bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Survey of Topical Cannabis Use in Canada
Authors: Mahmood Farhan , Lim Megan M. , Kirchhof Mark G. 
Published: November 2021

Background Since its legalization in Canada, cannabis use has expanded to include commercially available topical formations. Several scientifically unsupported claims regarding the therapeutic efficacy of topical cannabis are also being made. Developing an understanding of the consumer uses of topical cannabis is important for clinicians to provide appropriate counseling and inform potential areas of therapeutic development. We are examining the prevalence, purpose of use, and sources of information regarding topical cannabis in the Canadian population, with a focus on dermatologic uses. Method A cross-sectional, anonymous electronic, voluntary survey was developed to assess the use of topical cannabis amongst adults in Canada. Results Cannabis was used topically at least once by 24.3% of respondents who started the survey. The commonest form of topical cannabis were creams (26.2%). The most common dermatologic conditions being treated with topical cannabis included atopic dermatitis (25%), acne (19%), and anti-aging (16%); for non-dermatologic conditions, common uses were for joint stiffness or tendonitis (30%) and headaches and migraines (27%). Topical cannabis was reported to be most effective for joint stiffness and tendonitis, general muscular soreness, headaches, eczema, pruritus, acne, and psoriasis. Most respondents obtained and received information about topical cannabis from dispensaries. Conclusion Canadians use topical cannabis for a broad range of systemic and dermatologic purposes, most of which have limited evidence. Future clinical studies are required to elucidate the therapeutic efficacy and safety of topical cannabis. Dermatologists should screen their patients for topical cannabis use and be aware of the limited evidence of therapeutic potential.
Comparison of the Outcomes of Total Endovascular Aortic Arch Repair Between Branched Endograft and Chimney Endograft Technique in Zone 0 Landing
Authors: Kudo Tomoaki , Kuratani Toru , Shirakawa Yukitoshi , Shimamura Kazuo , Kin Keiwa , Sakamoto Tomohiko , Shijo Takayuki , Watanabe Yoshiki , Masada Kenta , Sakaniwa Ryoto , Sawa Yoshiki 
Published: November 2021

Purpose: Zone 0 landing in thoracic endovascular aortic repair (TEVAR) has recently gained increasing attention for the treatment of high-risk patients. The aim of this study was to compare the outcomes of total endovascular aortic arch repair between branched TEVAR (bTEVAR) and chimney TEVAR (cTEVAR) in the landing zone (LZ) 0. Materials and Methods: This was a single-center, retrospective, and observational cohort study. From January 2010 to March 2020, 40 patients (bTEVAR, n=25; cTEVAR, n=15; median age: 79 years) were enrolled in this study, with a median follow-up period of 4.1 years. These patients were considered unsuitable for open surgical treatment. Results: All procedures were successful and no cases of conversion to open repair were noted during the 30-day postoperative period. The 30-day mortality was 2.5% (n=1; bTEVAR [0 of 25, 0%] vs cTEVAR [1 of 15, 6.7%]; p=0.375), the perioperative stroke rate was 10.0% (n=4; bTEVAR [4 of 25, 16.0%] vs cTEVAR [0 of 15, 0%], p=0.278), and type 1a endoleak rate was 15.0% (n=6; bTEVAR [0 of 25, 0%] vs cTEVAR [6 of 15, 40.0%], p=0.001). The risk factor for stroke was atheroma grade of ≥2 in the brachiocephalic artery (p<0.001). The risk factor for type 1a endoleak was cTEVAR (p=0.001). The 8-year survival rate was 49.9%. The aorta-related death-free rate and aortic event-free rate at 8 years were 94.4% (bTEVAR: 95.5% vs cTEVAR: 93.3%, p=0.504) and 60.7% (bTEVAR: 70.7% vs cTEVAR: 40.0%, p=0.048), respectively. Conclusions: Total endovascular aortic arch repair using bTEVAR and cTEVAR is feasible for the treatment of aortic arch diseases in high-risk patients who are unsuitable for open surgery. However, as the rate of stroke is high, strict preoperative evaluation to prevent stroke is needed. No rupture of the aneurysm was observed in cTEVAR, but patients should be selected carefully because of the high incidence of type 1a endoleak.
Celastrus orbiculatus Extract Reduces Stemness of Gastric Cancer Stem Cells by Targeting PDCD4 and EIF3H
Authors: Zhu Yao-dong , Ba He , Chen Jie , Zhang Mei , Li Ping 
Published: November 2021

Background Celastrus orbiculatus ethyl acetate extract (COE) has shown a strong anti-gastric cancer effect, but the understanding of its mechanism is still lacking. The results of previous studies indicated that COE may be able to inhibit the stemness of gastric cancer stem cells (GCSCs) by regulating PDCD4 and EIF3H expression. Aims To explore if COE could inhibit the stemness of GCSCs by regulating PDCD4 and EIF3H expression in vitro and in vivo. Procedure The GCSCs model was established by stem cell-conditioned culture. Spheroid formation and flow cytometry assays were used to detect the effect of COE on the spheroid formation ability of GCSCs and the percentage of CD44+/CD24+ and ALDH+ cell subpopulations. Western blot analysis was applied to measure the expression of GCSCs biomarkers (Nanog, Oct-4, and SOX-2), PDCD4, and EIF3H in GCSCs treated with COE; and RT-PCR was performed to investigate the effect of COE on PDCD4 mRNA expression in GCSCs. An in vivo tumorigenicity experiment was also conducted to evaluate the effect of COE on tumor-initiating ability of GCSCs in vivo; and the expression of PDCD4 and EIF3H in xenograft tissues was examined by immunohistochemistry (IHC) staining. Results After culture in stem cell-conditioned medium, SGC7901 cells manifested significantly enhanced spheroid formation ability, upregulated Nanog, Oct-4, and SOX-2 expression and increased percentages of CD44+/CD24+ and ALDH+ cell subpopulations, indicating successful establishment of the GCSCs model. COE treatment significantly inhibited the spheroid formation ability of GCSCs and reduced the percentage of CD44+/CD24+ and ALDH+ cell subpopulations. The western blot analysis showed a significant decrease of Nanog, Oct-4, SOX-2, and EIF3H expression and an increase of PDCD4 expression in GCSCs after COE treatment in a concentration-dependent manner. COE treatment also significantly upregulated the mRNA expression of PDCD4 in GCSCs. In addition, COE displayed a strong inhibitory effect on the tumor-initiating ability of GCSCs in vivo and upregulated PDCD4 and downregulated EIF3H expression in xenograft tissues. Conclusion COE may be able to inhibit GC growth by suppressing the stemness of GCSCs via regulating PDCD4 and EIF3H expression.
Comparison between menstrual cups: first step to categorization and improved safety
Authors: Manley Hannah , Hunt John A , Santos Lívia , Breedon Philip 
Published: November 2021

Objectives: Menstrual cups come in a range of shapes, sizes, and firmnesses, but unlike tampons are not categorized in any way. With these factors having an impact on product leaks and comfort, as well as being linked to illness and injury, women need the same level of transparency when purchasing a menstrual cup. The comparison of physical and mechanical properties of menstrual cups will be the first step to achieve this. Methods: In October 2020, 14 popular and highly rated menstrual cups underwent quantitative comparison in laboratory settings (the United Kingdom), and they were compared in terms of their dimensions, volume, and compressive strength (firmness) using the Instron Universal Testing System. The overall designs were compared including shape, material, and features. Results: Although all the products in this comparison were marketed to women below 30 years of age having never given birth, total volume varied from 18.88 mL to 38.14 mL, and compressive load to compress the menstrual cup 50% (±0.5%) maximum diameter varied from 3.39 N to 13.92 N. Conclusions: Women are not sufficiently informed when choosing a menstrual cup. With no correlation between menstrual cup size, shape, and its volume, or material, shape, and its firmness, consumers cannot estimate which menstrual cup might be most suitable, and incorrect choice could cause injury. Transparency is needed across menstrual cup brands. With this and further regulation, women will make an informed decision to choose the correct menstrual cup and minimize injury. This work recommends firmness categories, ranging from ‘very soft’ to ‘very firm’ as a first step.
Liposomal irinotecan pre-emptive dose reduction in patients with pancreatic ductal adenocarcinoma: 667 patients’ experience within a population-based study
Authors: Chiu Tai-Jan , Su Yung-Yeh , Yang Shih-Hung , Li Chung-Pin , Bai Li-Yuan , Chiang Nai-Jung , Chuang Shih-Chang , Shan Yan-Shen , Chan De-Chuan , Chen Li-Tzong , Yen Chia-Jui , Peng Cheng-Ming , Chen Yen-Yang , Chen Jen-Shi , Chou Wen-Chi 
Published: November 2021

Background: Liposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (5-FU/LV) is currently the standard second-line treatment for patients with pancreatic ductal adenocarcinoma (PDAC) after previous failed gemcitabine-based therapy. This population-based study aimed to evaluate the efficacy and safety of nal-IRI + 5-FU/LV and the association of pre-emptive nal-IRI dosing with treatment outcomes in patients with PDAC. Methods: We retrospectively enrolled a total of 667 consecutive patients with PDAC who received nal-IRI plus 5-FU/LV treatment between August 2018 and November 2020 at 9 medical centers in Taiwan. Patients were allocated into groups according to pre-emptive nal-IRI dosing (⩾75%, 50–74%, <50%) for comparison of treatment efficacy and safety. Results: The median overall survival (OS) and time to treatment failure (TTF) were 5.9 months [95% confidence interval (CI), 5.3–6.5] and 2.8 months (95% CI, 2.6–3.0), respectively. The median OS was 6.5 months (95% CI, 5.7–6.7), 5.0 months (95% CI, 3.4–6.5), and 4.1 months (95% CI, 2.7–5.6), respectively, among the ⩾75%, 50–74%, and <50% pre-emptive nal-IRI dosing groups, whereas the median TTF of the three groups was 3.0 months (95% CI, 2.6–3.4), 2.6 months (95% CI, 2.3–2.9), and 1.9 months (95% CI, 1.6–2.2), respectively. Pre-emptive nal-IRI dosing <50% was an independent negative prognostic factor for OS and TTF in multivariate analyses. The most common severe adverse events were neutropenia (22.9%), anemia (21.1%), and hypokalemia (15.4%). Patients in the <50% pre-emptive nal-IRI dosing group had a significantly lower incidence of neutropenia and non-neutropenic infection than those in the other groups. Conclusion: Our results support the use of nal-IRI + 5-FU/LV as standard clinical practice for treating patients with PDAC based on this large population-based study. Our findings encourage physicians to provide adequate doses of nal-IRI in order to achieve better outcomes without compromising safety profiles.
How Frequently and for How Long Do Adults With Type 2 Diabetes Use Management Apps? The REALL Study
Authors: Fisher Lawrence , Fortmann Addie L. , Florissi Caterina , Stoner Keaton , Knaebel Jennifer , Stuhr Andreas 
Published: November 2021

Objective: The objective of the study is to identify predictors of utilization of a type 2 diabetes (T2D) management App over time for insulin users (IUs) and noninsulin users (NIUs). Research Design and Methods: We followed over 16 weeks a national sample of unselected T2D adults who independently elected to download and pair a CONTOUR DIABETES App with their CONTOUR NEXT ONE glucose meter. App use and frequency of glucose testing were recorded. Baseline surveys recorded participant demographic, disease status, distress, medication taking, and views of technology to predict utilization. Results: Mean age was 51.6 years (108 IUs; 353 NIUs), 48% were female, time with diabetes was 6.9 years, and self-reported HbA1c was 8.1% (36.3 mmol/mol). Mean duration of App use was 85.4 days and 40% stopped using the App before 16 weeks. Continuous users were older and reported higher distress, better medication taking, and more positive attitudes toward technology (all P < .01). IUs tested more frequently than NIUs, but frequency and intensity of testing decreased markedly for both groups over time. More predictors of App use frequency and testing occurred for NIUs than IUs: older age, higher HbA1c, lower distress, more medication taking (all P < .05). Conclusions: App use and testing decreased markedly over time. Variations in the predictors of frequency of App use suggest that the utilization of mobile technologies requires a tailored approach that addresses the specific needs of individual users, compared with adopting a one-size-fits-all strategy, and that IUs and NIUs may require very different strategies of customization.
Endoscopic Sinus Surgery for Cystic Fibrosis: Variables Influencing Sinonasal and Pulmonary Outcomes
Authors: Ji Keven S. Y. , Frank-Ito Dennis , Abi Hachem Ralph , Issa Khalil , Johnson Carrie , Mohamedaly Omar , Goldstein Bradley J. , Jang David W. 
Published: November 2021

Background Endoscopic sinus surgery is a well-established treatment for chronic rhinosinusitis in patients with cystic fibrosis, though its benefits seem to be limited to improving sinonasal symptoms rather than affecting lung function. Objective This study aims to identify clinical and demographic factors that may influence sinonasal and pulmonary outcomes after surgery. Methods This is a six-year retrospective analysis of adult cystic fibrosis patients who underwent endoscopic sinus surgery at a tertiary care center. 22-Item Sino-Nasal Outcomes Test scores and mean forced expiratory volume data at baseline and three to six months after surgery were analyzed using t-test and stepwise regression with the following covariates: age, gender, lung transplant, revision surgery, and pseudomonas on sinus culture. Results 119 surgeries were performed on 88 patients, with 69% on patients with transplant. The overall mean (Standard Deviation) improvement in 22-Item Sino-Nasal Outcomes Test score was 9.42 (18.15) for the entire cohort ( P < .001). Pseudomonas on culture was associated with less improvement in sinonasal scores ( P = .002). There was no significant change in forced expiratory volume after surgery ( P = .94). Revision surgery ( P = .004) and older age ( P = .007) were associated with less favorable change of pulmonary function on stepwise regression ( P = .002). There was no correlation between change in sinonasal scores and pulmonary function. Conclusion Although surgery was associated with a clinically and statistically significant improvement in sinonasal scores in cystic fibrosis patients, patients with pseudomonas may experience less benefit. Revision surgery and older age may be associated with less favorable pulmonary outcomes. Awareness of such variables may help when deciding which cystic fibrosis patients should undergo surgery.
Surgical strategy for pulmonary sequestration: Focus on precautions for aberrant vessels under minimally invasive surgery
Authors: Nakagawa Tomoki , Wada Atsushi , Aruga Naohiro , Watanabe Hajime , Masuda Ryota , Yamada Shunsuke , Iwazaki Masayuki 
Published: November 2021

Background Recently, thoracoscopic resection of pulmonary sequestration has become more common, since resection of an aberrant artery using an end-stapler is a safe maneuver in many cases. However, injury of the vessels can lead to major hemorrhage. We reported our surgical experience based on thoracoscopic surgery, with five cases of interlobar pulmonary sequestration, focusing on precautions for aberrant arterial vessels. Object and methods We performed pulmonary resections for five patients with interlobar pulmonary sequestration in a lower lobe (left, n = 4; right, n = 1) between April 2004 and May 2020. All aberrant vessels were derived from the lower thoracic artery. Two patients had a single aberrant artery and three had multiple. In four patients, these vessels were detected before surgery, and pulmonary sequestration was diagnosed in four. In one elderly patient, the aberrant vessel was overlooked, and lung cancer was suspected before surgery. Angiography or multidetector-row computed tomography was subsequently performed in four cases. The surgical plan was determined according to the location and size of the pulmonary lesion and three-dimensional images of aberrant vessels. Result In all patients, approaches were made thoracoscopically. Hemorrhage from an anomalous vessel was encountered in one case. Pulmonary resections included two lobectomies and three limited resections. Angioplasty for the root of anomalous branches was performed following pulmonary resections under converted minimal lateral thoracotomy in two cases. Conclusion Preoperative assessment of the anatomical variations in abnormal vessels is essential to achieve safe surgical procedures. According to the situation of the aberrant vessels, selecting surgical procedures with consideration of potential subsequent complications arising over a long period of time is important.
Postoperative Noninvasive Hemoglobin Monitoring Is Useful to Prevent Unnoticed Postoperative Anemia and Inappropriate Blood Transfusion in Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial
Authors: Nakamori Erisa , Shigematsu Kenji , Higashi Midoriko , Yamaura Ken 
Published: November 2021

Introduction Postoperative nadir hemoglobin (Hb) is related to a longer length of stay for geriatric patients undergoing orthopedic surgery. We investigated whether postoperative pulse Hb (SpHb) measurement is useful for avoiding anemia and inappropriate blood transfusion after total hip arthroplasty and total knee arthroplasty. Material and Methods This prospective randomized controlled study included 150 patients randomly assigned to receive blood transfusion, either guided by SpHb monitoring (SpHb group) or based on the surgeons’ experience (control group). The target laboratory Hb value was set to >8 g/dL at postoperative day 1 (POD1). The primary endpoints were the product of total time and degree of SpHb <8 g/dL (area under SpHb 8 g/dL) during the period up to POD1 and the incidence of laboratory Hb <8 g/dL at POD1. The secondary endpoints were the amount of blood transfusion and inappropriate blood transfusion, which was defined as allogeneic blood transfusion unnecessary in a case of SpHb >12 g/dL or delayed transfusion in a case of SpHb <8 g/dL. Results The area under SpHb 8 g/dL was 37.6 ± 44.1 g/dL-min (5 patients) in the control group and none in the SpHb group ( P = .0281). There was 1 patient with Hb <8 g/dL at POD1 in the control group. There was no difference in laboratory Hb levels and the amount of blood transfusion. Forty-one patients (19 in the control group and 22 in the SpHb group) received an allogeneic blood transfusion. Among these patients, 7 in the control group and none in the SpHb group received inappropriate blood transfusion ( P = .0022). Discussion The SpHb monitoring could reduce unnoticed anemia, which may prevent complications and be useful in avoiding unnecessary and excessive blood transfusion. Conclusion Postoperative SpHb monitoring decreased the incidence of transient, unnoticed anemia during the period up to POD1 and inappropriate blood transfusion.
Point of care testing using rapid automated antigen testing for SARS-COV-2 in care homes – an exploratory safety, usability and diagnostic agreement evaluation
Authors: Micocci Massimo , Buckle Peter , Hayward Gail , Allen A Joy , Davies Kerrie , Kierkegaard Patrick , Spilsbury Karen , Thompson Carl , Astle Anita , Heath Ros , Sharpe Claire , Akrill Cyd , Lasserson Dan , Perera Rafael , Body Richard , Gordon Adam L 
Published: November 2021

Introduction Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption.
Novel Ring Compression Test Method to Determine the Stress-Strain Relations and Mechanical Properties of Metallic Materials
Authors: Han Guangzhao , Cai Lixun , Bao Chen , Liang Bo , Lyu Yang , Huang Maobo , Liu Xiaokun 
Published: November 2021

AbstractAlthough there are methods for testing the stress-strain relation and strength, which are the most fundamental and important properties of metallic materials, their application to small-volume materials and tube components is limited. In this study, based on energy density equivalence, a new dimensionless elastoplastic load-displacement model for compressed metal rings with isotropy and constitutive power law is proposed to describe the relations among the geometric dimensions, Hollomon law parameters, load, and displacement. Furthermore, a novel test method was developed to determine the elastic modulus, stress-strain relation, yield and tensile strength via ring compression test. The universality and accuracy of the method were verified within a wide range of imaginary materials using finite element analysis (FEA), and the results show that the stress-strain curves obtained by this method are consistent with those inputted in the FEA program. Additionally, a series of ring compression tests were performed for seven metallic materials. It was found that the stress-strain curves and mechanical properties predicted by the method agreed with the uniaxial tensile results. With its low material consumption, the ring compression test has the potential to be as an alternative to traditional tensile test when direct tension method is limited.