patients undergoing laparoscopic colorectal surgery: A randomized controlled trial
Authors: Qin Pei-pei , Jin Ju-ying , Wang Wen-jian , Min Su 
Published: December 2020

Objective: The aim of this study was to determine whether perioperative breathing training reduces the incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal surgery. Design: A randomized controlled trial. Setting: University hospital. Subjects: A total of 240 patients undergoing laparoscopic colorectal surgery participated in this study. Intervention: The enrolled patients were randomized into an intervention or control group. Patients in the intervention group received perioperative breathing training, including deep breathing and coughing exercise, balloon-blowing exercise, and pursed lip breathing exercise. The control group received standard perioperative care without any breathing training. Main measures: The primary endpoint was the incidence of postoperative pulmonary complications. The secondary objectives were to evaluate the effect of perioperative breathing training on arterial oxygenation, incidence of other postoperative complications, patient satisfaction, length of stay, and hospital charges. Results: The incidence of postoperative pulmonary complications in the breathing training group was lower than that in the control group (5/120 [4%] vs 14/120 [12%]; RR 0.357, 95%CI 0.133–0.960; P = 0.031). In addition, PaO2 and arterial oxygenation index on the first and fourth days after surgery were significantly higher in the breathing training group than in the control group ( P < 0.001). In addition, patients with breathing training had shorter length of stay (6d [IQR 5–7] vs 8d [IQR 7–9]), lower hospital charges (7761 ± 1679 vs 8212 ± 1326), and higher patient satisfaction (9.46 ± 0.65 vs 9.21 ± 0.47) than those without. Conclusion: Perioperative breathing training may reduce the incidence of postoperative pulmonary complications and preserve of arterial oxygenation after laparoscopic colorectal surgery.
An investigation into whether cardiac risk stratification protocols actually predict complications in cardiac rehabilitation programs?
Authors: Ribeiro Felipe , Takahashi Carolina , Vanzella Lais Manata , Laurino Maria Julia Lopez , Lima Isabelle Maina , Silva Vitor Eduardo dos Santos , Silva João Pedro Lucas Neves , Valente Heloisa Balotari , da Silva Anne Kastelianne França , Christofaro Diego Giulliano Destro , Vanderlei Luiz Carlos Marques 
Published: December 2020

Objectives: This study evaluated the capacity of cardiac risk stratification protocols on simple complications that occur during activities of a cardiovascular rehabilitation program. Design: Observational longitudinal cohort study. Setting: Outpatient clinic of cardiovascular rehabilitation. Subject: Patients diagnosed with cardiovascular disease and/or risk factors. Interventions: Not applicable. Main measures: The relationship between the cardiac risk classes of seven risk stratification protocols and the occurrence of simple complications (such angina, abnormal changes in blood pressure, arrhythmias, fatigue, muscle pain, pallor) was assessed using the chi-square test, and when statistical significance was observed, sensitivity, specificity and accuracy were determined. Results: About 76 patients were analyzed. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) protocol showed a statistically significant relationship between simple complications and cardiac risk classes ( P-value = 0.046), however the results of sensitivity (0.53), specificity (0.52), and accuracy (0.53) were not significant. The other protocols analyzed were not significant: American College of Sports Medicine ( P-value = 0.801), Brazilian Society of Cardiology ( P-value = 0.734), American Heart Association ( P-value = 0.957), Pashkow ( P-value = 0.790), Society French Cardiology ( P-value = 0.314), and Spanish Society of Cardiology ( P-value = 0.078). Conclusion: The AACVPR protocol showed a significant relationship between the risk classes and the occurrence of simple complications, however, the low values obtained for sensitivity, specificity and accuracy show that it is not useful for this purpose. Clinical trials registration: NCT03446742.
Stress Pattern and Deformation in Mid-palatal Suture and Posterior Dentoalveolar Area With Two Different Types of Rapid Maxillary Expansion Appliances: A Finite Element Method Study
Authors: Shrivastava Nitya , Thukral Rakesh , Garg Ashish , Tripathi Amit , Marothiya Sunita 
Published: December 2020

Objective: The study was conducted to evaluate stress pattern and deformation in mid-palatal suture and posterior dentoalveolar area during maxillary expansion therapy with two different types of rapid maxillary expansion by finite element method study. Methods and Methodology: The finite element analysis was performed on a model of maxilla, with narrow maxillary base and teeth digitally reconstructed, based on CBCT images, acquired by child (age 12.5 years) but not in permanent dentition stage from available pool data. Result: More amount of stress was observed in mid-palatal suture and posterior dental alveolar area by using the Hyrax appliance as compared to the Haas appliance. Stress pattern evaluated in mid-palatal suture depicts maximum stress concentration on the anterior region of mid-palatal suture at the position of incisive papilla. Deformation in maximum quantity is observed in central incisors. Maximum stress generation and deformation are observed in lingual region of premolar and molar areas. Minimum stress generation and deformation are observed in the posterior part of last molars. Conclusion: Hyrax produces more stress and deformation in mid-palatal suture as well as in the posterior alveolar segment in comparison to Haas appliance. Better results in the immediate skeletal response were obtained by the Hyrax-type expander as compared to the Haas type.
Association of beta-catenin and CD44 in the development of renal cell carcinoma
Authors: Agrawal Akash , Datta Chhanda , Panda Chinmay Kumar , Pal Dilip Kumar 
Published: December 2020

Introduction and objective: Renal cell carcinoma (RCC) accounts for approximately 3% of all cancers. Approximately 25%–30% of patients present with metastatic disease at the time of diagnosis, and metastatic RCC is a treatment-resistant malignancy. Altered expression of cell adhesion molecules such as CD44 on tumor cells suggests a pathogenetic mechanism for tumor metastasis and may provide prognostic information for particular tumors. These cell matrix interactions of CD44 play a role in tumor cell invasion and metastasis. The Wnt/beta-catenin pathway turned out to be a promising target as it is involved in the regulation of cell proliferation, differentiation and apoptosis induction. Method: In this study, the expression of beta-catenin and CD44 was analyzed in primary renal cell carcinoma (RCC) samples to understand their association with development of the disease. For this purpose, immunohistochemical expression analysis of beta-catenin and CD44 was performed in 30 primary RCC histological samples and normal kidney tissues in different subtypes at different clinical stages of Indian patients (year: 2017–2019). Result: Most of the patients who presented were diagnosed as clear cell carcinoma and it was observed that expression of CD44 was high in patients with high stage tumors. Also beta-catenin was increased in advanced grade tumors, but there was insignificant correlation between high expression of molecules and survival or recurrence of disease. Conclusion: Both cd44 and beta-catenin activation was noted in patients with clear cell carcinoma, more in advanced tumors. Both can be promising targets for treatment in clear cell RCCs.