bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of a Community-Wide Health Intervention in a Low-Income, Primarily Hispanic Community: The Go! Austin/Vamos! Austin (GAVA) Initiative
Authors: Ranjit Nalini , Nielsen Aida , Akhavan Nika , Denis Laurence , Janda Kathryn , Jovanovic Christine , Basu Semonti , Hussaini Aliya , van den Berg Alexandra 
Published: October 2020

Objectives To describe outcomes of a 4-year physical activity (PA) and nutrition intervention (2013–2017) in Dove Springs, a low-income urban community in Texas. Method Go! Austin/Vamos! Austin is a place-based intervention targeting the built and social environments of PA and nutrition. Baseline and follow-up measures related to PA and nutrition were obtained from 357 parent–child dyads (final n = 236) in the intervention community and a control community. A three-level dose of exposure measure was created to indicate the amount of exposure to intervention activities across the 4 years. Pre–post changes in key outcomes by level of exposure and contrasts across “high exposure” and “no exposure” categories were obtained using repeated-measures regression, adjusting for important confounders. Results “High exposure” adult participants showed consistently more favorable changes than “no exposure” participants across a variety of indicators, including positive perceptions and utilization of community PA resources, amount of moderate PA, utilization of retail outlets offering fresh produce, and measures of healthy eating. Few improvements were seen in child-level outcomes. Conclusions Community interventions can successfully improve health-promoting behaviors provided they ensure sufficient dose of exposure.
Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience
Authors: Wang Ying , Zhang Guang-Yuan , Xu Li-Chao , He Xin-Hong , Huang Hao-Zhe , Li Guo-Dong , Wang Yao-Hui , Wang Guang-Zhi , Li Wen-Tao 
Published: October 2020

Purpose: The purpose of this study was to investigate the clinical efficacy of salvage percutaneous radiofrequency ablation in patients with unresectable colorectal cancer liver metastases. Methods: The cohort consisted of 81 patients with 126 colorectal cancer liver metastases who underwent radiofrequency ablation between January 2012 and September 2016. The clinical data and ablation data were retrospectively analyzed. The local tumor progression-free survival, overall survival, and prognostic factors were analyzed using the log-rank test and Cox regression model. Results: The technique success rate was 99.21%. The primary efficacy rate was 100% at the 1-month follow-up. Minor complications were observed in 2 patients, which recovered within 1 week. The median local tumor progression-free survival time of all patients was 29.8 months. The absence of subsequent chemotherapy was an independent predictor of a shorter local tumor progression-free survival time ( P < 0.001, hazard ratio: 2.823, 95% confidence interval: 1.603, 4.972). The median overall survival time was 26.8 months. A lesion size greater than 3 cm ( P = 0.011, hazard ratio: 2.112, 95% confidence interval: 1.188, 3.754) and the presence of early local tumor progression ( P = 0.011, hazard ratio: 2.352, 95% confidence interval: 1.217, 4.545) were related to a shorter survival time. Conclusions: Percutaneous radiofrequency ablation is safe in patients with colorectal cancer liver metastases refractory from chemotherapy. Subsequent chemotherapy is important to enhance local control. Small lesions and favorable early responses are related to prolonged overall survival.
Modifying the “Eye of the Tiger” Technique: Preserving Gluteal Artery Perfusion in the Treatment of an Aneurysm of the Hypogastric Artery
Authors: Iwakoshi Shinichi , Inagaki Masahiro , Yoshiyama Yutaka , Shimohara Yuichi , Yamashita Masanori , Ichihashi Shigeo , Kichikawa Kimihiko 
Published: October 2020

Purpose: In endovascular aneurysm repair, parallel stent graft deployment is sometimes utilized to preserve the distal branch perfusion. However, there will be some gutter space around 2 stent grafts, which may cause endoleak. The “eye of the tiger” technique was invented to minimize this leak when deploying a small side-branch stent graft in conjunction with a large aortic endograft. The purpose of this case report is to describe our modified technique for 2 small endografts deployed in double D-shape in order to prevent gutter leak, which we applied in endovascular treatment for a hypogastric artery aneurysm. Case Report: A 79-year-old male patient presented with a right hypogastric artery aneurysm measuring 44 mm. The patient refused the open surgical repair option and hoped for an endovascular treatment. Therefore, endovascular treatment to exclude the hypogastric artery aneurysm as well as preserve the gluteal arteries was planned. An Internal Iliac Component (IIC)(W. L. Gore & Associates, Flagstaff, AZ, USA) was utilized for the proximal sealing and 2 Viabahn stent grafts (W. L. Gore & Associates) were deployed in the superior and inferior gluteal arteries for distal sealing. Then, 2 VBX stent grafts (W. L. Gore & Associates) were added in the IIC as bridging stents to connect the IIC and both Viabahn stent grafts. Next, over-dilatation of VBX stent grafts was performed alternately with an 8 mm balloon catheter and subsequent kissing balloon dilation with 5 mm balloon catheters, which allowed the VBX stents to be set in double D-shape. A follow-up CT scan performed 1 week after the procedure revealed no endoleak and a favorable shape to the VBX stent grafts. Conclusion: The modified method of dilating the VBX stent grafts allowed the double D-shape deployment, minimizing the risk of gutter leak and preserving distal branch perfusion.
Critical care outcomes, for the first 200 patients with confirmed COVID-19, in England, Wales and Northern Ireland: A report from the ICNARC Case Mix Programme
Authors: Richards-Belle Alvin , Orzechowska Izabella , Doidge James , Thomas Karen , Harrison David A , Koelewyn Abby , Christian Michael D , Shankar-Hari Manu , Rowan Kathryn M , Gould Doug W 
Published: October 2020

Background Early in a pandemic, outcomes are biased towards patients with shorter durations of critical illness. We describe 60-day outcomes for patients critically ill with confirmed COVID-19 and explore the potential bias in the weekly reported data by ICNARC. Methods First 200 consecutive patients with confirmed COVID-19, admitted for critical care in England, Wales and Northern Ireland, followed-up for a minimum of 60 days from admission. Outcomes included survival and duration of critical care, receipt/duration of organ support in critical care and hospital survival . Results Mean age was 62.6 years, 70.5% were male, 52.0% were white, 39.2% obese and 9.0% had serious comorbidities. Median APACHE II score was 16 (IQR 12, 19). After 60 days, 83 (41.5%) patients had been discharged from hospital, 15 (7.5%) had been discharged from critical care but remained in hospital, 1 (0.5%) was still receiving critical care, 90 (45.0%) had died while receiving critical care and 11 (5.5%) had died in hospital after discharge from critical care. Median duration of critical care was 14.0 days (IQR 6.1, 23.0) for survivors and 10.0 days (IQR 5.0, 16.0) for non-survivors of critical care. Overall, 158 (79.0%) patients received advanced respiratory support for a median of 13 (IQR 8, 20) calendar days. Compared with weekly reports during the pandemic, critical care mortality started higher than but then decreased below that of the first 200 consecutive patients. Duration of critical care, for both survivors and non-survivors increased over time; however, both were still lower than those for the first 200 consecutive patients. Receipt and duration of organ support increased to values similar to those for the first 200 consecutive patients. Conclusion COVID-19 in critical care has high mortality and places a large burden on resources. Analysis of preliminary data with limited follow-up should be interpreted with caution, particularly for future planning in a pandemic.
Expression Pattern of HMGB1 Differs Between Eosinophilic Chronic Rhinosinusitis With Nasal Polyp and Non-Eosinophilic Chronic Rhinosinusitis With Nasal Polyp: A Preliminary Study
Authors: Min Hyun Jin , Kim Kyung Soo 
Published: October 2020

Background Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is histologically distinct from non-eosinophilic CRSwNP (NECRSwNP) and exhibits a high frequency of recurrence. The differences between the pathogenesis of ECRSwNP and NECRSwNP are not well-characterized. HMGB1 has been implicated in the pathogenesis of CRSwNPs; however, its precise contributions to ECRSwNP and NECRSwNP have not been established. Objective We evaluated the role of HMGB1 in the pathogenesis of ECRSwNP. Methods A total of 26 nasal polyps (NPs) from patients with ECRSwNP and NECRSwNP who underwent endoscopic sinus surgery were obtained. Western blotting and immunohistochemistry were performed to compare the HMGB1 levels between the NPs from ECRS and NECRS. A multiplex cytokine assay was performed to evaluate the levels of other cytokines and chemokines in exudates in the NPs. Nasal lavage fluids were used to evaluate extracellular HMGB1 levels using enzyme-linked immunosorbent assay. Results HMGB1 expression in the NPs was higher in ECRSwNP than in NECRSwNP. The level of HMGB1 in the exudate within the NPs was significantly higher in ECRSwNP than in NECRSwNP. Furthermore, HMGB1 levels in nasal lavage fluids from ECRSwNP were higher than those from NECRSwNP. We found that HMGB1 levels in the exudate in NPs and in nasal lavage fluids effectively differentiate ECRSwNP from NECRSwNP. Conclusion Our results suggest that a high level of HMGB1 in NPs is an important factor for differentiating ECRSwNP from NECRSwNP. HMGB1 may play a role in the development of ECRSwNP and should be further evaluated.
Oral Carbohydrate Administration in Patients Undergoing Cephalomedullary Nailing for Proximal Femur Fractures: An Analysis of Clinical Outcomes and Patient Satisfaction
Authors: Kweon Suc-hyun , Park Jin sung , Lee Yeong chang 
Published: October 2020

Purpose: The purpose of this study was to investigate the clinical effects of oral carbohydrate intake for cephalomedullary nailing on proximal femoral fractures and patient satisfaction. Subjects and Methods: 88 patients were admitted to our hospital with proximal femoral fracture from July 2019 to December 2019. All patients were treated with closed reduction and internal fixation (CR&IF, Cephalomedullary nailing) under spinal anesthesia. The exclusion criteria included the presence of endocrine disorders including diabetes mellitus (DM), patients treated with steroids, and cognitive impairment. Additionally, those with fasting blood glucose levels above 126 mg / dl or HbA1C> 6.5% were considered as having undiagnosed DM. After obtaining informed consent, the subjects were randomized into either the preoperative oral carbohydrate (POC) group or control group. Patients who were assembled into the control group fasted including water from midnight of the day of the surgical procedure according to the conventional method. Patients assembled into the POC group received 400 ml of oral carbohydrate solution (Nucare NONPO, DAESANG, 12.8%, 1 kcal/ml)) between 21-24 hours on the day before operation and 400 ml oral carbohydrate solution 2 hours before the administration of anesthesia. Serum glucose on the day before operation at 7 am (before breakfast, baseline), immediately before anesthesia, at skin incision, 1 hour, 4 hours, 6 hours, 24 hours after anesthesia, and 3 days after surgery (before breakfast) was measured, and insulin, cortisol, and IL-6 were measured at baseline 7 am at day before operation, immediately before anesthesia, 4 hours and 24 hours after anesthesia, and 3 days after surgery (before breakfast). The patients completed questionnaires about their satisfaction (thirst, hunger, nausea and vomiting, and anxiety) in the morning (before the surgery) on the day of the surgery. Additionally, the length of hospital stay (LOS) and preoperative opioid usage was also investigated. Results: The operative characteristics of the patients did not differ between the groups except for the actual fasting time. The glucose levels were higher in the control group at skin incision; however, there were no significant differences in both groups at other time points. Additionally, insulin, insulin resistance, cortisol, and IL-6 also did not differ significantly between the 2 groups at all time-points. Among the factors related to patient satisfaction, the POC group showed significantly higher scores for thirst and hunger factors and shorter LOS than the control group. Conclusion: The intake of oral carbohydrates in patients treated with closed reduction and internal fixation for proximal femoral fractures does not affect the improvement of post-operative insulin resistance. However, there was significant improvement in patients’ thirst and hunger before surgery and LOS.
Venous Thromboembolism Prophylaxis in Elective Spine Surgery
Authors: Solaru Samantha , Alluri Ram K. , Wang Jeffrey C. , Hah Raymond J. 
Published: October 2020

Study Design: Review. Objective: Venothromboembolic (VTE) complications, composed of deep vein thrombosis and pulmonary embolism are commonly observed in the perioperative setting. There are approximately 500 000 postoperative VTE cases annually in the United States and orthopedic procedures contribute significantly to this incidence. Data on the use of VTE prophylaxis in elective spinal surgery is sparse. This review aims to provide an updated consensus within the literature defining the risk factors, diagnosis, and the safety profile of routine use of pharmacological prophylaxis for VTE in elective spine surgery patients. Methods: A comprehensive review of the literature and compilation of findings relating to current identified risk factors for VTE, diagnostic methods, and prophylactic intervention and safety in elective spine surgery. Results: VTE prophylaxis use is still widely contested in elective spine surgery patients. The outlined benefits of mechanical prophylaxis compared with chemical prophylaxis varies among practitioners. Conclusion: The benefits of any form of VTE prophylaxis continues to remain a controversial topic in the elective spine surgery setting. A specific set of guidelines for implementing prophylaxis is yet to be determined. As more risk factors for thromboembolic events are identified, the complexity surrounding intervention selection increases. The benefits of prophylaxis must also continue to be balanced against the increased risk of bleeding events and neurologic injury.
Ultrasound-guided hydrodilatation for adhesive capsulitis of the shoulder: A case series
Authors: Ainen Adam , Sivan Manoj 
Published: October 2020

Adhesive capsulitis (AC) is a painful and debilitating condition of the glenohumeral joint and has been described as self-limiting. However, recent reports suggest that up to 40% of patients report persistent symptoms, therefore intervention strategies are needed to improve function and quality of life. One such intervention is the hydrodilatation of the glenohumeral joint with a high-volume injection, comprising of local anaesthetic, corticosteroid and normal saline, making a total volume of up to 40 ml. This service evaluation assessed the outcomes in 28 patients (23 females and 5 males; mean age 54.29 years) with AC who underwent ultrasound-guided (USG) hydrodilatation in a clinical outpatient setting. There was a statistically significant improvement in pain and all shoulder movements (all changes p value < 0.01). No adverse effects were encountered. Therefore, the USG glenohumeral joint hydrodilatation procedure in a clinical outpatient setting is a safe and effective intervention for AC.
A comparative study of lateral and palmar venous anastomosis in Ishikawa zone Ⅱ fingertip replantation
Authors: Li Xuedong , Zhai Huang , Zhao Gang , Pan Xiaoyun , Yao Qun , Hua Yong , Yu Jiong , Mi Jingyi 
Published: October 2020

Purpose: Venous anastomosis is the key procedure for Ishikawa zone Ⅱ fingertip replantation. Both palmar and lateral veins provide efficient venous drainage. This study compared the clinical effects between these venous anastomoses for fingertip replantation. Methods: In 2016–2018, 61 patients underwent Ishikawa zone Ⅱ fingertip replantation with venous anastomosis (28 and 33 cases with palmar and lateral anastomoses, respectively). Retrospective comparative analyses evaluated surgical technique and function, including operative time; rates of finger survival, venous congestion, and infection; sensation; joint motion; cold intolerance symptom severity (CISS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Vancouver scar scores; and chronic regional pain syndrome (CRPS) rates. Results: There were 33 patients with lateral vein anastomosis and 28 patients with palmar vein anastomosis. The average patient follow-up was 18.2 months. The survival rates did not differ significantly between groups (87.8% (29/33) vs. 85.7% (24/28), p > 0.05); however, the operative time was shorter in the lateral vein group than in the palmar vein group (78.57 ± 7.08 min vs. 67.88 ± 5.77 min, p < 0.05). Venous congestion and infection rates did not differ significantly between groups ( p > 0.05). The replanted finger function, including joint motion, sensation, DASH scores, Vancouver scar scores, and CRPS rates, did not differ significantly between groups ( p > 0.05). However, the CISS score was higher in the palmar vein group than in the lateral vein group (44.39 ± 5.16 vs. 38.09 ± 4.49, p < 0.05). Conclusions: Venous anastomosis with either palmar or lateral veins showed high survival rates and good function in fingertip replantation. The lateral vein had a shorter operative time and benefit to arterial revision and was especially suitable for patients with finger pulp damage.
Spontaneous Closure of a Macular Hole in Macular Telangiectasia Type 2
Authors: Chandra Varun , Merani Rohan , Hunyor Alex P. , Gillies Mark 
Published: October 2020

Purpose: Spontaneous closure of a macular hole in macular telangiectasia type 2 (MacTel) with vision improvement is described. Methods: A case report is presented. Results: A 71-year-old man presented with a 1-week history of distorted vision in his left eye. Left visual acuity (LVA) was 20/80. Optical coherence tomography showed an almost full-thickness left macular hole with an intact internal limiting membrane drape. Small inner retinal cavitations were present at the right macula; multimodal imaging confirmed MacTel. Managed conservatively, at 5 months the patient’s LVA had improved to 20/60, the defect was no longer full thickness, and the external limiting membrane had reconstituted. At the right macula, the inner cavitations grew and outer cavitations developed, but the external limiting membrane remained intact. At 32 months, right VA was 20/20 and LVA was 20/40. Conclusions: This case of MacTel with spontaneous closure of a macular hole was associated with an overlying internal limiting membrane drape.
Targeting the GCK pathway: a novel and selective therapeutic strategy against RAS-mutated multiple myeloma
Authors: Li Shirong , Fu Jing , Yang Jun , Ma Huihui , Bhutani Divaya , Mapara Markus Y. , Marcireau Christophe , Lentzsch Suzanne 
Published: October 2020

AbstractIn multiple myeloma (MM), frequent mutations of NRAS, KRAS, or BRAF are found in up to 50% of newly diagnosed patients. The majority of the NRAS, KRAS, and BRAF mutations occur in hotspots causing constitutive activation of the corresponding proteins. Thus, targeting RAS mutation in MM will increase therapeutic efficiency and potentially overcome drug resistance. We identified germinal center kinase (GCK) as a novel therapeutic target in MM with RAS mutation. GCK knockdown (KD) in MM cells demonstrated in vitro and in vivo that silencing of GCK induces MM cell growth inhibition, associated with blocked MKK4/7-JNK phosphorylation and impaired degradation of IKZF1/3, BCL-6, and c-MYC. These effects were rescued by overexpression of a short hairpin RNA (shRNA)-resistant GCK, thereby excluding the potential off-target effects of GCK KD. In contrast, overexpression of shRNA-resistant GCK kinase-dead mutant (K45A) inhibited MM cell proliferation and failed to rescue the effects of GCK KD on MM growth inhibition, indicating that GCK kinase activity is critical for regulating MM cell proliferation and survival. Importantly, the higher sensitivity to GCK KD in RASMut cells suggests that targeting GCK is effective in MM, which harbors RAS mutations. In accordance with the effects of GCK KD, the GCK inhibitor TL4-12 dose-dependently downregulated IKZF1 and BCL-6 and led to MM cell proliferation inhibition accompanied by induction of apoptosis. Here, our data identify GCK as a novel target in RASMut MM cells, providing a rationale to treat RAS mutations in MM. Furthermore, GCK inhibitors might represent an alternative therapy to overcome immunomodulatory drug resistance in MM.
Does COVID-19 change dietary habits and lifestyle behaviours in Kuwait: a community-based cross-sectional study
Authors: Husain Wafaa , Ashkanani Fatemah 
Published: October 2020

Abstract
Background
The coronavirus pandemic has transformed and continues to transform and affect the daily lives of communities worldwide, particularly due to the lockdown restrictions. Therefore, this study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak.

Methods
A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18–73 years).

Results
The rate of skipping breakfast remained consistent, with a slight increase during the pandemic. Lunch remained the main reported meal before and during COVID-19. Compared to before COVID-19, people were much more likely have a late-night snack or meal during COVID-19 (OR = 3.57 (95% CI 1.79–7.26), p < 0.001). Moreover, there was a drastic decrease in the frequency of fast-food consumption during COVID-19, up to 82% reported not consuming fast food (p < 0.001). There was a significant increase in the percentage of participants who had their main meal freshly made (OR = 59.18 (95% CI 6.55–1400.76), p = 0.001). Regarding food group patterns, no significant differences were found before and during the pandemic in terms of the weekly frequency of consumption, except in the case of fish and seafood. There were no remarkable changes in beverage consumption habits among participants before and during the pandemic, except for Americano coffee and fresh juice. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants.

Conclusion
In general, this study indicates some changes in daily life, including changes in some eating practices, physical activity and sleeping habits during the pandemic. It is important that the government considers the need for nutrition education programmes and campaigns, particularly during this critical period of the pandemic in Kuwait.