bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma metabolite profiling reveals potential biomarkers of giant cell tumor of bone by using NMR-based metabolic profiles
Authors: Wang Wei , Liu Xilin , Wu Juan , Kang Xia , Xie Qingyun , Sheng Jun , Xu Wei , Liu Da , Zheng Wei 
Published: October 2019

Abstract
Giant cell tumor (GCT) of bone is a locally aggressive bone tumor, which accounts for 4% to 5% of all primary bone tumors. At present, the early diagnosis and postoperative recurrence monitoring are still more difficult due to the lack of effective biomarkers in GCT. As an effective tool, metabolomics has played an essential role in the biomarkers research of many tumors. However, there has been no related study of the metabolomics of GCT up to now. The purpose of this study was to identify several key metabolites as potential biomarkers for GCT by using nuclear magnetic resonance (NMR)-based metabolic profiles.
Patients with GCT in our hospital were recruited in this study and their plasma was collected as the research sample, and plasma collected from healthy subjects was considered as the control. NMR was then utilized to detect all samples. Furthermore, based on correlation coefficients, variable importance for the projection values and P values of metabolites obtained from multidimensional statistical analysis, the most critical metabolites were selected as potential biomarkers of GCT. Finally, relevant metabolic pathways involved in these potential biomarkers were determined by database retrieval, based on which the metabolic pathways were plotted.
Finally, 28 GCT patients and 26 healthy volunteers agreed to participate in the study. In the multidimensional statistical analysis, all results showed that there was obvious difference between the GCT group and the control group. Ultimately, 18 metabolites with significant differences met the selection condition, which were identified as potential biomarkers. Through Kyoto Encyclopedia of Genes and Genomes (KEGG) and Human Metabolome Database (HMD) database searching and literature review, these metabolites were found to be mainly correlated with glucose metabolism, fat metabolism, amino acid metabolism, and intestinal microbial metabolism. These metabolic disorders might, in turn, reflect important pathological processes such as proliferation and migration of tumor cells and immune escape in GCT.
Our work showed that these potential biomarkers identified appeared to have early diagnostic and relapse monitoring values for GCT, which deserve to be further investigated. In addition, it also suggested that metabolomics profiling approach is a promising screening tool for the diagnosis and relapse monitoring of GCT patients.
Patient delay and associated factors among Chinese women with breast cancer
Authors: Zhang Huaguo , Wang Guorong , Zhang Jina , Lu Ying , Jiang Xiaolian 
Published: October 2019

Abstract
To examine the current situation of patient delay and to identify factors associated with patient delay among women with breast cancer in China.
A total of 283 women, aged 23 to 83 years old and with histologically confirmed breast cancer, were investigated in this cross-sectional study. The women were recruited from seven selected hospitals in Sichuan Province, China. Face-to-face interviews using a structured questionnaire were performed.
Among the 283 participants, the range of patient delay was 0.2 to 900 days with a median patient delay of 50 days. A total of 35.8% of patients waited ≥90 days to access medical treatment after symptom onset. Binary logistic regression analysis showed that the main predictors of patient delay were knowledge of breast cancer symptoms (OR = 0.716, 95%CI:0.637–0.804, P = .000), external health locus of control (OR = 1.173, 95%CI:1.087–1.266, P = .000), breast self-examination/physical examination (OR = 0.065, 95%CI: 0.007–0.590, P = .015), perceived health competence (OR = 0.873, 95%CI:0.808–0.944, P = .000), family support (OR = 0.911,95%CI:0.847–0.981, P = .013), pain stimulation (OR = 0.191, 95%CI:0.046–0.792, P = .023) and age (OR = 1.028, 95%CI:1.000–1.058, P = .049).
These factors explained 41.0% of the variance.
Information on the current situation and predictors of patient delay in Chinese women with breast cancer might provide meaning insights into the early diagnosis of breast cancer. The results of this study may help health professionals develop specific clinical practice strategies to reduce patient delay of initial treatment as a way to improve outcomes for women with breast cancer.
Efficacy of treatment regimens for advanced hepatocellular carcinoma
Authors: Chen Qi-Feng , Wu Pei-Hong , Huang Tao , Shen Lu-Jun , Huang Zi-Lin , Li Wang 
Published: October 2019

Abstract

Background:
This study aimed to perform a network meta-analysis to evaluate the therapeutic effect and safety of various modalities in treating advanced hepatocellular carcinoma (HCC). Typically, the modalities of interest were comprised of sorafenib, transarterial chemoembolization (TACE), sorafenib combined with TACE, TACE combined with traditional Chinese medicine (TCM), and sorafenib combined with hepatic arterial infusion chemotherapy (HAIC).

Methods:
Potentially eligible studies were systemically retrieved from the electronic databases (including PubMed and Cochrane Library) up to September 2018. The overall survival (OS) associated with the 5 modalities of interest enrolled in this study was compared by means of network meta-analysis. Meanwhile, major adverse events (AEs) were also evaluated.

Results:
The current network meta-analysis enrolled 7 published randomized controlled trials (RCTs), and the pooled results indicated that the TACE-TCM regimen displayed the highest efficacy in treating advanced HCC, followed by HAIC-sorafenib. By contrast, the TACE alone and sorafenib alone regimens had the least efficacy. Relative to other regimens of interest, the TACE-TCM regimen was associated with less incidence of treatment-associated AEs.

Conclusion:
The TACE-TCM regimen was associated with higher treatment responses in advanced HCC patients than those of the other regimens of interest.
Does long-term use of antidiabetic drugs changes cancer risk?
Authors: Liu Yi-Chun , Nguyen Phung-Anh , Humayun Ayesha , Chien Shuo-Chen , Yang Hsuan-Chia , Asdary Rahma Novita , Syed-Abdul Shabbir , Hsu Min-Huei , Moldovan Max , Yen Yun , Li Yu-Chuan (Jack) , Jian Wen-Shan , Iqbal Usman 
Published: October 2019

Abstract
Antidiabetic medications are commonly used around the world, but their safety is still unclear. The aim of this study was to investigate whether long-term use of insulin and oral antidiabetic medications is associated with cancer risk.
We conducted a well-designed case–control study using 12 years of data from Taiwan's National Health Insurance Research Database and investigated the association between antidiabetic medication use and cancer risk over 20 years. We identified 42,500 patients diagnosed with cancer and calculated each patient's exposure to antidiabetic drugs during the study period. We matched cancer and noncancer subjects matched 1:6 by age, gender, and index date, and used Cox proportional hazard regression and conditional logistic regression, adjusted for potential confounding factors, that is, medications and comorbid diseases that could influence cancer risk during study period.
Pioglitazone (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.05–1.38); and insulin and its analogs for injection, intermediate or long acting combined with fast acting (AOR, 1.22; 95% CI, 1.05–1.43) were significantly associated with a higher cancer risk. However, metformin (AOR, 1.00; 95% CI, 0.93–1.07), glibenclamide (AOR, 0.98; 95% CI, 0.92–1.05), acarbose (AOR, 1.06; 95% CI, 0.96–1.16), and others do not show evidence of association with cancer risk. Moreover, the risk for specific cancers among antidiabetic users as compared with nonantidiabetic medication users was significantly increased for pancreas cancer (by 45%), liver cancer (by 32%), and lung cancer (by 18%).
Antidiabetic drugs do not seem to be associated with an increased cancer risk incidence except for pioglitazone, insulin and its analogs for injection, intermediate or long acting combined with fast acting.
Supraglottic devices for airway management in awake craniotomy
Authors: Grabert Josefin , Klaschik Sven , Güresir Ági , Jakobs Patrick , Soehle Martin , Vatter Hartmut , Hilbert Tobias , Güresir Erdem , Velten Markus 
Published: October 2019

Abstract
Awake craniotomy is a unique technique utilized for mapping neuro and motor function during neurosurgical procedures close to eloquent brain tissue. Since active communication is required only during surgical manipulation of eloquent brain tissue and the patient is “sedated” during other parts of the procedure, different methods for anesthesia management have been explored. Furthermore, airway management ranges from spontaneous breathing to oro or nasotracheal intubation. Case reports have described the use of laryngeal masks (LMs) previously; however, its safety compared to tracheal intubation has not been assessed.
We conducted a retrospective analysis of 30 patients that underwent awake craniotomy for tumor surgery to compare the feasibility and safety of different airway management strategies. Nasal fiberoptic intubation (FOI) was performed in 21 patients while 9 patients received LM for airway management. Ventilation, critical events, and perioperative complications were evaluated.
Cannot intubate situation occurred in 4 cases reinserting the tube after awake phase, while no difficulties were described reinserting the LM (P < .0001). Furthermore, duration of mechanical ventilation after tumor removal was significantly lower in the LM group compared to FOI group (62 ± 24 vs. 339 ± 82 [min] mean ± sem, P < .0001). Postoperatively, 2 patients in each group were diagnosed with and treated for respiratory complications including pneumonia, without statistical significance between groups.
In summary, LM is a feasible airway management method for patients undergoing awake craniotomy, resulting in reduced ventilation duration compared to FOI procedure.
The landscape of vascularized composite allograft donation in the United States
Authors: Henderson Macey L. 
Published: October 2019

Purpose of review
Vascularized composite allograft (VCA) donation and transplantation has now demonstrated feasibility and impact to the lives of patients suffering from devastating and traumatic injury. This review summarizes the current landscape of VCA donation in the United States.

Recent findings
VCA donations are nonlife-saving allografts, for nonlife-saving transplants – and therefore, conservative donor selection focused on the optimization of donors for the lowest risk to transplant recipients is paramount. VCA donors in the United States are a demographically and clinically diverse group that largely reflects the characteristics of the VCA candidates waiting for transplants. Public opinion about VCA donation is generally supportive, but has lower support for VCA transplants than for solid organ transplants.

Summary
As an emerging area of transplantation, VCA donation is evolving in the United States with growing interest by the public, and those suffering from catastrophic injury for which reconstructive transplantation may offer excellent outcomes and a high quality of life.
Evaluation of Intraarterial Thrombolysis in Treatment of Cosmetic Facial Filler-Related Ophthalmic Artery Occlusion
Authors: Zhang Li-xia , Lai Lin-ying , Zhou Gui-wen , Liang Li-ming , Zhou Yun-chao , Bai Xin-yue , Dai Qiang , Yu You-tao , Tang Wei-qiang , Chen Min-liang 
Published: October 2019

Background:
With an increase in recent years in the number of people receiving cosmetic facial injection treatments of hyaluronic acid, the incidence of hyaluronic acid embolism has also increased commensurately. Hyaluronic acid embolism leads to serious complications, including blindness, eye and eyelid movement disorders, skin necrosis, and cerebral embolism. However, there is a lack of robust clinical evidence regarding the benefits of treatment for hyaluronic acid embolism by intraarterial thrombolysis therapy.

Methods:
This study included 24 patients with a decrease in visual acuity and other complications induced by facial hyaluronic acid injection. Patients underwent emergency intraarterial thrombolysis therapy by injection of hyaluronidase (500 to 1500 units) alone or hyaluronidase (750 to 1500 units) combined with urokinase (100,000 to 250,000 units), followed in both cases by a general symptomatic treatment and nutritional therapy.

Results:
Ten (42 percent) of 24 patients ultimately had improvements to visual acuity, even when the clinical application of the thrombolytic treatments had passed the recommended window for optimal treatment. In all cases, patients’ facial skin necrosis was restored to nearly normal appearance. In addition, the authors found that hyaluronidase combined with urokinase was a more effective therapy than hyaluronidase alone.

Conclusions:
The authors’ results indicate that intraarterial thrombolysis therapy is beneficial to patients suffering from blindness induced by hyaluronic acid embolism. The therapy was shown to be worthy of clinical application because it alleviated the impairment to patients’ vision and was also beneficial in the recovery from other serious complications, including eye movement disorder, eye edema, headaches, and skin necrosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
The Relationship between Animation Deformity and Patient-Reported Outcomes: Application of the BREAST-Q to a Quantitative Stratification of Animation Severity
Authors: Fracol Megan , Qiu Cecil S. , Chiu Max Wen-Kuan , Feld Lauren N. , Sood Rachita , Mioton Lauren M. , Kearney Aaron , Kim John Y. S. 
Published: October 2019

Background:
Animation deformity can occur following subpectoral breast reconstruction and is an oft-touted rationale for prepectoral reconstruction. Despite increasing recognition, there is a paucity of patient-reported outcome studies in women with animation deformity.

Methods:
Women presenting after subpectoral implant-based breast reconstruction were evaluated for animation deformity. Video analysis and quantitative deformity assessment were performed in conjunction with BREAST-Q surveys. BREAST-Q data were compared to our quantitative animation grading scale to assess the relationship between animation severity and patient-reported outcomes.

Results:
One hundred forty-one subpectoral breast reconstructions met inclusion criteria. Average scores were 67.8 ± 17.9 of 100 for satisfaction with breasts and 78.3 ± 14.1 of 100 for physical well-being. Animation deformity severity did not correlate with satisfaction with breasts (p = 0.44). Physical well-being, particularly pain-related questions, increased with increasing animation (p = 0.01); specifically, patients reported significantly less pulling, nagging, and aching in the breast (p = 0.01, p = 0.001, and p = 0.004, respectively). Patients with the least and most severe animation deformity had significantly higher numbers of revision procedures (0.89 and 1.03 procedures, respectively) compared with patients with intermediate deformity (0.49 procedures; p = 0.01 and p = 0.009, respectively).

Conclusions:
Although pectoralis release creates a more mobile—and more animating—reconstruction, this same release may lead to less pain because muscle is no longer contracting against a fixed space. This may lead to two distinct origins of subpectoral revision: (1) patients in pain (but low animation) and (2) patients with visibly distorted animation (but low pain).

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Development of a New Large-Animal Model for Composite Face and Whole-Eye Transplantation: A Novel Application for Anatomical Mapping Using Indocyanine Green and Liquid Latex
Authors: Bravo Miguel G. , Granoff Melisa D. , Johnson Anna Rose , Lee Bernard T. 
Published: October 2019

Background:
Recent advances in the field of vascularized composite allotransplantation have revolutionized reconstructive surgery and demonstrated opportunity for restoration of orbital content and perhaps vision. The development of an animal model that would facilitate study of surgical technique, nerve regeneration, vision restoration, and immunosuppression is needed. The aim of this study is to describe three different large-animal cadaveric models suitable for composite face and whole-eye transplantation. In addition, the authors introduce a novel colored liquid latex and indocyanine green mixture for vasculature identification and visualization.

Methods:
The authors studied three different flap designs using cadaveric Yorkshire swine and modified them for face and whole-eye transplant harvest. Flaps harvested included a chimeric flap, a monobloc flap, and a bipedicled free flap. The authors injected selected vasculature with colored latex to better delineate vascular anatomy supplying the orbit and face. Indocyanine green was added to the latex solution to allow for visualization of the vascular supply using near-infrared imaging.

Results:
Colored latex and indocyanine green injections were successfully visualized in all cadaveric dissections. All three modified flap designs showed a well-defined and consistent vascular network within each face and whole-eye transplantation flap using laser-assisted near-infrared imaging.

Conclusions:
The authors present the feasibility of composite face and whole-eye transplantation models using a novel mixture of liquid latex and indocyanine green in a porcine cadaver. Further study in large animals is needed to appraise the surgical feasibility of this procedure and potential for clinically relevant outcomes, including vision restoration. The authors believe this study establishes a foundation for translation into live animal models for optic nerve regeneration.
Creating a Favorable Microenvironment for Fat Grafting in a Novel Model of Radiation-Induced Mammary Fat Pad Fibrosis
Authors: Truong Jessica L. , Liu Muhan , Tolg Cornelia , Barr Meredith , Dai Cecilia , Raissi Thomas C , Wong Eugene , DeLyzer Tanya , Yazdani Arjang , Turley Eva A. 
Published: October 2019

Background:
Radiofibrosis of breast tissue compromises breast reconstruction by interfering with tissue viability and healing. Autologous fat transfer may reduce radiotherapy-related tissue injury, but graft survival is compromised by the fibrotic microenvironment. Elevated expression of receptor for hyaluronan-mediated motility (RHAMM; also known as hyaluronan-mediated motility receptor, or HMMR) in wounds decreases adipogenesis and increases fibrosis. The authors therefore developed RHAMM peptide mimetics to block RHAMM profibrotic signaling following radiation. They propose that this blocking peptide will decrease radiofibrosis and establish a microenvironment favoring adipose-derived stem cell survival using a rat mammary fat pad model.

Methods:
Rat mammary fat pads underwent a one-time radiation dose of 26 Gy. Irradiated (n = 10) and nonirradiated (n = 10) fat pads received a single intramammary injection of a sham injection or peptide NPI-110. Skin changes were examined clinically. Mammary fat pad tissue was processed for fibrotic and adipogenic markers using quantitative polymerase chain reaction and immunohistochemical analysis.

Results:
Clinical assessments and molecular analysis confirmed radiation-induced acute skin changes and radiation-induced fibrosis in rat mammary fat pads. Peptide treatment reduced fibrosis, as detected by polarized microscopy of picrosirius red staining, increased collagen ratio of 3:1, reduced expression of collagen-1 crosslinking enzymes lysyl-oxidase, transglutaminase 2, and transforming growth factor β1 protein, and increased adiponectin, an antifibrotic adipokine. RHAMM was expressed in stromal cell subsets and was downregulated by the RHAMM peptide mimetic.

Conclusion:
Results from this study predict that blocking RHAMM function in stromal cell subsets can provide a postradiotherapy microenvironment more suitable for fat grafting and breast reconstruction.
The Use of Higher Proportions of Platelet-Rich Plasma to Enrich Microfat Has Negative Effects: A Preclinical Study
Authors: Abellan Lopez Maxime , Bertrand Baptiste , Kober Frank , Boucekine Mohamed , De Fromont De Bouailles Marc , Vogtensperger Marie , Bernard Monique , Casanova Dominique , Magalon Jeremy , Sabatier Florence 
Published: October 2019

Background:
Platelet-rich plasma improves engraftment after fat transfer. However, the effects of platelet dose have never been investigated. The authors used magnetic resonance imaging to compare surviving graft volumes in mice after administration of four different formulations (microfat alone, and three platelet-rich plasma–enriched microfat mixes).

Methods:
The authors used a random, double-blinded, fat transfer protocol using three different platelet levels: 1 million (low-dose), 500 million (medium-dose), and 1000 million (high-dose) platelets/ml, and fat alone (control). The authors grafted 0.4 ml of the 70/30 platelet-rich plasma–enriched microfat mixtures (0.4 million, 200 million, and 400 million platelets per 0.12 ml for the low-dose, medium-dose, and high-dose mixtures, respectively) or 0.4 ml of microfat alone into 22 nude mice and monitored surviving graft volumes every month for 3 months. Then, the authors histologically analyzed all grafts to assess neoangiogenesis status and fat integrity.

Results:
Three-dimensional magnetic resonance imaging showed that the median surviving graft volumes at 3 months were 9.5 percent (interquartile range, 0 to 25 percent; p = 0.003) (high-dose), 4.1 percent (interquartile range, 0 to 18 percent; p = 0.001) (medium-dose), and 18 percent (interquartile range, 8 to 38 percent; p = 0.41) (low-dose) compared to 36 percent (interquartile range, 28 to 53 percent) for the control value. The histologic integrity of microfat-alone grafts was significantly better than those of the other grafts, although the high-dose and low-dose grafts exhibited higher levels of neoangiogenesis.

Conclusion:
Higher platelet levels in microfat grafts were associated with poor graft survival in nude mice; a clinical review would be appropriate.
Oncoplastic Lower Eyelid Reconstruction Analysis
Authors: Orgun Doruk , Hayashi Ayato , Yoshizawa Hidekazu , Shimizu Azusa , Horiguchi Masatoshi , Mochizuki Mariko , Kamimori Tomoki , Aiba-Kojima Emiko , Mizuno Hiroshi 
Published: October 2019

Background:
Oncoplastic lower eyelid reconstruction is a challenging task due to the complicated structure of the eyelid and requirement of high operative accuracy. Poorly treated defects result in ectropion and ptosis which may lead to keratitis and corneal ulceration. Previous related studies do not include a detailed comparison of the common reconstructive methods of the lower eyelid in terms of results and complication rates.

Objective:
The authors aim to demonstrate whether the choice of reconstruction affects the aesthetic and functional outcome of oncoplastic lower eyelid reconstruction.

Methods & Materials:
The authors performed a 10-year retrospective review of all oncoplastic lower eyelid reconstructions carried out in our hospital. Information on patient background, diagnosis and the choice of reconstructive method were evaluated. Postoperative photographs of each patient were then subjectively evaluated for color match, cosmesis, quality of shape, symmetry, and overall appearance. The authors hypothesized that the outcome is related to the main trajectory of the flap. Patients treated with local flaps of horizontal and vertical trajectories were then compared in terms of outcome and complication rates.

Results:
Reconstructions based on a horizontal trajectory compared with a vertical trajectory resulted with lower rates of ectropion and ptosis occurrence. The results were statistically significant.