bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosis and Management of Thick and Ultrathick Melanoma
Authors: Blakely Andrew M. , Cohen Joshua T. , Comissiong Danielle S. , Vezeridis Michael P. , Miner Thomas J. 
Published: September 2019

Objectives:
Thick melanomas, defined as ≥4 mm in thickness, represent ~5% of new melanoma diagnoses and have been associated with poor overall survival (OS). Ultrathick melanomas, those lesions ≥8 mm in thickness, have been associated with worse survival. We sought to compare prognostic factors for thick and ultrathick melanoma.

Methods:
Retrospective analysis of a prospective database of all patients receiving an operation for melanoma, June 2005 to December 2016 was performed. Multivariate Cox proportional hazards regression analyses were performed to identify predictors of progression-free survival (PFS) and OS.

Results:
Of 95 patients with thick melanoma, 37 (39%) had ultrathick tumors (≥8 mm thick). Thick and ultrathick lesions were not significantly different on the basis of tumor location, ulceration, mitotic rate, lymphovascular invasion, or performance or positivity of sentinel node biopsy or therapeutic lymphadenectomy. Disease recurrence was identified in 38 patients overall (40%), more commonly in ultrathick disease (55% vs. 29%, P=0.008). Serum neutrophil to lymphocyte ratio (NLR) was available for 36 patients, of whom 23 (64%) had high NLR (>3.0). Decreased PFS was independently associated with ultrathick tumors (HR, 2.9; P=0.003), head/neck location (HR, 2.6; P=0.023), and positive lymph nodes (HR, 3.3; P=0.004). Decreased OS was independently associated with high NLR (HR, 5.0; P=0.042).

Conclusions:
Disease progression was higher in the ultrathick melanoma group. Thicker tumors, head/neck location, and positive lymph nodes were associated with decreased PFS. High NLR was associated with decreased OS. Ultrathick melanomas represent advanced malignancy; however, patients may derive benefit from surgical treatment to achieve locoregional control.
Multimedia Technology Used to Supplement Patient Consent for Mohs Micrographic Surgery
Authors: West Lindsey , Srivastava Divya , Goldberg Leonard H. , Nijhawan Rajiv I. 
Published: September 2019

BACKGROUND
The patient consent process traditionally relies on conversations between the physician and the patient and rarely utilizes supplemental multimedia aids.

OBJECTIVE
To determine whether the addition of an educational video on Mohs micrographic surgery (MMS) can improve patient satisfaction with the consent process.

MATERIALS AND METHODS
This prospective observational quality improvement study compared the outcomes of traditional patient consent alone versus standard consent plus an educational video among patients undergoing their first MMS for a primary skin cancer. End points were patient satisfaction and preferences measured by postprocedure questionnaires.

RESULTS
The addition of a supplemental video to the consent process did not affect overall patient satisfaction, which was very high in both video and control groups. However, specific components of patient satisfaction were improved such as patient perception of the opportunity to ask questions and understand the procedure.

CONCLUSION
Multimedia aids can be effective tools in the patient consent process.
Cicatricial Ectropion Repair for Dermatologic Surgeons
Authors: Kooistra Laura J. , Scott Jeffrey F. , Bordeaux Jeremy S. 
Published: September 2019

BACKGROUND
Cicatricial ectropion occurs when tension of a scar below the eye has sufficient downward pull to evert the lower eyelid. There are many surgical techniques to repair cicatricial ectropion.

OBJECTIVE
To review the published literature on the repair of cicatricial ectropion, review relevant anatomy, and review surgical considerations for patients with cicatricial ectropion from the perspective of a dermatologic surgeon.

MATERIALS AND METHODS
A search of PubMed was conducted to identify articles on cicatricial ectropion repair through December 1, 2017. Articles were individually reviewed for applicability to dermatologic surgery.

RESULTS
Forty-one articles were reviewed. Many articles report significant differences in outcomes when comparing 1 cicatricial ectropion repair technique to another; however, 1 single surgical approach has not been shown to be superior to the rest for most patients.

CONCLUSION
There is a lack of consensus among the literature about the optimal approach to repairing cicatricial ectropion. The selection of surgical technique will vary depending on several factors including the lateral or medial extent of the ectropion, the degree of scarring and tissue density of potential donor sites for a skin flap, and the severity of lid laxity.
A Study of 219Rn Outgassing and 211Pb Contamination from 223Ra In dry, Liquid, and Murine Tissue Samples
Authors: Adler Stephen , Baidoo Kwamena , Jagoda Elaine , Phelps Tim , Roy Jyoti , Seidel Jurgen , Lin Frank , Choyke Peter 
Published: September 2019

Abstract

Introduction: A study of 211Pb contamination caused by the outgassing of 219Rn from 223Ra in dry, liquid, and murine tissues samples has been made to help design proper handling procedures for 223Ra in preclinical biodistribution work. Materials and Methods:
211Pb activity levels were measured from 223Ra in dry, liquid, and tissue samples using aspiration and autoradiography techniques. Results: Using aspiration techniques on dry samples of 223Ra, an average 219Rn outgassing rate of 51% ± 21% was measured with one measurement reaching as high as 81%. 31% ± 4% 211Pb contamination was measured within a 4.3 cm radius of a dry 223Ra source placed inside a 10-cm-diameter petri dish where the lip of the petri dish contained the 219Rn dissemination. Without the containment of the petri dish, 219Rn can reach as far as 7.8 cm from the source with trace levels spreading further. Using aspiration techniques on liquid samples of 223Ra, outgassing rates of 219Rn were 0.9% ± 0.3%. The outgassing levels in harvested organs from a biodistribution were as high as 10.1% ± 0.4% for an intraperitoneally injected mouse and 0.204% ± 0.006% for an intravenously injected mouse. The outgassing of the intravenously injected mouse carcass was less than 0.1%. Conclusion: In dry form, the high levels of 219Rn outgassing from a 223Ra source necessitate the use of ventilated biohoods when handling or preparing dry 223Ra from source vials. The very low levels of 219Rn outgassing from 223Ra liquid sources reduces exposure to 219Rn by a factor of 50. 219Rn exposure from murine organ tissue reaches levels of 10% when handling organs from an intraperitoneal injection and less than 0.2% for an intravenous injection.
FLUORESCENCE LIFETIME IMAGING OPHTHALMOSCOPY (FLIO) PATTERNS IN CLINICALLY UNAFFECTED CHILDREN OF MACULAR TELANGIECTASIA TYPE 2 (MACTEL) PATIENTS
Authors: Sauer Lydia , Vitale Alexandra S. , Andersen Karl M. , Hart Barbara , Bernstein Paul S. 
Published: September 2019

Purpose:
Macular telangiectasia Type 2 (MacTel) is an inherited retinal disease following an autosomal dominant pattern with late onset and reduced penetrance. Fluorescence lifetime imaging ophthalmoscopy (FLIO) enhances diagnosis by showing distinct changes in MacTel. This study investigates FLIO-associated changes in clinically unaffected family members.

Methods:
Eighty-one patients with MacTel (61 ± 12 years), 33 clinically healthy children under age 40 years of these MacTel patients (MacTel-C; 31 ± 6 years), 27 other family members (children over age 40 years, siblings, and parents) and 30 controls were investigated with the Heidelberg FLIO. All subjects underwent multimodal conventional imaging, including optical coherence tomography, blue-light reflectance, fluorescein angiography, and macular pigment imaging.

Results:
All 81 patients with MacTel showed typical FLIO patterns. Of the 33 investigated MacTel-C with completely normal eye examinations and conventional imaging, 12 (36%) show FLIO patterns consistent with early MacTel.

Conclusion:
Prolonged FLIO lifetimes in the parafoveal area within the short spectral channel, especially temporally, are MacTel-specific. Fluorescence lifetime imaging ophthalmoscopy detects these lifetime patterns in over one-third of clinically unaffected MacTel-C. Although further studies will be necessary to determine the specificity of FLIO, it may help diagnose MacTel before conventional imaging modalities show changes or patients experience visual disturbances. Early detection may facilitate future gene discovery studies and interventional trials.
EFFECT OF LASER PHOTOCOAGULATION ON MACULAR EDEMA ASSOCIATED WITH MACULAR HOLES
Authors: Francone Anibal , Essilfie Juliet , Sarraf David , Preti Rony C. , Monteiro Mario L. R. , Hubschman Jean-Pierre 
Published: September 2019

Purpose:
To report the outcomes of laser therapy to barricade eccentric full-thickness macular hole with associated cystoid macular edema.

Methods:
We report two patients who developed an eccentric full-thickness macular hole with persistent cystoid macular edema after pars plan vitrectomy with and without internal limiting membrane peel for epiretinal membrane and the results of argon laser therapy.

Results:
Barricade argon laser therapy was applied concentric to the full-thickness macular hole. Associated cystoid macular edema was noted to resolve within 1 to 3 months of therapy in both cases.

Conclusion:
Barricade laser therapy surrounding a macular hole can lead to resolution of associated cystoid macular edema. Pathogenic mechanisms to explain this favorable outcome are discussed.
ALTERNATIVE MANAGEMENT OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA USING INTRAVITREAL METOPROLOL
Authors: Jorge Rodrigo , Chaves Leandro , Cunha Armando da Silva , Correa Zelia M. 
Published: September 2019

Background/Purpose:
To describe a patient with visually symptomatic circumscribed choroidal hemangioma (CCH) treated successfully with intravitreal beta‐blocker.

Methods:
This is an interventional single case report of a 63 year‐old man with a juxtafoveal CCH and extensive subretinal fluid (SRF) unsuccessfully treated with intravitreal anti‐VEGF. Off‐label intravitreal use of metoprolol (50μg/0.05 ml) was then performed. Main outcome measures were resolution or decreased subretinal fluid on OCT, visual stability or improvement, lack of retinal/ocular toxicity.

Results:
Following 2 intravitreal injections of metoprolol (1 month apart), significant response was observed with decrease of SRF and visual improvement to 20/400 during a 9‐week follow‐up after the injections.

Conclusion:
These preliminary findings suggest that intravitreal metoprolol can be a safe alternative treatment for patients with CCH. This off‐label therapy could represent another option for patients with this condition.
Cognitive Dysfunction and Its Predictors in Adult Patients With Cancer Receiving Chemotherapy: A Cross-Sectional Correlational Study
Authors: WAZQAR Dhuha Youssef 
Published: September 2019

ABSTRACT

Background:
Chemotherapy-related cognitive dysfunction, one of the most frequently reported symptoms in patients with cancer, has a negative impact on the daily lives of patients. No research has examined cognitive dysfunction and its potential predictors in adult patients with cancer receiving chemotherapy in Saudi Arabia.

Purpose:
The purpose of this study was to examine the sociodemographic, clinical, and psychological factors associated with cognitive dysfunction in adult patients with cancer receiving chemotherapy.

Methods:
A cross-sectional correlational study was carried out with a convenience sample of 100 adult patients with cancer receiving chemotherapy at a university teaching hospital in Saudi Arabia. The Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, and sociodemographic and clinical surveys were completed by participants. Descriptive statistics and linear regression were used to analyze the data.

Results:
The data showed that the participants experienced moderate-to-severe cognitive dysfunction. Participants performed poorly in the divided attention and memory cognitive domains. Age, educational level, and depression factors were found to be significant predictors of cognitive dysfunction.

Conclusions/Implications for Practice:
Cognitive dysfunction is commonly seen in patients with cancer receiving chemotherapy. Chemotherapy, age, and psychological factors increase susceptibility to cognitive dysfunction in adult patients with cancer. Oncology nurses should be aware that patients with cancer may be extremely vulnerable to cognitive dysfunction. Furthermore, age and psychological factors must be considered when developing symptom management and supportive care intervention programs to reduce the incidence of negative cognitive outcomes in this population.
Prognostic value of pretreatment plasma fibrinogen in patients with colorectal cancer
Authors: Li Menglei , Wu Yang , Zhang Jiwang , Huang Lijun , Wu Xianlan , Yuan Yongqiang 
Published: September 2019

Abstract

Background:
Growing evidence showed that high pretreatment plasma fibrinogen could be used as a potential prognostic marker in colorectal cancer (CRC). However, the conclusions were controversial. Therefore, this meta-analysis was conducted to evaluate the prognostic value of pretreatment plasma fibrinogen in patients with CRC.

Methods:
Relevant studies were searched in the databases including PubMed, EMBASE, Web of Science, Cochrane library, and China National Knowledge Infrastructure up until December 10th, 2018. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were used to estimate the effects.

Results:
A total of 17 articles with 6863 patients were included in this meta-analysis. The results revealed that elevated pretreatment plasma fibrinogen was significantly associated with both poor overall survival (univariate analysis: HR = 1.69, 95% CI 1.47–1.95, P = .000; multivariate analysis: HR = 1.50, 95% CI 1.28–1.77, P = .000) and poor disease-free survival (univariate analysis: HR = 1.90, 95% CI 1.49–2.41, P = .000; multivariate analysis: HR = 2.08, 95% CI 1.52–2.86, P = .000) in patients with CRC.

Conclusions:
High pretreatment plasma fibrinogen level is significantly associated with worse survival outcomes in CRC patients. Plasma fibrinogen may be used as an effective prognostic marker and potential therapeutic target. Further studies are required to support these results.
A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures
Authors: Sun Dawei , Wang Chunling , Chen Yuhui , Liu Xiaochun , Zhao Peng , Zhang Hongan , Zhou Hui , Qin Chenghe 
Published: September 2019

Abstract

Purpose:
To find out whether the intramedullary fixations are superior to the extramedullary fixations in treating unstable femoral intertrochanteric fractures (UFIFs).

Methods:
The meta-analysis of randomized controlled trials (RCTs) was conducted by searching the PubMed, Cochrane Library, and Embase databases to evaluate functional scores, surgical outcomes, and adverse events in adult patients receiving intramedullary fixations in comparison to extramedullary fixations. Risk ratio (RR) or weighted mean difference (WMD)/standard mean difference (SMD) with 95% confidence intervals (CIs) were calculated as effect sizes.

Results:
A total of 18 RCTs, comprising 2414 patients, were included in this meta-analysis. Primary efficacy outcome: Parker scores [weighted mean difference, 1.10, 95% confidence interval (CI), 0.64–1.55; P < .0001] and Harris hip scores [risk ratio, 1.24, 95%CI, 1.09 –1.41; P = .0008] were higher in the intramedullary fixation group. Moreover, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group. Other secondary efficacy outcome: No significant differences were found between the 2 groups in terms of fluoroscopy time, mortality, cut-out, nonunion, superficial wound infection, later fracture, and reoperation.

Conclusions:
This meta-analysis suggested that intramedullary fixation is more effective and safer than extramedullary fixation in treating UFIFs. Furthermore, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group.
Mapping international collaboration in tuberculosis research from 1998 to 2017
Authors: Chang Leilei , Su Yanbing , Zhu Ruifang , Duan Zhiguang 
Published: September 2019

Abstract

Background:
TB is one of the top 10 causes of death and the leading cause from a single infectious agent. The study characterize the developmental trends and collaboration features in the field of tuberculosis (TB) at the national level and identify high-impact countries.

Methods:
Scientometrics and social network analysis methods were used to analyze the research situation and collaboration behaviors based on TB research indexed in Web of Science from 1998 to 2017.

Results:
The publication output, national collaborative rate, and collaborative level have steadily increased from 1998 to 2017. However, domestic publications still account for a substantial proportion of a nation's publications. Over time, the numbers of national publications and international collaborative publications have increased in total, but the growth trend of their share as a proportion of total national publications is not significant. The United States of America has the largest number of highly cited publications, while Denmark, the Netherlands, Switzerland, and Sweden have higher values of average relative citation than do other countries. Notably, the United Kingdom and South Africa have established the strongest and most stable collaboration.

Conclusions:
There was increasing research activity and collaboration in the field of TB during the period 1998 to 2017, but growth shows wide variability between countries. Further comprehensive and full collaboration should be promoted.
Traditional Chinese medicine on treating ureteral calculi
Authors: Li Haisong , Deng Sheng , Wang Jisheng , Yu Xudong , Gong Xuefeng , Li Yanfeng , Yuan Hongwei 
Published: September 2019

Abstract

Background
Ureteral calculi generally refer to the temporary obstruction of the human body after the ureteral stenosis. When the ureteral stones are not discharged in time, they can grow in the original site, causing the patient to have corresponding clinical manifestations, such as: renal colic, hematuria, etc, when severe, can cause renal obstruction and hydronephrosis, seriously endangering the patient's health. Ureteral calculi usually occur in young and middle-aged people. The peak age of the disease is between 20 and 50 years old. It also occurs in the young and middle-aged labor force. The men incidence rate is 2 to 3 times that of women. Ureteral calculi is one of the current refractory diseases, and the effect after treatment with integrated Chinese and Western medicine is remarkable.

Methods and analysis
We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to November 2018. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of ureteral.

Ethics and dissemination
This systematic review will evaluate the efficacy and safety of Traditional Chinese medicine for ureteral. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial.
Registration number: PROSPERO CRD42019137095
Effects of nursing intervention on lung infection prevention in patients with tracheotomy
Authors: Li Hua , Mao Xiao-Hong 
Published: September 2019

Abstract

Background:
This study will evaluate the effects of nursing intervention (NIV) on lung infection prevention (LIP) in patients with tracheotomy.

Methods:
The electronic databases of MEDLINE, Cochrane Library, EMBASE, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be retrieved from inception to the June 1, 2019 for randomized controlled trials investigating the effects of NIV on LIP in patients with tracheotomy without any language limitations. In addition, we will also search grey literature to avoid missing any potential studies. Two independent authors will perform study selection, data extraction, and risk of bias evaluation.

Results:
This study will investigate the effects of NIV on LIP in patients with tracheotomy. The primary outcome is incidence of lung infection. The secondary outcomes include pulmonary function, quality of life, and complications post-surgery.

Conclusion:
The results of this study will summarize recent evidence for the effects of NIV on LIP in patients with tracheotomy.
No ethic approval is needed in this study, because it will not need any individual data. The results of this study will be published at a peer-reviewed journal.
The effect of folic acid in patients with cardiovascular disease
Authors: Wang Yuan , Jin Yang , Wang Yao , Li Li , Liao Yanhong , Zhang Yun , Yu Dan 
Published: September 2019

Abstract

Background:
The effectiveness of folic acid supplementation in stroke risk has been investigated, however, the available results are inconclusive and conflicting. The purpose of this systemic review and meta-analysis was to assess the effect of folic acid in patients with cardiovascular disease (CVD).

Methods:
By searching the PubMed, EMBASE, and Cochrane library databases, we conducted a meta-analysis to evaluate effect of folic acid supplementation in patients with CVD. All-cause mortality, cardiovascular mortality, the risk of coronary heart disease (CHD) and stroke were summarized; hazard ratios (HR), the relative risk (RR) and its 95% confidence interval (CI) were also calculated. Fixed effects models were used to combine the data. A total of 12 randomized controlled trials, which involved 47,523 participants, met the inclusion criteria in this systematic review and meta-analysis.

Results:
Our meta-analysis showed that cardiovascular patients who received folic acid therapy had significantly decreased risk of stroke (RR = 0.85, 95% CI = 0.77–0.94, P
heterogeneity = .347, I

2
= 10.6%) compared with patients who received control treatment. However, no significant difference in all-cause mortality (HR, 0.97, 95% CI, 0.86–1.10, P
heterogeneity = .315, I

2
= 15.4%), cardiovascular mortality (HR, 0.87, 95% CI, 0.66–1.15, P
heterogeneity = .567, I

2
= 0) and risk of CHD (RR, 1.04, 95% CI, 0.99–1.10, P
heterogeneity = .725, I

2
= 0) were found between the 2 groups.

Conclusion:
This meta-analysis suggested that folic acid supplementation significantly reduced the risk of stroke in patients with CVD.
Inpatient rehabilitation facilities
Authors: Forrest George , Reppel Alycia , Kodsi Mina , Smith Joshua 
Published: September 2019

Abstract
The aim of this study was to determine whether patients whose treatment is consistent with the 3-hour rule have better outcomes than patients whose treatment is not consistent with the 3-hour rule.
This is a retrospective review of the records of 581 patients. The authors compared the outcomes of 397 patients whose therapy was consistent with the 3-hour rule to the outcomes of 184 patients whose therapy was not consistent with the rule for at least one 7-day period during the stay on an inpatient rehabilitation facility.
Patients whose care was consistent with the rule did not have more improvement in function or shorter length of stay than patients whose care was not consistent with the 3-hour rule.
There is not good evidence to support the 3-hour rule as a determinant of the care that a patient at an IRF needs to achieve a good outcome.