bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysregulated cytokine profile associated with biochemical premature ovarian insufficiency
Authors: Liu Peihao , Zhang Xiruo , Hu Jingmei , Cui Linlin , Zhao Shidou , Jiao Xue , Qin Yingying 
Published: June 2020

AbstractProblemPremature ovarian insufficiency (POI) imposes great challenge on female reproduction. Whether immune disturbance in ovarian environment was implicated in POI remains unclear. We aimed to characterize the cytokine profile in follicular fluid (FF) and paired serum in patients with biochemical POI (bPOI).Method of studyMultiplex immunoassay containing 45 cytokines was performed for individual FF and paired serum samples from 35 bPOI patients and 37 matched controls. Cytokine profiles were compared between the two groups and cytokines correlated to ovarian reserve, and the rates of day‐3 good‐quality embryos were further analyzed.ResultsIn FF, significantly elevated level of chemokines MIP‐1α (P = .043), CXCL8 (P = .024), IP‐10 (P = .041), and eotaxin‐1 (P = .015) as well as growth factors VEGF‐D (P = .047), BDNF (P = .043), LIF (P = .002), and bFGF (P = .046) was found in bPOI patients compared to controls. Yet RANTES manifested an opposite trend with reduced levels among bPOI patients (P = .006). All these chemokines and growth factors in FF were significantly correlated with ovarian reserve (P < .05). In paired serum, cytokine signature was not likely accordant with that in FF between two groups, except for increased IP‐10 (P = .032) in bPOI patients and its significant correlation to FSH and AFC (P < .05). Among all differentially expressed cytokines, RANTES in FF was correlated with the rate of day‐3 good‐quality embryos (P = .035).ConclusionAltered cytokine profile characterized by increased chemokines and growth factors was associated with early stage of POI, which may fuel the progression of the disease or even play a crucial role in the development of ovarian insufficiency.
Usefulness of Morphology‐Voltage‐P‐wave duration (MVP) score as a predictor of atrial fibrillation recurrence after pulmonary vein isolation
Authors: Yang Na , Yan Ning , Cong Guangzhi , Yang Zhen , Wang Mohan , Jia Shaobin 
Published: June 2020

AbstractBackgroundAtrial fibrillation (AF) is known to be the most common arrhythmia, and the successful rate of long‐term ablation can vary comparatively. Therefore, a clinical scoring system to predict rhythm outcome remains a critical unmet need. The electrocardiographic (ECG) risk score which is named Morphology‐Voltage‐P‐wave duration (MVP) score was reported to be useful for predicting new‐onset AF. The goal of the current study was to investigate whether the MVP score was a useful scheme in the prediction of rhythm outcome following pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF).MethodsWe retrospectively analyzed baseline characteristics, risk scores, and rates of AF recurrence 12 months postablation in the medical records of 207 consecutive patients with PAF undergoing PVI in General Hospital of Ningxia medical University from 2010 to 2018.ResultsTwo hundred and seven patients (71 females, median age 58.7 years) with symptomatic PAF underwent PVI. From the cohort, 32.3% (67) had a recurrence of AF within 1 year of the PVI. The area of the MVP score under the curve in the receiver operating characteristics (ROC) analysis was 0.789 (95% CI 0.730–0.840, p < .001). A score cut‐off value of >3 showed the best predictive ability for AF recurrence within 1 year after PVI, with sensitivity (53.03%) and specificity (89.87%).ConclusionsThe results of our study suggest that the easy‐to‐measure ECG MVP score can be used to predict recurrence of PAF after PVI.
Study of anorectal dynamics in patients undergoing laparoscopic ultra‐low resection and transanal intersphincteric resection for rectal cancer
Authors: Yu Si , Deng Jianzhong , Luo Tedong , Zhen Zuojun , Ji Yong 
Published: June 2020

AbstractBackgroundQuite a few studies on anal functions after open total mesorectal excision combined with transanal intersphincteric resection (ISR) have been reported, but there is little literature on anal function after laparoscopic total mesorectal excision (LTME) combined with transanal ISR. The aim of this study was to explore the post‐operative anorectal dynamic changes in ultra‐low rectal cancer patients undergoing LTME combined with transanal ISR.MethodsThe data of 26 ultra‐low rectal cancer patients undergoing LTME + transanal ISR were analysed. A total of 30 patients undergoing laparoscopic low anterior resection by the same surgeons during the same period were randomly enrolled into the control group.ResultsThere were no differences in the preoperative anorectal manometry data and Wexner anal function scores between the observation group and the control group (P > 0.05). There were no significant differences in the mean operation time, the mean amount of bleeding and the mean post‐operative hospital stay between the two groups (P > 0.05). The mean follow‐up time was 16 months. No recurrence and metastasis were found in all cases. At 3 and 6 months after the operation, there were significant differences in the anorectal manometry data and Wexner anal function scores between the two groups (P < 0.05). However, at 1 year after the operation, there were no significant differences in the anorectal manometry data and Wexner anal function scores between the two groups (P > 0.05).ConclusionLaparoscopic ISR for ultra‐low rectal cancer is technically feasible, but the surgical indications should be strictly defined.
Risk factors for mortality after emergency laparotomy: scoping systematic review
Authors: Barazanchi Ahmed W. H. , Xia Weisi , MacFater Wiremu , Bhat Sameer , MacFater Hoani , Taneja Ashish , Hill Andrew G. 
Published: June 2020

AbstractBackgroundEmergency laparotomy (EL) is a common procedure with high mortality leading to several efforts to record and reduce mortality. Risk scores currently used by quality improvement programmes either require intraoperative data or are not specific to EL. To be of utility to clinicians/patients, estimation of preoperative risk of mortality is important. We aimed to explore individual preoperative risk factors that might be of use in developing a preoperative mortality risk score.MethodsTwo independent reviewers identified relevant articles from searches of MEDLINE, EMBASE and Cochrane databases from January 1980 to January 2018. We selected studies that evaluated only preoperative predictive factors for mortality in EL patients.ResultsThe search yielded 6648 articles screened, with 22 studies included examining 157 728 patients. The combined post‐operative 30‐day mortality was 13%. All, but one small study, were at low risk of bias. A meta‐analysis of results was not possible due to the heterogeneity of populations and outcomes. Age, American Society of Anesthesiologists, preoperative sepsis, dependency status, current cancer and comorbidities were associated with increased mortality. Acute physiological derangements seen in renal, albumin and complete blood count assays were strongly associated with mortality. Delay to surgery and diabetes did not influence mortality. Higher body mass index was protective.ConclusionPreoperatively, risk factors identified can be used to develop and update risk scores specific for EL mortality. This scoping review focused on the preoperative setting which helps tailor treatment decisions. It highlights the need for further research to test the relevance of newer risk factors such as frailty and nutrition.
Correlation between computed tomography volumetry and nuclear medicine split renal function in live kidney donation: a single‐centre experience
Authors: Hua Lina , Sebben Ruben , Olakkengil Santosh , Russell Christine , Coates Toby , Bhattacharjya Shantanu 
Published: June 2020

AbstractBackgroundPotential live renal donors undergo both renal computed tomography angiogram (CTA) and nuclear imaging dimercaptosuccinic acid (DMSA) scans. Each kidney's renal function and vascular anatomy influences the choice of donor side. Although DMSA measures differential blood flow, it is a surrogate for renal function and nephron mass. Computed tomography techniques can provide volumetry information. The aim of this study was to determine the relationship between measured split renal volumes on computed tomography versus renal volumes derived from DMSA split function in live donors.MethodsProspective data of live kidney donors assessed at a single Australian centre from 2014 to 2017 were reviewed. All patients had pre‐operative CTA and DMSA imaging. Renal volume was determined via semi‐automated software calculation from CTA three‐dimensional image reconstructions by one investigator. Measured split renal volume was compared against calculated renal volume using measured DMSA split function (percentage split function multiplied by total renal volume).ResultsFifty‐three patients were included in the study. Split renal volumes on three‐dimensional CTA images correlate to calculated split volumes determined from DMSA (Pearson coefficient 0.95 for right renal volume, 0.95 for left). The decision of which kidney to remove can be achieved with CTA only. Omitting a DMSA scan would reduce the radiation load by 0.70 mSv (35 chest X‐rays) and potential cost saving of AU$1062.00 per donor.ConclusionCTA technology allows accurate assessment of renal volumes that correlate well with DMSA split function. Avoiding a DMSA scan results in cost and radiation reduction in the assessment of a live kidney donor.
Quilting suture versus conventional closure in prevention of seroma after total mastectomy and axillary dissection in breast cancer patients
Authors: Myint Sie Thu , Khaing Khin San , Yee Win , Mon Soe Myat , Lwin Thein 
Published: June 2020

AbstractBackgroundTotal mastectomy and axillary dissection is a common procedure for breast cancer patients in our institution. Seroma is common. This study aimed to compare the quilting suture and conventional closure in prevention of seroma after total mastectomy and axillary dissection.MethodsThis randomized comparative study was carried out from January 2018 to June 2019 in Yangon General Hospital. One hundred and forty patients (70 conventional and 70 quilting) were included. For quilting group, customized strategically placed interrupted alternate sutures were placed 2–3 cm apart with 3/0 vicryl sutures between skin flap and pectoral muscle.ResultsAge, body mass index and tumour diameter were comparable between the groups. The mean duration of operation was 111.44 ± 7.045 min in conventional and 124.5 ± 6.39 min in quilting (P = 0.0001). The mean drain output for conventional group was not significantly different from quilting group. In quilting, some area developed dimpling which resolved within a week. A total of 21 (30%) patients in the conventional group and 10 patients (14.3%) in the quilting group developed seroma (P = 0.041). The mean frequency and amount of seroma aspiration were significantly lower in the quilting group. Shoulder movement limitation and analgesia use showed no significant difference.ConclusionAlthough total amount of drain output, duration of drain, hospital stay and post‐operative complications were not different, the incidence of seroma was significantly lower in quilting group. Seroma is treated with more ease in the quilting group as the frequency and amount of aspiration were lower and less frequent follow‐up visits were required. Quilting can reduce the seroma incidence in total mastectomy and axillary dissection for breast cancer patients.
Prospective evaluation of the impact of human papilloma virus status and small node size on the diagnostic accuracy of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography for primary head and neck squamous cell carcinoma
Authors: Lee Jonathan , Emmett Louise , Tang Reuben , Ho Bao , Earls Peter , Matthews Tim , Gallagher Richard 
Published: June 2020

AbstractBackgroundFluorodeoxyglucose‐positron emission tomography/computed tomography (FDG‐PET/CT) is well validated in the staging of pre‐treatment head and neck squamous cell carcinoma (HNSCC), although the impact of human papilloma virus (HPV) status and node size on accuracy remains unclear. The aim of this study was to assess the diagnostic accuracy of PET/CT based on HPV status and node size and determine the effects of maximum standardized uptake value thresholds on sensitivity, specificity and positive predictive value.MethodsA total of 38 patients with primary HNSCC were recruited. All patients underwent primary tumour resection and cervical node dissection following FDG‐PET/CT.ResultsA total of 38 patients including 68 dissected necks, representing 353 nodal levels and a total of 2701 lymph nodes were included. Histopathological analysis revealed lymph node metastases in 4.3% (116/2701) of dissected lymph nodes. Forty‐four percent of patients had HPV‐positive tumours. Sixty‐four percent of involved lymph nodes were <1 cm. The sensitivity and specificity for HPV‐positive nodes were 67.2% and 99.3% versus 35.6% and 98.2% in HPV‐negative nodes, respectively (P < 0.001). Mean maximum standardized uptake value in HPV‐positive nodes was 6.3 versus 3.5 in HPV‐negative nodes (P < 0.001). Sensitivity and specificity were 30.7% and 99.2% in <1 cm nodes versus 90.2% and 84.8% in ≥1 cm nodes, respectively (P < 0.001).ConclusionFDG‐PET/CT has significantly higher diagnostic accuracy in determining nodal metastases in HPV‐positive HNSCC versus HPV‐negative disease. Accuracy was lower in <1 versus ≥1 cm nodes.
Assessment of the cervix in pregnant women with a history of cervical insufficiency during the first trimester using elastography
Authors: Chen Chen‐Yu , Chen Chie‐Pein , Sun Fang‐Ju 
Published: June 2020

AbstractIntroductionTo investigate changes in first trimester cervical elastography, cervical length and endocervical canal width in pregnant women with a history of cervical insufficiency, and further discuss the possibility of using these markers as predictors of cervical insufficiency in early pregnancy.Material and methodsThis was an observational ultrasound study of first trimester cervical changes in singleton pregnancies between January 2016 and June 2018. Cervical elastography, cervical length and endocervical canal width were measured during the first trimester. Strain elastography was used to estimate the softness of anterior and posterior cervical lips and was expressed as percentages (strain rate).ResultsOf the 339 pregnant women enrolled, 24 had a history of cervical insufficiency. The anterior cervical lip was significantly softer in the cervical insufficiency group (strain rate: 0.19% ± 0.05% vs 0.11% ± 0.04%; P < .001). Cervical length was significantly shorter in the cervical insufficiency group (36.3 ± 4.8 mm vs 38.3 ± 3.8 mm; P = .014). Endocervical canal width was significantly wider in the cervical insufficiency group (5.7 ± 1.1 mm vs 5.2 ± 0.7 mm; P = .001). Receiver operating characteristic curve analyses revealed that the optimal cut‐off values of anterior cervical lip, cervical length and endocervical canal width to confirm the diagnosis of cervical insufficiency were 0.15%, 35.5 mm and 5.75 mm, respectively. In multivariate logistic regression analysis, significant differences were still observed in anterior cervical strain rate (adjusted odds ratio [OR] 53.78, 95% [confidence interval [CI] 11‐270; P < .001) and endocervical canal width (adjusted OR, 5.41, 95% CI,1.2‐24.7; P = .029).ConclusionsFirst trimester cervical elastography is a valuable tool in the assessment of women with a history of cervical insufficiency. The anterior cervical lip was significantly softer in women with a history of cervical insufficiency, and the sensitivity and specificity of anterior cervical lip strain were better than that of cervical length and endocervical canal width.
Palliative and end of life care for a child: Understanding parents’ coping strategies
Authors: Darlington Anne‐Sophie , Randall Duncan , Leppard Lisa , Koh Michelle 
Published: June 2020

AbstractAimUnderstanding of coping strategies that parents use before the death of their child is crucial and will enable us to best provide support. The current study aimed to explore parents’ coping strategies, and map these onto an existing theoretical framework.MethodsBereaved parents and parents of a child with a life‐limiting/threatening condition were interviewed to investigate coping strategies, recruited through Intensive Care Units (2 Neonatal, 2 Paediatric, 1 Paediatric Cardiac) and a children's hospice. Analysis focused on coping strategies and mapping these onto the framework.Results24 parents of 20 children were interviewed and identified. Parents use a variety of coping strategies (n = 25) such as humour, staying positive, advocating and staying strong for others, expressing emotions and preparing, while also living life to the full, supported by others. The themes were successfully mapped onto the theoretical framework, which focuses on the constructs of approach and avoidance, as well as coping for self and others.ConclusionThe findings have provided a detailed account of the breadth and depth of coping strategies parents use, including those classed as avoidance. The strategies were successfully mapped onto the theoretical framework. Future research should investigate changes over times, and associations to negative long‐term outcomes.
When all I wanted was to hold my baby—The experiences of parents of infants who received therapeutic hypothermia
Authors: Bäcke Pyrola , Hjelte Beatrice , Hellström Westas Lena , Ågren Johan , Thernström Blomqvist Ylva 
Published: June 2020

AbstractAimThe knowledge is limited about how parents experience the time when their infant is receiving therapeutic hypothermia (TH) after severe perinatal asphyxia. The aim of this study was to explore parents’ experience of closeness and involvement in their infant's care while in the neonatal intensive care unit (NICU) with their newborn undergoing TH.MethodsFace‐to‐face, semi‐structured interviews were conducted with parents (n = 11) whose infants (n = 8, aged 3‐5 years at the time of the study) underwent TH at a level III Swedish NICU during 2013‐2016. The interviews were analysed using qualitative content analysis.ResultsAll the parents shared the trauma of being both physically and psychologically separated from their infant. They all described a need for information and emotional support, and reported that the NICU staff had influenced the extent to which they as parents had been able to be near and actively participate in the care. Parents described the wish to be closer to their infant and to be more actively involved in their infant's care.ConclusionStrategies to enable parent‐infant closeness and active guidance from staff might help alleviate the emotional stress of parents and promote their participation during TH.
Angiotensin‐converting enzyme inhibitor and angiotensin II type 1 receptor blocker: Potential agents to reduce post‐surgical scar formation in humans
Authors: Hu Yan‐Yan , Fang Qing‐Qing , Wang Xiao‐Feng , Zhao Wan‐Yi , Zheng Bin , Zhang Ding‐Ding , Tan Wei‐Qiang 
Published: June 2020

AbstractStudies on the effectiveness and mechanisms of reducing scar formation by interfering with the renin‐angiotensin‐aldosterone‐system (RAAS) have been demonstrated in animals, but not in humans due to the lack of clinical support. Our aim was to investigate whether angiotensin‐converting enzyme inhibitor (ACEI) and angiotensin II type 1 receptor blocker (ARB) could inhibit scar formation in humans. Thus, an observational and hypothesis‐generating study using a designed questionnaire was carried out. A total of 347 patients with postoperative scars secondary to thyroid tumours were enrolled. They were divided into four groups: ACEI group, ARB group, other antihypertensive drugs control group and blank control group according to the administration of antihypertensive drugs. The width of scar was measured, and the Scar Cosmesis Assessment and Rating (SCAR) Scale was filled out. Results showed that patients of ACEI group (mean scar width 1.60 mm) and ARB group (mean scar width 1.57 mm) formed smaller scars than those of other antihypertensive drugs control group (mean scar width 2.09 mm) and blank control group (mean scar width 2.0 mm). Oral administration of ACEI and ARB may be associated with better post‐surgical scar formation in humans. These two kinds of antihypertensive drugs may be active components of anti‐scar medicine.
Randomised trial of telephone counselling to improve participants' adherence to prescribed drugs in a vascular screening trial
Authors: Qvist Ina , Lindholt Jes S. , Søgaard Rikke , Lorentzen Vibeke , Hallas Jesper , Frost Lars 
Published: June 2020

AbstractA total of 1446 participants, 65‐ to 74‐year‐old men diagnosed with abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD) or high blood pressure (HB) in the Viborg Vascular (VIVA) screening trial, were consecutively included and randomised to a telephone counselling (TC) or no TC 3 months after being screened positive. Data from VIVA were linked to data from Danish registers from 2007 to 2016. The primary outcome was a composite outcome of proportion of days covered by statin, antithrombotic drugs and antihypertensive agents and for each specific drug class at 6‐month follow‐up. The same outcomes were assessed at 12 and 60 months and considered secondary outcomes. Outcome measures are reported as risk differences (RD). There were no differences between the groups in relation to the composite of all three drug classes over 6 months of follow‐up, RD = 4.1 (95% CI: −1.0; 9.1). A significant increase in redeemed statin prescriptions was observed in the intervention group at 6 months, RD = 9.8% (CI 95%: 0.5; 19.0). There was no intervention effect observed after 12 and 60 months. TC 3 months after screening improved adherence to statin at 6‐month follow‐up, but had no effect on the composite treatment, statins, antithrombotic or antihypertensive treatment over 60 months of follow‐up.
A taxonomy of clinical response to mood stabilizers
Authors: Scott Jan , Etain Bruno , Nierenberg Andrew , Bellivier Frank 
Published: June 2020

AbstractIntroductionAlthough clinical practice guidelines (CPG) identify first, second‐ and third‐line mood stabilizer (MS) treatments, they rarely define clinical response to prophylaxis or the core issues to be considered. This project aimed to develop a template for describing how clinical response may be classified and a framework to assist decision‐making and monitoring of response in day‐to‐day practice.MethodA scoping exercise was undertaken followed by narrative synthesis of (a) qualitative and quantitative definitions of MS response applied in clinical and research practice and (b) potential confounders (eg, non‐adherence; tolerability issues) of relevance to routine practice, for example, the concepts are applicable to individuals with bipolar disorder for whom sustained remission is a less realistic goal. Expert consensus was employed to develop a taxonomy of response and key concepts that inform clinical judgements about MS response.ResultsFive core constructs can be used to systematize clinical judgements regarding MS response and its monitoring: (a) quantitative, qualitative and/or patient‐reported outcome measures (PROMS), (b) personalized assessment of the acceptable benefit‐to‐harm ratio of a proposed treatment, (c) adequacy of treatment exposure (dose, duration, therapeutic monitoring and adherence), (d) illness activity pre‐ and post‐MS initiation, and (e) other potential confounders (co‐prescription of MS; polypharmacy) or protective factors (eg, psychosocial factors).ConclusionsThis heuristic framework might be used as a teaching aid or by clinicians who wish to take a more systematic approach to developing shared criteria for judging MS response that better match patient expectations and preferences. Heuristic approaches also allow seamless introduction of new evidence.