bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interactions Between Neutrophils and Platelets in the Progression of Acute Pancreatitis
Authors: Tokoro Tomokazu , Makino Isamu , Harada Shinichi , Okamoto Koichi , Nakanuma Shinichi , Sakai Seisho , Kinoshita Jun , Nakamura Keishi , Miyashita Tomoharu , Tajima Hidehiro , Ninomiya Itasu , Fushida Sachio , Ohta Tetsuo 
Published: June 2020

Objective
Severe acute pancreatitis is a serious disease, but its detailed mechanism has not yet been elucidated. We aimed to clarify the interaction between neutrophils and platelets in the pathogenesis of acute pancreatitis.

Methods
We induced acute pancreatitis in rats by injection of sodium taurocholate into the biliopancreatic duct and killed them over time. We observed the histological changes in pancreatic tissue with special attention to the dynamics of neutrophils and platelets. We also measured the concentrations of neutrophil- and platelet-derived factors in pancreatic tissue and blood samples.

Results
Neutrophils and platelets in the pancreatic tissue showed a similar pattern of migration. They initially spread in the interlobular connective tissue and finally into the lobules. The concentration of myeloperoxidase gradually increased in the inflamed pancreas until 24 hours and the concentration of thromboxane B2, plasminogen activator inhibitor 1, and CD41 also increased with time. Finally, the concentration of serum myeloperoxidase, citrullinated histone H3, and high-mobility group box 1 increased over time.

Conclusions
The interaction between neutrophils and platelets in pancreatic tissue plays an important role in the mechanism of advancing severity in acute pancreatitis. Circulating damage-associated molecular patterns induced by excessive local inflammation may lead to other organ injuries.
Dose Verification Errors in Hospitals
Authors: Hunt Sevgin , Chakraborty Joyram 
Published: June 2020

Background:
The effectiveness of the dose verification features of the electronic medication administration record (eMAR) and complementary systems in the hospital setting is not well understood.

Purpose:
The authors completed a narrative synthesis of literature findings on the effectiveness of eMAR-based systems in the hospital setting.

Methods:
A literature review was carried out across 5 bibliographic databases to evaluate the safety features of current eMAR-based systems in preventing dosing errors and design issues that impede their usability.

Results:
While eMAR-based systems are beneficial to reducing order and drug cross-checking errors, safe dose verification features are sporadically available for targeted tasks. Overall, the eMAR had little impact on preventing low to moderate dosing errors. Dosing errors may occur because of error-prone activities that result from system design and work process issues during medication administration.
Nurses' Knowledge, Perception, and Practice of Discharge Planning in Acute Care Settings
Authors: Hayajneh Audai A. , Hweidi Issa M. , Abu Dieh Milian W. 
Published: June 2020

Background:
Unsuccessful discharge planning (DP) may lead to undesirable health consequences among patients after discharge from the hospital.

Purpose:
The aims of this study were to assess nurses' knowledge, perception, and practice of DP in acute care settings and identify significant predictors for nurses' practice toward DP.

Methods:
The study had a descriptive correlational cross-sectional design. Three questionnaires about knowledge, perception, and nurses' activities toward DP were used. Nurses (n = 117) were recruited from 3 Jordanian hospitals.

Results:
The level of nurses' knowledge toward DP was very low to low. Slightly more than half (52.1%) of nurses had a negative perception toward DP and about 50% had poor practices related to DP. Nurse-to-patient ratio and perception of nurses were significant predictors for nurses' practice toward DP.

Conclusion:
The reinforcement of a positive perception toward DP among nurses working in acute care settings may lead to better health outcomes among patients after discharge from hospital.
Improving Staff Experience With Vaccine Data Entry With 2D Barcode Scanning
Authors: Evanson Heather V. , Reed Jenica Huddleston , Cox Regina , Clinthorne Ashley Daily , Williams Warren W. , Vallero Judi , Rodgers Loren , Greene Michael , Koeppl Patrick , Gerlach Ken 
Published: June 2020

Background:
Small fonts on vaccine labels make manually recording vaccine data in patient records time-consuming and challenging. Vaccine 2-dimensional (2D) barcode scanning is a promising alternative to manually recording these data.

Problem:
While vaccine 2D barcode scanning assists in data entry, adoption of scanning technology is still low.

Approach:
Pilot sites (n = 27) within a health system scanned 2D barcodes to record vaccine data for 6 months. The time to record through scanning and nonscanning methods was measured for 13 vaccinators at 9 sites. A survey was administered to participants across all sites about their experience.

Outcomes:
On average, 22 seconds were saved per vaccine scanned versus entered manually (7 vs 29 seconds, respectively). Participants reported preference for scanning over other vaccine entry options and identified benefits of scanning.

Conclusion:
Expanded use of 2D barcode scanning can meaningfully improve clinical practices by improving efficiency and staff satisfaction during vaccine data entry.
Making Magnets More Attractive
Authors: Brunnquell Christina L. , Hoff Michael N. , Balu Niranjan , Nguyen Xuan V. , Oztek Murat Alp , Haynor David R. 
Published: June 2020

AbstractPatient comfort is an important factor of a successful magnetic resonance (MR) examination, and improvements in the patient's MR scanning experience can contribute to improved image quality, diagnostic accuracy, and efficiency in the radiology department, and therefore reduced cost. Magnet designs that are more open and accessible, reduced auditory noise of MR examinations, light and flexible radiofrequency (RF) coils, and faster motion-insensitive imaging techniques can all significantly improve the patient experience in MR imaging. In this work, we review the design, development, and implementation of these physics and engineering approaches to improve patient comfort.
Endoscopic Endonasal Transclival Approach to Spontaneous Hypertensive Brainstem Hemorrhage
Authors: Liu Bolin , Zheng Tao , Mao Yanjun , Bian Ka , He Shiming , Lv Wenhai 
Published: June 2020

Abstract
Surgical management of spontaneous hypertensive brainstem hemorrhage remains a challenge for neurosurgeons, especially when the hemorrhage is located the ventral brainstem. Recently endoscopic endonasal approach has been applied for resection of ventral brainstem lesions, though no published literature has explored its utility in treating brainstem hemorrhage. Here we reported a successful evacuation of severe hypertensive brainstem hemorrhage through endoscopic endonasal transclival approach. A 37 years-old male with a 5-year history of uncontrolled hypertension was brought to the Emergency Department with sudden vomiting, limb convulsions, and loss of consciousness for 2 hours. Computed tomography demonstrated a hemorrhage measuring 2.5 × 2.2 cm in the ventral midbrain and pontine. He presented with a Glasgow coma scale (GCS) score of 3 and disrupted vitals, and was intubated in the Emergency Department. Considering the ventral location of the hemorrhage and the need for emergent surgical decompression, an endoscopic endonasal approach was applied. Evacuation of the brainstem hemorrhage was achieved and his spontaneous respiration improved immediately after surgery. He was weaned off the ventilator and extubated on postoperative day 1, along with an improved GCS score of 5 (E2V1M2). At 1 month postoperatively his GCS score improved to 11 (E4V2M5) and he is currently under rehabilitation. Endoscopic endonasal approach is a feasible alternative for emergent surgery of ventrally located brainstem hemorrhage in carefully selected cases by providing direct visualization of the area and a good working angle, which facilitate evacuation of the hemorrhage with minimal damage to the brainstem.
Direct Oral Feeding After a Minimally Invasive Esophagectomy
Authors: Fransen Laura F. C. , Janssen Thijs H. J. B. , Aarnoudse Martijn , Nieuwenhuijzen Grard A. P. , Luyer Misha D. P. 
Published: June 2020

Objective:
The aim of this single-center cohort study was to compare direct oral feeding (DOF) to standard of care after a minimally invasive esophagectomy (MIE) performed in a center with a stable and acceptable postoperative complication rate.

Background:
A recent multicenter, international randomized controlled trial showed that DOF following a MIE is comparable to standard of care (nil-by-mouth). However, the effect of DOF was potentially influenced by postoperative complications.

Methods:
Patients in this single-center prospective cohort study received either DOF (intervention) or nil-by-mouth for 5 days postoperative and tube feeding (standard of care, control group) following a MIE with intrathoracic anastomosis. Primary outcome was time to functional recovery and length of hospital stay. Secondary outcomes included anastomotic leakage, pneumonia, and other surgical complications.

Results:
Baseline characteristics were similar in the intervention (n = 85) and control (n = 111) group. Median time to functional recovery was 7 and 9 days in the intervention and control group (P < 0.001), respectively. Length of hospital stay was 8 versus 10 days (P < 0.001), respectively. Thirty-day postoperative complication rate was significantly reduced in the intervention group (57.6% vs 73.0%, P = 0.024). Chyle leakage only occurred in the control group (18.9%, P < 0.001). Anastomotic leakage, pneumonia, and other postoperative complications did not differ between groups.

Conclusion:
Direct oral feeding following a MIE results in a faster time to functional recovery and lower 30-day postoperative complication rate compared to patients that were orally fasted.
The Largest Single Center Report on Pediatric Liver Transplantation
Authors: Nikeghbalian Saman , Malekhosseini Seyed Ali , Kazemi Kourosh , Arasteh Peyman , Eghlimi Hesameddin , Shamsaeefar Alireza , Nikoupour Hamed , Gholami Siavash , Dehghani Masood , Dehghani Seyed Mohsen , Bahador Ali , Salahi Heshmatollah 
Published: June 2020

Objective:
We described our experiences on pediatric liver transplantation (LT) from the largest LT center in the world termed the Shiraz Transplant Center.

Background:
After the first successful pediatric LT in 1967, pediatric LT has become the routine treatment for children with liver failure worldwide.

Methods:
Data on a total of 1141 pediatric cases of LT were collected. Specifics on baseline and anthropometric characteristics, clinicopathology, prognosis of recipients of LT, and donor characteristics are reported.

Results:
Mean age of patients was 7.83 ± 5.55 years old. Most common etiologies for LT were biliary atresia (15.9%), progressive familial intrahepatic cholestasis (13.4%), and Wilson's disease (13.3%), respectively.
Whole organs, living donor grafts, and split grafts were used in 47.9%, 41%, and 11.1% of patients, respectively. In-hospital complications were seen among 34.7% of patients and the most common complications were infections (26.8%), bleeding (23.4%), and vascular complications (18%).
Median (interquartile range) model for end stage liver disease score was 20 (15, 25). Main causes of death among patients were sepsis (35.2%), followed by post-transplantation lymphoproliferative diseases (10.5%), and primary nonfunction of liver (9%).
Patient survival showed improvement over the years (1-year survival of 73.1%, 83.4%, and 84.4%, 2-year survival of 65.2%, 77.1%, and 78.7%, 5-year survival of 58.2%, 72%, and 77.8% for 1997–2007, 2007–2013, and 2013–2019, respectively; P < 0.001).

Conclusions:
This is the largest single-center report on pediatric LT in literature which provides valuable experiences in pediatric LT.
A Modern Assessment of Cancer Risk in Adrenal Incidentalomas
Authors: Kahramangil Bora , Kose Emin , Remer Erick M. , Reynolds Jordan P. , Stein Robert , Rini Brian , Siperstein Allan , Berber Eren 
Published: June 2020

Objective:
The aim of this study was to analyze the incidence of and risk factors for adrenocortical carcinoma (ACC) in adrenal incidentaloma (AI).

Summary of Background Data:
AI guidelines are based on data obtained with old-generation imaging and predominantly use tumor size to stratify risk for ACC. There is a need to analyze the incidence and risk factors from a contemporary series.

Methods:
This is a retrospective review of 2219 AIs that were either surgically removed or nonoperatively monitored for ≥12 months between 2000 and 2017. Multivariate logistic regression was performed to define risk factors. ROC curves constructed to determine optimal size and attenuation cut-offs for ACC.

Results:
16.8% of AIs underwent upfront surgery and rest initial nonoperative management. Of conservatively managed patients, an additional 7.7% subsequently required adrenalectomy. Overall, ACC incidence in AI was 1.7%. ACC rates by size were 0.1%, 2.4%, and 19.5% for AIs of <4, 4 to 6, and >6 cm, respectively. The optimal size cut-off for ACC in AI was 4.6 cm. ACC risks by Hounsfield density were 0%, 0.5%, and 6.3% for lesions of <10, 10 to 20, and >20 HU, with an optimal cut-off of 20 HU to diagnose ACC. 15.5% of all AIs and 19.2% of ACCs were hormonally active. Male sex, large tumor size, high Hounsfield density, and >0.6 cm/year growth were independent risk factors for ACC.

Conclusion:
This contemporary analysis demonstrates that ACC risk per size in AI is less than previously reported. Given these findings, modern management of AIs should not be based just on size, but a combination of thorough hormonal evaluation and imaging characteristics.
Evaluation of Recurrence Risk After Curative Resection for Patients With Stage I to III Colorectal Cancer Using the Hazard Function
Authors: Kudose Yozo , Shida Dai , Ahiko Yuka , Nakamura Yuya , Sakamoto Ryohei , Moritani Konosuke , Tsukamoto Shunsuke , Kanemitsu Yukihide 
Published: June 2020

Objective:
This study aimed to investigate transitions of recurrence hazard and peak recurrence time in patients with nonmetastatic CRC using the hazard function.

Summary of Background Data:
A postoperative surveillance period of 5 years is consistent across major guidelines for patients with nonmetastatic CRC, but surveillance intervals differ. Estimates of instantaneous conditional recurrence rate can help set appropriate intervals.

Methods:
The study population consisted of 4330 patients with stage I to III CRC who underwent curative resection at the National Cancer Center Hospital between January 2000 and December 2013. Hazard rates of recurrence were calculated using the hazard function.

Results:
Recurrence rates in patients with stage I, II, and III CRC were 4% (50/1432), 11% (136/1231), and 25% (424/1667), respectively. The hazard curve for stage I was relatively flat and hazard rates were consistently low (<0.0015) for 5 years after surgery. The hazard curve for stage II had a peak hazard rate of 0.0046 at 13.7 months, after which the curve had a long hem to the right. The hazard curve for stage III had an earlier and higher peak than that of stage II (0.0105 at 11.6 months), with a long hem to the right.

Conclusions:
Changes in recurrence hazard for CRC patients varied considerably by stage. Our findings suggest that short-interval surveillance might be unnecessary for stage I patients for the first 3 years after surgery, whereas short-interval surveillance for the first 3 years should be considered for stage III patients.
Tertiary Hyperparathyroidism
Authors: Dream Sophie , Chen Herbert , Lindeman Brenessa 
Published: June 2020

Objective:
To evaluate the reason for delay of surgical referral in tertiary hyperparathyroidism (THPT) and its impact on renal allograft function.

Background:
Persistent hyperparathyroidism after renal transplant has been shown to negatively impact allograft function, yet referral for definitive treatment of THPT is often delayed.

Methods:
A retrospective review was performed of patients undergoing parathyroidectomy for THPT (n = 38) at a single institution from May 2016 to June 2018. The first elevated serum calcium after transplant and time to referral for parathyroid surgery were recorded. Baseline creatinine post-transplant and the most recent creatinine level were used to assess allograft function.

Results:
Thirty-eight patients were included, with mean age 53 ± 2 years and 66% male. Mean preoperative calcium and parathyroid hormone were 10.8 ± 0.1 mg/dL and 328 ± 48 pg/mL, respectively. THPT after renal transplant was diagnosed at a median of 15 days (range of 1–4892 days). Median time to parathyroidectomy referral was 320 days (range 16–6281 days). In over 50% of patients, the cited reason for referral to an endocrine surgeon was difficulty with cinacalcet – either cost, poor calcium control, and poor compliance or tolerance. In comparing renal function between patients referred early (<278 days, n = 19) versus later (>278 days, n = 19) for parathyroidectomy, those referred early had an improvement in creatinine (27.6% vs −5%, P = 0.007).

Conclusions:
Patients with THPT wait approximately a year, on average, before referral to an endocrine surgeon for curative parathyroidectomy; earlier referral was associated with improvement in serum creatinine.
Electrocautery, Diathermy, and Surgical Energy Devices
Authors: Zakka Kimberley , Erridge Simon , Chidambaram Swathikan , Beatty Jasmine Winter , Kynoch Michael , Kinross James , Purkayastha Sanjay 
Published: June 2020

Objective:
The aim of the study was to provide a rapid synthesis of available data to identify the risk posed by utilizing surgical energy devices intraoperatively due to the generation of surgical smoke, an aerosol. Secondarily it aims to summarize methods to minimize potential risk to operating room staff.

Summary Background Data:
Continuing operative practice during the coronavirus disease-19 (COVID-19) pandemic places the health of operating theatre staff at potential risk. SARS-CoV2 is transmitted through inhaled droplets and aerosol particles, thus posing an inhalation threat even at considerable distance. Surgical energy devices generate an aerosol of biological particular matter during use. The risk to healthcare staff through use of surgical energy devices is unknown.

Methods:
This review was conducted utilizing a rapid review methodology to enable efficient generation and dissemination of information useful for concurrent clinical practice.

Results:
There are conflicting stances on the use of energy devices and laparoscopy by different surgical governing bodies and societies. There is no definitive evidence that aerosol generated by energy devices may carry active SARS-CoV2 virus. However, investigations of other viruses have demonstrated aerosolization through energy devise use. Measures to reduce potential transmission include appropriate personal protective equipment, evacuation and filtration of surgical plume, limiting energy device use if appropriate, and adjusting endoscopic and laparoscopic practice (low CO2 pressures, evacuation through ultrafiltration systems).

Conclusions:
The risk of transmission of SARS-CoV2 through aerosolized surgical smoke associated with energy device use is not fully understood, however transmission is biologically plausible. Caution and appropriate measures to reduce risk to healthcare staff should be implemented when considering intraoperative use of energy devices.
Therapeutic Suggestion in Postoperative Pain Control: A Randomized Controlled Trial
Authors: Shah Nemi M. , Andriani Leslie A. , Mofidi Jessica L. , Ingraham Caitlin F. , Tefera Eshetu A. , Iglesia Cheryl B. 
Published: June 2020

Objectives
There is conflicting research on the effect of therapeutic suggestion in the perioperative period. This study systematically compared subjective and objective measures of postoperative pain, nausea and vomiting, urinary and bowel function, and global perception of symptomatic improvement between participants receiving perioperative therapeutic suggestion versus routine perioperative care during minimally invasive pelvic reconstructive surgery.

Methods
This was a single-blinded, randomized controlled trial of participants undergoing vaginal hysterectomy with minimally invasive sacrocolpopexy and concomitant prolapse repairs. The intervention group received perioperative therapeutic suggestion, whereas the control group did not. Primary outcomes included postoperative pain scores and analgesic use. Secondary outcomes included a postoperative nausea and vomiting scale, the Pelvic Floor Distress Inventory Questionnaire—Short Form 20, the Patient Global Impression of Improvement scale, and time to return of bowel and bladder function.

Results
Sixteen participants were randomized to each group. Final analysis included 15 intervention and 14 control participants. Overall measures of postoperative pain and analgesic use were low across all participants without a significant difference between intervention and control groups (opioid: 52.5; interquartile range [IQR], 25.5–58.9 vs 66 IQR, 7.3–125.8; morphine milligram equivalents; P = 0.64; acetaminophen: 2225 mg; IQR, 500–2600 mg vs 2800 mg; IQR, 650–4775 mg; P = 0.38). There were no statistically significant differences in secondary outcomes of urinary symptoms, bowel function, and subjective improvement of prolapse symptoms.

Conclusions
No differences in postoperative pain, analgesic use, return of bowel and bladder function, or pelvic organ prolapse symptoms were noted in participants receiving perioperative therapeutic suggestion versus routine perioperative care.
Interactive Web Application for Plotting Personalized Prognosis Prediction Curves in Allogeneic Hematopoietic Cell Transplantation Using Machine Learning
Authors: Okamura Hiroshi , Nakamae Mika , Koh Shiro , Nanno Satoru , Nakashima Yasuhiro , Koh Hideo , Nakane Takahiko , Hirose Asao , Hino Masayuki , Nakamae Hirohisa 
Published: June 2020

Background.
Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative treatment option for malignant hematological disorders. Transplant clinicians estimate patient-specific prognosis empirically in clinical practice based on previous studies on similar patients. However, this approach does not provide objective data. The present study primarily aimed to develop a tool capable of providing accurate personalized prognosis prediction after allo-HCT in an objective manner.

Methods.
We developed an interactive web application tool with a graphical user interface capable of plotting the personalized survival and cumulative incidence prediction curves after allo-HCT adjusted by 8 patient-specific factors, which are known as prognostic predictors, and assessed their predictive performances. A random survival forest model using the data of patients who underwent allo-HCT at our institution was applied to develop this application.

Results.
We succeeded in showing the personalized prognosis prediction curves of 1-year overall survival, progression-free survival, relapse/progression, and nonrelapse mortality (NRM) interactively using our web application (https://predicted-os-after-transplantation.shinyapps.io/RSF_model/). To assess its predictive performance, the entire cohort (363 cases) was split into a training cohort (70%) and a test cohort (30%) time-sequentially based on the patients’ transplant dates. The areas under the receiver-operating characteristic curves for 1-year overall survival, progression-free survival, relapse/progression, and nonrelapse mortality in test cohort were 0.70, 0.72, 0.73, and 0.77, respectively.

Conclusions.
The new web application could allow transplant clinicians to inform a new allo-HCT candidate of the objective personalized prognosis prediction and facilitate decision-making.