bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Time-point of Response Assessment for Predicting Survival Is Associated With Tumor Burden in Hepatocellular Carcinoma Receiving Repeated Transarterial Chemoembolization
Authors: Xia Dongdong , Wang Qiuhe , Bai Wei , Wang Enxin , Wang Zhexuan , Mu Wei , Sun Junhui , Huang Ming , Yin Guowen , Li Hailiang , Zhao Hui , Zhang Chunqing , Li Jing , Wu Jianbing , Zhu Xiaoli , Yang Shufa , Pan Xingnan , Li Jiaping , Li Zixiang , Xu Guohui , Shi Haibin , Zhanf Hui , Zhanf Yuelin , Ding Rong , Yu Hui , Zheng Lin , Yang Xiaohu , Wang Guangchuan , You Nan , Feng Long , Zhang Shuai , Huang Wukui , Xu Tao , Fan Wenzhe , Li Xueda , Yang Xuegang , Zhou Weizhong , Li Xiaomei , Luo Bohan , Lv Yong , Li Kai , Guo Wengang , Yin Zhanxin , Fan Daiming , Xia Jielai , Han Guohong 
Published: July 2021

Abstract
BackgroundObjective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) has been identified as a surrogate endpoint of overall survival (OS). However, its optimal time-point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden. MethodsA total of 1549 eligible treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score ≤7, and performance status score ≤1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. ResultsBoth initial and best ORRs interacted with tumor burden defined as our previously proposed “six-and-twelve” criteria. Both initial and best ORRs could equivalently predict and correlated with OS in low (adjusted HR: 2.55 and 2.95, respectively, both P<0.001; R=0.84, P=0.035 and R=0.97, P=0.002, respectively) and intermediate tumor burden strata (adjusted HR: 1.81 and 2.22, respectively, both P<0.001; R=0.74, P=0.023, and R=0.9, P=0.002, respectively). For high strata, only best ORR exhibited qualified prognostic value (adjusted HR: 2.61, P<0.001) with a satisfying correlation (R=0.70, P=0.035), whereas initial ORR was not statistically significant (adjusted HR: 1.08 P=0.357; R=0.22, P=0.54). ConclusionsORR after TACE as a surrogate of OS is closely associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred over best ORR in its early availability upon similar sensitivity; whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden in future clinical trials and practice.
Knowledge and Attitude Regarding Infection Control Among Undergraduate Dental Students At B.P.Koirala Institute of Health Sciences
Authors: Acharya Pujan , Baral Ratna , Shrestha Sajeev , Baral Dharanidhar 
Published: July 2021

Abstract
Background

In academic institutes, dental students are not only involved in academic activities, but also in the management of patients’ care. This calls for inculcation of adequate knowledge and positive attitude among them so that a good clinical practice is implemented in the dental setting, thereby creating a safe working environment for students as well as patients. Thus, the study was conducted to assess knowledge and attitude regarding infection control among undergraduate dental students of B.P.Koirala Institute of Health Sciences, Dharan, Nepal.
Methods and materials:

An online descriptive cross-sectional study was conducted at BPKIHS from February till March 2021. Undergraduate students from third year, fourth year and internship were included in the study. A self-administered questionnaire comprised of demographic, knowledge and attitude regarding infection control was used to collect the data via a Google form. Descriptive and inferential statistics was used to analyze the data. The p value < 0.05 was considered statistically significant at 95% confidence interval.
Result

A total of 136 undergraduate dental students participated out of which 65.0% were females and 35.0% were males. Out of the total participants, 78.7% were found to have adequate knowledge while 74.3% participants showed ‘positive’ attitude. Mean age of the participants with adequate knowledge was significantly higher than participants with inadequate knowledge (p = 0.047). The difference in knowledge among participants was statistically significant (p = 0.001) in academic years. The majority (90.4%) of interns showed adequate knowledge followed by fourth year (83.7%) and third year (58.7%) students. The difference in attitude, was also statistically significant (p = 0.011) in academic years, but it was mostly (90.4%) of positive attitude in fourth year participants followed by third year (68.3%) and Interns (65.4 %).
Conclusion

The present study reports adequate knowledge and positive attitude regarding infection control among undergraduate dental students in BPKIHS. Further studies are encouraged to be conducted among students from different academic institutes all over the country to ascertain their level of attitude and knowledge regarding infection control in dental care services.
Validation of the Spanish Version of the Goodman Score in Total Hip Arthroplasty
Authors: Brañes Julian , Barahona Maximiliano , Carvajal Sebastian , Wulf Rodrigo , Barrientos Cristian 
Published: July 2021

Abstract
Purpose Currently, patient-reported outcome measures (PROMs) are the standard instruments used to compare arthroplasty results. Goodman et al. recently published a well-constructed scale with excellent psychometric properties that can be quickly administered. The main objective of our study was to translate, culturally adapt, and validate a Spanish version of the Goodman questionnaire in patients who underwent total hip arthroplasty (THA). MethodsThe original Goodman scale was translated into Spanish and cross-culturally adapted. Then, the data from this version were tested for psychometric quality. We designed a cross-sectional study for data collection. This study enrolled 2 institutions. Patients who underwent hip replacement due to primary osteoarthritis secondary to dysplasia between 1 January 2018 and 31 December 2019 were included. A total of 153 patients were contacted twice to record the Goodman and Oxford hip scales (OHS) to assess the validity of the questionnaire. Reliability was tested using the Cronbach’s alpha, Concordance using 3 test: intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), and the Bradley-Blackwood F test. The spearman correlation was used to asses correltion between the OHS and the Spanish-adapted Goodman scale. ResultsThe overall satisfaction after THA was reported to be "very satisfied" by 137 patients (75%), and only 14 patients reported some degree of dissatisfaction (6%). The improvement in quality of life was reported to be "more than I ever dreamed possible" by 41% patients. Cronbach’s alpha was acceptable, reaching a coefficient of 0.95 (95% confidence interval, 0.82–1). No statistical difference (t-test, p = 0.55) was found in the original version, with great internal validity. Test re-test concordance was optimal among the 3 tests used. A moderate correlation was found between the OHS and the Spanish-adapted Goodman scale.ConclusionThe Spanish version of the Goodman questionnaire in THA is a reliable, consistent, and feasible scale to evaluate patient satisfaction and improvement in the quality of life in Spanish speakers.
A Novel Method of Seizure Onset Zone Localization by Serial Tc-99m ECD Brain Perfusion SPECT Clearance Patterns
Authors: Sukprakun Chanan , Limotai Chusak , Khamwan Kitiwat , Pasawang Panya , Tepmongkol Supatporn 
Published: July 2021

Abstract
In this prospective study, we postulate that there is a difference between clearance of [99mTc]Tc- ethyl cysteinate dimer (ECD) in the seizure onset zone (SOZ) and other brain areas and thus SOZ localization by clearance patterns might become a potential novel method for SOZ localization in epilepsy. The parametric images of brain ECD clearance were generated by linear regression model analysis from serial brain SPECT scans from 30 minutes to 240 minutes after ECD injection (7-times point) in 7 patients with drug-resistant epilepsy and 3 normal volunteers. Clearance patterns of the SOZ confirmed by good surgical outcome or consensus with other investigations were analyzed quantitatively and semi-quantitatively by visual grading (slower or faster washout than contralateral brain regions). The average [99mTc]Tc-ECD clearance rates of SOZs were + 1.08 % ± 2.57 %/hr (wash in), -7.02 % ± 2.56 %/hr (washout), and − 5.37% ± 1.71 %/hr (washout) in ictal, aura and interictal states, respectively. Paired t-tests between the SOZ and contralateral regions showed statistically significant difference (p = 0.039 in interictal state). Clearance patterns that can define the SOZs were 1) wash in and slow washout on ictal slope, 2) fast washout on aura slope and interictal slope with 100% (6/6), 100% (2/2) and 75% (6/8) localization using ictal, aura, and interictal slope maps, respectively. Our study provided the evidence that clearance pattern methods are potential additive diagnostic tools for SOZ localization when routine one-time point SPECT are unable to define the SOZ.
Transanal Ileal Pouch-Anal Anastomosis for Ulcerative Colitis - A Retrospective Single-Center Study Regarding Anastomotic Leakage and Episodes of Pouchitis in the Long-Term
Authors: Lask Aina , Biebl Matthias , Dittrich Luca , Fischer Andreas , Adler Andreas , Tacke Frank , Aigner Felix , Schmuck Rosa , Chopra Sascha , Knoop Michael , Pratschke Johann , Gül-Klein Safak 
Published: July 2021

Abstract
Introduction:Colectomy with transanal ileal pouch-anal anastomosis (taIPAA) is a surgical technique that can be used to treat benign colorectal disease. Ulcerative colitis (UC) is the most frequent inflammatory bowel disease (IBD) and although pharmacological therapy has improved, colectomy rates reach up to 15%. Objective of this study was to determine anastomotic leakage (AL) rates and treatment after taIPAA as well as short- and long-term pouch function. Patients and Methods:Data from a prospectively collected database of all patients undergoing taIPAA in our center between March 2015 and August 2019 was analyzed retrospectively. Patients with indications other than UC or with adjuvant chemotherapy following colectomy for colorectal carcinoma were excluded. Results:Of 23 patients undergoing taIPAA in our center 20 patients met the inclusion criteria, with a median age of 36 years at the time of pouch formation. Overall prevalence of AL was 10% with one early (11 days after operation) and one late AL (19 months after operation). In both patients pouches could be preserved with a multimodal approach based on endosponge therapy. Data on short-term pouch function could be obtained in 11 (55.8%) patients and was satisfactory in all cases. In the long-term we observed a pouchitis rate of 57.9% and a pouch failure rate of 5.3%.Conclusion:In our study, taIPAA surgery is a safe procedure and results in good patient outcome. The rate of AL is comparable to transabdominal IPAA. In order to fully evaluate the risks and benefits of taIPAA further studies with larger cohorts of patients are required.
Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke using Chest Spectral CT: Relationship with Etiology
Authors: Rodriguez-Granillo Gastón A , Cirio Juan J. , Ciardi Celina , Caballero Maria L. , Fontana Lucia A. , Buezas Mariano D. , Diluca Pablo , Lylyk Pedro 
Published: July 2021

Abstract
PurposeHyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and the relationship with stroke etiology. MethodsSince July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. ResultsEighty consecutive patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n=3) and non-CE (n=2) etiologies. LIE, most commonly ischemic (82%), was identified in 38 (48%) patients. We did not identify significant relationships between AIS etiology and the presence, pattern, and extension of LIE (p>0.05); ECV (p=0.56), severe aortic (p=0.25) or valvular (p=0.26) disease, or the extent of coronary calcification (p=0.39). Patients with evidence of major cardiovascular DESCT findings had higher rate rates of all-cause death at 90 days (42% vs. 19%, p=0.037). ConclusionIn this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.
Experience of Intravenous Sedation Increases Incidence of Caries in Patients With Dental Anxiety
Authors: Kawasaki Hanako , Tanoue Naomi , Ayuse Terumi , Kurata Shinji , Okayasu Ichiro , Ayuse Takao 
Published: July 2021

Abstract
ObjectivesThe aim of this study was to investigate the factors that influence the decayed, missing due to caries, and filled teeth (DMFT) index of patients with dental anxiety during dental treatment discontinuation.Materials and MethodsA total of 110 patients who complained of fear and anxiety toward dental treatments and who re-visited following treatment discontinuation were enrolled in the study. Patient and dental data considered to be related to caries were digitally collected from medical and dental records. The decayed (D), missing (M), and filled (F) scores, and the DMFT index before and after discontinuation were compared using Wilcoxon signed-rank tests, and the influential factors were evaluated using the Poisson and multiple regression analyses.ResultsThe D score and DMFT index increased significantly during the discontinuation period, and the F score decreased. There was no significant change in the M score. The change in the D score was influenced by the pre-discontinuation D score and the number of experiences of intravenous sedation, and the change in the F score was affected by the duration of treatment discontinuation, the DMFT index before discontinuation, and the number of experiences of intravenous sedation. The increase in the DMFT index was affected by the experience of intravenous sedation, the D and M scores, and the DMFT index before discontinuation.ConclusionDiscontinuation of dental treatment was proven to increase the incidence of caries in patients with dental anxiety.Clinical Relevance: Avoiding treatment discontinuation is crucial, particularly in patients treated using intravenous sedation.
Real-time Co-site Optical Microscopy Study on the Morphological Changes of the Dentine’s Surface after Citric Acid and Sodium Hypochlorite. A Single-tooth Model.
Authors: Wilkoński Wojciech , Jamróz-Wilkońska Lidia , Zapotoczny Szczepan , Opiła Janusz , Giardino Luciano 
Published: July 2021

Abstract
BackgroundTo this day, the mechanisms of action and the effects of sodium hypochlorite and chelating agents during the smear layer removal, remain unclear. The study aimed to analyze the dentine's surface treated with 40% citric acid and 5.25% sodium hypochlorite according to two irrigation protocols. Materials and MethodsThe study employed a computer-controlled Nikon Eclipse LV100 optical microscope. Ten roots split longitudinally with canals prepared mechanically using the MTwo system to a size of 40/04 were observed. The root halves were divided into two study groups, one half in each of the groups. According to two irrigation protocols, the dentine's surface was irrigated with 40% citric acid and 5.25% sodium hypochlorite, separated with water. Dentine surface was observed in a fixed place and photographed in 500x magnification after each irrigation stage. The obtained images were then analyzed using computer software (NIS-Elements AR, GIMP-2.6, ImageJ 1.45s). ResultsVarious speed of removal of the smear layer and varied morphological changes of the dentine's surface were observed in both examined groups. Double irrigation of the dentine with citric acid for 30 seconds resulted in complete removal of the smear layer, and double irrigation for 60 seconds resulted in increased mean diameter of the dentine tubules (degradation of the dentine's surface).Conclusions Double alternating irrigation with citric acid and sodium hypochlorite for 30 seconds yielded satisfactory results, while double irrigation for 60 seconds resulted in increased mean diameter of the dentine tubules. A real time assessment of the dentine’s surface changes after both tested solutions can improve understanding of the phenomena that occur during the irrigation and as a result it might help to improve clinical outcomes in root canal treatment.
COVID-VU an ENT UK National Survey of Flexible Nasendoscopy in the Upper Aerodigestive Tract Amidst the COVID-19 Pandemic
Authors: Loizidou Avgi , Tatla Taranjit Singh , Harvey Ian , Aibibula Miriayi , Roe Justin , Sethi Neeraj , Schilder Anne GM 
Published: July 2021

Abstract
BackgroundFlexible nasendoscopy (FNE) is an invaluable multi-disciplinary tool for upper aerodigestive tract (UADT) examination. During the COVID-19 pandemic concerns were raised that FNE had the potential of generating aerosols resulting in human cross-contamination when performed on SARS-COV2 carriers. In the UK, and other European countries, national guidelines were issued restricting FNE to essential cases. We surveyed ENT UK members and Royal College of Speech and Language Therapists (RCSLT) members to determine the impact of the COVID-19 pandemic (first peak) on FNE practice in the UK.MethodsAn observational internet-based survey constructed in accordance to the CHERRIES checklist and setup in SurveyMonkeyof FNE practice amongst UK-based ENT surgeons and speech and language therapists in community clinics, the outpatient department, inpatient wards, ICU, emergency department and operating theatres (through the NHS and private sector) prior to, during and following the first COVID-19 wave in the UK. Results 314 responses collected (24% response rate), 82% from ENT clinicians, 17% from SLTs and 1% from other allied healthcare professionals. Overall, there has been a large reduction in the volume and indications for FNE during the first peak of the COVID-19 pandemic with limited recovery by mid-August 2020. Cancer and airway assessments were impacted less. A wide range of FNE protocols influenced by local factors are reported, varying in endoscope preference, Personal Protective Equipment (PPE) and sterilization methods. Where dedicated Aerosol Generating Procedure (AGP) rooms were unavailable, clinicians resorted to window opening and variable room “down-time” between patients. Endoscope preference reflected availability and user familiarity, ENT trainees favoring the use of single-use video endoscopes. ConclusionDespite national guidance, local practice of FNE remains interrupted and highly variable in the UK. A collaborative inter-disciplinary approach is required to re-introduce FNE safely in volume across healthcare settings, re-establishing timely endoscopic diagnosis and pre-pandemic levels of patient care.
The Toxic Effect of Cu and CuO Nanoparticles on Euplotes Aediculatus
Authors: Zhao Xiaohuan , Gong Zhiwei , Pérez Edgar , Gao Xilei , Wang Yiwen , Fan Xinpeng , Ni Bing 
Published: July 2021

Abstract
Toxicology tests were carried out by choosing Cu nanoparticles (CuNPs) and CuO nanoparticles (CuONPs) as experimental materials and Euplotes aediculatus as the experimental organism. To investigate the toxicity effect and mechanism of two NPs on E. aediculatus, we determined antioxidant enzyme activity and observed morphologic changes using optical and electron microscopes, combined with the Fourier infrared spectrum technique. The results showed that the 24 h-LC50 of CuNPs and CuONPs was 0.46 µg/L and 1.24×103 µg/L. The movement ability of cells was decreased and surface cilia gradually shed with CuNPs and CuONPs at 24 h-LC50. In addition, the cell body swelled and finally ruptured. There were varying extents of damage to the nucleus and mitochondria. With CuNPs, disappearance of nucleoli and condensation of chromatin were observed, while the mitochondria were wrinkled in an irregular shape and cristae were partially fractured. With CuONPs, changes of nucleus were not obvious, and the mitochondria were merely irregular. While neither CuNPs nor CuONPs had major effect on the ultrastructure of the membrane, some functional groups were oxidized with CuNPs, e.g. PO2-, C-O-C, δ(COH) of carbohydrates. The 24 h-EC50, 48 h-EC50 and 72 h-EC50 of CuNPs on E. aediculatus were 2.10×10-3 µg/L, 7.92×10-4 µg/L and 2.77×10-4 µg/L. The EC50 of CuONPs in same period was 7.20 µg/L, 0.86 µg/L and 0.19 µg/L. The above concentration of CuNPs and CuONPs could increase the activities of SOD, CAT and GPx, which were dose-dependent. The above results indicate that CuNPs and CuONPs inhibited reproduction and caused death. CuNPs were more toxic to E. aediculatus and more destructive to cell structure. Oxidative stress and destruction to cell structures may be toxic mechanisms. The E. aediculatus was more sensitive to CuNPs or CuONPs, and the value of 24 h-LC50 was much lower than other organisms, so it can be recommended as an indicator for early monitoring in freshwater environment.