bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Totally 3-Dimensional Laparoscopic Pancreaticoduodenectomy and Open Pancreaticoduodenectomy
Authors: Zhang Hang , Guo Xingjun , Xia Jia , Zhu Feng , Shen Ming , Wang Xin , Wang Min , Qin Renyi 
Published: April 2018

Objective
The aim of this study was to evaluate the safety, feasibility, and oncologic outcomes of 3-dimensional total laparoscopic pancreaticoduodenectomy (3D-TLPD).

Methods
Data of all patients who underwent 3D-TLPD (n = 202) or open pancreaticoduodenectomy (OPD) (n = 213) at a single institution between October 2014 and December 2016 were reviewed. We evaluated the safety, feasibility, and oncologic outcomes of 3D-TLPD compared with OPD.

Results
The mean operative times in the 3D-TLPD and OPD groups were comparable (P = 0.322). The estimated blood loss and perioperative transfusion rate were similar in both groups, as were the morbidity and mortality rates (P > 0.050). The mean number of analgesic administered and the mean length of hospital and intensive care unit stay were lower (P < 0.001) and shorter (P < 0.001, P = 0.009) in the 3D-TLPD group than in the OPD group, respectively. The surgical resection margins and the number of lymph nodes harvested did not differ between the 2 groups; however, a significant difference was observed in pathological results.

Conclusions
Three-dimensional TLPD had the typical advantages of minimally invasive abdominal procedures, such as shorter hospital stays. It is technically safe and feasible and has comparable operative times and similar oncologic outcomes to those of OPD.
Endoscopic Ultrasound–Based Pancreatic Cancer Screening of High-Risk Individuals
Authors: Gangi Alexandra , Malafa Mokenge , Klapman Jason 
Published: April 2018

Objectives
Pancreatic cancer (PC), a common cause of cancer death, is rarely diagnosed at an early stage. Early detection of PC may improve outcomes in affected patients. This study evaluated the utility of screening of high-risk individuals (HRIs) using an endoscopic ultrasound (EUS)-only approach to detect early malignant changes.

Methods
A prospective PC screening program for HRIs was opened in 2007. Fifty-eight patients have enrolled to date. Patients with normal EUS examinations underwent repeat EUS annually for 5 years. Patients with abnormal EUS underwent fine-needle aspiration (FNA) if a mass/cyst 1 cm or longer was found. Those with cysts/mass shorter than 1 cm or benign FNA underwent repeat EUS in 3 months. If unchanged, patients were followed with magnetic resonance imaging.

Results
Thirty-nine patients (67%) had initial normal EUS examinations, and 16 patients completed the 5-year trial. Five patients who initially had a normal EUS developed cysts on subsequent examinations. Of the 24 subjects (41%) with abnormal findings, 3 underwent FNA: 2 consistent with intraductal papillary mucinous neoplasm, 1 with benign cytology. The 21 remaining patients had 1 subcentimeter cyst or more followed by magnetic resonance imaging. No PCs have been detected.

Conclusions
Precancerous cysts are frequently detected with EUS in HRI. Whether screening impacts survival in HRIs remains unclear and requires further evaluation in larger multicenter trials.
Extracorporeal Shock Wave Lithotripsy for Chronic Pancreatitis Patients With Stones After Pancreatic Surgery
Authors: Wang Dan , Ji Jun-Tao , Xin Lei , Bi Ya-Wei , Pan Jun , Liao Zhuan , Du Ting-Ting , Lin Jin-Huan , Zhang Di , Zeng Xiang-Peng , Ye Bo , Zou Wen-Bin , Chen Hui , Xie Ting , Li Bai-Rong , Zheng Zhao-Hong , Li Zhao-Shen , Hu Liang-Hao 
Published: April 2018

Objectives
The objective of this study was to evaluate the safety and efficacy of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in chronic pancreatitis (CP) patients with pancreatic stones after previous pancreatic surgery.

Methods
This is a single-center study prospectively conducted in pained CP patients undergoing P-ESWL. Patients with a pancreatic surgery history (PSH) were included in the PSH group, and patients without a PSH during the same period were assigned to the control group. The primary outcomes included complications associated with P-ESWL and pain relief. Secondary outcomes included stone clearance and improved quality-of-life scores.

Results
From March 2011 to October 2014, P-ESWLs were performed on 1017 patients (50 in the PSH group, 967 in the control group). No significant difference was observed in the frequency of occurrence of P-ESWL complications between the PSH group and control group (14.0% vs 13.2%, P = 0.877). At follow-up (2.6 years; range, 1.0–4.5 years), pain relief was achieved in 36 patients (75.0%), and 37 patients (77.1%) experienced complete stone clearance. No significant differences were observed between these patients and the matched controls.

Conclusions
For CP patients who develop painful stones after pancreatic surgery, P-ESWL safely achieves significant pain relief and stone clearance, preventing the need for a repeat surgery.
Nationwide Multicenter Observational Study of FOLFIRINOX Chemotherapy in 399 Patients With Unresectable or Recurrent Pancreatic Cancer in Japan
Authors: Todaka Akiko , Mizuno Nobumasa , Ozaka Masato , Ueno Hideki , Kobayashi Satoshi , Uesugi Kazuhiro , Kobayashi Noritoshi , Hayashi Hideyuki , Sudo Kentaro , Okano Naohiro , Horita Yosuke , Kamei Keiko , Yukisawa Seigo , Nakamori Shoji , Yachi Yutaka , Henmi Toshiyuki , Kobayashi Marina , Boku Narikazu , Mori Keita , Fukutomi Akira 
Published: April 2018

Objectives
FOLFIRINOX (oxaliplatin, irinotecan, 5-fluorouracil, and leucovorin) is the standard therapy worldwide for unresectable pancreatic cancer; however, clinical data for Japanese patients are limited. Therefore, the observational study of FOLFIRINOX for patients with pancreatic cancer was conducted.

Methods
The study included 399 patients with unresectable or recurrent pancreatic cancer, from 27 institutions in Japan, treated with FOLFIRINOX and surveyed until December 2015.

Results
The median age was 63 years; in most patients, the Eastern Cooperative Oncology Group performance status was 1 or lower. The initial dose was reduced in 270 patients (68%). The main grade 3/4 toxicities were neutropenia (64%), anorexia (14%), and febrile neutropenia (13%). Fatal adverse events occurred in 5 patients, 4 of whom did not satisfy the main inclusion criteria of a previous Japanese phase II FOLFIRINOX study. The median overall survival and progression-free survival times were 10.8, and 4.5 months, respectively. The objective response rate was 21%, and the disease control rate was 61%. The median overall survival times were 11.1, 18.5, and 4.9 months in chemotherapy-naïve patients with metastatic, locally advanced, and recurrent disease, respectively.

Conclusion
When carefully managed, FOLFIRINOX is acceptably safe and efficacious in Japanese patients with unresectable pancreatic cancer.
Prediction of Insulin Secretion Ability With Microcirculation Evaluated by Contrast-enhanced Ultrasonography in Pancreas Transplantation
Authors: Aida Naohiro , Kenmochi Takashi , Ito Taihei , Nishikawa Toru , Hiratsuka Izumi , Shibata Megumi , Suzuki Atsushi , Hasegawa Midori , Kawai Akihiro , Kusaka Mamoru , Hoshinaga Kiyotaka , Matsubara Hisahiro 
Published: April 2018

Objectives
Contrast-enhanced ultrasonography can evaluate microcirculation. Thus, we used contrast-enhanced ultrasonography in evaluating pancreas graft perfusion and examined the relationship between graft circulation and function.

Methods
Contrast-enhanced ultrasonography was performed in 17 cases within 24 hours and at 1, 3, 5, 7, 14, 21, and 28 days after transplantation (Tx). The time between the time to peak intensity in the parenchyma and that in the vein was defined as delta-Tp(P-V). Graft function was evaluated with oral glucose tolerance test (OGTT) at 1 and 3 months after Tx, and glucagon stimulation test at 1 month after Tx.

Results
Differences in delta-Tp(P-V) between individual cases were more significant early after Tx, and delta-Tp(P-V) within 24 hours (delta-Tp[P-V]24h) was used in the subsequent analysis. Delta-Tp(P-V)24 hours showed a negative correlation with C-peptide increment in the glucagon stimulation test and the area under the curve of insulin level in oral glucose tolerance test. The cases were divided into the following 2 groups: the standard group (delta-Tp[P-V]24h ≤6.10 seconds) and the delayed group (>6.10 seconds). The area under the curve of insulin level increased significantly from 1 to 3 months after Tx in the standard group only.

Conclusions
These results suggest that delta-Tp(P-V)24 hours affects insulin secretion after Tx. Contrast-enhanced ultrasonography is useful in predicting endocrine function of the graft.
Antimicrobial Peptide Human Neutrophil Peptide 1 as a Potential Link Between Chronic Inflammation and Ductal Adenocarcinoma of the Pancreas
Authors: Pausch Thomas , Adolph Sarah , Felix Klaus , Bauer Andrea S. , Bergmann Frank , Werner Jens , Hartwig Werner 
Published: April 2018

ObjectivesDefensins are antimicrobial peptides playing a role in innate immunity, in epithelial cell regeneration, and in carcinogenesis of inflammation-triggered malignancies. We analyzed this role in pancreatic ductal adenocarcinoma (PDAC) in the context of its association with chronic pancreatitis (CP).MethodsHuman tissue of healthy pancreas, CP, and PDAC was screened for defensins by immunohistochemistry. Defensin α 1 (human neutrophil peptide 1 [HNP-1]) expression was validated using mass spectrometry and microarray analysis. Human neutrophil peptide 1 expression and influences of proinflammatory cytokines (tumor necrosis factor α, interleukin 1β, and interferon γ) were studied in human pancreatic cancer cells (Colo 357, T3M4, PANC-1) and normal human pancreatic duct epithelial cells (HPDE).ResultsAccumulation of HNP-1 in malignant pancreatic ductal epithelia was seen. Spectrometry showed increased expression of HNP-1 in CP and even more in PDAC. At RNA level, no significant regulation was found. In cancer cells, HNP-1 expression was significantly higher than in HPDE. Proinflammatory cytokines significantly led to increased HNP-1 levels in culture supernatants and decreased levels in lysates of cancer cells. In HPDE cytokines significantly decreased HNP-1 levels.ConclusionsInflammatory regulation of HNP-1 in PDAC tissue and cells indicates that HNP-1 may be a link between chronic inflammation and malignant transformation in the pancreas.
Cervical Cancer Screening in Women With Severe Mental Disorders
Authors: Borrull-Guardeño Jessica , Domínguez Alberto , Merizalde-Torres Milton H. , Sánchez-Martínez Vanessa 
Published: April 2018

Background
The incidence of invasive cervical cancer and its mortality have been reduced through primary and secondary prevention. Screening rates tend to be lower in vulnerable groups, such as people with severe mental disorders, who have a later detection of cancer and a higher mortality. The access of these women to cervical cancer screening is uncertain in our context.

Objective
The aim of this study was to determine the cervical cancer screening rates in women with severe mental disorders.

Methods
This was a descriptive cross-sectional study. Women 25 to 65 years old who were admitted during 2016 to the psychiatric unit of a public hospital in Spain were included in the study, and it was determined if they had had cervical cancer screening.

Results
A total of 103 eligible women, with a mean age of 45.6 years, were enrolled. Only 28 of the participants (27.2%) had had a cervical cancer screening done in the last 5 years. By age groups, statistically significant differences were found, with women between 35 and 44 years of age having higher rates of cervical cancer screening (41.9%) and the oldest, between 55 and 65 years of age, having the lowest (5%).

Conclusions
Women with severe mental health disorders who were admitted to acute psychiatric care units had much lower cervical cancer screening rates compared with the general population.

Implications for Practice
Mental health nurses could be the optimum professionals to promote cancer primary and secondary prevention in women with mental disorders.
Testing a Strategy to Identify Incidence of Nurse Suicide in the United States
Authors: Davidson Judy E. , Stuck Amy R. , Zisook Sidney , Proudfoot James 
Published: April 2018

OBJECTIVEThe aim of this study was to test a strategy for quantifying incidence of nurse suicide using San Diego County data as a pilot for national investigation.BACKGROUNDWorldwide, 1 person dies by suicide every 40 seconds; more than 1 000 000 suicides occur yearly. Suicide rates for nurses in the United States have not been evaluated. This methodological article tested a strategy to identify incidence of nurse suicide compared with those of physicians and the general public.METHODDeidentified San Diego County Medical Examiner data from 2005 to 2015 were analyzed with a descriptive epidemiologic approach.RESULTSOverall RN (18.51) and physician (40.72) incidences of suicide per 100 000 person-years were higher than the San Diego general population, excluding nurses (15.81) normalized to 100 000 person-years.CONCLUSIONSEstablishing incidence of nurse suicide is confounded by variation in reporting mechanisms plus incomplete availability of nurse gender data. Relatively small outcome numbers compared with the general population may underestimate results. Research using a larger sample is indicated. Nurse executives may decrease risk by proactively addressing workplace stressors.
Effects of Progressive Addition Lens Wear on Digital Work in Pre-presbyopes
Authors: Kee Chea-su , Leung Tsz Wing , Kan Ka-hung , Lam Christie Hang-I 
Published: April 2018

SIGNIFICANCE
Growing popularity of handheld digital devices imposes significant challenges to our visual system and clinical management. This study aimed to determine the effects of lens design on parameters that may influence the refractive management of pre-presbyopic adult computer users.

PURPOSE
To determine the effects of wearing conventional single-vision lenses (SVL) versus progressive addition lenses (PAL) on the working distance and refractive status.

METHODS
Adult computer users, recruited from two age cohorts (18 to 25 years, n = 19; 30 to 40 years, n = 45), were prescribed SVLs and PALs designed for use with handheld digital devices. For each lens type, the working distance and refractive shift (post-task − pre-task) were measured immediately after lens delivery (T0) and after 1 month of lens wear (T1). Working distances were recorded with an automatic ultrasound device while the participants were playing a video game. Refractive status through the subjects' glasses was measured before (pre-task) and after playing the game (post-task). Questionnaires assessing the frequencies of 10 digital work–related visual symptoms were conducted for both lens types at T1.

RESULTS
Switching from SVL to PAL increased the working distance in both cohorts (mean ± SEM = 1.88 ± 0.60 cm; P = .002) and induced a small but significant positive refractive shift (+0.08 ± 0.04 D, P = .021) in the older cohort at T1. In the younger cohort, the changes in working distance due to the switching lens design were correlated with myopic error (r = +0.66, P = .002). In the older cohort, the changes in refractive shift due to switching lens design were correlated with amplitude of accommodation at both time points (r for T0 and T1 = −0.32 and −0.30, respectively; both P < .05). Progressive addition lens was rated as causing less “increased sensitivity to light” compared with SVL.

CONCLUSIONS
Switching from SVL to PAL increased the working distance and induced a positive refractive shift in the majority of pre-presbyopic adults.
Fluorescein Angiography Indications: Changes after Optical Coherence Tomography and Antiangiogenics
Authors: Labrador-Velandia Sonia C. , Sanabria María R. 
Published: April 2018

SIGNIFICANCE
The present study provides quantitative data regarding the change of indications of fluorescein angiography in a tertiary hospital. Exhaustively compiled data over more than 10 years concerning all the angiographic studies including diagnosis, first-visit/follow-up, possible relation with antiangiogenics approval, and optic coherence tomography (OCT) are presented.

PURPOSE
The aim of this study was to determine the frequency and indications of fluorescein angiography before and after OCT and anti–vascular endothelial growth factor (anti-VEGF) treatment implantation.

METHODS
This was a retrospective and descriptive study of all fluorescein angiographies performed in a tertiary hospital between 2005 and 2016. Demographic data, diagnosis, follow-up, and type of angiograms were analyzed in relation with the implantation of time domain OCT (2006), spectral domain OCT (SD-OCT) (2013), and anti-VEGF (2007).

RESULTS
Of 3263 angiograms (2342 patients) analyzed, 72% were baseline angiograms, and 28% were follow-up angiograms. After anti-VEGF initiation, the number of angiograms per year increased progressively with peaks that matched with the approval of anti-VEGF for wet age-related macular degeneration (2007) (164.2%), macular edema secondary to retinal vein occlusions (2010) (102.2%), and diabetic macular edema (2011) (123.8%). After using SD-OCT, fluorescein angiographies decreased up to 57%.

CONCLUSIONS
Anti-VEGF introduction led to an increase in the indication of angiograms, which did not vary significantly after time domain OCT. Nevertheless, since SD-OCT became available, the indication of fluorescein angiography has halved in the hospital of reference.
Landiolol Hydrochloride Rapidly Controls Junctional Ectopic Tachycardia After Pediatric Heart Surgery
Authors: Yoneyama Fumiya , Tokunaga Chiho , Kato Hideyuki , Nakajima Tomomi , Mathis Bryan J. , Sakamoto Hiroaki , Hiramatsu Yuji 
Published: April 2018

Objectives:
Junctional ectopic tachycardia is a supraventricular tachyarrhythmia with atrioventricular dissociation that causes life-threatening postsurgical conditions in pediatric heart patients. This study evaluates the efficacy of landiolol hydrochloride for managing junctional ectopic tachycardia.

Design:
A single-center retrospective study.

Setting:
PICU at the university hospital.

Patients:
Of 561 pediatric patients who underwent open-heart surgery between 2006 and 2017, 10 patients developed sustained junctional ectopic tachycardia and were selected for landiolol treatment.

Interventions:
None.

Measurements and Main Results:
Landiolol decreased mean heart rate significantly from 206.1 ± 14.5 to 158.0 ± 8.6 beats/min within 2 hours after administration (p < 0.01). Mean time to achieve 20% heart rate reduction was 2.1 ± 0.5 hours. Systolic blood pressure between pre and post landiolol administration did not change significantly (72.6 ± 5.9 to 79.7 ± 6.2 mm Hg). Once junctional heart rate was sufficiently suppressed, atrioventricular sequential pacing was introduced to stabilize hemodynamics. Nine of 10 cases (90%) had atrioventricular sequential pacing to maintain appropriate heart rate and restore atrioventricular synchronicity under suppressed junctional heart rate. Subsequently, eight of 10 cases (80%) were converted to regular sinus rhythm within 24 hours after starting landiolol administration. The average time to achieve sinus rhythm conversion was 7.9 ± 3.4 hours.

Conclusions:
Landiolol rapidly suppresses junctional heart rate in junctional ectopic tachycardia after pediatric heart surgery without significant blood pressure compromises. Subsequent atrioventricular sequential pacing was effective at restoring atrioventricular synchronicity and stabilizing hemodynamics. Combining junctional rate control with landiolol and atrioventricular sequential pacing is therefore suggested as a promising option for prompt management of postoperative junctional ectopic tachycardia.
Toward Live Virtual Constructive Simulations in Healthcare Learning
Authors: Padilla Jose J. , Diallo Saikou Y. , Armstrong Robert K. 
Published: April 2018

Summary Statement
This article explores the combination of live, virtual, and constructive (LVC) simulations in healthcare. Live, virtual, and constructive simulations have long existed in the military, but their consideration (and deployment) in medical and healthcare domains is relatively new. We conducted a review on LVC— its current application in the military domain —and highlight an approach, challenges, and present suggestions for its implementation in healthcare learning. Furthermore, based on the state of the art in simulation in healthcare, we suggest that a combination of two simulation types (LV, VC, LC) at the time may be a simpler approach to the community at large.
Artificial intelligence can predict daily trauma volume and average acuity
Authors: Stonko David P. , Dennis Bradley M. , Betzold Richard D. , Peetz Allan B. , Gunter Oliver L. , Guillamondegui Oscar D. 
Published: April 2018

BACKGROUNDThe goal of this study was to integrate temporal and weather data in order to create an artificial neural network (ANN) to predict trauma volume, the number of emergent operative cases, and average daily acuity at a Level I trauma center.METHODSTrauma admission data from Trauma Registry of the American College of Surgeons and weather data from the National Oceanic and Atmospheric Administration was collected for all adult trauma patients from July 2013-June 2016. The ANN was constructed using temporal (time, day of week), and weather factors (daily high, active precipitation) to predict four points of daily trauma activity: number of traumas, number of penetrating traumas, average Injury Severity Score (ISS), and number of immediate operative cases per day. We trained a two-layer feed-forward network with 10 sigmoid hidden neurons via the Levenberg-Marquardt back propagation algorithm, and performed k-fold cross validation and accuracy calculations on 100 randomly generated partitions.RESULTSTen thousand six hundred twelve patients over 1,096 days were identified. The ANN accurately predicted the daily trauma distribution in terms of number of traumas, number of penetrating traumas, number of OR cases, and average daily ISS (combined training correlation coefficientr= 0.9018 ± 0.002; validationr= 0.8899 ± 0.005; testingr= 0.8940 ± 0.006).CONCLUSIONWe were able to successfully predict trauma and emergent operative volume, and acuity using an ANN by integrating local weather and trauma admission data from a Level I center. As an example, for June 30, 2016, it predicted 9.93 traumas (actual: 10), and a mean ISS of 15.99 (actual: 13.12). This may prove useful for predicting trauma needs across the system and hospital administration when allocating limited resources.LEVEL OF EVIDENCEPrognostic/epidemiological, level III.