bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Hepatectomy Based on a Hybrid Concept of Portal Perfusion of Anterior Segment and Venous Drainage Area of Superior Right Hepatic Vein
Authors: Saito Yu , Imura Satoru , Morine Yuji , Ikemoto Tetsuya , Yamada Shinichiro , Shimada Mitsuo 
Published: December 2020

Background Right hepatic vein sometimes could not be a reliable landmark between the anterior and posterior segment. The aim of this study was to clarify the portal perfusion area of the anterior segment and to propose a less invasive hepatectomy based on both the portal perfusion and the hepatic venous drainage. Methods Three-dimensional computerized tomography images of 66 patients were constructed. A case, in which the perfusion area of the anterior segment crossed over superior right hepatic vein (SRHV), was called as SRHV-inclusion. It was defined as inclusion of more than 1 cm of the proximal site of SRHV surrounded by the portal perfusion area of the anterior segment. Results SRHV-inclusion was observed in 26%. The cases with large inferior right hepatic vein (IRHV) had more frequent SRHV-inclusion (47%). The elderly patient with hepatic disorder, who had hepatocellular carcinoma near the root of the SRHV, underwent a less invasive hepatectomy (anterior segment + SRHV drainage area) resulting in the preservation of the IRHV. Conclusions The perfusion area of the anterior segment crossed over SRHV in one fourth of patients in the study. Our proposed less invasive hepatectomy based on a hybrid concept might be an alternative operative procedure other than right hepatectomy.
How High? Trends in Cannabis Use Prior to First Admission to Inpatient Psychiatry in Ontario, Canada, between 2007 and 2017
Authors: McGuckin Taylor , Ferro Mark A. , Hammond David , Stewart Shannon , Maloney-Hall Bridget , Madi Nawaf , Porath Amy , Perlman Christopher M. 
Published: December 2020

Objectives: To examine the trends in cannabis use within 30 days of first admission to inpatient psychiatry in Ontario, Canada, between 2007 and 2017, and the characteristics of persons reporting cannabis use. Methods: A retrospective cross-sectional analysis was conducted for first-time admissions to nonforensic inpatient psychiatric beds in Ontario, Canada, between January 1, 2007, and December 31, 2017, using data from the Ontario Mental Health Reporting System ( N = 81,809). Results: Across all years, 20.1% of patients reported cannabis use within 30 days of first admission. Use increased from 16.7% in 2007 to 25.9% in 2017, and the proportion with cannabis use disorders increased from 3.8% to 6.0%. In 2017, 47.9% of patients aged 18 to 24 and 39.2% aged 25 to 34 used cannabis, representing absolute increases of 8.3% and 10.7%, respectively. Increases in cannabis use were found across almost all diagnostic groups, with the largest increases among patients with personality disorders (15% increase), schizophrenia or other psychotic disorders (14% increase), and substance use disorders (14% increase). A number of demographic and clinical factors were significantly associated with cannabis use, including interactions between schizophrenia and gender (area under the curve = 0.88). Conclusions: As medical cannabis policies in Canada have evolved, cannabis use reported prior to first admission to inpatient psychiatry has increased. The findings of this study establish a baseline for evaluating the impact of changes in cannabis-related policies in Ontario on cannabis use prior to admission to inpatient psychiatry.
Critical Care Surge During the COVID-19 Pandemic: Implementation and Feedback From Frontline Providers
Authors: Keene Adam B. , Shiloh Ariel L. , Eisen Lewis , Berger Jay , Karwa Manoj , Fein Daniel , Orsi Deborah , Gong Michelle 
Published: December 2020

Purpose: Montefiore Medical Center (MMC) in the Bronx, New York, was subjected to an unprecedented surge of critically ill patients with COVID-19 disease during the initial outbreak of the pandemic in New York State in the spring of 2020. It is important to describe our experience in order to assist hospitals in other areas of the country that may soon be subjected to similar surges. Materials and Methods: We retrospectively reviewed the expansion of critical care medicine services at Montefiore during the COVID-19 surge in terms of space, staff, stuff, and systems. In addition, we report on a debriefing session held with a multidisciplinary group of frontline CCM providers at Montefiore. Findings: The surge of critically ill patients from COVID-19 disease necessitated a tripling of critical care bed capacity at (MMC), with attendant increased needs for staffing, equipment, and systematic innovations to increase efficiency and effectiveness. Feedback from a multidisciplinary group of frontline providers revealed multiple opportunities for improvement for the next potential surge at MMC as well as guidance for other hospitals. Conclusions: Given increasing cases and burden of critical illness from COVID-19 across the US, engineering safe and effective expansions of critical care capacity will be crucial. We hope that our description of what worked and what did not at MMC will help guide other hospitals in their pandemic preparedness.
Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults
Authors: Oyeyemi Deborah M. , Cooter Mary , Chung Stacey , Whitson Heather E. , Browndyke Jeffrey N. , Devinney Michael J. , Smith Patrick J. , Garrigues Grant E. , Moretti Eugene , Moul Judd W. , Cohen Harvey Jay , Mathew Joseph P. , Berger Miles ,   for the MADCO-PC Study Team Investigators
Published: December 2020

Objective: To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults. Methods: Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent cognitive testing, Center for Epidemiologic Studies-Depression, and State Anxiety Inventory screening before and 6 weeks after surgery. Cognitive test scores were combined by factor analysis into 4 cognitive domains, whose mean was defined as the continuous cognitive index (CCI). Postoperative global cognitive change was defined by CCI change from before to after surgery, with negative CCI change indicating worsened postoperative global cognition and vice versa. Results: Lower global cognition before surgery was associated with greater baseline depression severity (Spearman’s r = −0.30, p = 0.002) and baseline anxiety severity (Spearman’s r = −0.25, p = 0.010), and these associations were similar following surgery (r = −0.36, p < 0.001; r = −0.26, p = 0.008, respectively). Neither baseline depression or anxiety severity, nor postoperative changes in depression or anxiety severity, were associated with pre- to postoperative global cognitive change. Conclusions: Greater depression and anxiety severity were each associated with poorer cognitive performance both before and after surgery in older adults. Yet, neither baseline depression or anxiety symptoms, nor postoperative change in these symptoms, were associated with postoperative cognitive change.
Satisfaction of Patients With Severe Multiple Sclerosis and Their Family Members With Palliative Care: Interventional Study
Authors: Bužgová Radka , Kozáková Radka , Bar Michal 
Published: December 2020

Background: Patients with MS should be provided palliative care, which could help them manage symptoms more efficiently and could solve some psychosocial problems. Evaluating the satisfaction with provided care may be one of the factors of the quality of care evaluation. Aim: The aim of this controlled intervention study was to determine the factors affecting one’s satisfaction with care in patients in advanced stages of MS and their caregivers. Furthermore, the aim was to study the difference in the satisfaction of patients and family members with the provided specialized palliative care, as opposed to the standard care. Methods: The sample consisted of 103 patients with MS who were randomized to either a palliative care intervention or the control group. Family members of each patient were invited in the study, and 97 caregivers agreed to participe. The patients in the intervention group were provided with neuropalliative care in the form of consultations with a multidisciplinary palliative team. A modified questionnaire, CANHELP Lite, was used to collect data. Patients and family members completed the questionnaire 3 months after the intervention. Results: The patients and caregivers in the intervention group expressed significantly greater satisfaction in all analyzed areas (p = 0.000-0.002). The provided intervention predicted the satisfaction in the domains of a relationship with the doctor, disease management, and decision-making/communication. Another important predictor of the satisfaction in all domains was the functional state of the patient. Conclusion: Targeted consultations resulted in the greater satisfaction of patients with MS and their caregivers with the provided care.
Development and Validation of a Measure of Attachment Disorders Based on DSM-5 Criteria: The Early TRAuma-Related Disorders Questionnaire (ETRADQ)
Authors: Monette Sebastien , Cyr Chantal , Terradas Miguel M. , Couture Sophie , Minnis Helen , Lehmann Stine 
Published: December 2020

Background: A review of the scientific literature showed few valid tools for assessing reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED), two diagnostic entities traditionally grouped under “attachment disorders.” The Early TRAuma-related Disorders Questionnaire (ETRADQ), a caregiver report, was developed to assess attachment disorders in school-age children based on the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition criteria. This study sought to validate this instrument. Method: Caregivers of school-age children from the community ( n = 578) and caregivers of at-risk children adopted or in out-of-home care ( n = 245) completed a sociodemographic questionnaire, the ETRADQ, the Relationship Problem Questionnaire, the RADA ( RAD and DSED Assessment) interview, and the Barkley Functional Impairment Scale for Children and Adolescents. Results: Confirmatory factor analysis of the ETRADQ items supported the expected organization of the measure, that is, two second-order factors and five subfactors: (1) RAD scale (three subscales: Low selective attachment, Low social and emotional responsiveness, Emotional unpredictability) and (2) DSED scale (two subscales: Interactions with unfamiliar adults, Social disinhibition). All scales showed excellent internal consistency, test–retest reliability, convergent validity, and known-group validity. Conclusions: Results support the reliability and validity of the ETRADQ.
Left hemispheric deficit in the sustained neuromagnetic response to periodic click trains in children with ASD
Authors: Stroganova T. A. , Komarov K. S. , Sysoeva O. V. , Goiaeva D. E. , Obukhova T. S. , Ovsiannikova T. M. , Prokofyev A. O. , Orekhova E. V. 
Published: December 2020

AbstractBackgroundDeficits in perception and production of vocal pitch are often observed in people with autism spectrum disorder (ASD), but the neural basis of these deficits is unknown. In magnetoencephalogram (MEG), spectrally complex periodic sounds trigger two continuous neural responses—the auditory steady state response (ASSR) and the sustained field (SF). It has been shown that the SF in neurotypical individuals is associated with low-level analysis of pitch in the ‘pitch processing center’ of the Heschl’s gyrus. Therefore, alternations in this auditory response may reflect atypical processing of vocal pitch. The SF, however, has never been studied in people with ASD.MethodsWe used MEG and individual brain models to investigate the ASSR and SF evoked by monaural 40 Hz click trains in boys with ASD (N = 35) and neurotypical (NT) boys (N = 35) aged 7–12-years.ResultsIn agreement with the previous research in adults, the cortical sources of the SF in children were located in the left and right Heschl’s gyri, anterolateral to those of the ASSR. In both groups, the SF and ASSR dominated in the right hemisphere and were higher in the hemisphere contralateral to the stimulated ear. The ASSR increased with age in both NT and ASD children and did not differ between the groups. The SF amplitude did not significantly change between the ages of 7 and 12 years. It was moderately attenuated in both hemispheres and was markedly delayed and displaced in the left hemisphere in boys with ASD. The SF delay in participants with ASD was present irrespective of their intelligence level and severity of autism symptoms.LimitationsWe did not test the language abilities of our participants. Therefore, the link between SF and processing of vocal pitch in children with ASD remains speculative.ConclusionChildren with ASD demonstrate atypical processing of spectrally complex periodic sound at the level of the core auditory cortex of the left-hemisphere. The observed neural deficit may contribute to speech perception difficulties experienced by children with ASD, including their poor perception and production of linguistic prosody.
Sanders stage 7b: Using the appearance of the ulnar physis improves decision-making for brace weaning in patients with adolescent idiopathic scoliosis
Authors: Cheung Prudence Wing Hang , Cheung Jason Pui Yin 
Published: December 2020

Aims The aim of this study was to investigate whether including the stages of ulnar physeal closure in Sanders stage 7 aids in a more accurate assessment for brace weaning in patients with adolescent idiopathic scoliosis (AIS). Methods This was a retrospective analysis of patients who were weaned from their brace and reviewed between June 2016 and December 2018. Patients who weaned from their brace at Risser stage ≥ 4, had static standing height and arm span for at least six months, and were ≥ two years post-menarche were included. Skeletal maturity at weaning was assessed using Sanders staging with stage 7 subclassified into 7a, in which all phalangeal physes are fused and only the distal radial physis is open, with narrowing of the medial physeal plate of the distal ulna, and 7b, in which fusion of > 50% of the medial growth plate of distal ulna exists, as well as the distal radius and ulna (DRU) classification, an established skeletal maturity index which assesses skeletal maturation using finer stages of the distal radial and ulnar physes, from open to complete fusion. The grade of maturity at the time of weaning and any progression of the curve were analyzed using Fisher’s exact test, with Cramer’s V, and Goodman and Kruskal’s tau. Results We studied a total of 179 patients with AIS, of whom 149 (83.2%) were female. Their mean age was 14.8 years (SD 1.1) and the mean Cobb angle was 34.6° (SD 7.7°) at the time of weaning. The mean follow-up was 3.4 years (SD 1.8). At six months after weaning, the rates of progression of the curve for patients weaning at Sanders stage 7a and 7b were 11.4% and 0%, respectively for those with curves of < 40°. Similarly, the rates of progression of the curve for those being weaned at ulnar grade 7 and 8 using the DRU classification were 13.5% and 0%, respectively. The use of Sanders stages 6, 7a, 7b, and 8 for the assessment of maturity at the time of weaning were strongly and significantly associated (Cramer’s V 0.326; p = 0.016) with whether the curve progressed at six months after weaning. Weaning at Sanders stage 7 with subclassification allowed 10.6% reduction of error in predicting the progression of the curve. Conclusion The use of Sanders stages 7a and 7b allows the accurate assessment of skeletal maturity for guiding brace weaning in patients with AIS. Weaning at Sanders stage 7b, or at ulnar grade 8 with the DRU classification, is more appropriate as the curve did not progress in any patient with a curve of < 40° immediately post-weaning. Thus, reaching full fusion in both distal radial and ulnar physes (as at Sanders stage 8) is not necessary and this allows weaning from a brace to be initiated about nine months earlier. Cite this article: Bone Joint J 2021;103-B(1):141–147.
Radiological and clinical outcomes using induced membrane technique combined with bone marrow concentrate in the treatment of chronic osteomyelitis of immature patients
Authors: Shen Jie , Sun Dong , Yu Shengpeng , Fu Jingshu , Wang Xiaohua , Wang Shulin , Xie Zhao 
Published: December 2020

AimsTreatment of chronic osteomyelitis (COM) for young patients remains a challenge. Large bone deficiencies secondary to COM can be treated using induced membrane technique (IMT). However, it is unclear which type of bone graft is optimal. The goal of the study was to determine the clinical effectiveness of bone marrow concentrator modified allograft (BMCA) versus bone marrow aspirate mixed allograft (BMAA) for children with COM of long bones.MethodsBetween January 2013 and December 2017, 26 young patients with COM were enrolled. Different bone grafts were applied to repair bone defects secondary to IMT procedure for infection eradication. Group BMCA was administered BMCA while Group BMAA was given BMAA. The results of this case-control study were retrospectively analyzed.ResultsPatient infection in both groups was eradicated after IMT surgery. As for reconstruction surgery, no substantial changes in the operative period (p = 0.852), intraoperative blood loss (p = 0.573), or length of hospital stay (p = 0.362) were found between the two groups. All patients were monitored for 12 to 60 months. The median time to bone healing was 4.0 months (interquartile range (IQR) 3.0 to 5.0; range 3 to 7) and 5.0 months (IQR 4.0 to 7.0; range 3 to 10) in Groups BMCA and BMAA, respectively. The time to heal in Group BMCA versus Group BMAA was substantially lower (p = 0.024).ConclusionIMT with BMCA or BMAA may attain healing in large bone defects secondary to COM in children. The bone healing time was significantly shorter for BMCA, indicating that this could be considered as a new strategy for bone defect after COM treatment. Cite this article: Bone Joint Res 2021;10(1):31–40.
Rejuvenated ageing mesenchymal stem cells by stepwise preconditioning ameliorates surgery-induced osteoarthritis in rabbits
Authors: Zong Zhixian , Zhang Xiaoting , Yang Zhengmeng , Yuan Weihao , Huang Jianping , Lin Weiping , Chen Ting , Yu Jiahao , Chen Jiming , Cui Liao , Li Gang , Wei Bo , Lin Sien 
Published: December 2020

Aims Ageing-related incompetence becomes a major hurdle for the clinical translation of adult stem cells in the treatment of osteoarthritis (OA). This study aims to investigate the effect of stepwise preconditioning on cellular behaviours in human mesenchymal stem cells (hMSCs) from ageing patients, and to verify their therapeutic effect in an OA animal model. Methods Mesenchymal stem cells (MSCs) were isolated from ageing patients and preconditioned with chondrogenic differentiation medium, followed by normal growth medium. Cellular assays including Bromodeoxyuridine / 5-bromo-2'-deoxyuridine (BrdU), quantitative polymerase chain reaction (q-PCR), β-Gal, Rosette forming, and histological staining were compared in the manipulated human mesenchymal stem cells (hM-MSCs) and their controls. The anterior cruciate ligament transection (ACLT) rabbit models were locally injected with two millions, four millions, or eight millions of hM-MSCs or phosphate-buffered saline (PBS). Osteoarthritis Research Society International (OARSI) scoring was performed to measure the pathological changes in the affected joints after staining. Micro-CT analysis was conducted to determine the microstructural changes in subchondral bone. Results Stepwise preconditioning approach significantly enhanced the proliferation and chondrogenic potential of ageing hMSCs at early passage. Interestingly, remarkably lower immunogenicity and senescence was also found in hM-MSCs. Data from animal studies showed cartilage damage was retarded and subchondral bone remodelling was prevented by the treatment of preconditioned MSCs. The therapeutic effect depended on the number of cells applied to animals, with the best effect observed when treated with eight millions of hM-MSCs. Conclusion This study demonstrated a reliable and feasible stepwise preconditioning strategy to improve the safety and efficacy of ageing MSCs for the prevention of OA development. Cite this article: Bone Joint Res 2021;10(1):10–21.
Antischistosomal, antionchocercal and antitrypanosomal potentials of some Ghanaian traditional medicines and their constituents
Authors: Twumasi Emmanuella Bema , Akazue Pearl Ihuoma , Kyeremeh Kwaku , Gwira Theresa Manful , Keiser Jennifer , Cho-Ngwa Fidelis , Flint Adrian , Anibea Barbara , Bonsu Emmanuel Yeboah , Amewu Richard K. , Amoah Linda Eva , Appiah-Opong Regina , Osei-Safo Dorcas 
Published: December 2020

BackgroundGhana is endemic for some neglected tropical diseases (NTDs) including schistosomiasis, onchocerciasis and lymphatic filariasis. The major intervention for these diseases is mass drug administration of a few repeatedly recycled drugs which is a cause for major concern due to reduced efficacy of the drugs and the emergence of drug resistance. Evidently, new treatments are needed urgently. Medicinal plants, on the other hand, have a reputable history as important sources of potent therapeutic agents in the treatment of various diseases among African populations, Ghana inclusively, and provide very useful starting points for the discovery of much-needed new or alternative drugs.Methodology/Principal findingsIn this study, extracts of fifteen traditional medicines used for treating various NTDs in local communities were screenedin vitrofor efficacy against schistosomiasis, onchocerciasis and African trypanosomiasis. Two extracts, NTD-B4-DCM and NTD-B7-DCM, prepared from traditional medicines used to treat schistosomiasis, displayed the highest activity (IC50= 30.5 μg/mL and 30.8 μg/mL, respectively) againstSchistosoma mansoniadult worms. NTD-B2-DCM, also obtained from an antischistosomal remedy, was the most active against female and male adultOnchocera ochengiworms (IC50= 76.2 μg/mL and 76.7 μg/mL, respectively). Antitrypanosomal assay of the extracts againstTrypanosoma brucei bruceigave the most promising results (IC50= 5.63 μg/mL to 18.71 μg/mL). Incidentally, NTD-B4-DCM and NTD-B2-DCM, also exhibited the greatest antitrypanosomal activities (IC50= 5.63 μg/mL and 7.12 μg/mL, respectively). Following the favourable outcome of the antitrypanosomal screening, this assay was selected for bioactivity-guided fractionation. NTD-B4-DCM, the most active extract, was fractionated and subsequent isolation of bioactive constituents led to an eupatoriochromene-rich oil (42.6%) which was 1.3-fold (IC50<0.0977 μg/mL) more active than the standard antitrypanosomal drug, diminazene aceturate (IC50= 0.13 μg/mL).Conclusion/SignificanceThese findings justify the use of traditional medicines and demonstrate their prospects towards NTDs drug discovery.