bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autologous Homologous Skin Constructs Allow Safe Closure of Wounds: A Retrospective, Noncontrolled, Multicentered Case Series
Authors: Mundinger Gerhard S. , Armstrong David G. , Smith David J. , Sailon Alexander M. , Chatterjee Abhishek , Tamagnini Greg , Partridge Joanna , Baetz Nicholas , Labroo Pratima , Swanson Edward W. , Sopko Nikolai A. , Granick Mark S. 
Published: May 2020

Summary:
An autologous homologous skin construct (AHSC) has been developed for the repair and replacement of skin. It is created from a small, full-thickness harvest of healthy skin, which contains endogenous regenerative populations involved in native skin repair. A multicenter retrospective review of 15 wounds in 15 patients treated with AHSC was performed to evaluate the hypothesis that a single application could result in wound closure in a variety of wound types and that the resulting tissue would resemble native skin. Patients and wounds were selected and managed per provider’s discretion with no predefined inclusion, exclusion, or follow-up criteria. Dressings were changed weekly. Graft take and wound closure were documented during follow-up visits and imaged with a digital camera. Wound etiologies included 5 acute and chronic burn, 4 acute traumatic, and 6 chronic wounds. All wounds were closed with a single application of AHSC manufactured from a single tissue harvest. Median wound, harvest, and defect-to-harvest size ratio were 120 cm2 (range, 27–4800 cm2), 14 cm2 (range, 3–20 cm2), and 11:1 (range, 2:1–343:1), respectively. No adverse reactions with the full-thickness harvest site or the AHSC treatment site were reported. Average follow-up was 4 ± 3 months. An AHSC-treated area was biopsied, and a micrograph of the area was developed using immunofluorescent confocal microscopy, which demonstrated mature, full-thickness skin with nascent hair follicles and glands. This early clinical experience with ASHC suggests that it can close different wound types; however, additional studies are needed to verify this statement.
The transition from acute to chronic pain: dynamic epigenetic reprogramming of the mouse prefrontal cortex up to 1 year after nerve injury
Authors: Topham Lucas , Gregoire Stephanie , Kang HyungMo , Salmon-Divon Mali , Lax Elad , Millecamps Magali , Szyf Moshe , Stone Laura S. 
Published: May 2020

Abstract
Chronic pain is associated with persistent structural and functional changes throughout the neuroaxis, including in the prefrontal cortex (PFC). The PFC is important in the integration of sensory, cognitive, and emotional information and in conditioned pain modulation. We previously reported widespread epigenetic reprogramming in the PFC many months after nerve injury in rodents. Epigenetic modifications, including DNA methylation, can drive changes in gene expression without modifying DNA sequences. To date, little is known about epigenetic dysregulation at the onset of acute pain or how it progresses as pain transitions from acute to chronic. We hypothesize that acute pain after injury results in rapid and persistent epigenetic remodelling in the PFC that evolves as pain becomes chronic. We further propose that understanding epigenetic remodelling will provide insights into the mechanisms driving pain-related changes in the brain. Epigenome-wide analysis was performed in the mouse PFC 1 day, 2 weeks, 6 months, and 1 year after peripheral injury using the spared nerve injury in mice. Spared nerve injury resulted in rapid and persistent changes in DNA methylation, with robust differential methylation observed between spared nerve injury and sham-operated control mice at all time points. Hundreds of differentially methylated genes were identified, including many with known function in pain. Pathway analysis revealed enrichment in genes related to stimulus response at early time points, immune function at later time points, and actin and cytoskeletal regulation throughout the time course. These results emphasize the importance of considering pain chronicity in both pain research and in treatment optimization.
Prevalence and Correlates of Cost-Related Medication Nonadherence to Immunosuppressive Drugs After Heart Transplantation
Authors: Schönfeld Sandra , Denhaerynck Kris , Berben Lut , Dobbels Fabienne , Russell Cynthia L. , Crespo-Leiro Marisa G. , De Geest Sabina ,   On behalf of the BRIGHT Study Team†
Published: May 2020

BackgroundCost-related medication nonadherence (CRMNA) refers to not taking medications as prescribed because of difficulties paying for them.ObjectivesThe aims of this study were (1) to assess the prevalence of CRMNA to immunosuppressants in heart transplant recipients internationally and (2) to determine multilevel correlates (patient, center, and healthcare system levels) of CRMNA.MethodsUsing data from the cross-sectional international BRIGHT study, applying multistaged sampling, CRMNA was assessed via 3 self-report items in 1365 patients from 36 heart transplant centers in 11 countries. Cost-related medication nonadherence was defined as any positive answer on any of the 3 items. Healthcare system–level (ie, insurance coverage, out-of-pocket expenditures) and patient-level (ie, intention, perceived financial burden, cost as a barrier, a health belief regarding medication benefits, cost-related self-efficacy, and demographic factors) CRMNA correlates were assessed. Correlates were examined using mixed logistic regression analysis.ResultsAcross all study countries, CRMNA had an average prevalence of 2.6% (range, 0% [Switzerland/Brazil] to 9.8% [Australia]) and was positively related to being single (odds ratio, 2.29; 95% confidence interval, 1.17–4.47), perceived financial burden (odds ratio, 2.15; 95% confidence interval, 1.55–2.99), and cost as a barrier (odds ratio, 2.60; 95% confidence interval, 1.66–4.07). Four protective factors were identified: white ethnicity (odds ratio, 0.37; 95% confidence interval, 0.19–0.74), intention to adhere (odds ratio, 0.44; 95% confidence interval, 0.31–0.63), self-efficacy (odds ratio, 0.54; 95% confidence interval, 0.43–0.67), and belief about medication benefit (odds ratio, 0.70; 95% confidence interval, 0.57–0.87). Regarding variability, 81.3% was explained at the patient level; 13.8%, at the center level; and 4.8%, at the country level.ConclusionIn heart transplant recipients, the CRMNA prevalence varies across countries but is lower than in other chronically ill populations. Identified patient-level correlates are novel (ie, intention to adhere, cost-related barriers, and cost-related self-efficacy) and indicate patient-perceived medication cost burden.
A Successful Quality Improvement Project for Detection and Management of Acute Stroke in Hospitalized Patients
Authors: Droegemueller Carol J. , Kashyap Bhavani , Huna Wagner Roberta L. , Shibeshi Hannah , Clayton Mitchell W. , Fennig Mary W. , Hussein Haitham M. 
Published: May 2020

ABSTRACT

BACKGROUND: The incidence rate of stroke in hospitalized patients ranges between 2% and 17% of all strokes—a higher rate than in the community. Delays in recognition and management of stroke in hospitalized patients lead to worse outcomes. At our hospital, the existing in-hospital stroke (IHS) code showed low usage and effectiveness. In a quality improvement (QI) project, we aimed to improve the identification of and the quality of care for inpatient strokes. METHODS: A nurse-driven IHS protocol was implemented, which alerted a specialized stroke team and cleared the computed tomography (CT) scanner. The protocol focused on prioritizing staff education, simplifying the process, empowering staff to activate an IHS code, ensuring adequate support and teamwork, identifying well-defined quality metrics (eg, time to CT and documentation tool use), and providing feedback communication. We analyzed 2 years of postimplementation IHS data for impact on stroke detection and outcomes. RESULTS: In the 2 years post QI, there was a more than 10-fold increase in IHS (pre-QI, n = 8; first year post QI, n = 94; second year post QI, n = 123). In the post-QI cohort, after excluding patients with missing information (n = 26), 69 cases had new stroke diagnoses (63 ischemic, 6 hemorrhagic), and 148 were stroke mimics. The mean (SD) time from IHS to CT was 18.7 (7.0) minutes. Of the 63 new ischemic stroke cases, 25 (39.7%) were treated with thrombolytic therapy and/or mechanical thrombectomy. CONCLUSION: The new IHS protocol has led to a marked increase in cases identified, rapid evaluation, and high utilization rate of acute stroke therapies.
How to Search for Orthotic Literature Using “Brace” Term?
Authors: Jafarian Fahimeh-Sadat , Rahimi Alireza , Sadeghi-Demneh Ebrahim 
Published: May 2020

ABSTRACT

Introduction
The selection of appropriate search queries is a primary step to explore electronic databases for evidence-based practice. Preliminary searches revealed that no previous scientific study introduced a precise search query to identify prosthetic and orthotic studies in the electronic databases.

Objective
The aim of this study was to evaluate the effectiveness of different variations of the “brace” term for identifying the relevant studies in the orthotics field.

Study Design
This is a cross-sectional study.

Methods
A series of electronic searches in Scopus and Web of Science was carried out using all variations of “brace” term, which were previously used in published reviews in the prosthetics and orthotics field. The yields were classified into relevant and irrelevant subject areas. The rate of the relevant subject area was used to define the specificity of the free-text literature search. To define a standard search query for the “brace” term, the specificity of yields was measured while combining them with another common keyword in the same subject area (orthosis) or limiting the yields to human studies.

Results
“Brace” term was very widely used within different studies with an irrelevant subject area. Using truncation techniques with “brace” could reduce the precision of the subject area in the yields. The combination of “brace” with a synonym subject heading term increased the sensitivity of search, and refining search results through applying a filter (e.g., human studies) improved the precision of yields.

Conclusions
This study indicated that using “brace” as a free-text literature search does not have enough precision to recall relevant studies in the prosthetics and orthotics field.
Total and hidden blood loss between open posterior lumbar interbody fusion and transforaminal lumbar interbody fusion by Wiltse approach
Authors: Lei Fei , Li Zhongyang , He Wen , Tian Xinggui , Zheng Lipeng , Kang Jianping , Feng Daxiong 
Published: May 2020

Abstract
The purpose of this study was to calculate and compare the volume of hidden blood loss (HBL) and perioperative blood loss between open posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) by Wiltse approach.
We retrospectively analyzed 143 patients between March 2017 and December 2017, they were randomly divided into PLIF group and TLIF group. The following information were collected on admission: patient's age, gender, height, weight, body mass index (BMI), surgery levels, surgical time, duration time, disorder type, intraoperative bleeding, wound drainage, visual analog scale (VAS) scores, neurological complications, transfusion rate. Preoperative and postoperative hematocrit (Hct) were recorded in order to calculate total blood loss (TBL) according to Gross's formula. To calculate each patient's HBL, chi-square test and Student's t test were used to analyze data.
Patients in PLIF had a mean TBL of 1144 ± 356 mL, and the mean HBL was 486 ± 203 mL, 43.9 ± 16.2% of the TBL. While patients in TLIF, the mean TBL was 952 ± 303 mL, and the mean HBL was 421 ± 178 mL, 44.7 ± 17.0% of the TBL. Hence, there was significant difference in TBL and HBL between 2 groups, respectively (P = .000, P = .044). However, there was no difference in the ratio of the HBL between 2 groups (P = .797).
The volume of HBL is lower in open TLIF by Wiltse approach than that in PLIF, which may be a large proportion of TBL in posterior lumbar fusion surgery. Comprehensive understanding of HBL can contribute to keep patient safety and better to rehabilitation in perioperative.
Polypoidal choroidal vasculopathy as a complication of choroidal osteoma
Authors: Kim Doyeon , Ryu Gahyung , Sagong Min 
Published: May 2020

Abstract

Introduction:
Choroidal osteoma (CO) is a rare benign tumor that particularly affects young, healthy women. Its prognosis is influenced by complications, such as choroidal neovascularization (CNV), subretinal hemorrhage, subretinal fluid (SF), decalcification status, and overlying retinal pigment epithelium (RPE) atrophy. In case of CNV as the complication of CO, it is typically present in the classic form; however, reports on polypoidal choroidal vasculopathy (PCV) have been rare. Here, we report a case of an older, male patient with PCV as a complication of CO.

Patient concerns:
A 70-year-old male patient visited the hospital with vision impairment in the right eye since 2 weeks.

Diagnosis:
Fundus examination revealed a red-yellow, well-demarcated, scalloped lesion around the optic nerve in each eye; the lesions were highly reflective on ultrasound examination, and thus, CO was diagnosed. Indocyanine green fluorescence angiography and optical coherence tomography (OCT) revealed that the right eye also had PCV accompanied with SF. OCT confirmed the presence of large quiescent type 1 CNV bilaterally in decalcified areas of the lesions adjacent to the optic nerve.

Interventions:
Intravitreal bevacizumab (IB) injection was performed.

Outcomes:
Best-corrected visual acuity had improved and OCT showed a decrease in the SF, while OCT angiography showed partial regression of branching vascular network.

Conclusion:
CO can be accompanied by quiescent type 1 CNV; this should be closely monitored because it can progress to PCV. Optical coherence tomography, alongside indocyanine green fluorescence angiography, is useful for the diagnosis and monitoring of potential CNV as a complication of CO.
Effect of intraventricularly administered low-dose recombinant tissue plasminogen activator on interleukin 1-beta and transforming growth factor beta concentrations in cerebrospinal fluid of patients with primary intracerebral hemorrhage associated with intraventricular hemorrhage
Authors: Sošić Matija , Antončić Igor , Tarčuković Janja , Dunatov Siniša , Šustić Alan , Ćurko-Cofek Božena , Sotošek Vlatka 
Published: May 2020

Abstract
It is increasingly recognized that modulation of brain inflammation may uncover new potential therapeutic strategies for stroke. Recent studies have shifted focus from immunological implications in ischemic stroke to a more devastating form; the hemorrhagic stroke.
The aim of this study was to investigate the neuroinflammatory response in cerebrospinal fluid in patients with primary intracerebral hemorrhage (ICH) associated with intraventricular hemorrhage (IVH) in the presence of low-dose recombinant tissue plasminogen activator (rt-PA).
This retrospective study included 88 adults with primary ICH associated with IVH. Patients were divided into 2 groups: rt-PA group and non-rt-PA group, which received normal standard of care for this diagnosis. The rt-PA group was treated via catheter-based clot lysis using low-dose rt-PA injected through the external ventricular drain (EVD) system, and the non-rt-PA group was treated with saline applied to EVD system in equivalent volume. Cerebrospinal fluid samples from rt-PA were obtained from the EVD system at 4 time points: once before the drug administration, and then on day 1, 3, and 7. No attempt at randomization was made. The decision to inject rt-PA was based on the preference of the primary attending neurologist and the ability to obtain consent. Temporal interleukin-1 beta and transforming growth factor beta concentration changes were analyzed and compared between the 2 groups.
The concentration of interleukin-1 beta was significantly lower in the rt-PA group than in the non-rt-PA group on day 7. In addition, the concentration of transforming growth factor beta was significantly higher in the rt-PA group than in the non-rt-PA group on day 1. There was a significant difference in interleukin-1 beta concentration between days 0 and 1 in comparison to day 3 in the rt-PA group, and between day 0 in comparison to day 3 and 7 in the non-rt-PA group. We also observed a significant difference in transforming growth factor beta concentration between days 0 and 1 and between days 3 and 7.
The different pattern of pro- and anti-inflammatory cytokines in patients with ICH associated with IVH suggest distinct characteristics of secondary brain injury depending on the treatment modality.
Acupuncture for cancer-related hiccups
Authors: Ma Rui , Li Yan , Liu Songjiang , Zhao Wenhui 
Published: May 2020

Abstract

Background:
Hiccups are involuntary contractions of the diaphragm and intercostal muscles, which lead to sudden contractions of the glottis. CAM, such as acupuncture is commonly used and stimulation of the vagus nerve and interference with phrenic nerve conduction are also used to treat hiccups. However, there is little evidence on the effectiveness of acupuncture for cancer-related hiccups. We will plan to conduct a systematic review and meta-analysis of RCTs to evaluate the current evidence on the effects of acupuncture for cancer-related hiccups.

Method:
The following databases will be searched: PubMed, the Cochrane Library, Wanfang Data, China National Knowledge Infrastructure (CNKI), SinoMed, VIP, Medline, Embase, and EI. Randomized controlled trials will be included to evaluate the effect and safety of acupuncture on cancer patients with hiccups. We will set standards for the curative effect on the basis of the standard of cure and improvement for clinical disease diagnoses. The risk of bias will be assessed by the Cochrane risk of bias tool. We will conduct a meta-analysis and sensitivity analysis, as well as a subgroup analysis if high heterogeneity is present, using Revman 5.3. We will use funnel plots to identify potential reporting biases. We will test asymmetry using Egger test. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used to evaluate the quality of evidence.

Results:
This study will be to assess the effect and safety of acupuncture for cancer-related hiccups.

Conclusions:
This study will assess the effect of acupuncture for cancer-related hiccups and provide reliable evidence for the choice of treatments.
Oncologic safety of laparoscopic radical cholecystectomy in pT2 gallbladder cancer
Authors: Navarro Jonathan Geograpo , Kang Incheon , Hwang Ho Kyoung , Yoon Dong Sup , Lee Woo Jung , Kang Chang Moo 
Published: May 2020

Abstract
The role of laparoscopic radical cholecystectomy (LRC) in the surgical management of T2 gallbladder carcinoma (GBC) is still controversial.
The medical records of patients with T2 GBC treated with radical cholecystectomy were retrospectively reviewed. In this study, we compare the short- and long-term oncologic outcomes, using propensity score matching analysis, of patients with T2 GBC who underwent LRC and open radical cholecystectomy (ORC).
Among 183 patients, 86 were selected by propensity score matching (LRC = 43 and ORC = 43). The ORC group underwent more extensive surgery (liver resections and extended lymph node dissections [ELND]) than the LRC group. The LRC group had less operative blood loss, shorter length of hospital stay, fewer complications, and had the earlier start of adjuvant chemotherapy. There was no significant difference between the laparoscopic and open surgery groups in terms of 5-year overall survival rate (64.6% vs 80.4%, P = .214) and disease-free survival rate (77.1% vs 82.2%, P = .641). A subgroup analyses showed that liver resection and ELND had no survival advantage compared to no liver resection and regional lymph node dissection, respectively.
Our LRC approach is safe and effective, with long-term survival comparable to that of ORC.
Atypical replantation and reconstruction of frozen ear
Authors: Dvořák Zdeněk , Stupka Igor 
Published: May 2020

Abstract

Rationale:
The first successful ear replantation was performed by Pennigton in 1980 in Sydney. At least 84 ear replantations have been described in the literature over a period of 37 years since the first case. The authors have not found any previous case of frozen ear replantation in the literature.

Patient concerns:
We report the case of a 38-year-old man, who had an injury to the head while working with a machine.

Diagnosis:
The patient suffered total traumatic avulsion of the left ear. The ear was wrapped in moistened, sterile gauze and was transported on dry ice. At the time of admission to our department, the amputated ear was frozen to stiff, solid nonelastic matter.

Interventions:
We attempted replantation. Despite repeated arterial thrombosis during surgery, the ear was successfully replanted with arterial and venous anastomosis.

Outcomes:
Venous congestion occurred within 9 h of surgery and was treated using leeches. Freezing cold injury developed during reattachment. The radix and proximal parts of the helix exhibited necrosis and so were reconstructed by contralateral conchal cartilage graft, which was wrapped with a local subauricular skin flap. On completion of treatment, a satisfactory shape was achieved, although the replanted and reconstructed left auricle slightly was smaller than the contralateral auricle.

Lessons learned:
Our report confirms that the replantation of a frozen, amputated ear is possible, and we suggest that ear replantation should be the method of choice for the treatment of ear loss even under these conditions.
Comparison of laparoscopic cholecystectomy with and without abdominal drainage in patients with non-complicated benign gallbladder disease
Authors: Yang Jia , Liu Yang , Yan Peijing , Tian Hongwei , Jing Wutang , Si Moubo , Yang Kehu , Guo Tiankang 
Published: May 2020

Abstract

Objective:
To evaluate whether conventional postoperative drainage is more effective than not providing drainage in patients with non-complicated benign gallbladder disease following laparoscopic cholecystectomy (LC).

Methods:
A search of the electronic databases MEDLINE, EMBASE, Web of science, Cochrane Library, and Chinese Biomedical Database (CBM) was conducted for randomized controlled trials (RCTs) reporting outcomes of LC surgery with and without an abdominal drain.

Results:
Twenty-one RCTs involving 3246 patients (1666 with drains vs 1580 without) were included in the meta-analysis. There were no statistically significant differences in the rates of incidence of intra-abdominal fluid (RR: 1.10; 95% CI: 0.81–1.49; P = .54) or post-surgical mortality (RR: 0.44; 95% CI: 0.04–4.72; P = .50) between the two groups. Abdominal drains did not reduce the overall incidence of nausea and vomiting (RR: 1.16; 95% CI: 0.95–1.42; P = .15) or shoulder tip pain (RR: 1.03; 95% CI: 0.76–1.38; P = .86). The abdominal drain group displayed significantly higher pain scores (MD: 1.07; 95% CI: 0.69–1.46; P < .001) than the non-drainage patients. Abdominal drains prolonged the duration of the surgical procedure (MD: 5.69 min; 95% CI: 2.51–8.87; P = .005) and postoperative hospital stay (MD: 0.47 day; 95% CI: 0.14–0.80; P = .005). Wound infection was found to be associated with the use of abdominal drains (RR: 1.97; 95% CI: 1.11–3.47; P = .02).

Conclusions:
Currently, there is no evidence to support the use of routine drainage after LC in non-complicated benign gallbladder disease. Further well-designed randomized clinical trials are required to confirm this finding.