bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negative-pressure wound therapy after stoma reversal in colorectal surgery: a randomized controlled trial
Authors: Carrano Francesco M , Maroli Annalisa , Carvello Michele , Foppa Caterina , Sacchi Matteo , Crippa Jacopo , Clerico Giuseppe , De Lucia Francesca , Coppola Elisabetta , Ben David Nadav , Spinelli Antonino 
Published: November 2021

Abstract

Background
Stoma-reversal surgery is associated with high postoperative morbidity, including wound complications and surgical-site infections (SSIs). This study aims to assess whether the application of negative-pressure wound therapy (NPWT) can improve wound healing compared with conventional wound dressing.

Methods
This was a single-centre, superiority, open-label, parallel, individually randomized controlled trial. Patients undergoing stoma reversal were randomized (1 : 1) to receive NPWT or conventional wound dressing. The primary endpoint of the study was the rate of wound complications and SSIs after stoma closure. The secondary endpoints were postoperative wound pain, rate of wound healing after 30 days from stoma closure, and wound aesthetic satisfaction.

Results
Between June 2019 and January 2021, 50 patients were allocated to the NPWT group (all received NPWT, 49 were analysed); 50 patients were allocated to the conventional wound dressing group (48 received the treatment, 45 were analysed). No significant difference was found in wound-complication rate (10 per cent NPWT versus 16 per cent controls; odds ratio 0.61 (95 per cent c.i. 0.18 to 2.10), P = 0.542) and incisional SSI rate (8 per cent NPWT versus 7 per cent controls; odds ratio 1.24 (95 per cent c.i. 0.26 to 5.99), P = 1.000). The NPWT group showed less pain, higher aesthetic satisfaction (P &lt; 0.0001), and a higher proportion of wound healing (92 versus 78 per cent; P = 0.081) compared with the control group.

Conclusion
NPWT does not reduce the incidence of SSI after stoma-reversal surgery compared with conventional wound dressing. However, NPWT improved the healing of uninfected wounds, reduced wound pain and led to better aesthetic outcomes.
Registration number: NCT037812016 (clinicaltrials.gov).
Qualitative Studies of Foster Carer Experiences in Providing Out of Home Care for Children: A Scoping Review and Narrative Synthesis
Authors: D’Amato Stephanie , Brownlee Keith 
Published: October 2021

Summary
In this scoping review, we examined the available qualitative research exploring the experiences of non-relative foster carers providing out of home care for children. Qualitative articles covering the last twenty-five years were extracted from eight databases, Google Scholar and a hand search of the reference sections of identified journals. Using specified inclusion and exclusion criteria, twenty-two articles were retained for analysis. A relatively high degree of consistency was found amongst the studies from a range of countries. Five major themes were identified: Open communication of a child’s needs and behaviours; Full spectrum support; Challenges; Stress; and Rewards. The Challenges theme comprised three sub-themes: Anticipating being a family, Carer bond and loss and Inherent limits of training. The themes reflected by the foster carers encompassed both stresses associated with the challenges of fostering children and personal rewards that encouraged them to begin and maintain their role as carers. The possible implications for practice and further research of the findings are discussed.
Robot-assisted kidney transplantation: an update
Authors: Spiers Harry V M , Sharma Videha , Woywodt Alexander , Sivaprakasam Rajesh , Augustine Titus 
Published: October 2021

ABSTRACTRenal transplantation has become the gold-standard treatment for the majority of patients with established renal failure. Recent decades have seen significant progress in immunosuppressive therapies and advances in post-transplant management of recipients, resulting in improved graft and patient outcomes. However, the open technique of allograft implantation has stood the test of time, remaining largely unchanged. In a world where major advances in surgery have been facilitated by innovations in the fields of biotechnology and medical instrumentation, minimally invasive options have been introduced for the recipient undergoing kidney transplantation. In this review we present the evolution of minimally invasive kidney transplantation, with a specific focus on robot-assisted kidney transplant and the benefits it offers to specific patient groups. We also discuss the ethical concerns that must be addressed by transplant teams considering developing or referring to robotic programs.
Baryonic imprints on DM haloes: population statistics from dwarf galaxies to galaxy clusters
Authors: Anbajagane Dhayaa , Evrard August E , Farahi Arya 
Published: October 2021

ABSTRACT
In a purely cold dark matter (CDM) universe, the initial matter power spectrum and its subsequent gravitational growth contain no special mass- or time-scales, and so neither do the emergent population statistics of internal dark matter (DM) halo properties. Using 1.5 million haloes from three illustristng realizations of a ΛCDM universe, we show that galaxy formation physics drives non-monotonic features (‘wiggles’) into DM property statistics across six decades in halo mass, from dwarf galaxies to galaxy clusters. We characterize these features by extracting the halo mass-dependent statistics of five DM halo properties – velocity dispersion, NFW concentration, density- and velocity-space shapes, and formation time – using kernel-localized linear regression (Kllr). Comparing precise estimates of normalizations, slopes, and covariances between realizations with and without galaxy formation, we find systematic deviations across all mass-scales, with maximum deviations of 25 per cent at the Milky Way mass of $10^{12} \, {\rm M}_\odot$. The mass-dependence of the wiggles is set by the interplay between different cooling and feedback mechanisms, and we discuss its observational implications. The property covariances depend strongly on halo mass and physics treatment, but the correlations are mostly robust. Using multivariate Kllr and interpretable machine learning, we show the halo concentration and velocity-space shape are principal contributors, at different mass, to the velocity dispersion variance. Statistics of mass accretion rate and DM surface pressure energy are provided in an appendix. We publicly release halo property catalogues and kllr parameters for the TNG runs at 20 epochs up to z = 12.
Day-One Pain Reductions After Hip and Knee Replacement When Buprenorphine-Clonidine-Dexamethasone Is Added to Bupivacaine Nerve/Plexus Blocks: A Randomized Clinical Trial
Authors: Williams Brian A , Ibinson James W , Mikolic Joseph M , Boudreaux-Kelly Monique Y , Paiste Henry J , Gilbert Karen L , Bonant Samantha A , Ritter Marsha E , Ezaru Catalin S , Muluk Visala S , Piva Sara R 
Published: November 2021

Abstract

Objective
To compare pain outcome reports of patients undergoing hip or knee replacement who received single-injection nerve/plexus blocks with plain bupivacaine (BPV) with those of patients who received injections of buprenorphine-clonidine-dexamethasone (BCD) admixed with BPV.

Design
Prospective, parallel-arm, randomized, double-blind trial.

Setting
A single veterans’ hospital.

Subjects
Ninety-eight veterans scheduled for total hip or knee replacement surgery with spinal as the primary anesthetic.

Methods
Participants were randomized to BPV-BCD or plain BPV groups. They underwent nerve/plexus blocks in the L2–L4 and L4–S3 distributions in advance of joint replacement surgery. The primary outcome was change in pain from baseline during the postoperative day, as assessed by the total pain score on the short-form McGill Pain Questionnaire-v2 (SF-MPQ-2). Secondary outcomes were pain during movement, pain interference, range of motion, mobility, and quality of recovery.

Results
On postoperative day one, the SF-MPQ-2 total score for the BPV-BCD group demonstrated greater pain reduction than that of the plain BPV group (mean difference 1.8 points, 95% confidence interval 0.6 to 3.0, P = 0.003). The BPV-BCD group also had larger reductions in pain during movement in the surgical joint and less pain interference, along with increased range of hip and knee flexion, compared with the plain BPV group. Outcomes of mobility and quality of recovery were not different between groups.

Conclusions
Preoperative BPV-BCD blocks in the L2–L4 and L4–S3 nerve distributions for hip and knee replacements led to less pain on postoperative day one and increased knee and hip range of motion, compared with plain BPV blocks.

Trial registration
ClinicalTrials.gov ID NCT02891798.
Hypothyroidism in vasculitis
Authors: Kermani Tanaz A , Cuthbertson David , Carette Simon , Khalidi Nader A , Koening Curry L , Langford Carol A , McAlear Carol A , Monach Paul A , Moreland Larry , Pagnoux Christian , Seo Philip , Specks Ulrich , Sreih Antoine , Warrington Kenneth J , Merkel Peter A ,   the Vasculitis Clinical Research Consortium
Published: October 2021

Abstract

Objective
To study the prevalence, risk and clinical associations of hypothyroidism among several forms of vasculitis.

Methods
Patients with GCA, Takayasu’s arteritis (TAK), PAN and the three forms of ANCA-associated vasculitis [AAV; granulomatosis with polyangiitis (GPA), microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (EGPA)] enrolled in a prospective, multicentre, longitudinal study were included.

Results
The study included data on 2085 patients [63% female, 90% White] with a mean age of 54.6 years (s.d. 17.2). Diagnoses were GCA (20%), TAK (11%), PAN (5%), GPA (42%), microscopic polyangiitis (8%) and EGPA (14%). Hypothyroidism was present in 217 patients (10%) (83% female), with a mean age 59.8 years (s.d. 14.5). Age- and sex-adjusted risk of hypothyroidism was GCA, odds ratio (OR) 0.61 (95% CI 0.41, 0.90); TAK, OR 0.57 (95% CI 0.31, 1.03); PAN, OR 0.59 (95% CI 0.25, 1.38); GPA, OR 1.51 (95% CI 1.12, 2.05); microscopic polyangiitis, OR 1.81 (95% CI 1.18, 2.80) and EGPA, OR 0.82 (95% CI 0.52, 1.30). Among patients with AAV, age- and sex-adjusted risk of hypothyroidism was higher with positive MPO-ANCA [OR 1.89 (95% CI 1.39, 2.76)]. The clinical manifestations of vasculitis were similar in patients with and without hypothyroidism, except transient ischaemic attacks, which were more frequently observed in patients with GCA and hypothyroidism (12% vs 2%; P = 0.001).

Conclusions
Differences in the risk of hypothyroidism among vasculitides may be due to genetic susceptibilities or immune responses. This study confirms an association of hypothyroidism with MPO-ANCA.
Unique Recognizable Histopathologic Variant of Palisaded Neutrophilic and Granulomatous Dermatitis that Is Associated With SRSF2-Mutated Chronic Myelomonocytic Leukemia: Case Report and Review of the Literature
Authors: Enescu Christina D. , Patel Avni , Friedman Ben J. 
Published: November 2021

Abstract:
Palisaded neutrophilic and granulomatous dermatitis (PNGD) represents a cutaneous histopathologic reaction spectrum associated with several underlying disorders. Few cases of PNGD have been associated with chronic myelomonocytic leukemia (CMML), a malignant hematopoietic disorder with features in between those of a myeloproliferative neoplasm and myelodysplastic syndrome. We present a patient with a generalized papular skin reaction involving the neck, chest, and shoulders with histomorphological features on the spectrum of PNGD. Subsequent laboratory workup demonstrated a persistent mild monocytosis, raising concern for CMML. The diagnosis was ultimately confirmed with a bone marrow biopsy and associated mutational analysis through next-generation sequencing which identified deleterious variants in SRSF2, IDH2, and ASXL1. The findings in this case strengthen the previously made association between PNGD and SRSF2-mutated CMML and may help better define a unique recognizable clinical–histopathological–molecular subtype for dermatopathologists.
Epidermal Hyperproliferation With Less Prominent Dermal Inflammation Is the Unique Histopathological Feature of the Refractory Lesions in Psoriasis Treated With Ustekinumab
Authors: Kim Minsu , Yang Seungkeol , Kim Bo Ri , Youn Sang Woong 
Published: November 2021

Abstract:
Although ustekinumab (UST) shows excellent efficacy in treating psoriasis, not all patients have a complete clearance rate. The purpose of this study was to investigate the histopathological characteristics of refractory psoriasis lesions in patients with excellent response to UST. Fifty-seven patients with newly diagnosed psoriasis and 66 patients with a 75% reduction in the Psoriasis Area and Severity Index score after UST treatment were included. Computer-aided image analysis was performed to measure the epidermal thickness, horny layer thickness, number of dermal vessels, and dermal inflammatory cell infiltration rate. Parakeratosis was scored using a 4-point scale. These measurements were compared between the refractory lesions of UST-treated patients and the untreated lesions of newly diagnosed patients after the adjustment for confounding factors. The dermal inflammatory cell infiltration rate was significantly lower in the refractory lesions (P = 0.022). Meanwhile, the epidermal thickness, horny layer thickness, grade of parakeratosis, and dermal vessel count did not differ between the groups (P = 0.125, 0.719, 0.542, and 0.758, respectively). Subgroup analyses were performed within the UST-treated group after dividing them into 2 groups according to the number of treatments or treatment response rates. None of these features were significantly different between the subgroups. This study suggests that the reduction of dermal inflammation by UST was not sufficient to ameliorate the epidermal changes and implies the role of the interleukin-23–independent downstream cytokine pathway in causing the refractory lesions among patients who responded well to UST. The continuation of UST treatment might not further improve epidermal alterations.
Asynchronous and Synchronous Delivery Models for Home-Based Cardiac Rehabilitation
Authors: Thomas Randal J. , Petersen Cara E. , Olson Thomas P. , Beatty Alexis L. , Ding Rongjing , Supervia Marta 
Published: November 2021

Purpose:
To review the principles, advantages, and disadvantages of asynchronous and synchronous delivery models of home-based cardiac rehabilitation (HBCR).

Methods:
We reviewed recently published systematic reviews and other publications of randomized studies of asynchronous and synchronous HBCR to assess principles, outcomes, and limitations of those delivery methods compared with center-based cardiac rehabilitation (CBCR).

Summary:
While most studies prior to 2016 involved asynchronous HBCR approaches to care, studies since 2016 have included asynchronous or synchronous delivery models. Both delivery models have been shown to help provide core components of cardiac rehabilitation (CR). Studies using either method have been shown to have similar short-term patient outcomes as CBCR, at least in low- to moderate-risk patients who have been studied. Asynchronous HBCR offers greater flexibility for patients and CR staff, while synchronous HBCR provides greater real-time oversight and feedback to patients.
Asynchronous and synchronous HBCR is an option to consider for patients eligible for CR. Additional research is needed for both delivery models, applied separately or in combination, to compare their impact on shorter- and longer-term patient outcomes and to assess their impact in patient subgroups (referral diagnosis, women, elderly, underrepresented racial and ethnic minority groups, patients at a higher cardiovascular disease risk, patients with multiple comorbid conditions, etc).
Artifacts in EEG-based BCI therapies: friend or foe?
Authors: McDermott Eric James , Raggam Philipp , Kirsch Sven , Belardinelli Paolo , Ziemann Ulf , Zrenner Christoph 
Published: October 2021

AbstractEEG-based brain-computer interfaces (BCI) have promising therapeutic potential beyond traditional neurofeedback training, such as enabling personalized and optimized virtual reality (VR) neurorehabilitation paradigms where the timing and parameters of the visual experience is synchronized with specific brain-states. While BCI algorithms are often designed to focus on whichever portion of a signal is most informative, in these brain-state-synchronized applications, it is of critical importance that the resulting decoder is sensitive to physiological brain activity representative of various mental states, and not to artifacts, such as those arising from naturalistic movements. In this study, we compare the relative classification accuracy with which different motor tasks can be decoded from both extracted brain activity and artifacts contained in the EEG signal. EEG data was collected from 17 chronic stroke patients while performing six different head, hand, and arm movements in a realistic VR-based neurorehabilitation paradigm. Results show that the artifactual component of the EEG signal is significantly more informative than brain activity with respect to classification accuracy. This finding is consistent across different feature extraction methods and classification pipelines. While informative brain signals can be recovered with suitable cleaning procedures, we recommend that features should not be designed solely to maximize classification accuracy, as this could select for remaining artifactual components. We also propose the use of machine learning approaches that are interpretable to verify that classification is driven by physiological brain-states. In summary, whereas informative artifacts are a helpful friend in BCI-based communication applications, they can be a problematic foe in the estimation of physiological brain states.
Metacognition, cortical thickness, and tauopathy in aging
Authors: Zhuang Kailin , Chen Xi , Cassady Kaitlin E. , Baker Suzanne L. , Jagust William J. 
Published: October 2021

AbstractWe investigated two aspects of metacognition and their relationship with cortical thickness and Alzheimer’s Disease (AD) biomarkers, amyloid and tau, in cognitively healthy older adults (N=151). The two metacognition measures were self-appraisal rating of task performance and the difference between self-appraisal rating and actual task performance (appraisal discrepancy). All participants underwent neuropsychological testing and 1.5T structural MRI. A subset (N=66) received amyloid-PET with [11C] PiB and tau-PET with [18F] Flortaucipir. We found that worse performers had lower self-appraisal ratings, but still overestimated their performance, consistent with the Dunning-Kruger effect. Self-appraisal rating and appraisal discrepancy revealed distinct relationships with cortical thickness and AD pathology. Greater appraisal discrepancy, indicating overestimation, was related to thinning of inferior-lateral temporal, fusiform, and rostral anterior cingulate cortices. Lower self-appraisal was associated with higher entorhinal and inferior temporal tau. These results suggest that overestimation could implicate structural atrophy beyond AD pathology, while lower self-appraisal could indicate early behavioral alteration due to AD pathology, supporting the notion of subjective cognitive decline prior to objective deficits.
Comparison of the immunogenicity of BNT162b2 and CoronaVac COVID-19 Vaccines in Hong Kong
Authors: Pun Mok Chris Ka , Cohen Carolyn A , Cheng Samuel M.S. , Chen Chunke , Kwok Kin-On , Yiu Karen , Chan Tat-On , Bull Maireid , Ling Kwun Cheung , Dai Zixi , Ng Susanna S , Lui Grace Chung-Yan , Wu Chao , Amerasinghe Gaya K. , Leung Daisy W , Shan Wong Samuel Yeung , Valkenburg Sophie A , Peiris Malik , Hui David S 
Published: October 2021

AbstractBackgroundFew head-to-head evaluations of immune responses to difference vaccines have been reported.MethodsSurrogate virus neutralization test (sVNT) antibody levels of adults receiving either 2 doses of BNT162b2 (n=366) or CoronaVac (n=360) vaccines in Hong Kong were determined. An age-matched subgroup (BNT162b2 (n=49) vs CoronaVac (n=49)) were tested for plaque reduction neutralizing (PRNT) and spike binding antibody and T cell reactivity in peripheral blood mononuclear cells (PBMC).FindingsOne month after the second dose of vaccine, BNT162b2 elicited significantly higher PRNT50, PRNT90, sVNT, spike receptor binding, spike N terminal domain binding, spike S2 domain binding, spike FcR binding and antibody avidity levels than CoronaVac. The geometric mean PRNT50 titres in those vaccinated with BNT162b2 and CoronaVac vaccines were 251.6 and 69.45 while PRNT90 titres were 98.91 and 16.57, respectively. All of those vaccinated with BNT162b2 and 45 (91.8%) of 49 vaccinated with CoronaVac achieved the 50% protection threshold for PRNT90. Allowing for an expected seven-fold waning of antibody titres over six months for those receiving CoronaVac, only 16.3% would meet the 50% protection threshold versus 79.6% of BNT162b2 vaccinees. Age was negatively correlated with PRNT90 antibody titres. Both vaccines induced SARS-CoV-2 specific CD4+ and CD8+ T cell responses at 1-month post-vaccination but CoronaVac elicited significantly higher structural protein-specific CD4+ and CD8+ T cell responses.ConclusionVaccination with BNT162b2 induces stronger humoral responses than CoronaVac. CoronaVac induce higher CD4+ and CD8+ T cell responses to the structural protein than BNT162b2.Summary At a GlanceThrough the head-to-head comparison, vaccination with BNT162b2 induces significantly higher levels of SARS-CoV-2 specific binding and neutralizing antibody responses when compared to CoronaVac. CoronaVac induce higher CD4+ and CD8+ T cell responses to the structural protein than BNT162b2.
Genetic Diversity of Non-Tuberculous Mycobacteria among Symptomatic TB negative Patients in Kenya
Authors: Mwangi Zakayo M , Mukiri Nellie , Onyambu Frank G , Bulimo Wallace 
Published: October 2021

AbstractNon-Tuberculous Mycobacteria (NTM) transmission to humans occurs through inhalation of dust particles or vaporized water containing NTM leading to pulmonary manifestations. NTM infections are often misdiagnosed for tuberculosis (TB) due to their similar clinical and radiological manifestations. We, therefore, performed a species-level identification of NTM in symptomatic TB negative patients through sequencing of the hsp65 gene. We conducted a cross-sectional study at the National Tuberculosis Reference Laboratory in the period between January to November 2020. One hundred and sixty-six mycobacterial culture-positive samples that tested negative for TB using capilia underwent Polymerase Chain Reaction targeting the hsp65 gene. Isolates showing a band with gel electrophoresis at 441 bp position were sequenced using Sanger technology. Geneious software was used to analyze the obtained sequences, and the National Center for Biotechnology Information gene database identified NTM species for each isolate. A phylogenetic tree was constructed from the DNA sequences and evolutionary distances computed using the general time-reversible method. Pearson chi-square was used to determine the association between NTM infection and participants’ characteristicsOur study identified 43 different NTM species. The dominant NTM belonged to Mycobacterium avium complex 37 (31%). Slow-growing NTM were the majority at 86 (71%) while rapid-growing NTM were 36 (29%). A significant association (p<0.05) was observed for regions and age, while patient type had a week likelihood of NTM infection. Our study characterized the diversity of NTM in Kenya for the first time and showed a high diversity of NTM species.