bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiotherapy Results in Locally Advanced Sinonasal Cancer
Authors: Duru Birgi Sümerya , Özkaya Akagündüz Özlem , Dagdelen Meltem , Yazici Gözde , Canyilmaz Emine , Ceylaner Biçakçi Beyhan , Çetinayak Hasan O. , Baltalarli Papatya B. , Demiröz Abakay Candan , Kaydihan Nuri , Delikgöz Soykut Ela , Erdiş Eda , Akyürek Serap , Esassolak Mustafa , Uzel Ömer E. , Bakirarar Batuhan , Cengiz Mustafa 
Published: February 2024

Objective:
This study aims to examine the treatment outcomes and related factors in locally advanced sinonasal cancer across Turkiye.

Methods:
Twelve centers participants of the Turkish Society for Radiation Oncology Head and Neck Study Group attended the study. One hundred and ninety-four patients treated with intensity-modulated radiation therapy between 2001 and 2021 were analyzed retrospectively. The survival analysis was performed using the Kaplan-Meier method. Acute and late toxicity were recorded per Common Toxicity Criteria for Adverse Events V4.0.

Results:
The median age was 58 years and 70% were male. The majority of tumors were located in maxillary sinus (59%). Most of the patients (%83) had T3 and T4A disease. Fifty-three percent of patients were in stage 4A. Radiotherapy was administered to 80% of the patients in the adjuvant settings. Median 66 Gy dose was administered in median 31 fractions. Chemotherapy was administered concomitantly with radiotherapy in 45% of the patients mostly with weekly cisplatin. No grade ≥4 acute and late toxicity was observed. The median follow-up was 43 months. The 5-year and 10-year overall survival (OS); locoregional recurrence-free survival (LRFS); distant metastasis-free survival (DMFS), and progression-free survival (PFS) rates were 61% and 47%; 69% and 61%; 72%, and 69%, and 56% and 49%, respectively. In the multivariate analysis, several factors demonstrated significant influence on OS, such as performance status, surgery, and lymph node involvement. Moreover, surgery was the key prognostic factor for LRFS. For DMFS, lymph node involvement and surgical margin were found to be influential factors. In addition, performance status and lymph node involvement were identified as significantly affecting PFS.

Conclusions:
In our study, the authors obtained promising results with IMRT. Performance status, lymph node involvement, and surgery emerged as the primary factors significantly influencing OS.
The impact of leader member exchange quality and differentiation on counterproductive and citizenship behavior in health care teams
Authors: Mitchell Rebecca , Gu Jun , Boyle Brendan 
Published: February 2024

Background
Organizational citizenship behavior (OCB) may increase service quality. In contrast, counterproductive work behavior (CWB) may undermine patient safety. Efforts to increase OCB and reduce CWB rely on a good understanding of their antecedents, yet there is a lack of research in health care to inform such endeavors.

Purpose
The aim of this study was to investigate the role of leadership, specifically leader–member exchange (LMX), in reducing CWB and increasing OCB in health care teams.

Methodology/Approach
Team survey data were collected from 75 teams in U.S. health services organizations. Polynomial regression and response surface analysis was used to investigate our hypotheses.

Results
For OCB, the response surface along the line of incongruence (a
3) was positive and significant, and for CWB, a
3 was negative and significant.

Conclusion
The results of polynomial regression and response surface analysis indicate that OCB increases when LMX quality is high and that LMX differentiation is comparatively lower. In contrast, CWB increases when LMX differentiation is high, whereas LMX quality is lower.

Practice Implications
These findings provide useful suggestions to promote valuable extra-role behaviors in health care teams. Health care team leaders should aim to develop strong exchange relationships with all members if they wish to increase citizenship behavior and decrease counterproductive behavior. Building positive exchange relationships with only a few team members is likely to undermine citizenship behavior and increase counterproductive behavior.
Risk Assessment for Workers with Wearable Medical Devices Exposed to Electromagnetic Fields
Authors: Vivarelli Cecilia , Censi Federica , Calcagnini Giovanni , Falsaperla Rosaria , Mattei Eugenio 
Published: February 2024

Abstract
The exponential diffusion of wearable medical devices (WMD) in recent years has involved people of all ages, including workers. Workers who use WMDs should be considered at a particular risk from electromagnetic fields, and in accordance with EU Directive 2013/35/EU, they require an individual risk assessment. Currently, there is no international standard that provides specific guidance on how to perform such a risk assessment. This paper focuses on the effects of electromagnetic fields on WMDs and does not consider the direct effects on human body tissues. It aims to offer practical recommendations to employers and/or health physicists for the risk assessment of workers with WMDs. Focusing on EU countries, we first describe the requirements outlined by the technical standard for the electromagnetic compatibility (EMC) of medical electrical equipment EN 60601-1-2. Then, some general guidelines on how to perform the risk assessment are provided. The assessment can be conducted by comparing the field values measured in the workplace with the immunity test levels specified in the technical standards of medical electrical equipment. If the measured values are lower than the immunity test levels indicated in the standard and the distance from the electromagnetic source is greater than the distance used by the manufacturer during the EMC (electromagnetic compatibility) tests (typically 30 cm), the risk for the worker may be considered acceptable. However, if the measured values exceed the immunity test levels or the distance criteria, a specific evaluation based on a case-by-case analysis is required.
Decommissioning of a Medical Cyclotron Vault: The Case Study of the National Cancer Institute of Milano
Authors: Pola Andrea , Bortot Davide , Pasquato Stefano , Mazzucconi Davide , Chiesa Carlo , Zanellati Fabio , Brusa Anna 
Published: February 2024

Abstract
In the widespread use of medical cyclotrons for isotope production, radiological and economic consequences related to the decommissioning of particle accelerators are often neglected. However, decommissioning regulation and its related procedures always demand efforts and costs that can unexpectedly impact on budgets. The magnitude of this impact depends strongly on the residual radioactivity of the accelerator and of the vault, and more specifically on the kind and activity concentration of residual radionuclides. This work reports and discusses a case study that analyzes in detail the characterization activities needed for optimized management of the decommissioning of a medical cyclotron vault. In particular, this paper presents the activities carried out for assessing the activity concentrations and for guiding the disposal of the cyclotron vault of the Italian National Cancer Institute of Milano (INT). An unshielded 17 MeV cyclotron vault was characterized by high resolution gamma-ray spectrometry both in-situ and in-laboratory on extracted samples. Monte Carlo simulations were also carried out to assess the overall distribution of activation in the vault. After a few months from the final shutdown of the accelerator, activity concentrations in the concrete walls due to neutron activation exceeded the clearance levels in many regions, especially close to the cyclotron target. Due to the relatively long half-lives of some radionuclides, a time interval of about 20 y after the end of bombardment is necessary for achieving clearance in some critical positions. Far from the target or in positions shielded by the cyclotron, activation levels were below the clearance level. The comparison between Monte Carlo simulations and experimental results shows a good agreement. The in-situ measurements, simpler and economically advantageous, cannot completely replace the destructive measurements, but they may limit the number of required samples and consequently the decommissioning costs. The methodology described and the results obtained demonstrated that it is possible to obtain accurate estimations of activity concentrations with cheap and quick in-situ measurements if the concentration profile in-depth inside the wall is well known. This profile can be obtained either experimentally or numerically through suitably validated Monte Carlo simulations.
Success in managing a giant hepatic hydatid cyst: a case report of successful conservative surgical intervention in an endemic setting
Authors: Touati Dheker M. , Khefacha Fahd , Ben Othmane Mohamed R. , Khlifi Nadhem , Jaouad Firas , Idani Marwa , Belhadj Anis , Saidani Ahmed , Chebbi Faouzi 
Published: February 2024

Introduction and importance:
Echinococcosis, also known as a hydatid cyst, arises from a parasitic infection caused by the larval form of the tapeworm Echinococcus granulosus in humans. This endemic disease in Tunisia presents a significant public health challenge. The case highlights the enormous size of the liver hydatid cyst, emphasizing the importance and success of conservative surgical treatment.

Case Presentation:
A 45-year-old female shepherdess presented with abdominal pain and a mass, diagnosed as a giant hepatic hydatid cyst. A computed tomography scan revealed a dysmorphic liver with a large multivesicular cyst. Surgical intervention included the resection and closure of multiple cystic fistulas. Postoperative recovery was uneventful and at the 6-month follow-up, the patient displayed no indications of recurrence.

Clinical discussion:
Echinococcosis, prevalent in livestock-farming regions, primarily affects the liver and lungs. It often remains asymptomatic, detected incidentally. Diagnosis relies on imaging, with surgical excision as the primary treatment. Percutaneous options exist but are less effective. Serologies are underused. Management challenges include complications and recurrence. Conservative surgery is common but faces complications. Radical surgery is more effective, albeit complex. Albendazole preoperatively proves promising, reducing cyst viability. Regular follow-up is crucial for recurrence detection.

Conclusion:
Managing giant hepatic hydatid cysts requires tailored approaches, especially in endemic regions. Our success with conservative surgical treatment highlights its effectiveness in confronting formidable cyst sizes, informing clinical practice, and contributing to the medical literature.
Accuracy of the KOROT P3 Accurate automated auscultatory blood pressure measuring device for professional use in people with extra-large arms
Authors: Fania Claudio , Giletto Antonella , Niero Alice , Palatini Paolo 
Published: February 2024

Objective
To determine the accuracy of the KOROT P3 Accurate (previously InBody BPBIO480KV) monitor, an automated auscultatory blood pressure (BP) measuring device developed for professional use, in people with extra-large arms according to the ISO81060-2 2018 protocol.

Methods
The KOROT P3 Accurate was tested in 37 subjects with upper-arm circumference ranging from >42 to 53 cm using a mercury sphygmomanometer coupled to a 20 × 40 cm tronco-conical cuff as the reference standard.

Results
The mean BP difference between the device and the observers’ reference measurements was 1.2 ± 2.0 mmHg for systolic BP and 1.0 ± 2.0 mmHg for diastolic BP. These data were in agreement with criterion 1 of the protocol standard requirements (≤5 ± 8 mmHg). Also criterion 2 was satisfied being the standard deviations ± 1.7 mmHg for systolic BP and ± 1.6 for diastolic BP, well below the maximum values required by the protocol (±6.84/6.87 mmHg). Scatterplots of device-reference systolic and diastolic BP differences showed similar accuracy across the range of participants’ BP, arm circumference and upper-arm slant angle.

Conclusions
These data show that the KOROT P3 Accurate monitor satisfied the ISO 81060-2:2018 standard requirements in a special population of people with extra-large arms ranging from >42 to 53 cm.
Status epilepticus resulted in rhabdomyolysis-induced AKI associated with hepatotoxicity induced by synergistic carbamazepine and diazepam: A case report
Authors: Soliman Nawwar , Alsultan Mohammad , Alhusseini Ayham , Alsamarrai Omar , Basha Kassem 
Published: February 2024

Rationale:
Rhabdomyolysis is a serious complication of status epilepticus (SE) caused by muscle cell damage and can lead to a life-threatening acute kidney injury (AKI).

Patient concerns:
A 35-year-old man with a history of seizures treated with 3 different antiepileptic drugs (carbamazepine, lamotrigine, and levetiracetam) presented with SE. The patient received 5 doses of diazepam to control the SE in another hospital and was transferred to our emergency due to AKI.

Diagnoses:
Laboratory tests corresponded with rhabdomyolysis-induced AKI and disseminated intravascular coagulation. Thereafter, the decrease in renal excretion of both drugs (diazepam and carbamazepine) caused acute liver injury and neurotoxicity. The carbamazepine concentration was 16.39 mcg/mL, which considered in toxic level, despite using the usual dose.

Interventions:
The patient was treated with hydration and sodium bicarbonate, however; severe AKI mandated a hemodialysis session.

Outcomes:
The diuresis started to increase, kidney and liver functions improved, and altered mental status reversed.

Lessons:
This case alerts physicians to consider the synergistic drug side effects and interactions, especially when patients present with impaired liver or kidney functions. The reduction in metabolism or excretion of drugs can cause an increase in serum concentrations and induce toxicity, even when the drug intake at the usual dose.
Brain natriuretic peptide in acute heart failure and its association with glomerular filtration rate: A systematic review and meta-analysis
Authors: Mughal Hamdah Bashir , Majeed Ayesha Isani , Aftab Maria , Ubaid Muhammad Furqan , Zahra Sabahat , Abbasi Muhammad Sajid Rafiq , Qadir Mamoon , Ahmad Mumtaz , Akbar Amna , Tasneem Sabahat , Jadoon Sarosh Khan , Tariq Maham , Hussain Saddam , Khandker Shahad Saif , Alvi Sarosh 
Published: February 2024

Background:
Acute heart failure (AHF) is one of the most common cardiovascular diseases. Early diagnosis and prognosis are essential, as they can eventually lead to a fatal condition. Recently, brain natriuretic peptide (BNP) has been recognized as one of the most popular biomarkers for AHF. Changes in glomerular filtration rate (GFR) are often observed in AHF.

Methods:
We searched PubMed, Google Scholar, and ScienceDirect between March and June 2023. Original case control studies written in English that assessed levels oh BNP in AHF were included. Systematic reviews, letters to editor, correspondence, comprehensive reviews, and duplicated studies were excluded. Funnel plots were constructed to assess publication bias.

Results:
A total of 9 studies were selected and we obtained the mean difference (MD) of BNP level to be 2.57 (95% CI: 1.35, 3.78), and GFR to be −15.52, (95% CI: −23.35, −7.70) in AHF patients. Sensitivity analyses supported the robustness of the outcome.

Conclusion:
Results indicated that BNP was a promising prognostic biomarker of AHF, whereas GFR was found to be negatively correlated with AHF.
The investigation of cytotoxic and apoptotic activity of Cl-amidine on the human U-87 MG glioma cell line
Authors: Öğüten Pinar Naile , Engür Öztürk Selin , Dikmen Miriş 
Published: February 2024

Background:
Peptidyl (protein) arginine deiminases (PADs) provide the transformation of peptidyl arginine to peptidyl citrulline in the presence of calcium with posttranslational modification. The dysregulated PAD activity plays an important role on too many diseases including also the cancer. In this study, it has been aimed to determine the potential cytotoxic and apoptotic activity of chlorine-amidine (Cl-amidine) which is a PAD inhibitor and whose effectiveness has been shown in vitro and in vivo studies recently on human glioblastoma cell line Uppsala 87 malignant glioma (U-87 MG) forming an in vitro model for the glioblastoma multiforme (GBM) which is the most aggressive and has the highest mortality among the brain tumors.

Methods:
In the study, the antiproliferative and apoptotic effects of Cl-amidine on GBM cancer model were investigated. The antiproliferative effects of Cl-amidine on U-87 MG cells were determined by 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate method at the 24th and 48th hours. The apoptotic effects were analyzed by Annexin V and Propidium iodide staining, caspase-3 activation, and mitochondrial membrane polarization (5,5’, 6,6’-tetrachloro-1,1’, 3,3’ tetraethyl benzimidazolyl carbocyanine iodide) methods in the flow cytometry.

Results:
It has been determined that Cl-amidine exhibits notable antiproliferative properties on U-87 MG cell line in a time and concentration-dependent manner, as determined through the 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate assay. Assessment of apoptotic effects via Annexin V and Propidium iodide staining and 5,5’, 6,6’-tetrachloro-1,1’, 3,3’ tetraethyl benzimidazolyl carbocyanine iodide methods has revealed significant efficacy, particularly following a 24-hour exposure period. It has been observed that Cl-amidine induces apoptosis in cells by enhancing mitochondrial depolarization, independently of caspase-3 activation. Furthermore, regarding its impact on healthy cells, it has been demonstrated that Cl-amidine shows lower cytotoxic effects when compared to carmustine, an important therapeutic agent for glioblastoma.

Conclusion:
The findings of this study have shown that Cl-amidine exhibits significant potential as an anticancer agent in the treatment of GBM. This conclusion is based on its noteworthy antiproliferative and apoptotic effects observed in U-87 MG cells, as well as its reduced cytotoxicity toward healthy cells in comparison to existing treatments. We propose that the antineoplastic properties of Cl-amidine should be further investigated through a broader spectrum of cancer cell types. Moreover, we believe that investigating the synergistic interactions of Cl-amidine with single or combination therapies holds promise for the discovery of novel anticancer agents.
External treatment of traditional Chinese medicine for cancer pain: A systematic review and network meta-analysis
Authors: Jin Hong , Liang Ji , Zhang Siqi , Ma Shuai , Qin Hongyu , Zhang Dongxu , Pang Xueying , Zhang Miao 
Published: February 2024

Background:
Cancer pain is one of the most intolerable and frightening symptoms of cancer patients. However, the clinical effect of the three-step analgesic ladder method (TSAL) is not satisfactory. The combination of external treatment of traditional Chinese medicine (TCM) can improve the clinical effect.

Objective:
This study used network meta-analysis to compare the effects of different external treatment methods of TCM combined with TSAL on cancer pain.

Methods:
Databases searched by our team included Google Scholar, Web of Science, Scopus, Embase, PubMed, and Cochrane Library. Randomized controlled trials related to the external treatment of TCM combined with TSAL for cancer pain were screened from the establishment of the database till now. The above literature extracted clinical efficacy, NRS score, KPS score, analgesic onset time, and duration as the main results after the screening. The 95% confidence interval (95% CI) of OR value and SMD value was used as the effect index to compare the difference in efficacy of different interventions, and the ranking was conducted. STATA 17.0 software was used for the statistical analysis of the above data.

Results:
A total of 78 studies were included, including 8 interventions and 5742 participants. Based on ranking probability, the clinical effective rate of manual acupuncture combined with TSAL was the best when the intervention time was set at 4 weeks [OR = 5.42, 95% CI (1.99,14.81)], and the improvement effect on KPS score was also the best [SMD = 0.97, 95% CI (0.61, 1.33)]. Acupoint external application was the best intervention in reducing NRS score [SMD = −1.14, 95% CI (−1.90, −0.93)]. Acupoint moxibustion combined with TSAL was considered to be the most effective intervention to prolong the duration of analgesia [SMD = 1.69, 95% CI (0.84, 2.54)] and shortening the onset time of analgesia [SMD = −3.00, 95% CI (−4.54, −1.47)].

Conclusions:
TSAL combined with manual acupuncture is the best in terms of clinical efficacy and improvement of patients’ functional activity status. With the extension of treatment time, the intervention of this kind of treatment on the clinical effect is more pronounced. Acupoint external application also has a unique advantage in reducing the pain level of patients. From the point of view of analgesic duration and duration of analgesia, combined acupoint moxibustion has the best effect.
Association between types of abdominopelvic cancer in patients with situs inversus total: Systematic review
Authors: Valenzuela-Fuenzalida Juan José , Martínez Hernández Daniela , Milos-Brandenberg Daniel , Koscina Zmilovan , Avila-Sepulveda Roberto , Baez Belen , Perez-Jimenez Daniela , Nova Baeza Pablo , Orellana Donoso Mathias , Bruna-Mejias Alejandro 
Published: February 2024

Background:
Situs inversus is a rare congenital anatomical variant that involves a group of anomalies regarding the arrangement of intrathoracic and intraabdominal organs. Being able to find in the abdominal region the liver, gallbladder, inferior vena cava, and head of the pancreas and ascending colon on the left side of the abdomen, while on the right side there is the spleen, the stomach, the body of the pancreas, the ligament of Treitz, descending colon among others. In this same way, the thoracic organs, lungs and heart, are changed in their position in a mirror translocation.

Methods:
We systematically searched MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and LILACS; the search strategy included a combination of the following terms: “Situs inversus,” “Situs inversus totalis,” “Cancer,” “Neoplasm,” “Abdominopelvic regions,” and “clinical anatomy.”

Results:
Within the 41 included studies, 46 patients with situs inversus who had cancer, in addition to being found in this organ and in these regions, we also found as a result that the majority of the studies in the research were in stage II; finally, no one study could assert the direct relationship between the situs inversus totalis and the cancer.

Conclusion:
If our hallmarks could make us think that more exhaustive follow-up of the stomach and other organs should be carried out in these patients, there could also be other predisposing factors for cancer, which is why more studies are suggested to give future diagnostic and treatment guidelines treatment.