bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective feasibility study of indigo naturalis ointment for chemotherapy-induced oral mucositis
Authors: Hirata Kenro , Yamada Yuka , Hamamoto Yasuo , Tsunoda Kazuyuki , Muramatsu Hiroshi , Horie Sara , Sukawa Yasutaka , Naganuma Makoto , Nakagawa Taneaki , Kanai Takanori 
Published: October 2021

ObjectivesIndigo naturalis, a herbal medicine effective against ulcerative colitis, exhibits anti-inflammatory effects and induces interleukin-22-mediated antimicrobial peptide production. Anti-inflammatory activity and the prevention of secondary infection are essential for the management of chemotherapy-induced oral mucositis (CIOM); therefore, we developed an indigo naturalis ointment to be administered topically for CIOM and evaluated its feasibility.MethodsWe performed a single-centre, open-label, prospective feasibility study from March 2017 to December 2018. The key eligibility criteria for the subjects were as follows: (1) receiving chemotherapy for a malignant tumour; (2) grade 1 or 2 CIOM and (3) receiving continuous oral care. The treatment protocol comprised topical indigo naturalis ointment application three times a day for 7 days. The primary endpoint assessed was feasibility. The secondary endpoints assessed were the changes in oral findings, oral cavity pain and safety.ResultsNineteen patients with CIOM were enrolled. The average feasibility (the proportion of prescribed applications that were carried out) observed in this study was 94.7%±8.9% (95% CI 90.5% to 99.0%), which was higher than the expected feasibility. The revised oral assessment guide scores of the mucous membrane domain and total scores were significantly improved. All patients reported a reduction in oral cavity pain, with a median pain resolution duration of 6 days. No serious adverse events were observed.ConclusionsThe indigo naturalis ointment was feasible, and showed the potential for efficacy and safety. Larger randomised controlled trials are needed to further assess the efficacy and safety of indigo naturalis compared with a placebo.Trial registration numberUMIN000024271.
Three Year Review Following Bone Anchor Repair of Acute Biceps Tendon Insertion Rupture
Authors: Hand C J , Howell G E D 
Published: October 2021

AbstractThree patients with acute biceps brachii tendon insertion ruptures were treated (less than 7 days post injury) using bone anchor anatomical repair. Dynamometer assessment of strength in both limbs was performed after completion of rehabilitation and again at 3.3 years after surgery.All patients were male, age 34, 35 and 53 years. Early isokinetic assessment was performed at 6, 7 and 12 months post surgery and medium assessment at 3.3 years post surgery. A full range of movement was achieved at early assessment and maintained into medium term assessment. All patients returned to their full premorbid occupation and sporting activity. Dynamometer strength of a repaired dominant limb equated to two thirds of a normal non dominant limb at early assessment, equal power was found at medium term assessment and a measurable increase in strength in both affected and unaffected arms was seen.
Lisfranc Injury - Surgical Fixation Facilities An Early Return To Work
Authors: Brinsden M D , Smith S R , Loxdale P H 
Published: October 2021

AbstractBackgroundLisfranc injury is rare and the diagnosis maybe easily missed. This study reviews the experience of a single centre.MethodsA prospective review of patients with Lisfranc injuries presenting to a single surgeon with a specialist interest in foot and ankle surgery over a one year period.ResultsFive patients were identified-four men and one woman with a median age of 31 years (range 22-50 years). Presentation was a mean of 25 days after injury (range 3-56 days). The left foot was affected in three cases and the right in two. There was joint diastasis in four patients and fracture-dislocation in one. Three patients presented early and were treated by internal fixation and two presented late and were managed conservatively. Mean follow-up was eight months (range 4.5-12 months). Surgery resulted in a return to work by 6 months with no symptoms. The two patients managed conservatively continued to experience pain at 12 months and were unable to return to their original occupations.ConclusionInjury to the Lisfranc joint should be excluded in any foot injury. Early diagnosis and internal fixation appears to result in an earlier return to work when compared to nonoperative management.
Endogenous Retroelements and the Viral Mimicry Response in Cancer Therapy and Cellular Homeostasis
Authors: Chen Raymond , Ishak Charles A. , De Carvalho Daniel D. 
Published: October 2021

AbstractFeatures of the cancer epigenome distinguish cancers from their respective cell of origin and establish therapeutic vulnerabilities that can be exploited through pharmacologic inhibition of DNA- or histone-modifying enzymes. Epigenetic therapies converge with cancer immunotherapies through “viral mimicry,” a cellular state of active antiviral response triggered by endogenous nucleic acids often derived from aberrantly transcribed endogenous retrotransposons. This review describes the initial characterization and expansion of viral mimicry–inducing approaches as well as features that “prime” cancers for viral mimicry induction. Increased understanding of viral mimicry in therapeutic contexts suggests potential physiologic roles in cellular homeostasis.Significance:Recent literature establishes elevated cytosolic double strand RNA (dsRNA) levels as a cancer-specific therapeutic vulnerability that can be elevated by viral mimicry–inducing therapies beyond tolerable thresholds to induce antiviral signaling and increase dependence on dsRNA stress responses mediated by ADAR1. Improved understanding of viral mimicry signaling and tolerance mechanisms reveals synergistic treatment combinations with epigenetic therapies that include inhibition of BCL2, ADAR1, and immune checkpoint blockade. Further characterization of viral mimicry tolerance may identify contexts that maximize efficacy of conventional cancer therapies.
Redox Regulation in Cancer Cells during Metastasis
Authors: Tasdogan Alpaslan , Ubellacker Jessalyn M. , Morrison Sean J. 
Published: October 2021

Abstract

Metastasis is an inefficient process in which the vast majority of cancer cells are fated to die, partly because they experience oxidative stress. Metastasizing cancer cells migrate through diverse environments that differ dramatically from their tumor of origin, leading to redox imbalances. The rare metastasizing cells that survive undergo reversible metabolic changes that confer oxidative stress resistance. We review the changes in redox regulation that cancer cells undergo during metastasis. By better understanding these mechanisms, it may be possible to develop pro-oxidant therapies that block disease progression by exacerbating oxidative stress in cancer cells.

Significance:
Oxidative stress often limits cancer cell survival during metastasis, raising the possibility of inhibiting cancer progression with pro-oxidant therapies. This is the opposite strategy of treating patients with antioxidants, an approach that worsened outcomes in large clinical trials.
HDL (High-Density Lipoprotein) Subspecies, Prevalent Covert Brain Infarcts, and Incident Overt Ischemic Stroke: Cardiovascular Health Study
Authors: Koch Manja , Aroner Sarah A. , Fitzpatrick Annette L. , Longstreth W.T. , Furtado Jeremy D. , Mukamal Kenneth J. , Jensen Majken K. 
Published: October 2021

Background:
Whether HDL (high-density lipoprotein) is associated with risk of vascular brain injury is unclear. HDL is comprised of many apo (apolipoprotein) species, creating distinct subtypes of HDL.

Methods:
We utilized sandwich ELISA to determine HDL subspecies from plasma collected in 1998/1999 from 2001 CHS (Cardiovascular Health Study) participants (mean age, 80 years).

Results:
In cross-sectional analyses, participants with higher apoA1 in plasma and lower apoE in HDL were less likely to have prevalent covert magnetic resonance imaging–defined infarcts: odds ratio for apoA1 Q4 versus Q1, 0.68 (95% CI, 0.50–0.93), and odds ratio for apoE Q4 versus Q1, 1.36 (95% CI, 1.01–1.84). Similarly, apoA1 in the subspecies of HDL that lacked apoC3, apoJ, or apoE was inversely related to covert infarcts, and apoE in the subspecies of HDL that lacked apoC3 or apoJ was directly related to covert infarcts in prospective analyses. In contrast, the concentrations of apoA1 and apoE in the complementary subspecies of HDL that contained these apos were unrelated to covert infarcts. Patterns of associations between incident overt ischemic stroke and apoA1, apoE, and apoA1 and apoE in subspecies of HDL were similar to those observed for covert infarcts but less pronounced.

Conclusions:
This study highlights HDL subspecies defined by apo content as relevant biomarkers of covert and overt vascular brain injury.
The distribution and biogeography of slow worms (Anguis, Squamata) across the Western Palearctic, with an emphasis on secondary contact zones
Authors: Jablonski Daniel , Sillero Neftalí , Oskyrko Oleksandra , Bellati Adriana , Čeirāns Andris , Cheylan Marc , Cogălniceanu Dan , Crnobrnja-Isailović Jelka , Crochet Pierre-André , Crottini Angelica , Doronin Igor , Džukić Georg , Geniez Philippe , Ilgaz Çetin , Iosif Ruben , Jandzik David , Jelić Dušan , Litvinchuk Spartak , Ljubisavljević Katarina , Lymberakis Petros , Mikulíček Peter , Mizsei Edvárd , Moravec Jiří , Najbar Bartłomiej , Pabijan Maciej , Pupins Mihails , Sourrouille Patricia , Strachinis Ilias , Szabolcs Márton , Thanou Evanthia , Tzoras Elias , Vergilov Vladislav , Vörös Judit , Gvoždík Václav 
Published: October 2021

Abstract
The slow-worm lizards (Anguis) comprise five species occurring throughout most of the Western Palearctic. Although these species are relatively uniform morphologically – with the exception of A. cephallonica, which exhibits a quite unique morphology – they are genetically deeply divergent. Here, we provide detailed distribution maps for each species and discuss their biogeography and conservation based on updated genetic data and a robust distribution database. We pay particular attention to the so called ‘grey zone’, which typically represents secondary contact zones and in some cases confirmed or presumed hybrid zones. Four of the five species live in parapatry, while only two species, A. cephallonica and A. graeca from the southern Balkans occur in partial sympatry. Further research should focus on the eco-evolutionary interactions between species in contact, including their hybridization rates, to reveal deeper details of the slow-worm evolutionary and natural history.
General Surgery Resident Operative Experiences in Solid Organ Injury: An Examination of Case Logs
Authors: Nordin Andrew B. , Wach Michael M. , Jalal Kabir , Cooper Clairice A. , Jordan Jeffrey M. 
Published: October 2021

Background Non-operative management (NOM) of traumatic solid organ injury (SOI) has become commonplace. This paradigm shift, along with reduced resident work hours, has significantly impacted surgical residents’ operative trauma experiences. We examined ongoing changes in residents’ operative SOI experience since duty hour restriction implementation, and assessed whether missed operative experiences were gained elsewhere in the resident experience. Methods We examined data from American College of Graduate Medical Education case log reports from 2003 to 2018. We collected mean case volumes in the categories of non-operative trauma, trauma laparotomy, and splenic, hepatic, and pancreatic trauma operations; case volumes for comparable non-traumatic solid organ operations were also collected. Solid organ injury operative volumes were compared against non-traumatic cases, and change over time was analyzed. Results Over the study period, both trauma laparotomies and non-operative traumas increased significantly ( P < .001). In contrast, operative volumes for splenic, hepatic, and pancreatic trauma all significantly decreased ( P < .001; P = .014; P < .001, respectively). Non-traumatic spleen cases also significantly decreased ( P < .001), but liver cases and distal pancreatectomies increased ( P < .001; P = .017). Pancreaticoduodenectomies increased, albeit not to a significant degree ( P = .052). Conclusions Continuing increases in NOM of SOI correlate with declining resident experience with operative solid organ trauma. These decreases can adversely affect residents’ technical skills and decision-making, although trends in specific non-traumatic areas may help to mitigate such losses. Further work should determine the impact of these trends on resident competence and autonomy.
Catastrophic Health Expenditure before and after of the Implementation of Health Sector Evolution Plan in Iran
Authors: Ahmadi Razieh , Shafiei Milad , Ameri Hosein , Askari Roohollah , Fallahzadeh Hossein 
Published: October 2021

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods: Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results: The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.
Quantifying image quality in chest computed tomography angiography: Evaluation of different contrast-to-noise ratio measurement methods
Authors: Chatzaraki Vasiliki , Kubik-Huch Rahel A , Thali Michael , Niemann Tilo 
Published: October 2021

Background Contrast-to-noise ratio is used to objectively evaluate image quality in chest computed tomography angiography (CTA). Different authors define and measure contrast-to-noise ratio using different methods. Purpose To summarize and evaluate the different contrast-to-noise ratio calculation formulas in the current literature. Material and Methods A systematic review of the recent literature for studies using contrast-to-noise ratio was performed. Contrast-to-noise ratio measurement methods reported by the different authors were recorded and reproduced in three patients who underwent chest CTA in our department for exploring variations among the different measurement methods. Results The search resulted in 109 articles, of which 26 were included. The studies involved 69 different measurements and overall, three different formula patterns. In all three, aorta and pulmonary arteries comprised the objects of interest in the numerator. In the denominator, standard deviation of the attenuation of the object of interest itself or of another background were used to reflect image noise. Some authors averaged the ratio values at different levels to obtain global ratio values. Using the object of interest itself for image noise calculation in the denominator compared to the usage of another background caused the most prominent variances of contrast-to-noise ratio between the two different protocols used for the reproduction of the measurements. Conclusion We recommend using the standard deviation of the attenuation of a background indicator as image noise rather than the object of interest itself for more reliable and comparative values. Global contrast-to-noise ratios based on averaging the values of different measurement levels should be avoided.
Aldehyde dehydrogenase 1 (ALDH1) immunostaining in axillary lymph node metastases is an independent prognostic factor in ALDH1-positive breast cancer
Authors: Guan Xin , Dong Yi , Fan Zhimin , Zhan Yue , Xie Xinpeng , Xu Gege , Zhang Yu , Guo Guoqiang , Shi Aiping 
Published: October 2021

Objective To determine whether aldehyde dehydrogenase 1 (ALDH1) immunostaining in axillary lymph node metastases in patients with breast cancer is associated with poor clinical prognosis. Methods This retrospective study reviewed data from the medical records of patients with immunohistochemistry-confirmed invasive ductal carcinoma (IDC) and 1–3 metastatic lymph nodes in the ipsilateral axilla between December 2012 and July 2015. The association between ALDH1 immunostaining in axillary lymph node metastases and clinical parameters and prognosis was analysed using χ2-test, Kaplan–Meier survival analysis, univariate and multivariate Cox regression analyses. Results A total of 229 patients with IDC were enrolled in the study. The median follow-up was 61 months (range, 20–89 months). Patients with ALDH1-positive axillary lymph node metastases had significantly shorter relapse-free survival and overall survival compared with those with ALDH1-negative axillary lymph node metastases. ALDH1 immunostaining in axillary lymph node metastases was a significant predictor of poor prognosis in univariate and multivariate analyses. Conclusion This large study with long-term follow-up suggests that ALDH1 immunostaining in axillary lymph node metastases is an independent predictor of poor prognosis in patients with breast cancer. The clinical relevance of this finding should be confirmed in further well-designed prospective studies.
Adipose-Derived Stem Cell Sheets Improve Early Biomechanical Graft Strength in Rabbits After Anterior Cruciate Ligament Reconstruction
Authors: Matsumoto Tatsuaki , Sato Yuiko , Kobayashi Tami , Suzuki Kunika , Kimura Atsushi , Soma Tomoya , Ito Eri , Kikuchi Toshiyuki , Kobayashi Shu , Harato Kengo , Niki Yasuo , Matsumoto Morio , Nakamura Masaya , Miyamoto Takeshi 
Published: October 2021

Background: Although various reconstruction techniques are available for anterior cruciate ligament (ACL) injuries, a long recovery time is required before patients return to sports activities, as the reconstructed ACL requires time to regain strength. To date, several studies have reported use of mesenchymal stem cells in orthopaedic surgery; however, no studies have used adipose-derived stem cell (ADSC) sheets in ACL reconstruction (ACLR). Hypothesis: ADSC sheet transplantation can improve biomechanical strength of the autograft used in ACLR. Study Design: Controlled laboratory study. Methods: A total of 68 healthy Japanese white rabbits underwent unilateral ACLR with a semitendinosus tendon autograft after random enrollment into a control group (no sheet; n = 34) and a sheet group (ADSC sheet; n = 34). At 2, 4, 8, 16, and 24 weeks after surgery, rabbits in each group were sacrificed to evaluate tendon-bone healing using histological staining, micro–computed tomography, and biomechanical testing. At 24 weeks, scanning transmission electron microscopy of the graft midsubstance was performed. Results: The ultimate failure load for the control and sheet groups, respectively, was as follows: 17.2 ± 5.5 versus 37.3 ± 10.3 ( P = .01) at 2 weeks, 28.6 ± 1.9 versus 47.4 ± 10.4 ( P = .003) at 4 weeks, 53.0 ± 14.3 versus 48.1 ± 9.3 ( P = .59) at 8 weeks, 66.2 ± 9.3 versus 95.2 ± 43.1 ( P = .24) at 16 weeks, and 66.7 ± 27.3 versus 85.3 ± 29.5 ( P = .39) at 24 weeks. The histological score was also significantly higher in the sheet group compared with the control group at early stages up to 8 weeks. On micro–computed tomography, relative to the control group, the bone tunnel area was significantly narrower in the sheet group at 4 weeks, and the bone volume/tissue volume of the tendon-bone interface was significantly greater at 24 weeks. Scanning transmission electron microscopy at 24 weeks indicated that the mean collagen fiber diameter in the midsubstance was significantly greater, as was the occupation ratio of collagen fibers per field of view, in the sheet group. Conclusion: ADSC sheets improved biomechanical strength, prevented bone tunnel enlargement, and promoted tendon-bone interface healing and graft midsubstance healing in an in vivo rabbit model. Clinical Relevance: ADSC sheets may be useful for early tendon-bone healing and graft maturation in ACLR.
Continuous Flow Peritoneal Dialysis: Assessment of Fluid and Solute Removal in a High-Flow Model of “Fresh Dialysate Single Pass”
Authors: Freida Philippe , Issad Belkacem 
Published: October 2021

♦ Background Growing concern over the limited capacity of the peritoneal dialysis (PD) system has revived interest in continuous flow peritoneal dialysis (CFPD), a modality in which continuous circulation of PD fluid is maintained at a high flow rate using two separate catheters or one dual-lumen catheter. The CFPD regimen contrasts the “inflow/outflow” regimen, which requires specific times devoted to filling and draining the peritoneum via a single-lumen catheter. Historical data established CFPD capabilities in providing higher solute clearance and ultrafiltration rate (UFR) using either an open loop system with a single pass of fresh PD fluid, or various external purifications of the spent dialysate. ♦ Objective To compare, in patients with various peritoneal transport patterns, fluid and solute removal achieved during a standardized program of CFPD versus two control schedules: nightly intermittent peritoneal dialysis (NIPD) and nightly tidal peritoneal dialysis (NTPD). This study focused on small solute clearances and UFR using only isotonic PD solution (Dianeal PD1 1.36%; Baxter Healthcare, Castlebar, Ireland). The model of fresh dialysate, single pass, was used to optimize solute gradients and to characterize the impact of a continuous flow regimen on peritoneal transport characteristics. ♦ Methods In a crossover trial, 4-hour CFPD sessions were performed at a fixed dialysate flow rate (100 mL/minute) in 5 patients being treated with automated PD. A hemofiltration monitor (BM25; Baxter Healthcare, Brussels, Belgium) was adapted to the CFPD technique. The peritoneal cavity was filled through a temporary second catheter and simultaneously drained using the permanent peritoneal access. Fluid and solute removal were compared to data obtained from a control period based on 8-hour sessions of NIPD or NTPD using 13 L of isotonic dialysate. ♦ Results High-flow CFPD enhanced the diffusive transport coefficient compared with the alternative flow regimen in patients ranging from low to high transporters. Weekly creatinine clearance increased from 36.9 L (22.3 – 49.6 L) and 37.3 L (27.5 – 45.0 L) with NIPD and NTPD respectively, to 74.9 L (42.3–107.5 L) with CFPD. Mean UFR was 2.44 mL/min with CFPD versus 0.92 and 0.89 mL/min with NIPD and NTPD respectively. The mass transfer area coefficient (MTAC) of creatinine with CFPD was 2.5-fold that obtained from the peritoneal equilibration test data. ♦ Conclusion Our results confirm that CFPD is highly effective in increasing fluid and solute removal. Furthermore, consistent with historical data, our findings indicate that the enhanced solute transfer is not due only to steeper solute gradients, but also depends on increased MTAC in a wide range of peritoneum transport characteristics.