bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hormetic endoplasmic reticulum stress in hematopoietic stem cells
Authors: Luchsinger Larry L. 
Published: July 2021

Purpose of review
Hematopoietic stem cells (HSCs) possess the ability to regenerate over a lifetime in the face of extreme cellular proliferation and environmental stress. Yet, mechanisms that control the regenerative properties of HSCs remain elusive. ER stress has emerged as an important signaling event that supports HSC self-renewal and multipotency. The purpose of this review is to summarize the pathways implicating ER stress as cytoprotective in HSCs.

Recent findings
Recent studies have shown multiple signaling cascades of the unfolded protein response (UPR) are persistently activated in healthy HSCs, suggesting that low-dose ER stress is a feature HSCs. Stress adaptation is a feature ascribed to cytoprotection and longevity of cells as well as organisms, in what is known as hormesis. However, assembling this information into useful knowledge to improve the therapeutic application of HSCs remains challenging and the upstream activators and downstream transcriptional programs induced by ER stress that are required in HSCs remain to be discovered.

Summary
The maintenance of HSCs requires a dose-dependent simulation of ER stress responses that involves persistent, low-dose UPR. Unraveling the complexity of this signaling node may elucidate mechanisms related to regeneration of HSCs that can be harnessed to expand HSCs for cellular therapeutics ex vivo and transplantation in vivo.
Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex
Authors: Sinatti Céline , Schechter Michal Yaela , Spinoit Anne-Françoise , Hoebeke Piet 
Published: July 2021

Purpose of review
Although immediate surgical outcomes of genitourinary reconstruction used to be the main focus in hypospadias and exstrophy-epispadias complex (EEC), recent research demonstrates rising concerns about long-term functional and psychosexual outcomes. Recent results about long-term outcomes of complex genitourinary reconstruction in those children transitioning into adulthood are summarized and discussed in this comprehensive review.

Recent findings
Long-term outcomes in hypospadias focus on psychosexual satisfaction and decisional regret. Interestingly, uncomplicated hypospadias repair results in equal satisfaction rates to those found in controls. Most adult patients are happy with their parents’ decision to have them undergo surgery during childhood. No decisional regret was found in parents. Reinterventions were associated with a decline in satisfaction, as was a decrease in perceived penile length. Long-term, males with EEC are more dissatisfied with penile length than with continence problems. In cases of severe penile insufficiency, phalloplasty shows promising psychosexual outcomes at the price of a high complication rate. Female EEC patients show higher rates of pregnancy complications, portending a higher risk of miscarriage.

Summary
Psychosexual satisfaction of patients with repaired hypospadias transitioning into adulthood demonstrates equal satisfaction rates to those found in controls, without decisional regret associated with surgery during childhood. In EEC, more complications are seen when transitioning into a sexually active adult life.
Esthesioneuroblastoma Presenting With Orbital Hypertelorism and Foster-Kennedy Syndrome
Authors: Shah Saumya M. , Halbach Caroline S. , Wagner Lilly H. 
Published: July 2021

Abstract
Esthesioneuroblastoma is a rare neoplasm originating from the olfactory neuroepithelium at the cribriform plate. The superior nasal cavity is primarily affected. Morbidity and mortality are related to locally destructive growth as well as metastatic potential. Orbital involvement is associated with decreased survival. The authors describe a case of advanced esthesioneuroblastoma with bilateral orbital involvement, presenting with a rare constellation of orbital hypertelorism and Foster-Kennedy Syndrome.
The Use of Dual Energy X-Ray Bone Density Scan in Assessment of Alveolar Cleft Grafting Using Bone Marrow Stem Cells Concentrate/Platelet-Rich Fibrin Regenerative Technique
Authors: Mossaad Aida M. , Ahmady Hatem H. Al , Ghanem Wael H. , Abdelrahman Moustapha A. , Abdelazim Ahmed F. , Elsayed Shadia A. 
Published: July 2021

Objectives:
To determine the densitometric quality of regenerated bone at the site of bone marrow and platelet-rich membrane grafting technique at unilateral alveolar cleft region using dual energy x-ray bone density scan (DEXA).

Methods:
The present prospective cohort study included 16 unilateral alveolar cleft patients who were selected randomly from the outpatient maxillofacial surgery clinic and suffered from unilateral alveolar cleft. Bone marrow aspirate and platelet-rich fibrin (PRF) (bone marrow stem cells + PRF) were used as the grafting material. Six months of follow-up have been conducted for all patients’ including clinical and radiographic assessments with (DEXA scan).

Results:
Sixteen unilateral patients with a mean age of 12.56 ± 1.71 years were included in the sample and the majority of patients were females with a frequency of 56.2 percent. The current research revealed no infection or wound dehiscence. After surgery, the pain and edema scores were reasonable. Our findings showed that, after 6 months of regenerative graft, the average bone mineral density of the cleft side DEXA scan value was 1.56 ± 0.32 gm/cm2, compared to 1.51 ± 0.488 gm/cm2 on the normal side of the noncleft scan. There was no statistically significant difference in DEXA bone mineral content measurements between the cleft and standard sides (P = 0.461).

Conclusions:
The bone marrow stem cells + PRF regenerative graft technique has been successfully integrated, and the DEXA scan approach for measuring regenerated grafted bone mineral content was found to be appropriate for simple and inexpensive follow-up of alveolar cleft lip patients.
Effect of Perioperative Systemic Dexamethasone on Pain, Edema, and Trismus in Mandibular Fracture Surgery: A Randomized Trial
Authors: Oksa Marko , Haapanen Aleksi , Furuholm Jussi , Thorén Hanna , Snäll Johanna 
Published: July 2021

Abstract
The authors’ aim was to evaluate the effect of perioperative systemic dexamethasone (DXM) administration on postoperative pain, edema, and trismus in mandibular fracture patients. The authors conducted a prospective randomized study of 45 patients with one or 2 noncomminuted fractures of the dentate part of the mandible. All patients underwent surgery for intraoral miniplate fixation. Patients in the study group were given a total of 30 mg DXM, while patients in the control group received neither DXM nor placebo. Only paracetamol and opioids were served as analgesics. Pain severity was assessed using the visual analog scale. The effect in facial swelling was measured in centimeters and analyzed as percentage change. Trismus was evaluated as the difference in maximal mouth opening by measuring interincisal distance in millimeters. The Mann-Whitney U test was applied to determine the statistical significance of differences between the groups. Thirty-four patients were included in the statistical analysis. The visual analog scale score was significantly lower in the study group than in the control group at 18 hours postoperatively (P = 0.033). Significant differences in edema or trismus were not found postoperatively between the DXM and control groups. In conclusion, perioperative DXM decreases postoperative pain in mandibular fracture patients when nonsteroidal anti-inflammatory drugs are not used, but it does not seem to be effective in reducing edema or trismus.
Temporal Bone Pneumatization: Relationship With Sex and Variants of the Ethmoid and Sphenoid Bone
Authors: Gibelli Daniele , Cellina Michaela , Gibelli Stefano , Panzeri Marta , Termine Giovanni , Floridi Chiara , Sforza Chiarella 
Published: July 2021

Abstract
Pneumatization variants of the temporal bone have a crucial importance in several surgical interventions. However, very few data are known about possible correlation with other pneumatization variants.
Pneumatization of glenoid fossa, petrous apex, and infralabyrinthine portion of temporal bone was assessed in 200 computed tomography scans, equally divided between males and females (18–92 years). Pneumatization variants of the ethmoid (concha bullosa, agger nasi, pneumatized crista galli) and the sphenoid sinuses (pneumatized pterygoid processes, anterior clinoid processes, dorsum sellae, volume) were recorded as well.
Differences in prevalence of each pneumatization type according to sex and side, among different portions of the temporal bone, and between temporal bone and the pneumatized variants of the ethmoid bone and sphenoid sinuses, were assessed through chi-square test (P < 0.05). Differences in sphenoid volume among different pneumatization degrees of the temporal bone were assessed through 1-way analysis of covariance test (P < 0.05).
Pneumatization of the petrous apex and the infralabyrinthine portion was significantly more frequent in males than in females, whereas pneumatization of the glenoid fossa was more often observed on the right side (P < 0.05). Variants of the temporal bone are all related one with each other in males, whereas in females only the relationship between pneumatized petrous apex and infralabyrinthine portion was found. Moreover, in females the pneumatized petrous apex was related with pneumatized anterior clinoid process, and the pneumatized infralabyrinthine portion was related with the sphenoid sinus volume.
Results may be useful for predicting these important variants in planning surgical interventions of the cranial base.
Benefits and Reduced Hospital Costs of Direct Surgery in Perforated Appendicitis With Abscess Cost-effectiveness Analysis of Treatment Complicated Appendicitis
Authors: Kim Euitae , Kim Kilhwan , Park Yoonjoon 
Published: July 2021

Purpose:
Elective interval appendectomy (IA) after percutaneous catheter drainage (PCD) is traditionally advocated for perforated appendicitis with an abscess. However, this is not the only way to manage these patients when we consider the cost-effectiveness of treatment. This study compared the outcomes and cost-effectiveness of patients who underwent IA and those who underwent direct surgery.

Materials and Methods:
A retrospective analysis of 79 patients who were diagnosed with perforated appendicitis with abscess was conducted. We compared the hospital course, outcomes, and total medical costs between the 2 groups.

Results:
Forty-three patients underwent PCD insertion for the management of appendiceal abscess (IA group), and 36 underwent appendectomy (DS group). There was no significant difference in abscess size (5.67 vs. 5.35 cm, P=0.15), appendectomy method (laparoscopic/open 39/4 vs. 37/5, P=0.523), or complications (7 vs. 6 cases, P=0.963) between the 2 groups. The operation time was longer in the DS group (83.8 vs. 112.7 min, P<0.001). However, length of hospitalization (15.4 vs. 7.7 d, P<0.001) and total hospital cost (US$2090.47 vs. US$3402.22, P<0.001) was greater in the IA group.

Conclusion:
Direct surgery without PCD insertion in perforated appendicitis accompanied by abscess is more cost-effective and reduces the total length of hospitalization compared with the traditional IA.
Cancer care disparities among Australian and Aotearoa New Zealand Indigenous peoples
Authors: Davies Amy , Gurney Jason , Garvey Gail , Diaz Abbey , Segelov Eva 
Published: July 2021

Purpose of review
Persistent and significant inequalities for Indigenous people with cancer around the globe exist, arising from colonial settlement of Indigenous land with profound social, economic and cultural impacts. We summarize recent publications concerning cancer disparities affecting Australian Aboriginal and Torres Strait Islander Peoples and Aotearoa New Zealand Māori Peoples.

Recent findings
Cancer-free survival and overall survival statistics testify to the urgent need to ‘close the gap’. For Indigenous peoples in Australia and New Zealand, disparity persists along the cancer care pathway, from increased risk factors to lower screening access, health resource utilization and survivorship care. Recent publications highlight multimorbidity as contributing to poor cancer outcomes in Indigenous populations. The implementation of tailored Optimal Care Pathways is described, as is the validation of tailored tools capturing the perspectives of Indigenous persons. Finally, the importance of Indigenous-led research is emphasized.

Summary
Cancer-specific outcomes in Indigenous people of Australia and New Zealand remain poor with many widening disparities compared to non-indigenous populations. A growing body of epidemiological, health service and clinical research is documenting both the problems and potential solutions. Further work is needed in both broad health policies and the workforce, in building cultural competence to optimize individual care encounters.
Hypoventilation syndrome in neuromuscular disorders
Authors: Wenninger Stephan , Jones Harrison N. 
Published: July 2021

Purpose of review
Hypoventilation syndrome in neuromuscular disorders (NMDs) is primarily due to respiratory muscle weakness and results in increased morbidity and mortality. This article highlights current aspects of neuromuscular hypoventilation syndrome, including pathophysiology, clinical symptoms, assessment, respiratory involvement in various NMD, and causal and symptomatic treatments with an emphasis on recent research and advances.

Recent findings and Summary
New therapeutic agents have been developed within the last years, proving a positive effect on respiratory system. Symptomatic therapies, including mechanical ventilation and cough assistance approaches, are important in NMD and respiratory muscle training may have benefit in strengthening respiratory muscles and should be offered patients with respiratory muscle weakness the same way as physiotherapy. Correct respiratory assessments and their correct interpretation are hallmarks for early diagnosis of hypoventilation syndrome and treatment.
Depression predicts chronic pain interference in racially-diverse, low-income patients
Authors: Nephew Benjamin C. , Rodriguez Angela C. Incollingo , Melican Veronica , Polcari Justin J. , Nippert Kathryn E. , Rashkovskii Mikhail , Linnell Lilly-Beth , Hu Ruofan , Ruiz Carolina , King Jean A. , Gardiner Paula 
Published: July 2021

ABSTRACTBackgroundChronic pain is one of the most common reasons adults seek medical care in the US, with estimates of prevalence ranging from 11% to 40%. Mindfulness meditation has been associated with significant improvements in pain, depression, physical and mental health, sleep, and overall quality of life. Group medical visits are increasingly common and are effective at treating myriad illnesses including chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence based integrative medicine, and medical group visits and can be used as adjuncts to medications, particularly in diverse underserved populations with limited access to non-pharmacological therapies.Objective and DesignThe objective of the present study was to use a blended analytical approach of machine learning and regression analyses to evaluate the potential relationship between depression and chronic pain in data from a randomized clinical trial of IMGV in socially diverse, low income patients suffering from chronic pain and depression.MethodsThis approach used machine learning to assess the predictive relationship between depression and pain and identify and select key mediators, which were then assessed with regression analyses. It was hypothesized that depression would predict the pain outcomes of average pain, pain severity, and pain interference.ResultsOur analyses identified and characterized a predictive relationship between depression and chronic pain interference. This prediction was mediated by high perceived stress, low pain self-efficacy, and poor sleep quality, potential targets for attenuating the adverse effects of depression on functional outcomes.ConclusionsIn the context of the associated clinical trial and similar interventions, these insights may inform future treatment optimization, targeting, and application efforts in racially diverse, low income populations, demographics often neglected in studies of chronic pain.
Efficacy of remdesivir-containing therapy in hospitalized COVID-19 patients: a prospective clinical experience
Authors: Russo Alessandro , Binetti Erica , Borrazzo Cristian , Cacciola Elio Gentilini , Battistini Luigi , Ceccarelli Giancarlo , Mastroianni Claudio Maria , d’Ettorre Gabriella 
Published: July 2021

ABSTRACTObjectivesremdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2.Methodsthis was a prospective, observational study conducted on a large population of patients hospitalized for COVID-19. The primary endpoint of the study was to evaluate the impact of remdesivir-containing therapy on 30-day mortality; secondary endpoint was the impact of remdesivir-containing therapy on the need of high flow oxygen therapy (HFNC) or non-invasive ventilation (NIV) or mechanical ventilation. Data were analyzed after propensity score matching.Results407 patients with SARS-CoV-2 pneumonia were consecutively enrolled. Out of these, 294 (72.2%) and 113 (27.8%) were respectively treated or not with remdesivir. Overall, 61 (14.9%) patients were treated during hospitalization with non-invasive or mechanical ventilation, while a 30-day mortality was observed in 21 (5.2%) patients with a global in-hospital mortality of 11%. Cox regression analysis, after propensity score matching, showed that therapies, including remdesivir-containing therapy, were not statistically associated with 30-day survival or mortality, while need of HFNC/NIV (HR 17.921, CI95% 0.954-336.73, p=0.044) and mechanical ventilation (HR 3.9, CI95% 5.36-16.2, p=0.003) resulted independently associated with 30-day mortality. Finally, therapies including or not remdesivir were not independently associated with a lower or higher risk of HFNC/NIV or mechanical ventilation.Conclusionsthis real-life experience about the remdesivir use in hospitalized patients with COVID-19 was not associated with significant increase in rates of survival or reduced use of HFNC/NIV or mechanical ventilation, compared to patients treated with other therapies not including remdesivir.
Evaluation of gait cycle time variability in patients with knee osteoarthritis using a triaxial accelerometer
Authors: Akimoto Takeshi , Kawamura Kenji , Wada Takaaki , Ishihara Naomichi , Yokota Akane , Suginoshita Takehiko , Yokoyama Shigeki 
Published: July 2021

AbstractKnee osteoarthritis can alter gait variability. However, few studies have compared the temporal factors of the gait cycle between patients with knee osteoarthritis and healthy subjects. Furthermore, no studies have investigated the relationship between gait variability and potential contributing factors (knee joint functions such as muscle strength) in knee osteoarthritis. The first objective of this study was to compare gait cycle variability between female patients with knee osteoarthritis and healthy elderly women to determine gait characteristics in patients with knee osteoarthritis. The second objective was to examine whether gait cycle variability in knee osteoarthritis is associated with potential contributing factors. Twenty-four female patients diagnosed with knee osteoarthritis and 12 healthy elderly women participated. Gait cycle variability (coefficient of variation of gait cycle time), knee extension range of motion, knee extension strength, 5-meter walk test, Timed Up & Go Test, and Western Ontario and McMaster Universities Osteoarthritis Index were measured. All assessment results were compared between the knee osteoarthritis and healthy groups. Gait cycle variability was significantly higher in the knee osteoarthritis group (3.2%±1.5%) compared to the healthy group (2.1%±0.7%). A significant positive correlation was found between the gait cycle variability and 5-meter walk test (r=0.46) and Western Ontario and McMaster Universities Osteoarthritis Index (r=0.43). The gait of patients with knee osteoarthritis may be more unstable than that of healthy individuals. In addition, unstable gait may be associated with gait speed and quality of life. Therefore, we believe that rehabilitation to improve unstable gait can enhance the quality of life of patients with knee osteoarthritis.
Nonresponse adjustment using clinical and perioperative patient characteristics is critical for understanding post-discharge opioid consumption
Authors: Kennedy Chris J. , Marwaha Jayson S. , Scalise P. Nina , Robinson Kortney A. , Booth Brandon , Fleishman Aaron , Nathanson Larry A. , Brat Gabriel A. 
Published: July 2021

AbstractBackgroundPost-discharge opioid consumption is an important source of data in guiding appropriate opioid prescribing guidelines, but its collection is tedious and requires significant resources. Furthermore, the reliability of post-discharge opioid consumption surveys is unclear. Our group developed an automated short messaging service (SMS)-to-web survey for collecting this data from patients. In this study, we assessed its effectiveness in estimating opioid consumption by performing causal adjustment and comparison to a phone-based survey as reference.MethodsPatients who underwent surgical procedures at our institution from 2019-2020 were sent an SMS message with a link to a secure web survey to quantify opioids consumed after discharge. Several patient factors extracted from the EHR were tested for association with survey response. Following targeted learning (TL) nonresponse adjustment using these EHR-based factors, opioid consumption survey results were compared to a prior telephone-based survey at our institution as a reference.Results6,553 patients were included. Opioid consumption was measured in 2,883 (44%), including 1,342 (20.5%) through survey response. Characteristics associated with inability to measure opioid consumption included age, length of stay, race, tobacco use, and missing preoperative assessment. Among the top 10 procedures by volume, EHR-based TL nonresponse bias adjustment corrected the median opioid consumption reported by an average of 57%, and corrected the 75th percentile of reported consumption by an average of 11%. This brought median estimates for 6/10 procedures closer to telephone survey-based consumption estimates, and 75th percentile estimates for 3/10 procedures closer to telephone survey-based consumption estimates.ConclusionWe found that applying electronic health record (EHR)-based machine learning nonresponse bias adjustment is essential for debiased opioid consumption estimates from patient surveys. After adjustment, post-discharge surveys can generate reliable opioid consumption estimates. Clinical factors from the EHR combined with TL adjustment appropriately capture differences between responders and nonresponders and should be used prior to generalizing or applying opioid consumption estimates to patient care.