bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laparoscopic liver resection after laparoscopic pancreatoduodenectomy for liver metastases of ampulla of Vater adenocarcinoma
Authors: Kiriyama Muneyasu , Kaneoka Yuji , Maeda Atsuyuki , Takayama Yuichi , Takahashi Takamasa , Seita Kazuaki 
Published: October 2020

Abstract
Background
Repeat laparoscopic surgery has become increasingly common. However, reports of liver resection after pancreatoduodenectomy are scarce, and we report the first successful case of a patient who underwent laparoscopic liver resection after laparoscopic pancreatoduodenectomy.

Case presentation
A 65-year-old man underwent laparoscopic pancreatoduodenectomy for ampulla of Vater adenocarcinoma. According to the American Joint Committee on Cancer (8th edition) staging guidelines, the tumour was labelled as stage IIIB (fT2N2M0). Twelve months later, a computed tomography (CT) scan revealed liver masses (in segments 3 and 5) and swollen para-aortic lymph nodes. After six chemotherapy courses of gemcitabine with cisplatin, the CT scan showed the disappearance of the para-aortic lymph nodes and progression of liver metastases. Nineteen months after the initial surgery, the patient underwent laparoscopic partial liver resection of segment 5 and left lateral sectionectomy. First, we performed the operation in the left half lateral decubitus position. In this position, the portal vein was isolated safely without hindering the hepato-jejunal anastomosis, although the adhesions around the hepato-jejunal anastomosis were dense. Therefore, we were able to perform liver transection safely with vascular inflow control. The operation duration was 235 min, and the volume of blood loss was 100 g. Macroscopically, the resected margins were negative. The patient was uneventfully discharged 12 days after the second operation. Afterwards, drainage was needed because of an intra-abdominal abscess. Currently, he has been alive for 8 months postoperatively, receives chemotherapy to suppress para-aortic lymph node metastases, and has not had another recurrence.

Conclusions
Liver resection after pancreatoduodenectomy can be performed safely with an innovative body position to isolate the portal vein, which is a key point of the surgery. A laparoscopic approach for liver resection after pancreatoduodenectomy is a feasible option.
Reliability and validity of the elements of desire questionnaire in premenopausal women with hypoactive sexual desire disorder
Authors: Revicki Dennis A. , Althof Stanley E. , Derogatis Leonard R. , Kingsberg Sheryl A. , Wilson Hilary , Sadiq Amama , Krop Julie , Jordan Robert , Lucas Johna 
Published: October 2020

Abstract
Background
The Elements of Desire Questionnaire (EDQ) is a patient-reported outcome (PRO) measure developed to evaluate sexual desire and was included in two identically designed phase 3 clinical trials (RECONNECT) as an exploratory endpoint. The EDQ was developed based on a literature review, qualitative research with patients with hypoactive sexual desire disorder (HSDD), and input from clinical experts. This instrument is intended to be used to collect efficacy data in clinical trials evaluating potential treatments for HSDD. The objective of this study was to evaluate the measurement properties of both the monthly and daily recall versions of the EDQ during the RECONNECT trials.

Methods
Participants completed the EDQ daily version for 7 consecutive days prior to selected monthly clinic visits. The monthly recall version was completed at each monthly clinic visit. The analysis population consisted of all subjects with Female Sexual Function Index (FSFI) data at baseline and ≥ 1 follow-up visit.

Results
At baseline, 1144 and 676 subjects completed the monthly and daily recall EDQs, respectively. The EDQ scores had good internal consistency and test-retest reliability. Monthly and daily recall EDQ scores were correlated with FSFI-desire domain scores at baseline and month 3. Scores from the monthly and daily recall versions were also correlated. After 6 months, there was a significantly greater improvement for bremelanotide versus placebo in both the monthly and daily recall versions (both P < 0.0001).

Conclusions
The results demonstrated that EDQ exhibited good reliability, validity, and sensitivity to change. Consistent with other validated PRO measures of sexual desire, the EDQ provides additional insights into sexual desire.

Trial registration
NCT02338960 and NCT02333071 (RECONNECT studies).
Trans-Radial Approach: technical and clinical outcomes in neurovascular procedures
Authors: Romano D. G. , Frauenfelder G. , Tartaglione S. , Diana F. , Saponiero R. 
Published: October 2020

Abstract
Background
To evaluate efficacy and safety of Trans-Radial Approach (TRA) in cerebral angiography for diagnostic and therapeutic purpose.

Methods
We retrospectively included consecutive patients eligible for TRA cerebral angiography at our Institution between September 2019 and January 2020. Cerebral DSA was classified in diagnostic (one-vessel imaging) or therapeutic (emergency/elective). Technical and clinical outcome were recorded for each group.

Results
A total of 61 TRA angiographies were evaluated. Right-sided TRA was obtained in 85,2% of all cases. Interventional procedures included 11 strokes, 2 ruptured aneurysms, 2 unrupted aneurysms, 1 DAVF and 3 symptomatic atheromatous intracranial stenosis. Successful TRA angiographies were obtained in 97,6% and 94,7% for diagnostic and therapeutic group, respectively. No major radial artery complications were recorded. Mean puncture-to-final angiogram was 11 and 62 min for diagnostic and therapeutic groups, respectively. Mean radial compression maintenance was 4 h, allowing patients discharge within 6 h in all cases undergone diagnostic angiography.

Conclusions
TRA could be a valid technique in terms of efficacy and safety both for diagnostic and therapeutic cerebral angiographies, with low complication rate.
Do early trends in oak barrens fire treatment predict later outcomes? Insights from three decades of vegetation monitoring
Authors: Taft John B. 
Published: October 2020

Abstract
Background
Vegetation structure, species diversity, and composition have been monitored at a fire-treatment and a fire-free control unit of a dry oak barrens and woodland complex in southern Illinois, USA, over a 29-year period and five burns. The restoration hypothesis is that fire management would result in different trends for vegetation parameters of conservation interest between fire treatment and control units, that before–after differences would be greater with fire management, and that early trends provide a reliable predictor for later outcomes. This study examines effectiveness of management in achieving restoration goals and uses response to the first two burns and monitoring results over the first seven years as an estimation period to test whether early trends with fire treatment are a reliable predictor for outcomes following three additional burns over the following 22 years.

Results
Trends differed between fire-treatment and control units for all parameters measured, and before–after differences were greater at the fire treatment unit. However, trends at the fire-treatment unit during the estimation period were a poor predictor of later outcomes. Tree density and basal area declined more than expected while ground-layer species density, richness, diversity, and percent cover did not keep pace with expectations of increase. Trends at the control unit were more predictable; however, tree basal area declined more than expected, possibly due to an outbreak of rapid white oak mortality disease, and decline of ground-layer species density was less than predicted from the early estimation period.

Conclusions
Results suggested that fire alone can be effective at restoring woodland and barrens natural areas and that a fire return interval of about every four years would be optimal for maintaining composition and diversity in this specific oak barrens habitat. However, burns followed immediately by severe drought possibly can have negative interactions, resulting in declines of ground-layer species diversity.
COL1A1 polymorphism and neurological complications in pediatric acute lymphoblastic leukemia patients and their associations with altered bone mineral density
Authors: Omran Alaa A. , Nageeb Rania S. , Nageeb Ghada S. , Yosif Manal A. , Mohammad Yassir A. , Ali Alshimaa A. , Atfy Mervat , Azmy Taghreed M. , Elsaid Hanaa H. 
Published: October 2020

Abstract
Background
Osteoporosis and neurological complications are consequences of acute lymphoblastic leukemia (ALL). Collagen type I alpha 1 gene (COL1A1) polymorphism is associated with osteoporosis. This study aimed to detect the COL1A1 polymorphism and the neurological complications in ALL patients and their association with decreased lumbar spine bone mineral density (BMDLS). This study included 100 pediatric ALL patients and 100 controls. All participants were subjected to laboratory assessment and assessment of BMDLS at the start of the study and 3 years later. COLIA1 genotyping was done once for all participants.

Results
At the start of the study, there was a significant decrease in osteocalcin (OC), alkaline phosphatase (ALP), and BMDLS levels in the patients. G/T variants and “T” alleles were significantly more detected in the patients (34% and 35% respectively); also, significant differences were detected between patients with polymorphism (G/T and T/T) and those without polymorphism (G/G) regarding OC, ALP, and BMDLS. After 3 years, significant decrement in BMDLS, OC, and ALP was detected in the patients. Twenty-four patients had neurological complications and seven patients had bone fractures. Those patients had significant decrement in BMDLS, OC, and ALP levels. As regards COL1A1 gene polymorphism, the GT and TT variants were significantly detected in fractured patients, while there was no significant difference regarding GT and TT variants in the patients with neurological complications. T allele, neurological complications, high-risk stratification, and age were significantly associated with decreased BMDLS. T allele was the most significant risk factor.

Conclusion
COLIA1 gene polymorphism, decreased BMDLS, and neurological complications were significantly detected in pediatric ALL patients. COLIA1 gene polymorphism is a significant risk factor for decreased BMDLS in pediatric ALL patients. There is no significant relation between COLIA1 gene polymorphism and the development of neurologic complications.
Clinical outcome and safety of selective renal artery embolization using permanent occlusive agents for acute renal bleeding
Authors: Alwarraky Mohamed S. , Abdallah Mohamed M. , Elgharbawy Mohamed S. 
Published: October 2020

AbstractBackgroundTo evaluate how far is selective renal artery embolization (RAE) using permanent agents effective in treating acute renal artery bleeding. We retrospectively reviewed the medical records of patients (n= 45) with renal bleeding who were managed by selective RAE using coils, N-butyl-cyanoacrylate glue (NBCA glue), and polyvinyl alcohol (PVA). Data retrieved included the cause, number, and type of the bleeding lesions as well as the results of the embolization for 1 year after RAE. Clinical success was the primary outcome while re-bleeding and complications were the secondary outcomes.ResultsThere were 55 bleeding lesions detected by angiography in the included 45 patients. Coils were used in 23/45 patients (51.1%), NBCA glue in 15/45 patients (33.3%), and PVA in 7 patients (15.6%). Bleeding could be controlled with embolization in a single session in 41/45 patients with primary clinical success 91.1%. Four patients needed re-embolization sessions to control bleeding and only one patient was controlled, giving secondary clinical success of 92.3%. Three patients failed to respond to embolization and nephrectomy was done. Iatrogenic dissection of the segmental branch was seen in one patient. Post embolization syndrome was seen in 14/45 patients (31.1%). Non-target embolization was seen in 2 patients: one during treatment with NBCA glue and the other with PVA. No other complications were recorded. No significant differences between clinical success among coil, NBCA glue, and PVA subgroups (P> 0.05).ConclusionSelective RAE using permanent agents is effective in controlling renal bleeding and no significant difference among coil, NBCA glue, and PVA.
Implementation fidelity and acceptability of an intervention to improve vaccination uptake and child health in rural India: a mixed methods evaluation of a pilot cluster randomized controlled trial
Authors: Pérez Myriam Cielo , Chandra Dinesh , Koné Georges , Singh Rohit , Ridde Valery , Sylvestre Marie-Pierre , Seth Aaditeshwar , Johri Mira 
Published: October 2020

AbstractBackgroundThe Tika Vaani intervention, an initiative to improve basic health knowledge and empower beneficiaries to improve vaccination uptake and child health for underserved rural populations in India, was assessed in a pilot cluster randomized trial. The intervention was delivered through two strategies: mHealth (using mobile phones to send vaccination reminders and audio-based messages) and community mobilization (face-to-face meetings) in rural Indian villages from January to September 2018. We assessed acceptability and implementation fidelity to determine whether the intervention delivered in the pilot trial can be implemented at a larger scale.MethodsWe adapted the Conceptual Framework for implementation fidelity to assess acceptability and fidelity of the pilot interventions using a mixed methods design. Quantitative data sources include a structured checklist, household surveys, and mobile phone call patterns. Qualitative data came from field observations, intervention records, semi-structured interviews and focus groups with project recipients and implementers. Quantitative analyses assessed whether activities were implemented as planned, using descriptive statistics to describe participant characteristics and the percentage distribution of activities. Qualitative data were analyzed using content analysis and in the light of the implementation fidelity model to explore moderating factors and to determine how well the intervention was received.ResultsFindings demonstrated high (86.7%) implementation fidelity. A total of 94% of the target population benefited from the intervention by participating in a face-to-face group meeting or via mobile phone. The participants felt that the strategies were useful means for obtaining information. The clarity of the intervention theory, the motivation, and commitment of the implementers as well as the periodic meetings of the supervisors largely explain the high level of fidelity obtained. Geographic distance, access to a mobile phone, level of education, and gender norms are contextual factors that contributed to heterogeneity in participation.ConclusionsAlthough the intervention was evaluated in the context of a randomized trial that could explain the high level of fidelity obtained, this evaluation provides confirmatory evidence that the results of the study reflect the underlying theory. The mobile platform coupled with community mobilization was well-received by the participants and could be a useful way to improve health knowledge and change behavior.Trial registrationISRCTN 44840759(22 April 2018)
Educational attainment trajectories among children and adolescents with depression, and the role of sociodemographic characteristics: longitudinal data-linkage study
Authors: Wickersham Alice , Dickson Hannah , Jones Rebecca , Pritchard Megan , Stewart Robert , Ford Tamsin , Downs Johnny 
Published: October 2020

BackgroundDepression is associated with lower educational attainment, but there has been little investigation of long-term educational trajectories in large cohorts with diagnosed depression.AimsTo describe the educational attainment trajectories of children with a depression diagnosis in secondary care, and to investigate whether these trajectories vary by sociodemographic characteristics.MethodWe identified new referrals to South London and Maudsley's NHS Foundation Trust between 2007 and 2013 who received a depression diagnosis at under 18 years old. Linking their health records to the National Pupil Database, we standardised their performance on three assessments (typically undertaken at ages 6–7 years (school Year 2), 10–11 (Year 6) and 15–16 (Year 11)) relative to the local reference population in each academic year. We used mixed models for repeated measures to estimate attainment trajectories.ResultsIn our sample of 1492 children, the median age at depression diagnosis was 15 years (interquartile range = 14–16). Their attainment showed a decline between school Years 6 and 11. Attainment was consistently lower among males and those eligible for free school meals. Black ethnic groups also showed lower attainment than White ethnic groups between Years 2 and 6, but showed a less pronounced drop in attainment at Year 11.ConclusionsThose who receive a depression diagnosis during their school career show a drop in attainment in Year 11. Although this pattern was seen among multiple sociodemographic groups, gender, ethnicity and socioeconomic status predict more vulnerable subgroups within this clinical population who might benefit from additional educational support or more intensive treatment.
The DISCO App: A pilot test of an electronic patient intervention to reduce the financial burden of cancer through improved cost communication.
Authors: Hamel Lauren M. , Dougherty David W. , Hastert Theresa A. , Seymour Erlene Kuizon , Kim Seongho , Assad Hadeel , Phalore Jasminder , Eggly Susan 
Published: October 2020

1 Background: Financial toxicity, the burden of treatment cost, affects 30-50% of people with cancer in the US. Although experts recommend patients and oncologists discuss treatment cost to identify patients who need assistance, cost discussions occur in fewer than half of cancer treatment discussions. We pilot-tested the feasibility and efficacy of the Discussions of Cost (DISCO) App, a patient communication intervention designed to improve cost discussions and other financial toxicity-related outcomes during and following oncology treatment consultations. The DISCO App provides an individualized list of cost-related questions patients can ask their oncologist, specific to a patient’s economic situation. Methods: While waiting to see their oncologist, newly diagnosed patients with breast or lung cancer (n=32) used the DISCO App on an iPad. Clinic visits were videorecorded and patients completed pre- and post-intervention measures of self-efficacy for managing treatment costs, self-efficacy for interacting with oncologists, cost-related distress, and perceptions of the DISCO App. A trained coder observed the recordings to determine the presence of a cost discussion, the cost-related topic, and any emergent factors. Results: Findings showed increases in patients’ self-efficacy for managing treatment costs (p=.02) and interacting with oncologists (p=.001). Cost-related distress decreased but not significantly (p=.20). Patients reported the DISCO App was understandable (M=4.5 out of 5), useful as they talked with their oncologist (M=4.0), and 84% of patients reported needing less than 15 minutes to use the DISCO App. Most (94%) interactions were videorecorded (in two cases technical difficulties prevented videos from being collected); all (100%) of the videorecorded interactions included a cost discussion. The most frequently discussed topics were: insurance, time off from work, and financial navigation. Frequently, the oncologist asked the patient for his/her question list and discussed/answered the questions. Conclusions: Findings suggest the DISCO App is feasible to implement in the clinic and effective in improving patient-oncologist cost discussions and financial toxicity-related outcomes. Patient acceptance of the DISCO App and oncologist engagement suggested the intervention prompted cost discussions. Next steps include conducting a longitudinal randomized controlled trial to determine the effectiveness of the DISCO App on financial toxicity, and other outcomes. Clinical trial information: NCT03676920 .
The effects of COVID-19 on new oral oncolytic treatments.
Authors: Mitchell Rachel L. , Arrowsmith Edward , Taylor Jack L. , Schleicher Stephen Matthew , Dickson Natalie R. , McCullough Stacey 
Published: October 2020

102 Background: Dependable and timely dispensing and delivery of oral oncolytics to patients with a new indication for therapy is a central part of modern cancer care. The COVID-19 pandemic has presented numerous impediments and challenges to patients receiving oral therapy from many specialty pharmacies in a timely due to remote pharmacy staffing and drug shipment. Tennessee Oncology has an integrated URAC and ACHC accredited Specialty Pharmacy to ensure the seamless care for our patients prescribed oral oncolytics. We investigated the effect of COVID-19 on the number of patients initiating care with an oral oncolytic and the time to fill during the pandemic. Methods: We analyzed the number of overall new patients to the practice and new patients receiving oral oncolytics in two year-to-year comparisons: (1) January-March 2019 vs. January-March 2020 and (2) April-May 2019 vs. April-May 2020. We then compared the average pharmacy turnaround time (defined as the time of entry of a regimen in the electronic medical record that contained an oral oncolytic until the time that prescription was ready for shipment) and the average time from regimen entry until the patient received that medication. Prescriptions received and filled on the day of order entry were recorded as a one-day turnaround time. Results: A year to year increase of 7% in practice new-patient volume was associated with a 13% increase in new oral oncolytic patients from January-March 2020. Year to year April and May comparisons, noted a 33% decrease in new-patient volume to our practice with an associated 10% decrease in new oral oncolytic patients. Time to fill remained consistent in March and April 2020 at 1.84 days vs. 1.78 for 2019. The time from regimen entry to patient shipment receipt was also stable year to year (3.10 vs. 3.06 days). Conclusions: Our in-house Specialty Pharmacy was able to continue delivery of new prescriptions for oral oncolytics during the COVID-19 pandemic. There was a fall in the number of new patient dispensing in April-May 2020 that we attribute to a decrease in cancer diagnoses related to COVID-19 as reflected by a fall in total practice new patients. New patient on-boarding activities including prior authorizations, co-pay assistance, patient education were maintained and the measured time to fill from regimen entry to patient receipt were unchanged.