bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation-Induced Intraosseous Malignant Peripheral Nerve Sheath Tumor: A Case Report
Authors: Wagner C. , Alfattal R. , Mallick J. 
Published: October 2024

Introduction The significance of radiation therapy in cancer treatment comes with associated complications, including fibrosis, osteonecrosis, and the development of secondary malignancies, such as malignant peripheral nerve sheath tumors (MPNSTs). We emphasize the importance of understanding these complications for an effective patient management. Methods We report a 47-year-old man with a history of squamous cell carcinoma of the tongue, treated with surgery, chemotherapy, and radiation therapy. The patient later presented with symptoms that led to the discovery of an intraosseous MPNST. Results Histopathological examination revealed characteristic features of MPNST, including spindle cells arranged is sweeping fascicles with contrasting hypercellular and hypocellular areas, producing a marble-like pattern, with atypical wavy, buckled, hyperchromatic nuclei, and brisk mitotic activity. Immunohistochemical analysis showed patchy positive staining for S100 and SOX10, and a complete loss of H3K27me3 expression. This report underscores the challenge of diagnosing secondary malignancies post-radiation therapy and the importance of careful histological examination to differentiate them from other conditions. Conclusions In conclusion, radiation-induced secondary malignancies are a significant late side effect of radiation therapy that can profoundly impact treatment decision-making and requires a high index of suspicion during post radiation surveillance. Malignant peripheral nerve sheath tumor serves as a pertinent example, highlighting the importance of considering long-term risks when developing optimal management plans for cancer patients.
Effect of a novel cannulation device for vascular access on AVF maturation in a goat carotid-jugular fistula model
Authors: Glowczwski Alan , Hohmann Stephen , Ross John , Peden Eric , Gowda Ashok , Lovelady April , Glowczwski Justin , Fridley Jennifer , Simon Bradley T 
Published: October 2024

Objective: The Ark is a 3-D printed titanium device designed to be implanted around the draining vein of an arteriovenous fistula (AVF) to facilitate vascular access. The purpose of this study was to assess AVF maturation after Ark implantation in a large animal model. Methodology: End-to-side AVFs were created between the carotid artery and jugular vein in nine pygmy goats that included three control (AVF only) and six experimental (AVF and Ark device) animals. For experimental animals, an Ark device was implanted approximately 10 cm downstream of the anastomosis at the time of AVF creation. Postoperative ultrasounds and cannulations of the jugular vein fistula were performed over 12 months. At the conclusion of the study, the AVF was ligated and Ark devices along with a segment of the arterialized vein and surrounding tissues were explanted for gross and histological assessment. Results: The control and experimental Ark groups exhibited increased dilation and flow as well as diminished depth underscoring the parallel developments in vascular attributes and AVF maturation between the two groups. Gross pathology, histology, and micro-CT imaging revealed intact endothelium, mature tissue integration throughout the porous Ark device, and no underlying stenosis. No adverse events such as foreign body reaction, skin or vessel erosion were identified. Conclusion: The study showed maturation without stenosis of the fistula in all animals. This study confirmed that the Ark device functions as a scaffold around the access vein, allows fistula maturation, and can be consistently cannulated without infiltrations over a 12-month period in a large animal model.
Bedside 3D ultrasound fistula maturation assessment by non-expert sonographers provides equivalent accuracy to formal duplex sonography: A prospective clinical trial
Authors: Lauvao Lannery , Burgess Jason , O’Brien-Coon Devin , Rogers Tyson , Yevzlin Alex , Beaver Jason 
Published: October 2024

Background: EchoSure is an automated point-of-care 3D ultrasound (3DUS) designed to be used by dialysis technicians without advanced ultrasound training. The EchoMark/EchoSure System is a two-part system comprised of a bioresorbable implant, EchoMark, and a diagnostic ultrasound imaging platform, EchoSure. EchoSure was designed to enable any healthcare personnel in a dialysis clinic setting to obtain non-invasive, direct measurements of flow and vessel parameters that are critical quantifications used in the assessment of AVF maturation and readiness for hemodialysis cannulation. Objective: In this pilot feasibility study, we sought to explore whether use of an automated 3DUS could enable fistula assessment by non-experts and obtain measurement accuracy comparable to expert sonographer Duplex. Method: This was a 20 subject prospective multicenter trial conducted at four sites in the United States. All subjects had an EchoMark implanted under their AVF during the fistula creation procedure. Subjects were evaluated at 2-weeks post-op with EchoSure and Duplex, followed by monthly assessments until either the 4-month visit or until radiographic maturation was achieved, whichever was longer. Beyond monthly ultrasound assessments, clinical follow-up continued every 6 months between months 6 and 24. Result: Technical success of EchoMark implantation was demonstrated in 100% of subjects. Technical success of EchoSure was 99% across all scans. The mean percent difference in flow rate measurements between EchoSure and Duplex was −9.2% with a standard deviation of 38.1% compared to a mean percent difference of −15.7% with a standard deviation of 35.5% between Duplex measurements taken at the cannulation zone and brachial artery. Pearson correlation between EchoSure and Duplex was 0.708 versus 0.716 for the two Duplex measurements. Radiographic maturation was achieved in 70% of study subjects by 30 days and continued to rise to 90% through 90 days and 95% through 180 days after baseline. Conclusion: This study demonstrates the feasibility and accuracy of an automated 3D ultrasound system for assessment of maturation at the dialysis bedside by non sonographers.
Bifurcated Endografts for the Treatment of Aortoiliac Disease a Systematic Review and Individual Patient Data (IPD) Meta-Analysis
Authors: Manaki Vasiliki , Bontinis Vangelis , Bontinis Alkis , Giannopoulos Argirios , Kontes Ioannis , Ktenidis Kiriakos 
Published: October 2024

Background: This review aimed to assess the efficacy and safety of bifurcated endografts in the treatment of aortoiliac disease (AOID). Methods: A systematic search on PubMed, Scopus, and Web of Science was performed. The primary endpoint was primary patency, whereas secondary endpoints included reintervention, technical, clinical success, and overall postoperative complications. Results: Ten studies with a total of 365 patients were included in this review. Most included studies used the AFX unibody endograft, one study the Excluder endograft, and one the Powerlink endograft. The majority of included patients displayed TransAtlantic InterSociety Consensus (TASC) D aortoiliac lesions (56.1% 205/365). The pooled primary patency estimates at 12, 24, and 36 months were 93.93% (95% confidence interval [CI]: 87.7–100), 91.46% (95% CI: 84.6–98.8), and 90.25% (95% CI: 82.6–98.6), respectively. The mean primary patency time was 85.74 months (95% CI: 71.99–86.88). The pooled freedom from reintervention estimates at 12, 24, and 36 months were 91.94% (95% CI: 81.4–100), 91.03% (95% CI: 79.8–100), and 91.03% (95% CI: 79.8–100), respectively. The pooled estimates of major complications (rupture, graft thrombosis, amputation) were 11.12% (95% CI, 0.05%–3.03%), 3.76% (0.32%–9.45%), and 0.38% (0%–2.59%), whereas the pooled estimates for minor complications (hematoma, groin infection, dissection) and overall mortality were 5.27% (95% CI, 1.11%–11.38%), 6.93% (95% CI, 2.94%–12.16%), 2.19% (95% CI, 0.06%–6.14%), and1.57% (95% CI, 0.13–3.97), respectively. Technical and clinical success estimates were 99.92% (95% CI: 98.86%–100%) and 99.47% (95% CI: 94.92%–100%), respectively. Conclusion: The application of bifurcated endografts may present a safe and viable option in the treatment of AOID, with preliminary results indicating promising primary patency outcomes. However, the definitive assessment of their efficacy and safety will be better determined through long-term follow-up studies and high-quality randomized controlled trials, which are essential to substantiate these initial findings. Clinical Impact Bifurcated endograft application may be a safe and viable alternative for high-risk patients with complex AOID TASC C and D lesions with encouraging primary patency outcomes potentially comparable to those of open surgery. Non-negligible postoperative complication rates were also noted. High-quality randomized controlled trials and studies comparing CERAB, kissing stenting, and the use bifurcated endografts for the treatment of AOID is necessary to draw more definite conclusions.
Robotic-Assisted Navigation in Single-Level Transforaminal Lumbar Interbody Fusion Reduces Surgeons’ Mental Workload Compared With Fluoroscopic and Computed Tomographic Techniques: A Nonrandomized Prospective Controlled Trial
Authors: Morse Kyle W. , Subramanian Tejas , Zhao Eric , Maayan Omri , Oquendo Yousi , Gang Catherine Himo , Dowdell James , Qureshi Sheeraz , Iyer Sravisht 
Published: October 2024

Background: Pedicle screw placement during spine fusion is physically and mentally demanding for surgeons. Consequently, spine surgeons can become fatigued, which has implications for both patient safety and surgeon well-being. Purpose: We sought to assess the cognitive workload of surgeons placing pedicle screws using robotic-assisted navigation compared with fluoroscopic and computed tomography (CT)-assisted placement. Methods: We performed a nonrandomized prospective controlled trial to compare the cognitive workload of 3 surgeons performing single-level minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) using robotic, CT, or fluoroscopic navigation on 25 patients (15 in the robotic navigation group and 10 in the nonrobotic group). Immediately after each procedure, surgeons submitted the National Aeronautics and Space Administration–Task Load Index (NASA-TLX), which has 6 subscales: mental demands, physical demands, temporal demands, performance, effort, and frustration. Four tasks associated with pedicle screw placement were assessed independently: (1) screw planning, (2) calibrating robot/obtaining imaging/registration, (3) pedicle cannulation, and (4) screw placement. Patient demographics and surgical characteristics were obtained and reviewed. Results: Surgeons’ self-reported cognitive workload was significantly reduced when using robotic-assisted navigation versus CT/fluoroscopic navigation. Workload was reduced for screw planning, pedicle cannulation, and screw placement. In addition, there were significant reductions in each subdomain for these 3 tasks, encompassing mental demand, physical demand, temporal demand, effort, and frustration with improved task performance. Conclusions: This study found significant reductions in mental workload with improved perceived performance for robotic-assisted pedicle screw placement compared with fluoroscopic and CT-navigation techniques. Lowering the cognitive burden associated with screw placement may allow surgeons to address the remainder of the operative case with less decision fatigue, prevent complications, and increase surgeon wellness.
When control becomes a matter of life: a phenomenological exploration of intestinal failure patients’ lived experience receiving assistance from home care nurses in home parenteral nutrition management
Authors: Andersson Jacqueline Victoria Nederbye , Martinsen Bente 
Published: October 2024

Background: Parenteral nutrition (PN) provides the body with essential nourishment through intravenous infusion. Home parenteral nutrition (HPN) has a significant impact on the lives of its users; however, very few studies explore the phenomenon of homecare nurse provided assistance for the management and administration of HPN. Method: The phenomenological approach, Reflective Lifeworld Research, was utilised. Data were collected through semi-structured interviews with five patients with intestinal failure. The analysis was performed according to the instructions of Reflective Lifeworld Research. Results: Four constituents were identified: (1) balanced nursing experience, (2) correct handling of procedures, (3) reversed expert roles and (4) the homecare nurse as a lifeline. Control was found to be the essence of the phenomenon, multi-faceted and characterised by the participants’ ambivalent feelings. Conclusion: The participants were ambivalent about receiving assistance from the homecare nurses. HPN is a complex treatment in which demands are placed on the homecare nurses’ competencies to deliver a high quality of care. The patients live with a constant fear of complications and hospitalisations. The participants felt compelled to perform control, monitoring the homecare nurses’ work, to ensure that errors did not occur. As more assistance was received from homecare nurses, the participants experienced a loss of control. However, the assistance did also give a sense of security, whereby the homecare nurse was perceived as a lifeline. From a sociological perspective, the need for control can be a result of the constant development of society, where greater demands were placed on citizens’ commitment and responsibility for their own treatment, prompting a larger need for individual control.
Health promotion and prevention in early times of the COVID-19 pandemic: insights from a Delphi study in Switzerland
Authors: Lutz Andrea , Duperrex Olivier , Gendre Aude , Zürcher Karin 
Published: October 2024

Background: COVID-19 pandemic and confinement measures had a major impact on the health and well-being of the population. Health promotion and prevention (HP&P) professionals had to rethink their practices to respond to the challenges raised by the pandemic context. This study aimed to build a professional consensus on the HP&P priorities (apart from the COVID-19 fight) in the early times of the pandemic in Switzerland and to identify the most relevant interventions to respond to these issues. Methods: HP&P experts from the three main linguistic regions of Switzerland reached a consensus through a two-round Delphi methodology with online questionnaires in June–July and October–November, 2020. Out of 282 experts contacted, 121 (43%) contributed in the first round and 99 (35%) in the second. Results: A strong consensus emerged about the importance of tackling mental health problems, non-communicable diseases and their main risk factors, as well as multiple social determinants of health. Although they believed that HP&P priorities changed in this context, experts reported that professional practices had only partially adapted to this new context due to multiple constraints (political, strategic, financial). The experts noted the need to adapt the means of communication to reach the different target groups. They underlined the potential of communication via digital technologies, but also drew attention to the risk of widening social inequalities due to the unequal access to these resources. Conclusions: This study generated new insights and confirmed pre-established knowledge regarding the orientations the field of HP&P should follow. While stressing the need to consolidate the traditional missions of the field (i.e. the fight against non-communicable diseases and the actions on social determinants of health), experts surveyed in this study also revaluated health priorities and rethought the way of developing HP&P actions in this specific context of the early pandemic of COVID-19.
Disproportionality analysis of reslizumab based on the FDA Adverse Event Reporting System
Authors: Li Huqun , Guo Cuilian , Wang Chongshu 
Published: October 2024

Background: With the increasing prescription of reslizumab for severe asthma with an eosinophilic phenotype, a real-world pharmacovigilance analysis of reslizumab is urgently required to detect potential unreported adverse events (AEs) in clinical practice. Objectives: We aimed to provide a comprehensive evaluation of reslizumab-related AEs in the real world. Design: Disproportionality analysis based on the FDA Adverse Event Reporting System (FAERS) database. Methods: Reslizumab-related AEs between the second quarter of 2016 and the fourth quarter of 2022 from the FAERS database were obtained. A disproportionality analysis was performed to evaluate the safety profile of reslizumab using the reporting odds ratio. Results: A total of 10,450,353 reports were collected from the FAERS database. Of the 403 reslizumab-related AEs, 42 distinct AEs were identified with positive signals. The most common AEs including dyspnea and oropharyngeal pain were identified, consistent with the instruction and clinical studies. Unexpected AEs of disproportionality such as bronchospasm and chest pain were also observed. Drug ineffective was identified as a noteworthy concern that accounted for 13.90% (56/403) of the overall reslizumab-related reports. Conclusion: While reslizumab offered a promising treatment option for severe eosinophilic asthma, more attention should be paid to the common AEs and new unexpected AEs. Based on the current findings of signal detection, further prospective studies are needed for the next signal validation and confirmation.
Continent urinary diversion and management of pouch calculi as a late complication: A case series
Authors: Ball Kathryn , Warner Ross M , Douglas-Moore Jayne L , Khan Masood A , Mellon J Killian , Kockelbergh Roger C 
Published: October 2024

Objective: Following cystectomy, there are several reconstructive options. A continent cutaneous urinary diversion (CUD) avoids an ileal conduit if patients are unsuitable for an orthotopic neobladder. Reservoir stone formation is common, and management is challenging. Our data present incidence and management of calculi following Indiana pouch reconstruction after radical cystectomy. Patients and Methods: Prospective database review identified 30 patients with Indiana pouch CUD in our series of 450 open cystectomies. Paper, electronic medical records, and radiological imaging were reviewed. Results: Six (20%) patients with up to 15 years follow-up were identified with stones. At cystectomy, all patients were stone free with normal renal function and electrolytes. Time to first stone formation was 29–60 months. Eighty percent became recurrent stone formers. Management involved a combination of endoscopic LASER litholapaxy, percutaneous and open access. All patients had a functioning CUD following stone treatment. Time to stone recurrence improved with assessment for metabolic abnormalities, timed pouch emptying, pouch irrigation and treatment of urine infections. Conclusion: The risk of stone formation and requirement for rigorous post-operative prevention protocols should be discussed with patients. Follow-up for this group should be lifelong to include imaging and metabolic monitoring. Management requires a multimodal, multi-disciplinary approach. Level of evidence: Not applicable
How online healthcare team evolve into organization: A social network analysis
Authors: Ding Xiaoyan , Zhang Xin , Wang Wen Hao , You Xiang 
Published: October 2024

Objective The rapid development of online healthcare has greatly promoted the transformation of healthcare service. The effectiveness of online healthcare is enhanced by the team that supports the doctor–patient connection. However, extant researches lack the comprehensive analysis of social networks within online healthcare team. In this study, we aim to clarify the characteristics and models of online healthcare team. Method This study focuses on the online healthcare context and collects data from online healthcare team. Using social network analysis, the social networks of online healthcare members are also developed as part of the research. Result This study uncovers the different modes of online healthcare teams from individual, team and organizational levels. These results shed light on the characteristics of an online healthcare team and show that such teams are capable of restructuring social networks. In addition, collaboration between teams allows for the development of multilevel relationships and the potential for the online healthcare team to evolve into a large-scale online healthcare organization. Conclusion Through social network analysis, this study offers a fresh viewpoint on online healthcare and its implications for management, team construction, and organizational restruction. By examining the characteristics and models of online healthcare team, this research offers valuable insights for improving the overall effectiveness of online healthcare.
Dry eye disease in episodic and chronic migraine: A cross-sectional clinic-based study
Authors: Chowdhury Bithi , Kumar Pradeep , Sharma Hemant , Chowdhury Debashish 
Published: October 2024

Background Dry eye disease (DED) and migraine, two common disorders with public health concerns, may have a bidirectional relationship. Population-based studies have found that migraine patients have higher odds of DED and vice versa. We aimed to evaluate and compare the presence of DED symptoms and objective signs between migraine patients and non-migraine controls. Methods This was a case-control study. We prospectively enrolled 60 consecutive migraine patients (30 episodic and 30 chronic) presenting in the medicine outpatient department, aged 18–65 years, and 60 non-migraine healthy controls visiting the ophthalmology department for refractive errors between February 2019 and June 2021. Consecutive migraine patients and non-migraine healthy controls were assessed in the ophthalmology department at Hindu Rao Hospital, Delhi by the Ocular Disease Surface Index (OSDI) questionnaire for DED symptoms and objectively by measuring tear break-up time (TBUT), Schirmer test (ST), and Fluorescein staining (FS). DED severity was assessed by the Odessey algorithm. Results The mean OSDI score was significantly greater in migraineurs than in controls (31.2 ± 19.8 vs 22.7 ± 15.6; p = 0.010). 45% of migraineurs had DED compared to 18.3% in controls (p = 0.002), whereas 23.3% had severe DED compared to one (1.7%) in the control group (p < 0.001). Migraineurs, compared to controls, had significantly lower mean TBUT (10.1 ± 6.5 s versus 13.4 ± 5.8 s; p = 0.004), higher FS grade (1.57 ± 1.4 versus 0.92 ± 1.2; p = 0.008) and lower ST scores (11.5 ± 5.8 mm versus 14.2 ± 6.2 mm; p = 0.014). Migraineurs with DED, compared with those without DED, had longer migraine disease duration, higher frequency, pain severity, and disability. Compared to episodic migraine, chronic migraine patients had significantly lower TBUT (11.9 ± 5.9 vs 8.3 ± 6.7; p = 0.30) and higher OSDI scores (25.7 ± 20.1 vs 36.8 ± 18.2). Conclusions This study showed that migraine patients had an increased presence of DED and severe DED compared to controls. Further, increased migraine severity and chronicity were associated with increased subjective symptoms and objective signs of DED. Migraine patients with DED were more disabled.CM patients had more DED symptoms and signs.