bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scar tissue I wish you saw: Patient expectations regarding scar treatment
Authors: Gomolin Tamar , Cline Abigail , Ginsberg David , Safai Bijan 
Published: January 2021

AbstractAlthough many invasive and noninvasive approaches exist, management of keloids and hypertrophic scars remains challenging. By better understanding patient expectations regarding scar treatments, dermatologists can provide higher quality and more satisfying care. Survey patients age 18 to 80 years with a history of hypertrophic, keloid, or disfiguring scars. Overall, 187 participants completed the 25‐question survey. Expectations and willingness were measured on a 1‐5 Likert scale. Results were analyzed overall and by patient demographics. Older respondents more often expected scar reduction, while younger patients expected scar removal. Compared with Caucasians, Asian respondents were more symptomatic, more likely to have seen a physician, and more willing to undergo invasive therapies. Respondent willingness for treatment and their perceived efficacy significantly differed across gender, age, and race. This study explores a gap in the literature of what role patient expectations play in electing specific treatments. Although patient expectations are complex and context dependent, gaining more understanding of what therapies patients are willing to attempt, and their expectations from those therapies could help guide counseling with the goal setting realistic expectations to improve patient compliance and satisfaction.
An appealing meal: Creating conditions for older persons’ mealtimes – a focus group study with healthcare professionals
Authors: Blomberg Karin , Wallin Anne‐Marie , Odencrants Sigrid 
Published: January 2021

AbstractBackgroundHealthcare professionals’ knowledge and attitudes may have an impact on older persons’ nutritional status. Therefore, it is important to explore different healthcare professionals’ perspectives on older persons’ meals.AimThe aim of this study was to describe healthcare professionals’ understanding of and views on the mealtime experience of older persons in municipal care.MethodsSeven focus group discussions with various healthcare professionals (nurse assistants, registered nurses and occupational therapists) (n = 52) working in nursing homes and/or home care for older persons were conducted and analysed using interpretive description. The COREQ checklist was used for reporting the findings.ResultsThe results revealed a striving to create conditions for an appealing meal, regardless of profession. This overall theme, ‘An appealing meal – creating conditions for older persons’ mealtimes’, consisted of four sub‐themes: ‘Food is crucial’, ‘The mealtime as a social interaction’, ‘Identifying the individual older person's needs’ and ‘Integrating different perspectives of meal‐related situations among the team’.ConclusionThe findings show that the different professionals strive to prioritise meals in the everyday care of older persons, but at same time there is a lack of a common view on how to prioritise meal‐related issues. This indicates that the care may be fragmented, being based on each professional's duties and interpretation of responsibility for older persons’ meals, rather than constituting comprehensive integrated person‐centred care provided by a multidisciplinary team.Relevance to clinical practiceTo enhance older persons’ mealtimes, we need to map how mealtimes are valued and implemented in clinical practice and approached in healthcare professionals’ education. Education on older person's nutritional needs should be team‐based, and not focus on the perspective of a single profession.
The perspectives of people with dementia on their future, end of life and on being cared for by others: A qualitative study
Authors: Bolt Sascha R. , van der Steen Jenny T. , Khemai Chandni , Schols Jos M. G. A. , Zwakhalen Sandra M. G. , Meijers Judith M. M. 
Published: January 2021

AbstractAims and objectivesTo explore the perspectives of people with dementia on being cared for by others, on the future and on the end of life, and to evaluate the capability and willingness of participants to have these conversations.BackgroundAwareness about perspectives of people with dementia should decrease stigmatisation and improve their quality of life. Applying palliative care principles from an early stage is important to address diverse needs and to anticipate the future. Few studies investigate perspectives of people with dementia regarding palliative care, including advance care planning.DesignQualitative descriptive design.MethodsWe performed in‐depth interviews with 18 community‐dwelling persons with dementia in South‐Limburg, the Netherlands. Transcripts were analysed using an inductive content analysis. Two authors coded the data and regularly compared coding. All authors discussed abstraction into categories and themes. We followed the COREQ reporting guidelines.ResultsFive overarching themes derived from the interviews were as follows: (a) My life still has value and meaning, (b) I am my own unique individual, (c) I place my trust in other people, (d) The future worries me, and (e) I accept and embrace what life brings.ConclusionsParticipants' thoughts about the future and the end of life involved feelings of ambiguity and anxiety, but also of contentment and resignation. Despite worrying thoughts of decline, participants primarily demonstrated resilience and acceptance. They expressed appreciation and trust towards those who care for them. They wished to be recognised as unique and worthy humans, until the end of life.Relevance to clinical practiceThis study demonstrates capability and willingness of people with dementia to discuss the future and end‐of‐life topics. Public and professional awareness may facilitate opportunities for informal end‐of‐life discussions. Healthcare professionals should promote belongingness of persons with dementia and strive to build equal, trustful care relationships with them and their families.
Clear cell degeneration associated with endometriosis of abdominal wall after cesarean section: A case report and systematic review of literature
Authors: Ferrari Federico , Valenti Gaetano , Forte Sara , Ardighieri Laura , Iraci Sareri Marco , Barra Fabio , Sartori Enrico , Odicino Franco 
Published: January 2021

AbstractAimThe scar of cesarean section (CS) is the most common site of abdominal wall endometriosis (AWE), whose tumor degeneration has been reported in an increasing number of cases; the most frequent histological type is clear cell carcinoma (CCC).MethodsWe conducted a systematic research of the literature, collecting data regarding the evidence on tumor degeneration from AWE after CS. Moreover, we reported a case of clear cell borderline tumor (CCBT) originating from AWE.ResultsWe included data of 37 patients with diagnosis of CCC. The average time between the last CS and the diagnosis of CCC was around 15 years. Overall, 26.0% and 73.9% patients received exclusive local abdominal resection of the lesion and additional surgery, respectively. Lymph nodes involvement was detected in 26.0 % patients and adjuvant chemotherapy was administered in 52.0 % cases. During follow‐up period, 15.2% patients died of disease, 32.6% had no evidence of disease, and 17.4% recurred. We diagnosed a CCBT arose in a patients with AWE and a personal history of several surgical procedures for endometriosis, a CS and a subsequent transverse laparotomy. We performed an open bilateral ovariectomy and a large excision of the endometriotic abdominal lesion.ConclusionTumor degeneration from AWE seems to be a real occurrence with an increasing number of events. Considering the lack of risk factors and diagnostic instruments for tumor degeneration, the removal of AWE localization could be advisable, even though there was long average time between the trigger surgery and the tumor finding.
Disrupted nocturnal melatonin in autism: Association with tumor necrosis factor and sleep disturbances
Authors: da Silveira Cruz‐Machado Sanseray , Guissoni Campos Leila Maria , Fadini Cintia Cristina , Anderson George , Markus Regina P. , Pinato Luciana 
Published: January 2021

AbstractSleep disturbances, abnormal melatonin secretion, and increased inflammation are aspects of autism spectrum disorder (ASD) pathophysiology. The present study evaluated the daily urinary 6‐sulfatoxymelatonin (aMT6s) excretion profile and the salivary levels of tumor necrosis factor (TNF) and interleukin‐6 (IL‐6) in 20 controls and 20 ASD participants, as well as correlating these measures with sleep disturbances. Although 60% of ASD participants showed a significant night‐time rise in aMT6s excretion, this rise was significantly attenuated, compared to controls (P < .05). The remaining 40% of ASD individuals showed no significant increase in nocturnal aMT6s. ASD individuals showed higher nocturnal levels of saliva TNF, but not IL‐6. Dysfunction in the initiation and maintenance of sleep, as indicated by the Sleep Disturbance Scale for Children, correlated with night‐time aMT6s excretion (r = −.28, P < .05). Dysfunction in sleep breathing was inversely correlated with aMT6s (r = −.31, P < .05) and positively associated with TNF level (r = .42, P < .01). Overall such data indicate immune‐pineal axis activation, with elevated TNF but not IL‐6 levels associated with disrupted pineal melatonin release and sleep dysfunction in ASD. It is proposed that circadian dysregulation in ASD is intimately linked to heightened immune‐inflammatory activity. Such two‐way interactions of the immune‐pineal axis may underpin many aspects of ASD pathophysiology, including sleep disturbances, as well as cognitive and behavioral alterations.
CT characteristics of uterine and vaginal mesenchymal tumours in dogs
Authors: Barozzi M. C. M. , Saba C. F. , Gendron K. P. 
Published: January 2021

ObjectivesTo describe the CT characteristics of uterine and vaginal mesenchymal tumours in dogs and to discuss imaging findings of the tumour types encountered.Materials and MethodsRetrospective study on female dogs with confirmed histological diagnosis of uterine and vaginal mesenchymal tumours and available CT images.Results120 records obtained through a medical record search were manually evaluated for eligibility, and 11 dogs presenting masses associated with the genital tract were identified. Of these 11 dogs, 7 dogs met the inclusion criteria and were included in the study. A clear degree of overlap was present between measurements of maximal diameter of benign and malignant tumours; however, malignant neoplasms tended to occupy a larger portion of the pelvic canal. Objective measurements of length suggest that malignant tumours were longer than benign forms. Bone involvement was only observed with malignancy.Clinical SignificanceAlthough CT is likely to play a limited role in the advanced workup of uterine and vaginal mesenchymal neoplasms, CT may represent a more accessible diagnostic tool than MRI and results of this study may help imagers familiarise themselves with their appearances.
Missed linkage to care for patients who screened positive for Hepatitis C in a tertiary care centre: Results of the Telepass project
Authors: Ponziani Francesca Romana , Santopaolo Francesco , Siciliano Massimo , De Belvis Antonio Giulio , Tortora Annalisa , Mora Vincenzina , Fanali Caterina , Morsella Alisha , Balducci Fulvio , Vetrugno Giuseppe , D’Alfonso Maria Elena , Cambieri Andrea , Cauda Roberto , Bellantone Rocco , Sanguinetti Maurizio , Pompili Maurizio , Gasbarrini Antonio 
Published: January 2021

AbstractItaly is one of the countries on track with the WHO’s agenda to eliminate hepatitis C virus (HCV) by 2030. Healthcare facilities play a crucial role in seeking patients who are infected but have not yet been treated. We assessed the effectiveness of a recall strategy, named ‘Telepass’ project, for patients exposed to HCV infection who have not yet been linked to care in a large tertiary care centre. The ‘Telepass’ project was structured in two phases: (a) a retrospective analysis first identified all anti–HCV‐positive subjects among patients who underwent pre‐operative assessment in the facility in the course of one year; (b) a following prospective phase, aimed to recall patients in need either of further diagnostic tests (ie HCV‐RNA) or treatment. A total of 12246 records of patients tested for HCV antibodies were reviewed. The overall prevalence of anti–HCV‐positive subjects was 1.83% (224/12246) with a male/female ratio of 2.07. Out of the 224 anti–HCV‐positive patients, 123 (54.91%) did not have documented HCV‐RNA tests and were therefore selected for recall. Of these, 123 were reachable and 26 (21.13%) were successfully linked to care. Ten patients (38.46%) tested HCV‐RNA positive and initiated treatment with direct‐acting antivirals (DAAs). The Telepass study highlights that a recall strategy starting from internal hospital databases can help identify patients with chronic HCV infection who have not yet been linked to care, and provides an epidemiological insight into the prevalence of HCV infection in Italy in the late DAAs era.
Risk factors for difficult‐to‐treat hepatitis C virus genotype 4r in Rwanda and implications for elimination in sub‐Saharan Africa
Authors: Shumbusho Fabienne , Liu Anne F. , Kateera Fredrick , Kabahizi Jules , Nsanzaimana Sabin , Serumondo Janvier , Damascene Makuza Jean , Grant Philip M. , Musabeyezu Emmanuel , Muvunyi Claude , Gupta Neil 
Published: January 2021

AbstractIn sub‐Saharan Africa, there exist distinct HCV genotype (GT) subtypes harbouring resistance‐associated substitutions to commonly used non‐structural protein 5A (NS5A) inhibitor–based direct‐acting antiviral (DAA) regimens. In particular, GT4r subtype has demonstrated high rates of treatment failure. In the absence of routine viral sequencing in sub‐Saharan Africa, it is important to identify sociodemographic, epidemiologic, and clinical characteristics that may be associated with GT4r infection. Methods: A secondary analysis was performed on data from 300 adults with HCV GT4 enrolled in a prospective trial assessing the safety and efficacy of sofosbuvir‐ledipasvir in Rwanda in 2017. The association between characteristics at enrolment and GT subtype was assessed by chi‐square analysis and logistic regression. In multivariate analysis, there were a higher proportion of participants with GT4r subtype with age <40 years (OR: 3.6, 95% CI: 1.3–10.5, p = 0.02), previous hospitalization (OR: 2.5, 95% CI: 1.3–5.0, p = 0.006), previous surgery (OR: 2.2, 95% CI: 1.1–4.2, p = 0.03), cirrhosis (OR: 3.2, 95% CI: 1.3–7.5, p = 0.008) and baseline HCV RNA >1 million IU/ml (OR: 3.4, 95% CI: 1.6–6.9, p = 0.001). Rwandan adults with GT4r are more likely to be younger, have a history of hospital admissions and surgeries and have more active or advanced liver disease compared to those with other GT4 subtypes. In the absence of advanced diagnostics to assess GT subtype, patients with these characteristics may warrant closer monitoring for treatment failure or alternative DAA regimens. More treatment experience with diverse DAA regimens is urgently needed for GT subtypes particular to this region.
Visualization of brain microvasculature and blood flow in vivo: Feasibility study using confocal laser endomicroscopy
Authors: Belykh Evgenii , Zhao Xiaochun , Ngo Brandon , Farhadi Dara S. , Kindelin Adam , Ahmad Saif , Martirosyan Nikolay L. , Lawton Michael T. , Preul Mark C. 
Published: January 2021

AbstractObjectiveQualitative and quantitative analyses of blood flow in normal and pathologic brain and spinal cord microvasculature were performed using confocal laser endomicroscopy (CLE).MethodsBlood flow in cortical, dural, and spinal cord microvasculature was assessed in vivo in swine. We assessed microvasculature under normal conditions and after vessel occlusion, brain injury due to cold or surgical trauma, and cardiac arrest. Tumor‐associated microvasculature was assessed in vivo and ex vivo in 20 patients with gliomas.ResultsWe observed erythrocyte flow in vessels 5‐500 µm in diameter. Thrombosis, flow arrest and redistribution, flow velocity changes, agglutination, and cells rolling were assessed in normal and injured brain tissue. Microvasculature in in vivo CLE images of gliomas was classified as normal in 68% and abnormal in 32% of vessels on the basis of morphological appearance. Dural lymphatic channels were discriminated from blood vessels. Microvasculature CLE imaging was possible for up to 30 minutes after a 1 mg/kg intravenous dose of fluorescein.ConclusionsCLE imaging allows assessment of cerebral and tumor microvasculature and blood flow alterations with subcellular resolution intraoperative imaging demonstrating precise details of real‐time cell movements. Research and clinical scenarios may benefit from this novel intraoperative in vivo microscopic fluorescence imaging modality.
Novel Design of the Chimeric Deep Inferior Epigastric Artery Perforator Flap that Provides for Three‐Dimensional Reconstruction of Composite Tissue Defects of the Heel in Children
Authors: Yu Junyi , Luo Zhenhua , Wu Panfeng , Tang Juyu 
Published: January 2021

ObjectiveThe aim of the present study was to report a novel design of the chimeric deep inferior epigastric artery perforator flap (DIEP) to achieve dead space filling, Achilles tendon bridging, and skin resurfacing simultaneously with minimal donor‐site morbidity.MethodsFrom September 2012 to May 2016, a retrospective study was carried out on six pediatric patients with composite soft tissue defects of the heel that were repaired with the chimeric DIEP flap. The chimeric flap design included a flap of the anterior sheath of the rectus, a block of rectus muscle, and a large skin paddle. All the parts were supplied by a common artery. After harvesting the flap, all element parts were inserted at the corresponding sites in a tension‐free manner. With one set of vessel anastomoses at the recipient site, accurate repair with tendon reconstruction, dead space elimination, and wound covering were accomplished. The donor site incisions were closed initially. Data on patient age, medical history, injury severity, defect size, flap dimensions, recipient vessels, donor site closure, complications, and follow‐up were collected and reviewed.ResultsFive of the six chimeric DIEP flaps survived without complications. The remaining one case experienced partial necrosis of the skin paddle caused by venous congestion, which healed after routine dressing changes. Primary donor site closure was accomplished in all cases. The mean follow‐up was 18.6 months (range, 10–36 months). Five patients had satisfactory aesthetic and functional outcomes; one patient needed a secondary debulking procedure. Compared to the unaffected side, the affected side showed no obvious difference for ankle movement, tiptoe function, and patient gait during the follow‐up period. Good ankle function was observed in all patients. There was no donor site breakdown, with only a slightly noticeable linear scar.ConclusionThe chimeric DIEP flap reduced the operative time, solved the problem of deficiency of recipient vessels, and attained satisfactory functional and aesthetic outcomes with low donor site morbidity. Therefore, it is a promising option for three‐dimensional reconstruction of composite defects with dead space and Achilles tendon defects as well as skin loss in children.
Risk‐Stratified Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty: Low Molecular Weight Heparins and Sequential Aspirin vs Aggressive Chemoprophylaxis
Authors: Peng Hui‐ming , Chen Xi , Wang Yi‐ou , Bian Yan‐yan , Feng Bin , Wang Wei , Weng Xi‐sheng , Qian Wen‐wei 
Published: January 2021

ObjectiveVenous thromboembolism (VTE) is a significant concern post total joint arthroplasty (TJA). However, the optimal prevention method of VTE remains controversial at present. This study aims to evaluate a risk‐stratified VTE prophylaxis protocol for patients undergoing TJA.MethodsA total of 891 TJA patients from January 2011 to November 2019 were retrospectively investigated. The study was divided into two cohorts. In cohort 1, 410 patients (250 females and 160 males, mean age 64.32 years) were treated with an aggressive VTE chemoprophylaxis protocol. In cohort 2, 481 patients were treated with a risk‐stratified protocol that utilized low molecular weight heparins (LMWH) and sequential aspirin (ASA) for standard‐risk patients (a total of 288 containing 177 females and 111 males, mean age 65.4 years), and targeted anticoagulation for high‐risk patients (a total of 193 containing 121 females and 72 males, mean age 66.8 years). The patients were followed up at 2–4 weeks for an initial visit and at 6–10 weeks for a subsequent visit after surgery. A chart review of all patient medical records was performed to record the demographics, comorbidities, deep vein thrombosis, pulmonary embolus, superficial infection, deep infection, bleeding complications, and 90‐day readmissions.ResultsThe VTE rate was 1.71% (7/410) in cohort 1 and 1.46% (7/481) in cohort 2 respectively. For cohort 2, the VTE rate was 2.07% (4/193) in high‐risk group and 1.04% (3/288) in standard‐risk group. The readmission rate was 2.44% (10/410) in cohort 1 and 2.08% (10/481) in cohort 2. For cohort 2, the readmission rate was 2.07% (4/193) in high‐risk group and 2.08% (6/288) in standard‐risk group. The reasons for readmission were as follows: infection, 1.3% (5/410) in cohort 1 and 1.3% (6/481) in cohort 2; wound or bleeding complications, 0.48% (2/410) in cohort 1 and 0.2% (1/481) in cohort 2; trauma, 0.2% (1/410) in cohort 1 and 0.2% (1/481) in cohort 2; VTE, 0.2% (1/410) in cohort 1 and 0.2% (1/481) in cohort 2; others, 0.2% (1/410) in cohort 1 and 0.6% (3/481) in cohort 2. There was a decrease in VTE events and readmissions in the risk‐stratified cohort, although this did not reach statistical significance. However, it was found that there was a significant reduction in costs (P < 0.001) with the use of LMWH/ASA, when compared with aggressive anticoagulation agents in the risk‐stratified cohort.ConclusionThe use of LMWH/ASA in a risk‐stratified TJA population is a safe and cost‐effective method of VTE prophylaxis.
Guide for diagnosis and treatment of hyperphenylalaninemia
Authors: Shintaku Haruo , Ohura Toshihiro , Takayanagi Masaki , Kure Shigeo , Owada Misao , Matsubara Yoichi , Yoshino Makoto , Okano Yoshiyuki , Ito Tetsuya , Okuyama Torayuki , Nakamura Kimitoshi , Matuo Masafumi , Endo Fumio , Ida Hiroyuki 
Published: January 2021

AbstractImportanceSapropterin hydrochloride, a natural coenzyme (6R‐tetrahydrobiopterin) of phenylalanine hydroxylase, was first approved as a treatment for tetrahydrobiopterin deficiency in 1992 in Japan, and was then approved as a treatment for a tetrahydrobiopterin‐responsive hyperphenylalaninemia in 2007 and 2008, in the USA and Japan, respectively. Guidelines are required on the proper use of sapropterin hydrochloride for tetrahydrobiopterin‐responsive hyperphenylalaninemia.ObservationsIt is recommended that tetrahydrobiopterin‐responsive hyperphenylalaninemia should be diagnosed in all cases of hyperphenylalaninemia, including phenylketonuria, by tetrahydrobiopterin administration tests rather than by phenotype or blood phenylalanine levels.Conclusions and RelevanceIf tetrahydrobiopterin‐responsive hyperphenylalaninemia is diagnosed, all ages can be treated with sapropterin hydrochloride. Although there are reports that sapropterin hydrochloride is effective and safe for the prevention of maternal phenylketonuria, further investigation is required.