bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase I/II Dose-Escalation Trial of 3-Fraction Stereotactic Radiosurgery for Resection Cavities From Large Brain Metastases
Authors: Rahimy Elham , Dudley Sara A. , von Eyben Rie , Pollom Erqi L. , Seiger Kira , Modlin Leslie , Wynne Jacob , Fujimoto Dylann , Jacobs Lisa R. , Chang Steven D. , Gibbs Iris C. , Hancock Steven L. , Adler John R. , Li Gordon , Choi Clara Y.H. , Soltys Scott G. 
Published: September 2021

Objectives:
We investigated differences in quality of life (QoL) in patients enrolled on a phase I/II dose-escalation study of 3-fraction resection cavity stereotactic radiosurgery (SRS) for large brain metastases.

Methods:
Eligible patients had 1 to 4 brain metastases, one of which was a resection cavity 4.2 to 33.5 cm3. European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires core-30 (QLQ-30) and brain cancer specific module (QLQ-BN20) were obtained before SRS and at each follow-up. Nine scales were analyzed (global health status; physical, social, and emotional functioning; motor dysfunction, communication deficit, fatigue, insomnia, and future uncertainty). QoL was assessed with mixed effects models. Differences ≥10 points with q-value (adjusted P-value to account for multiplicity of testing) <0.10 were considered significant.

Results:
Between 2009 and 2014, 50 enrolled patients completed 277 QoL questionnaires. Median questionnaire follow-up was 11.8 months. After SRS, insomnia demonstrated significant improvement (q=0.032, −17.7 points at 15 mo post-SRS), and future uncertainty demonstrated significant worsening (q=0.018, +9.9 points at 15 mo post-SRS). Following intracranial progression and salvage SRS, there were no significant QoL changes. The impact of salvage whole brain radiotherapy could not be assessed because of limited data (n=4 patients). In the 28% of patients that had adverse radiation effect, QoL had significant worsening in 3 metrics (physical functioning, q=0.024, emotional functioning q=0.001, and future uncertainty, q=0.004).

Conclusions:
For patients treated with 3-fraction SRS for large brain metastasis cavities, 8 of 9 QoL metrics were unchanged or improved after initial SRS. Intracranial tumor progression and salvage SRS did not impact QoL. Adverse radiation effect may be associated with at least short-term QoL impairments, but requires further investigation.
Optimizing Parameters for Smoke Evacuation
Authors: Ahluwalia Jusleen , de Golian Emily , Yuan Joyce , Brian Jiang Shang I. 
Published: September 2021

BACKGROUND
Current literature lacks recommendations regarding the ideal organization of the smoke evacuation system to minimize inhalation of surgical smoke.

OBJECTIVE
This study determines optimal parameters of the smoke evacuation system with respect to the surgical field.

MATERIALS AND METHODS
This study was conducted in an outpatient surgical facility at a tertiary care center. After 30 seconds of continuous electrocautery of tissue, particulate measurements were recorded using the TSI DustTrak Aerosol Monitor 8520 (>2.5 μm particles) and the TSI P-Trak Ultrafine Particle Counter 8525 (<1 μm particles) while changing the angle and distance of the smoke evacuation system.

RESULTS
Particulate matter measurements were lower when suction angle was at 45° than at 90°. For both small-sized and large-sized particles, the lowest particulate matter was recorded when the evacuator was maintained at a 45° angle, 2 to 4 inches away from the cauterizing procedure. Particulate matters dramatically increased after increasing the distance of the smoke evacuator beyond 8 inches from the procedural site.

CONCLUSION
In an effort to reduce smoke inhalation, the authors recommend that smoke evacuation should be placed at a 45° suction angle, no further than 8 inches away from the surgical site, while preserving the surgeon's field of vision.
Intra-operative ventilator mechanical power as a predictor of postoperative pulmonary complications in surgical patients
Authors: Karalapillai Dharshi , Weinberg Laurence , Neto A Serpa , Peyton Philip , Ellard Louise , Hu Raymond , Pearce Brett , Tan Chong O. , Story David , O’Donnell Mark , Hamilton Patrick , Oughton Chad , Galtieri Jonathan , Wilson Anthony , Eastwood Glenn , Bellomo Rinaldo , Jones Daryl A. 
Published: September 2021

BACKGROUND
Studies in critically ill patients suggest a relationship between mechanical power (an index of the energy delivered by the ventilator, which includes driving pressure, respiratory rate, tidal volume and inspiratory pressure) and complications.

OBJECTIVE
We aimed to assess the association between intra-operative mechanical power and postoperative pulmonary complications (PPCs).

DESIGN
Post hoc analysis of a large randomised clinical trial.

SETTING
University-affiliated academic tertiary hospital in Melbourne, Australia, from February 2015 to February 2019.

PATIENTS
Adult patients undergoing major noncardiothoracic, nonintracranial surgery.

INTERVENTION
Dynamic mechanical power was calculated using the power equation adjusted by the respiratory system compliance (C
RS). Multivariable models were used to assess the independent association between mechanical power and outcomes.

MAIN OUTCOME MEASURES
The primary outcome was the incidence of PPCs within the first seven postoperative days. The secondary outcome was the incidence of acute respiratory failure.

RESULTS
We studied 1156 patients (median age [IQR]: 64 [55 to 72] years, 59.5% men). Median mechanical power adjusted by C
RS was 0.32 [0.22 to 0.51] (J min−1)/(ml cmH2O−1). A higher mechanical power was also independently associated with increased risk of PPCs [odds ratio (OR 1.34, 95% CI, 1.17 to 1.52); P < 0.001) and acute respiratory failure (OR 1.40, 95% CI, 1.21 to 1.61; P < 0.001).

CONCLUSION
In patients receiving ventilation during major noncardiothoracic, nonintracranial surgery, exposure to a higher mechanical power was independently associated with an increased risk of PPCs and acute respiratory failure.

TRIAL REGISTRATION
Australia and New Zealand Clinical Trials Registry no: 12614000790640.
Afterload-related cardiac performance predicts prognosis in critical ill patients with sepsis
Authors: Zhao Cong-Cong , Zhang Li-Ru , Liu Li-Xia , Sun Li-Xiao , Hu Zhen-Jie 
Published: September 2021

Abstract
To investigate the usefulness of afterload-related cardiac performance (ACP) for assessing cardiac impairment and predicting prognosis in septic patients.
Adult patients with sepsis in the intensive care unit were included. Cardiac output, cardiac index, cardiac power index, and ACP were calculated at the time of admission (D0) and 48–72 h after admission (D3). They were correlated with Acute Physiology and Chronic Health Evaluation II and sequential organ failure assessment scores, then the prognostic values were analyzed.
A total of 41 patients with sepsis were selected. ACP showed a stronger negative correlation with Acute Physiology and Chronic Health Evaluation II and sequential organ failure assessment scores than cardiac output, cardiac index, and cardiac power index. ACP predicted 28-day mortality with an area under the curve of 0.775 and 0.976 on D0 and D3, respectively. In addition, most non-survivors had emergent cardiac impairment (ACP ≤ 80%) on D0, and cardiac function was deteriorated on D3. Survival analysis showed that the patients with a decreased ACP from D0 to D3 had the highest mortality. The decrease of ACP on D3 was an independent risk factor for mortality (hazard ratio, 11.89; P = .0028).
ACP can be used to assess the severity of cardiac impairment in sepsis. Continued decline of ACP during the first 3 days strongly suggests a poor prognosis.
The assessment of usability of pain medical device by physiatrists and physiotherapists
Authors: Kwak Hyunseok , Oh Hyunjung , Cha Byoungwoo , Kim Jong Moon 
Published: September 2021

Abstract
When developing a new medical device, it is essential to assess the usability of such a device through various stakeholders.
This study assessed the usability of pain medical devices through a Delphi survey administered to physiatrists and physiotherapists.
A Delphi survey was conducted on the problems and improvements in hardware and software for a panel consisting of 10 physiatrists and 10 physiotherapists. A total of 3 rounds of surveys were conducted, and the third round of survey was confirmed through a Likert scale (1 = strongly agree to 5 = strongly disagree).
The 2 groups generally had a common perception of the problems and improvements in pain medical devices. However, the physiatrist group mostly identified problems such as linking patient information, whereas the physiotherapist group deemed hardware problems such as device weight or connection cables as being more important (mean [standard deviation]; physiatrist, hardware 2.90 [0.93], software 2.28 [0.91] / physiotherapist, hardware 3.04 [0.84], software 3.03 [1.13]).
To date, analysis has not been conducted by dividing the focus of various stakeholders using pain medical devices. The difference in view of the usability of these 2 stakeholder groups should be considered when improving the hardware or software of pain medical devices in the future. Further research is warranted to investigate other stakeholders such as patients and device developers to improve the devices.
Cognitive decline according to amyloid uptake in patients with poststroke cognitive impairment
Authors: Yoon Bora , Yang Dong Won , Hong Yun-Jeong , Kim Taewon , Na Seunghee , Noh Sang-Mi , Park Hye Lim , Ku Bon D. , Yang Young Soon , Choi Hojin , Jang Jae-Won , Kim Seongheon , Kim Yerim , Shim YongSoo 
Published: September 2021

Abstract

Background and purpose:
Poststroke cognitive impairment (PSCI) is common, but the impact of β-amyloid (Aβ) on PSCI is uncertain. The proposed study will investigate amyloid pathology in participants with PSCI and how differently their cognition progress according to the amyloid pathology.

Methods:
This multicenter study was designed to be prospective and observational based on a projected cohort size of 196 participants with either newly developed cognitive impairment, or rapidly aggravated CI, within 3 months after acute cerebral infarction. They will undergo 18F-flutemetamol positron emission tomography at baseline and will be categorized as either amyloid-positive (A+) or amyloid-negative (A−) by visual rating. The primary outcome measures will be based on Korean Mini-Mental State Examination changes (baseline to 12 months) between the A+ and A− groups. The secondary outcome measures will be the dementia-conversion rate and changes in the Korean version of the Montreal Cognitive Assessment (baseline to 12 months) between the A+ and A− groups.

Conclusions:
This study will provide a broadened perspective on the impact of Aβ on the cause and outcomes of PSCI in clinical practice. Identifying amyloid pathology in patients with PSCI will help select patients who need more focused treatments such as acetylcholinesterase inhibitors

Trial registration:
Clinical Research Information Service identifier: KCT0005086
Hypothermia therapy for the treatment of acute myocardial infarction
Authors: Jiang Fen , Zeng Defei , Xing Kongyu , Yang Xiaoli 
Published: September 2021

Abstract

Background:
In patients with acute myocardial infarction (AMI) receiving percutaneous coronary intervention (PCI), the role of systemic therapeutic hypothermia remains controversial. We performed a protocol for systematic review and meta-analysis to investigate the effect of systemic therapeutic hypothermia in patients with AMI receiving PCI.

Methods:
This study will use the Cochrane Library, Web of Science, PubMed, Embase, Allied and Complementary Medicine Database, China Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and Ongoing Clinical Trials Database. The search terms were hypothermia, cooling, myocardial infarction, myocardial ischemia and acute coronary syndrome. Quality assessment of the included studies was evaluated using the Cochrane risk of bias assessment tool. Statistical analyses were performed using RevMan 5.4 software.

Results:
The findings of this study will be submitted to peer-reviewed journals for publication.

Conclusion:
This systematic review will provide evidence to determine whether hypothermia therapy is an effective and safe intervention for patients with AMI receiving PCI.
Registration number: 10.17605/OSF.IO/9XJSB.
CXCL10 and its related key genes as potential biomarkers for psoriasis
Authors: Zou Ailing , Jian Qichao 
Published: September 2021

Abstract
Although several studies have attempted to investigate the etiology of and mechanism underlying psoriasis, the precise molecular mechanism remains unclear. Our study aimed to explore the molecular mechanism underlying psoriasis based on bioinformatics.
GSE30999, GSE34248, GSE41662, and GSE50790 datasets were obtained from the Gene Expression Omnibus database. The Gene Expression Omnibus profiles were integrated to obtain differentially expressed genes in R software. Then a series of analyses was performed, such as Gene Ontology annotation, Kyoto Encyclopedia of Genes and Genomes pathway analysis, protein-protein interaction network analysis, among others. The key genes were obtained by CytoHubba, and validated by real-time quantitative polymerase chain reaction.
A total of 359 differentially expressed genes were identified between 270 paired lesional and non-lesional skin groups. The common enriched pathways were nucleotide-binding and oligomerization domain-like receptor signaling pathway, and cytokine-cytokine receptor interaction. Seven key genes were identified, including CXCL1, ISG15, CXCL10, STAT1, OASL, IFIT1, and IFIT3. These key genes were validated as upregulated in the 4 datasets and M5-induced HaCaT cells.
Our study identified 7 key genes, namely CXCL1, ISG15, CXCL10, STAT1, OASL, IFIT1, and IFIT3, and 2 mostly enriched pathways (nucleotide-binding and oligomerization domain-like receptor signaling pathway, and cytokine-cytokine receptor interaction) involved in psoriatic pathogenesis. More importantly, CXCL1, ISG15, STAT1, OASL, IFIT1, IFIT3, and especially CXCL10 may be potential biomarkers. Therefore, our findings may bring a new perspective to the molecular mechanism underlying psoriasis and suggest potential biomarkers.
Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment
Authors: Suwanthanma Weerapat , Kitudomrat Saowanee , Euanorasetr Chakrapan 
Published: September 2021

Abstract
To determine the clinical and pathological outcome of locally advanced rectal cancer patients treated with neoadjuvant chemoradiation (chemoradiotherapy [CRT]) followed by curative surgery and to identify predictive factors of pathological complete response (pCR).
Locally advanced rectal cancer patients undergoing CRT followed by curative surgery from January 2012 to December 2017 were included. Patient's demographic data, pretreatment tumor characteristics, type of CRT regimens, type of surgery, postoperative complications, pathological reports and follow up records were analyzed. Univariate and multivariate analyses were applied to identify predictive factors for pCR. Five-year disease free and overall survival were estimated by Kaplan–Meier method and compared between pCR and non-pCR groups.
A total of 85 patients were analyzed. Eighteen patients (21.1%) achieved pCR. The sphincter-saving surgery rate was 57.6%. After univariate analyses, tumor length >4 cm (P = .007) and positive lymph nodes (P = .040) were significantly associated with decreased rate of pCR. Complete clinical response was significantly associated with higher rate of pCR (P = .015). Multivariate analyses demonstrated that tumor length >4 cm (P = .010) was significantly associated with decreased rate of pCR. After a median follow-up of 65 months (IQR 34–79), the calculated 5-year overall survival and disease-free survival rates were 81.4% and 69.7%, respectively. Patients who achieved pCR tend to had longer 5-year disease-free survival (P = .355) and overall survival (P = .361) than those who did not.
Tumor length >4 cm was associated with decreased rate of pCR in locally advanced rectal cancer who had CRT followed by surgery. Longer waiting time or more intense adjuvant treatment may be considered to improved pCR and oncological outcomes.
Clinical usefulness of PET/MRI in differentiating anterior mediastinal masses
Authors: Sugawara Haruto , Ito Kimiteru , Watanabe Hirokazu , Morita Takahiro , Yatabe Yasushi , Watanabe Shun-ichi , Kusumoto Masahiko 
Published: September 2021

Objectives
To investigate the clinical usefulness of 18F-fluorodeoxyglucose (FDG) PET/MRI in differentiating anterior mediastinal lesions, including small ones.

Material and methods
Among 96 patients who underwent 18F-FDG PET/MRI screening for anterior mediastinal lesions, we retrospectively reviewed images of 42 patients with histologically or clinically diagnosed thymic carcinomas, thymomas or anterior mediastinal cysts. MRI findings and maximum standardized uptake value (SUVmax) were compared among the three categories. In addition, small lesions measuring <3.0 cm which did not show very high signal intensity (isointense to water) on T2 weighted images (T2WI) were sub-analyzed.

Results
Significant differences in SUVmax were observed among anterior mediastinal cysts (P < 0.001, vs. thymomas and thymic carcinomas), thymomas (P = 0.032, vs. thymic carcinomas) and thymic carcinomas. Regarding the MRI findings, anterior mediastinal cysts showed higher T2WI signal intensity (P = 0.004 vs. thymomas and P = 0.042 vs. thymic carcinomas) and thymic carcinomas tended to show ill-defined contours (P = 0.024 vs. anterior mediastinal cysts and P = 0.036 vs. thymomas). SUVmax was also significantly higher in small thymic tumors than small anterior mediastinal cysts without very high T2WI signal intensity (P = 0.003).

Conclusion
18F-FDG PET/MRI is clinically useful in differentiating anterior mediastinal lesions, including those smaller than 3 cm.
“It Took Away the Joy:” First American Mothers' Experiences with Postpartum Depression
Authors: Heck Jennifer L. , Wilson Janet Sullivan , Parker Judy Goforth 
Published: September 2021

Abstract

Background:
Postpartum depression (PPD) is a devastating mental illness associated with adverse health outcomes for mother, child, and family. Higher PPD prevalence in First American women suggests a racial/ethnic disparity, yet little is known about how PPD is experienced from their perspective.

Purpose:
To 1) describe First American women's PPD experiences and the meanings they ascribe to those experiences and 2) describe the cultural knowledge, influences, and practices during the perinatal period.

Study Design and Methods:
This phenomenological study used a community-based participatory research approach. Criterion and snowball sampling captured First American women who had PPD now or in the past (N = 8). Interviews used a semistructured guide and thematic analysis followed.

Results:
Mean age was 30.25 years. Most women were multigravidas (n = 7) and rated themselves as “very” (n = 4) or “mostly” (n = 3) Native American. Women were mostly of low socioeconomic status and had a history of depression (n = 7) and/or a history of prenatal depression (n = 6). Themes: 1) stressors that contributed to PPD; 2) how PPD made me feel; 3) what made my PPD better; 4) heritage-centered practices; 5) support through PPD; 6) how I felt after PPD; and 7) am I a good mother?

Clinical Implications:
This study provides a better understanding of some First American women's PPD experiences that facilitates judgment of the importance of PPD within a cultural context. Clinicians need to create culturally appropriate responses to First American women's PPD needs.
Can You Trust Dr Google for Health and Nutrition?
Authors: Cai Hannah C. , Dwyer Johanna T. 
Published: September 2021

Most patients realize that the Internet is no substitute for professional advice, but they cannot resist the impulse to cruise the Web to get a second opinion from “Dr Google.” Can they trust Dr Google for health and nutrition advice?
This article describes what the Google search engine is, how it is funded, and why health professionals and consumers should be wary of using it for health and nutrition information. These search results often lack objectivity, feature unsound recommendations based on faulty evidence, and include a confusing mixture of advertisements, anecdotal reports, and even outlandish claims. The Internet is no substitute for professional advice, but it is here to stay, and we summarize ways to separate dependable from dubious search engine results.
The Relationship between High-reliability practice and Hospital-acquired conditions among the Solutions for Patient Safety Collaborative
Authors: Randall Kelly H. , Slovensky Donna , Weech-Maldonado Robert , Sharek Paul 
Published: September 2021

Introduction:
Theoretically, the application of reliability principles in healthcare can improve patient safety outcomes by informing process design. As preventable harm continues to be a widespread concern in healthcare, evaluating the association between integrating high-reliability practices and patient harms will inform a patient safety strategy across the healthcare landscape. This study evaluated the association between high-reliability practices and hospital-acquired conditions.

Methods:
Twenty-five pediatric organizations participating in the Children’s Hospitals Solutions for patient safety collaborative participated in this nonexperimental design study. A survey utilizing the high-reliability healthcare maturity model assessed the extent of implementing high-reliability practices at each participating site. We analyzed responses for each component and a composite score of high reliability against an aggregate measure of hospital-acquired conditions.

Results:
Of the 95 invited sites, 49 responded and 25 were included in the final results. There was a significant inverse relationship between the culture of safety component score and the Serious Harm Index (odds ratio [OR] = 0.63, 95% confidence interval [CI] 0.42–0.95, P = 0.03). There was no association between the overall high-reliability score (OR = 0.91, 95% CI 0.78–1.05, P = 0.19), the Leadership component score (OR = 0.97, 95% CI 0.70–1.33, P = 0.84), or the robust process improvement (RPI) component score (OR = 0.75, 95% CI 0.41–1.28, P = 0.26) and the Serious Harm Index.

Conclusion:
The integration of high-reliability principles within healthcare may support improved patient safety in the hospital setting. Further research is needed to articulate the breadth and magnitude of the impact of integrating high-reliability principles into healthcare.