bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Like Yin and Yang”: Perceptions of Methamphetamine Benefits and Consequences Among People Who Use Opioids in Rural Communities
Authors: Baker Robin , Leichtling Gillian , Hildebran Christi , Pinela Cristi , Waddell Elizabeth Needham , Sidlow Claire , Leahy Judith M. , Korthuis P. Todd 
Published: June 2020

Objectives:
The objective of this study was to investigate methamphetamine use among people who use opioids in rural Oregon communities to explore reasons for use and perceptions of methamphetamine consequences.

Methods:
We conducted interviews and surveys with participants who inject drugs or misuse prescription opioids in 2 rural Oregon counties with high opioid overdose rates. Survey participants were identified through participant-driven sampling initiated in syringe service programs and field outreach (n = 144). Semi-structured interviews with participants were recruited from the same locations (n = 52).

Results:
Of 144 surveys completed, 112 reported using opioids in the past 30 days; 96% of the 112 also report methamphetamine use. Among the 124 reporting injection drug use, 50% indicated they injected both methamphetamine and heroin in the past 30 days. Interview participants reported early exposure to methamphetamine and indicated that methamphetamine was more widely available, less expensive, and less stigmatized compared to heroin. Participants reported using methamphetamine to improve work-life functioning and because they enjoy the high produced from simultaneous use. Several participants reported a conscious effort to shift to methamphetamine from heroin as a harm reduction strategy.
Some participants reported being involuntarily discharged from treatment for opioid use disorder due to methamphetamine use. Several participants perceived methamphetamine as conveying overdose prevention or reversal benefits, while fentanyl contamination in methamphetamine was reported or suspected.

Conclusion:
As rural communities respond to evolving drug supply and demand, there is increasing need for public health efforts to address the emerging issue of concurrent methamphetamine and opioid use.
Surgical treatment of acute calculous cholecystitis complicated with hepatic dysfunction
Authors: Tian Yuanhu , Suo Xiaopeng 
Published: June 2020

Abstract
To evaluate the timing, feasibility, and necessity of early laparoscopic cholecystectomy (LC) in the management of patients with acute calculous cholecystitis complicated with hepatic dysfunction.
The clinical data of 60 patients with acute calculous cholecystitis complicated with hepatic dysfunction treated from January 2016 to January 2018 were analyzed retrospectively. A total of 32 patients underwent LC within 72 hours of the cholecystitis attack, 28 patients after 72 hours. The results were compared with those from 28 patients with delayed LC.
All the patients were operated by experienced surgeons, and no LC transfer to open operation. No significant differences were detected in the operation time, postoperative complications, intraoperative blood loss, white TBIL, ALT, GGT before and after the operation between the 2 groups (P > .05). Patients who underwent early LC had a short hospital stay and fewer hospital costs (P < .05). All the patients were cured.
It is safe, feasible, and necessary to perform LC within 72 hours in patients with acute calculous cholecystitis complicated with hepatic dysfunction. Such patients show a high positive correlation between the inflammation of acute calculous cholecystitis and the damage of hepatic function.
A comprehensive assessment of single nucleotide polymorphisms associated with pancreatic cancer risk
Authors: Ye Zhuo-Miao , Li Li-Juan , Zheng Jing-Hui , Zhang Chi , Lu Yun-Xin , Tang Youming 
Published: June 2020

Abstract

Background:
Single nucleotide polymorphisms (SNPs) have been inconsistently associated with pancreatic cancer (PC) risk. This meta-analysis aimed to synthesize relevant data on SNPs associated with PC.

Methods:
Databases were searched to identify association studies of SNPs and PC published through January 2020 from the databases of PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database (VIP) and Wanfang databases. Network meta-analysis and Thakkinstian algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. The methodological quality of data was assessed based on the STREGA statement Stata 14.0 will be used for systematic review and meta-analysis.

Results:
This study will provide a high-quality evidence to find the SNP most associated with pancreatic cancer susceptibility and the best genetic model.

Conclusions:
This study will explore which SNP is most associated with pancreatic cancer susceptibility.
Registration: INPLASY202040023.
Protrusion of a ceramic femoral head through the acetabular metallic cup in total-hip arthroplasty
Authors: Zhao Ding , Zhang De-Bao , Han Dong-Feng , Gu Gui-Shan 
Published: June 2020

Abstract

Rationale:
Dislocation, wear, metallosis, and implant loosening are well-known complications of a failed total-hip arthroplasty (THA), and acetabular liner dissociation is an uncommon but catastrophic complication. To our knowledge, this is the first description of metallosis due to acetabular liner dissociation, but not presenting as a result of wear of a metal-on-metal articulation and a polyethylene liner of other articulation.

Patient concerns:
We described a 61-year-old man who had a 2-year history of pain in the right groin region after THA. Postoperative period of primary THA was uneventful. However, he did not undergo postoperative follow-up, and often participated in strenuous sports activities including mountain climbing and long-distance running.

Diagnosis:
Radiographs demonstrated superior subluxation of the femoral head and direct articulation and abrasion wear of the ceramic femoral head on the cup. Preoperative laboratory data revealed no signs of infection.

Interventions:
We performed revision THA using a direct lateral approach with ceramic-on-ceramic hip prosthesis.

Outcomes:
Postoperatively, the patient wore a hip orthosis for 6 weeks to prevent dislocation but was allowed full weight bearing. At 1-year follow-up, there was no recurrence of hip pain.

Lessons:
Wear of THA components can result in catastrophic failure of the implants and significant soft-tissue metallosis. Therefore, regular postoperative follow-up is necessary for early intervention, even in those with asymptomatic hips.
Clinicopathologic characteristics of resectable colorectal cancer with mismatch repair protein defects in Chinese population
Authors: Li Jingjing , Xu Qi , Luo Cong , Chen Lei , Ying Jieer 
Published: June 2020

Abstract
Colorectal cancer (CRC) represents a major malignancy globally, with microsatellite instability as its second top molecular mechanism of carcinogenesis. Immunohistochemical (IHC), whose sensitivity and specificity exceed 90%, is used routinely to detect 4 MMR proteins (MLH1, PMS2, MSH2, and MSH6) for screening mismatch repair system defects. We aimed to assess associations of clinicopathologic characteristics with MMR status in resectable CRC patients.
Stage I-III CRC cases administered surgical resection in Zhejiang Cancer Hospital in 2013 to 2015 were retrospectively analyzed. MLH1, MSH2, MSH6, and PMS2 protein amounts were evaluated immunohistochemically. Clinicopathological information, including age, sex, tumor location, histological subclass, disease stage, regional lymph node (LN) metastasis, American Joint Committee on Cancer (AJCC) 8th edition stage, and survival data were retrospectively reviewed.
A total of 133 CRC cases were assessed, including 74 (55.6%), 45 (33.8%), 55 (41.4%), and 77 (57.9%) not expressing MLH1, MSH2, MSH6, and PMS2, respectively. There were significant associations of MLH1, MSH2, MSH6, and PMS2 proteins with age and sex (P < .05). MLH1, MSH2, and MSH6 (but not PMS2) showed positive associations with primary tumor location (P < .05). Of the 133 patients, 70 and 63 cases were affected on the right and left sides, respectively; significant associations of primary site with age and sex were observed (P < .05). Regarding the MMR status, MLH1, MSH2, and MSH6 protein expression levels were positively associated with primary site (P < .05). Five-year overall survival (OS) rates were 84.2% and 79.2% in left-side and right-side cases, respectively; 5-year disease-free survival (DFS) rates were 74.0% and 69.8%, respectively. Survival had no differences between left- and right-side patients in terms of OS (P = .318) and DFS (P = .481).
These data demonstrate that 4 major dMMR proteins are expressed differently in left- and right-side CRCs, and survival is comparable in right- and left-side resectable CRC cases with dMMR.
Systematic training program for nursing home staff based on the concept of combination of medicine and care
Authors: Wang Lin , Chen Hong , Yang Liu , Qian Chunhua , Sun Dongmei , Sun Yan 
Published: June 2020

Abstract
It is important to improve the training for nursing home staff in order to achieve better quality of life for the elderly.
This study aimed to develop a systematic training program for nursing home staff based on the concept of combination of medicine and care.
Thirty-four nursing staff from 2 representative nursing homes in Qiqihar City were selected as study subjects and divided into experimental and control groups. The subjects in both groups received routine training following “National Occupational Standards of Elderly Nursing Staff”. In addition, the subjects in experimental groups received systematic training at three levels based on the concept of combination of medicine and care for 4 months.
After the training, the competence scores of nursing staff in experimental group increased significantly compared to control group, the living quality of the elderly in nursing homes cared by nursing staff in experimental group was significantly improved, and the satisfaction of the elderly to nursing staff in experimental group improved significantly, compared to control group (P < .05).
We develop systematic training program for nursing home staff based on the concept of combination of medicine and care, which can improve nursing care for the elderly in nursing home.
Efficacy of albumin–bilirubin score to predict hepatic encephalopathy in patients underwent transjugular intrahepatic portosystemic shunt
Authors: Lin Xinran , Gao Feng , Wu Xixi , Cai Weimin , Chen Xiaofu , Huang Zhiming 
Published: June 2020

Background and aims
The occurrence of hepatic encephalopathy is one of the main factors limiting the development and application of transjugular intrahepatic portosystemic shunt (TIPS). Our study aimed to verify the efficacy of the albumin–bilirubin score, an objective and simple scoring system, to predict post-TIPS hepatic encephalopathy.

Methods
From February 2014 to July 2019, a total of 224 patients who underwent TIPS procedure were entered into the study. All patients were followed up after TIPS placement. Relevant clinical data within 24 h after admission were collected to compare the differences between patients with and without hepatic encephalopathy after TIPS placement.

Results
A total of 82 (36.6%) patients developed post-TIPS hepatic encephalopathy. Age and albumin–bilirubin score was found to be independent risk factors for post-TIPS hepatic encephalopathy. The albumin–bilirubin score shows a good ability to predict the occurrence of hepatic encephalopathy within 1 year after TIPS. The area under the receiver operating characteristic curve is 0.74 (95% confidence interval: 0.673–0.806). In addition, in order to improve its feasibility, we regrouped the albumin–bilirubin score into three levels (albumin–bilirubin≤ –1.95, low risk; 1.95 <albumin–bilirubin ≤1.45, intermediate risk; albumin–bilirubin > –1.45, high risk).

Conclusion
The albumin–bilirubin score has a good predictive value for the possibility of post-TIPS hepatic encephalopathy, which is better than the model for end-stage liver disease and Child-Pugh score.
Risk Factors Associated With Bronchiolitis in Puerto Rican Children
Authors: Rivera-Sepúlveda Andrea , García-Rivera Enid , Castro Mario , Soto Fernando 
Published: June 2020

Objective
The objective of this study was to identify frequency, severity, and risk factors associated with bronchiolitis in Puerto Rican children.

Methods
A cross-sectional was study performed at 4 emergency departments of Puerto Rico's metropolitan area, between June 2014 and May 2015. We included children younger than 24 months, with a clinical diagnosis of bronchiolitis, who were born and living in Puerto Rico at the time of recruitment. A physician-administered questionnaire inquiring about the patient's medical, family, and social history and a bronchiolitis severity assessment were performed. Daily weather conditions were monitored, and aeroallergens were collected with an air sample and precision weather station within the metropolitan area to evaluate environmental factors.

Results
We included 600 patients for 12 months. More than 50% of the recruited patients had a previous episode of bronchiolitis, of which 40% had been hospitalized. Older age (odds ratio [OR], 18.3; 95% confidence interval [CI], 9.2–36.5), male sex (OR, 1.6; 95% CI, 1.1–2.4), history of asthma (OR, 8.9; 95% CI, 3.6–22), allergic rhinitis (OR, 3.6; 95% CI, 1.8–7.4), and smoke exposure by a caretaker (OR, 2.3; 95% CI, 1.2–4.4) were predictors of bronchiolitis episodes. Bronchiolitis episodes were associated with higher severity score (P = 0.040), increased number of atopic factors (P < 0.001), and higher number of hospitalizations (P < 0.001).

Conclusions
This study identifies Puerto Rican children who may present a severe clinical course of disease without traditional risk factors. Atopy-related factors are associated with frequency and severity of bronchiolitis. Puerto Rican children present risk factors related to atopy earlier in life, some of which may be modified to prevent the subsequent development of asthma.
Bridging the Gap
Authors: Martin Philip Aidan , Loughins Lyndsay , Weatherup Nicola , Mullen Stephen 
Published: June 2020

Introduction
Adolescents are attending emergency departments (EDs) in increasing numbers, accounting for 21% attendances in the United Kingdom. A recent report by the Northern Ireland Commissioner for Children and Young People highlighted deficiencies in the support offered by EDs to adolescents.

Aim
The aim of this study was to develop a high-fidelity simulation-based course focused on managing common adolescent presentations to the ED.

Methodology
A 1-day mixed-modality course comprising of simulations, lectures, and skill stations, mapped to the pediatric and emergency medicine curriculum, was designed. The faculty developed and delivered 8 high-fidelity simulations. Precourse and immediate postcourse questionnaires were used to assess confidence levels and gain qualitative data. Delayed feedback was collected at 3 months.

Results
There were 36 participants; 86% (n = 31) completed the precourse feedback, 96% (n = 34) completed the postcourse feedback, and 47% (n = 17) completed the delayed feedback. There was a statistically significant increase in self-reported confidence across all domains with a median increase of 21.25% immediately, sustained at 20% on delayed 3-month feedback. Qualitative feedback noted a change in practice, “I used (the knowledge) regularly while working in children's A + E.”

Conclusions
This was a feasible, high-fidelity simulation-based study day covering the key components of adolescent medicine. The sustained increase in confidence at 3 months and the positive qualitative and quantitative feedback are supportive of the use of simulation to improve adolescent emergency care.
Interobserver Agreement of Inferior Vena Cava Ultrasound Collapse Duration and Correlated Outcomes in Children With Dehydration
Authors: Zhou Amy Z. , Green Robert S. , Haines Elizabeth J. , Vazquez Michelle N. , Tay Ee T. , Tsung James W. 
Published: June 2020

Objective
Dehydration is a common concern in children presenting to pediatric emergency departments and other acute care settings. Ultrasound (US) of the inferior vena cava (IVC) may be a fast, noninvasive tool to gauge volume status, but its utility is unclear. Our objectives were to determine the interobserver agreement of IVC collapse and collapse duration, then correlate IVC collapse with the outcome of intravenous (IV) versus oral (PO) rehydration.

Methods
We conducted a prospective study by enrolling patients 0 to 21 years old with emesis requiring ondansetron or diarrhea requiring IV hydration. Clinical operators interpreted US examinations in real time to determine whether the IVC was collapsed. Two blinded reviewers interpreted the US videos to determine IVC collapse and collapse duration. Cohen's kappa(κ) was calculated for reviewer-reviewer and reviewer-operator agreement. Primary outcomes were PO versus IV rehydration, and admitted versus discharged.

Results
One hundred twelve patients were enrolled, and 102 had complete data for analysis. The mean age was 7.2 years with 51% female. Twenty-nine patients received IV hydration. The reviewer-operator agreement for IVC collapse was κ = 0.57 (95% confidence interval [CI], 0.38–0.75) and interreviewer agreement was κ = 0.93 (95% CI, 0.83–1.0). The interreviewer agreement for collapse duration was κ = 0.66 (95% CI, 0.51–0.82). All patients with noncollapsed IVCs tolerated PO hydration. The likelihood of receiving IV hydration was correlated with the duration of IVC collapse (P = 0.034).

Conclusions
Based on a novel dynamic measure of IVC collapse duration, children with increasing duration of IVC collapse correlated positively with the need for IV rehydration. Noncollapsing IVCs on US were associated with successful PO rehydration without need for IV fluids or emergency department revisits.
Immune and Cell Therapy in Non-Hodgkin Lymphoma
Authors: Merryman Reid W. , Houot Roch , Armand Philippe , Jacobson Caron 
Published: June 2020

Abstract
The promise of immunotherapy has shone brightly for decades in hematologic malignancies and specifically in non-Hodgkin lymphoma. The last decade has witnessed the emergence of completely novel forms of immunotherapy, including immune checkpoint blockade, bispecific antibodies, and chimeric antigen receptor T cells. These treatments have shown phenomenal, and in some cases possibly curative, successes in various relapsed/refractory lymphomas. This review summarizes the most notable successes and promising findings as well as some of the attendant failures. These treatments will doubtlessly transform the treatment paradigms across many lymphoma subtypes. Yet, only if we can better understand their mechanisms of action, toxicity, and resistance will be able to maximize their therapeutic benefit.
Role of Microenvironment in Non-Hodgkin Lymphoma
Authors: Khurana Arushi , Ansell Stephen M. 
Published: June 2020

Abstract
Lymphoma microenvironment is a dynamic and well-orchestrated network of various immune and stromal cells that is indispensable for tumor cell survival, growth, migration, immune escape, and drug resistance. Recent progress has enhanced our knowledge of the pivotal role of microenvironment in lymphomagenesis. Understanding the characteristics, functions, and contributions of various components of the tumor niche, along with its bidirectional interactions with tumor cells, is paramount. It offers the potential to identify new therapeutic targets with the ability to restore antitumor immune surveillance and eliminate the protumoral factors contributed by the tumor niche.
Lymphoma Classification
Authors: de Leval Laurence , Jaffe Elaine S. 
Published: June 2020

Abstract
Twenty-five years after the Revised European American Classification of Lymphoid Neoplasms classification was published, its principle of an integrative approach to disease definition based on several parameters still prevails and has been adopted and expanded in the following World Health Organization classifications of tumors of the hematopoietic organs. The latest World Health Organization classification revised in 2017 comprises more than 80 entities of mature lymphoid neoplasms (B-cell, T-cell, and Hodgkin lymphomas), which are defined according to their morphology, immunophenotype, genetic lesions and molecular profiles, clinical features, and cellular derivation. The classification also recognizes both incipient and indolent lymphoid neoplasms with a low potential of progression. In this review, we highlight some of the new data and recent modifications introduced in the 2017 classification.
Use of the Adductor Magnus Muscle Free Flap for Lower-Extremity Soft Tissue Coverage
Authors: Melissinos Emmanuel G. , Maiorino Eric J. , Marques Erik S. 
Published: June 2020

Background
The gracilis muscle free flap has proven to be a dependable tool for the reconstructive microsurgeon for coverage of small- to medium-sized lower-extremity soft tissue defects because of its reliable anatomy, ease of elevation, and minimal donor site morbidity. We describe our experience with the adductor magnus muscle free flap which we have utilized in cases when confronted with the rare situation in which the dominant vascular pedicle to the gracilis muscle is insufficient or absent.

Methods
We conducted a retrospective chart review of a single surgeon's experience (EG Melissinos) over an 18-year period of all patients that underwent adductor magnus muscle free flap coverage for lower-extremity soft tissue injuries.

Results
Twenty-four adductor magnus free flaps in 24 patients were performed over an 18-year period (2000–2018). All of the adductor magnus muscle free flaps were performed with the initial intention of gracilis muscle harvest for lower-extremity soft tissue coverage. The most common wound etiology was motor vehicle collisions (8 patients, 33%). All of the adductor magnus free flaps were used for coverage of lower-extremity wounds in the following anatomic locations: distal third (10 patients, 41.7%), ankle (11 patients, 45.8%) and foot (3 patients, 12.5%). All flaps were successful. There were minimal donor site complications. Limb salvage rate was 100%.

Conclusions
Use of the adductor magnus muscle free flap is a reasonable alternative to the gracilis muscle in cases when unfavorable gracilis vascular anatomy is encountered intraoperatively. It can be easily and safely harvested within the same donor incision and permits reliable coverage of small- to medium-sized lower-extremity soft tissue defects while avoiding the morbidity of a secondary donor site.