bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of weight-bearing Liuzijue Qigong on cardiopulmonary function
Authors: Li Desheng , Shen Mei , Yang Xiaoyan , Chen Desheng , Zhou Chunxiu , Qian Qiuyang 
Published: February 2023

Background:
Since the outbreak of coronavirus disease 2019, many people have had to reduce their outdoor activities. Therefore, a convenient, simple, at-home training method to improve or maintain cardiopulmonary function is required. This study aimed to explore the therapeutic effect of weight-bearing Liuzijue Qigong on cardiopulmonary function in healthy volunteers.

Methods:
This study was a longitudinal trial. The health participants completed a 4-week Liuzijue Qigong exercise with 0.25 kg sandbag wore on each wrist. Each training session took 30 minutes to complete 2 consecutive cycles, and 5 times a week. The cardiopulmonary function of participants was evaluated at baseline (T0) and the end of the intervention (T4). Outcomes measures were pulmonary function, diaphragm movement, and cardiac hemodynamic parameters. Paired t test was used to analyze differences within the group.

Results:
After 4 weeks of weight-bearing Liuzijue Qigong exercise intervention, the differences in the forced expiratory volume in the 1st second (P = .006), forced vital capacity rate of 1 second (P = .003), maximal mid-expiratory flow curve (P = .002), forced expiratory flow at 50% of forced vital capacity (P = .003), and maximum ventilatory volume (P < .001) of the participants were statistically significant. The diaphragmatic excursion (P = .009) under the calm breathing mode and the diaphragmatic contraction speed (P = .003) under the deep breathing mode improved significantly. The cardiac output (P = .04), cardiac index (P = .035), contractility index (P = .018), early diastolic filling ratio (P = .042), systemic vascular resistance index (P = .019), systemic vascular resistance (P = .017), and estimated ejection fraction (P = .016) of participants improved significantly in the resting stage. At the end stage of fast walking, that is, the sixth minute of six-minute walk test, the stroke volume index (P = .048), heart rate (P = .019), cardiac output (P = .008), cardiac index (P = .003), and left cardiac work index (P = .028) of participants were significantly increased compared with those before training, and the systemic vascular resistance index (P = .003) and systemic vascular resistance (P = .005) were decreased.

Conclusion:
Weight-bearing Liuzijue Qigong training significantly improved cardiopulmonary function in healthy volunteers, thus representing home-based cardiopulmonary rehabilitation training.
Efficacy and safety of double- versus single-balloon retrograde enteroscopy
Authors: Garg Rajat , Singh Amandeep , Mohammed Abdul , Aggarwal Manik , Stevens Tyler , Vargo John , Jang Sunguk 
Published: February 2023

Introduction
Data on the safety and efficacy of double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) are conflicting. We aimed to compare the efficacy and safety of retrograde DBE to SBE.

Methods
We performed a retrospective analysis of all patients who underwent retrograde DBE or SBE at a large tertiary referral center from 2008 to December 2018. Outcomes assessed included technical success, diagnostic yield, therapeutics, depth of insertion, and procedural duration.

Results
A total of 523 (403 DBE, 120 SBE) patients underwent retrograde enteroscopy during the study period. The mean age was 59.4 ± 17.24 and 59.57 ± 16.94 years in DBE and SBE groups, respectively. There was no difference in technical success (91.0% vs. 92.5%, P = 0.85), diagnostic yield (40.9% vs. 40.8%, P = 0.95), and therapeutics (17.1% vs. 19.1%, P = 0.61) between DBE and SBE. Compared to SBE, DBE had significantly shorter mean procedure time (26.5 ± 34.5 min vs. 34.8 ± 29.4 min, P = 0.01) and higher maximal depth of insertion from ileocecal valve (108.1 ± 84.1 cm vs. 73.3 ± 63.4 cm, P = 0.001). Safety events were rare and similar in both groups.

Conclusion
Retrograde DBE is associated with a significantly higher depth of insertion and shorter procedural duration, but similar diagnostic yield and technical success compared to SBE.
Outcomes after hospitalisation with spontaneous bacterial peritonitis over a 13-year period: a retrospective cohort study
Authors: Ubhi Nicholas , Mourad Adele , Tausan Matija , Lewis Declan , Smethurst James , Wenlock Rhys , Gouda Mahmoud , Bremner Stephen , Verma Sumita 
Published: February 2023

Goals
Assess outcomes in patients with an index presentation of spontaneous bacterial peritonitis (SBP) over a 13-year period.

Background
SBP, a bacterial infection of ascites, has a poor prognosis.

Study
Retrospective cohort study assessing mortality (standardised to 32 months) and prognostic factors in patients with SBP during two periods: period 1 (June 2006–November 2012) and period 2 (December 2012–May 2019).

Results
The study included 178 patients who were followed up for 11.6 (29.2) months. Mortality was high, with 12-, 24- and 32-month survival being 32%, 26% and 24%, respectively. Inpatient mortality was 36% with mortality in those surviving hospitalisation being 62%. Serum creatinine at the time of SBP diagnosis was an independent predictor of mortality at 32 months [hazard ratio (HR) 1.002, P = 0.023] and inpatient mortality (HR 1.003, P = 0.035). Positive ascitic fluid culture and ascitic fluid neutrophil count were independent predictors of 32-month (HR 1.679, P = 0.008) and inpatient mortality (HR 1.0001, P = 0.005), respectively. Patients in period 2 had lower ascitic fluid albumin (5.9 ± 3.3 g/L vs. 10.8 ± 5.4 g/L, P < 0.001), higher ascitic fluid neutrophil count (815.0 cells/mm3 vs. 345.0 cells/mm3, P < 0.001) and higher rates of hepatorenal syndrome-acute kidney injury (58 vs. 35%, P = 0.002). Mortality at 32 months and mortality in those surviving hospitalisation were similar at 78 vs. 73%, P = 0.392 and 66 vs. 58%, P = 0.355, for periods 1 and 2, respectively.

Conclusions
Despite more advanced initial presentations, mortality rates have remained similar over the last 13 years. Serum creatinine at the time of SBP diagnosis is an independent predictor of mortality.
Satisfaction of Older Patients With Emergency Department Care
Authors: Hoonakker Peter L. T. , Carayon Pascale , Brown Roger L. , Schwei Rebecca , Green Rebecca K. , Rabas Mackenzie , Hoang Ly , Wust Kathryn L. , Rutkowski Rachel , Salwei Megan E. , Barton Hanna J. , Shah Manish N. , Pulia Michael S. , Patterson Brian W. , Dail Paula v.W. , Krause Sheryl , Buckley Denise , Hankwitz Jennifer , Werner Nicole E. 
Published: February 2023

Background:Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales.Purpose:The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care.Methods:We administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects.Results:Using several criteria, we improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring.Conclusion:We addressed several methodological issues with the CECSS and provided recommendations for improvement.
Efficacy of Cognitive Behavioral Therapy for Insomnia for the Treatment of Child and Adolescent Anxiety and Depression
Authors: Reddy Abhishek , Mansuri Zeeshan , Vadukapuram Ramu , Shah Kaushal , Thootkur Mounica , Trivedi Chintan 
Published: February 2023

Abstract
Cognitive behavioral therapy for insomnia (CBT-I) has shown promising results in the adult population. However, there is not enough evidence for children and adolescents. Hence, we evaluated the current evidence of CBT-I in the treatment of anxiety and depression in children and adolescents. Published randomized clinical trials published before June 2020 were searched from PubMed, Cochrane Library of database, clinicaltrials.gov, and Google Scholar. Out of seven included studies, six studies assessed the effect of CBT-I on depression, and five assessed the effect on anxiety. In this review, most studies in this review showed a strong effect of CBT-I on symptoms of depression. Although a positive effect of CBT-I on anxiety was noted, only a small number of studies have considered this management. These findings should be considered preliminary, and further large-scale studies are warranted to further explore this finding further.
Clinical Characteristics of Melancholic and Nonmelancholic Depressions
Authors: Valerio Marina P. , Lomastro Julieta , Igoa Ana , Martino Diego J. 
Published: February 2023

AbstractThis study aimed to compare clinical-demographic features of melancholic and nonmelancholic depressions. We included 141 depressed inpatients classified as melancholic and nonmelancholic by the Sydney Melancholia Prototype Index (SMPI) andDiagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5) criteria. Results were controlled for confounders, including severity measures. Melancholic patients by both diagnostic systems were more severely depressed and presented more psychotic symptoms, neurological soft signs, and psychomotor disturbances. Melancholic patients classified by the SMPI were also older at illness onset and had fewer suicide attempts. After controlling for confounders, although all differences remained significant for SMPI diagnosis, theDSM-5diagnosis of melancholia was only associated with further impaired motor sequencing. The results obtained with the SMPI support the hypothesis that melancholia has clinical features qualitatively different from those of nonmelancholic depressions. Contrarily, theDSM-5specifier seems to reflect the severity of depressive episodes rather than core clinical features of melancholia.
The Role of Emotion Dysregulation in the Relationship Between Sleep Disturbances and PTSD Symptom Severity
Authors: Dolan Megan , Slavish Danica C. , Weiss Nicole H. , Contractor Ateka A. 
Published: February 2023

Abstract
Emotion dysregulation is implicated in the development, maintenance, and treatment of sleep disturbances and posttraumatic stress disorder (PTSD) separately. However, few studies have assessed interactions among these variables. To address this gap, this study examined whether the associations of sleep quality and sleep quantity with PTSD severity were stronger at higher levels of negative and positive emotion dysregulation in a community sample of 199 trauma-exposed individuals. This study found that both poorer sleep quality and lower sleep quantity were associated with greater PTSD severity at low to average (but not high) levels of negative emotion dysregulation. Positive emotion dysregulation did not moderate the relationships between sleep quality or quantity and PTSD severity. Exploratory additive multiple moderation analyses showed significant associations between poorer sleep quality and lower sleep quantity with greater PTSD severity at low to average levels of negative emotion dysregulation, coupled with any level of positive emotion dysregulation. Findings inform theoretical perspectives on the sleep-PTSD relationship and clinical applications of targeting emotion dysregulation in the treatment of sleep disturbances and PTSD symptoms for trauma-exposed individuals.
Outcome of tibial shaft fractures treated with the SIGN FIN nail at Addis Ababa Emergency, Burn, and Trauma Hospital (AaEBT) Addis Ababa, Ethiopia
Authors: Tesso Cheru Beyene , Zirkle Lewis G. , Worku Abiy , Tilahun Getachew , Kebede Samuel , Desta Tilahun 
Published: February 2023

Abstract

Objectives:
To determine the outcome of tibial fractures treated with the SIGN FIN nail.

Study Design:
Retrospective case series study.

Study Setting:
Trauma center.

Methods and Materials:
We included 14 patients aged 18–51 years with 16 tibial fractures in this study. Patients were followed clinically and radiographically, and the minimum time followed was 6 months. Johner and Wruhs criteria with modification were used to assess the outcome.

Result:
There were 11 male (78.6%) and three female (21.4%) patients. The mean age was 32.44 ± 8.98 (range 18–51) years. The right-sided tibia was injured in six as compared with the left side in four, and four patients had bilateral injuries. Eight (50%) fractures were closed fractures, whereas the rest eight (50%) were open types of fractures. Among the latter, half (n = 4; 50%) fractures were Gustilo type II fractures, while three (37.5%) fractures were Gustilo type III fractures, and one (12.5%) patient had a Gustilo type I fracture. All patients had radiologic union. There were no infections or secondary surgery for any reason. Excellent, good, and fair results were achieved in 62.5%, 25%, and 12.5%, respectively. All patients were able to return to their preinjury activity except two patients.

Conclusion:
SIGN FIN nail is an option for treating tibial shaft fractures with good outcomes and few complications in selected fractures.

Level of evidence:
Level IV
Long-term ultrasonographic and histologic changes in acellular dermal matrix in implant-based breast reconstructions
Authors: Lee Jun Ho , Choi Bong Gyu , Lee Won Seob , Seo Min-Gi , Park Bo-Yoon , Kim Young Seon , Park Do Young , Kim Il-Kug 
Published: February 2023

Background:Acellular dermal matrix (ADM) is composed of extracellular matrix (ECM) and is widely used in implant-based breast reconstructions. However, long-term changes in the ADM around implants have not been established. This study aimed to investigate long-term changes in the ADM covering breast implants using serial ultrasound (US) and histologic evaluations.Methods:We evaluated the US results of 144 patients who underwent implant-based breast reconstructions with ADM coverings. The US results obtained within 18 months of surgery and those obtained 5 years postoperatively were analyzed to determine the change in the ADM thickness. For histologic analysis, the ADM was harvested from 30 patients who underwent secondary breast surgery. Histologic features of the ECM and cellular components within the ADM were compared at specific intervals from ADM implantation and the second operation (early ADM group: <18 months, late ADM group: >5 years postoperatively).Results:The ADM thickness on US examination significantly decreased in the late ADM compared with that in the early ADM (p< 0.001). Histologic analyses revealed that the late ADM group had less thickness with lower ECM levels than the early ADM group had. Increased infiltration of host cells such as vascular endothelial cells, myofibroblasts, and immune cells occurred in the late ADM.Conclusions:Implanted ADMs underwent gradual thinning over time, in addition to ECM reduction and infiltration of host cells. These findings are useful in understanding the natural course of ADMs currently used in implant-based breast reconstructions.
Gender Surgery in Adolescents and Young Adults: A Review of Ethical and Surgical Considerations
Authors: Robinson Isabel S. , Carswell Jeremi M. , Boskey Elizabeth , Agarwal Cori A. , Brassard Pierre , Bélanger Maud , Zhao Lee C. , Bluebond-Langner Rachel 
Published: February 2023

BACKGROUND:
The incidence of transgender adolescents seeking gender affirming surgery (GAS) in increasing. Surgical care of the adolescent transgender patient is associated with several unique technical, legal, and ethical factors. The authors present a review of the current literature on gender affirming surgery for individuals under the age of legal majority and propose directions for future research.

METHODS:
A scoping review of recent literature was performed to assess evidence on gender affirming surgery in individuals under the age of legal majority. Papers were included that examined either ethical or technical factors unique to pediatric GAS. Study characteristics and conclusions were analyzed in conjunction with expert opinion.

RESULTS:
Twelve papers were identified meeting inclusion criteria. Ten of these papers discussed ethical challenges in adolescent GAS, seven papers discussed legal challenges, and five papers discussed technical challenges. Ethical discussions focused on the principles of beneficence, nonmaleficence, and autonomy. Legal discussions centered on informed consent and insurance coverage. Technical discussions focused on the impact of puberty blockade on natal tissue.

CONCLUSIONS:
Surgical care of the adolescent transgender patient involves important ethical, legal, and technical considerations that must be addressed by the clinical team. As the population of individuals seeking GAS after puberty blockade increases, future research is needed describing functional and psychosocial outcomes in these individuals.
Photon Counting Detector CT-Based Virtual Noniodine Reconstruction Algorithm for In Vitro and In Vivo Coronary Artery Calcium Scoring: Impact of Virtual Monoenergetic and Quantum Iterative Reconstructions
Authors: Fink Nicola , Zsarnoczay Emese , Schoepf U. Joseph , Griffith Joseph P. , Wolf Elias V. , O'Doherty Jim , Suranyi Pal , Baruah Dhiraj , Kabakus Ismail M. , Ricke Jens , Varga-Szemes Akos , Emrich Tilman 
Published: February 2023

ObjectivesThe aim of this study was to evaluate the impact of virtual monoenergetic imaging (VMI) and quantum iterative reconstruction (QIR) on the accuracy of coronary artery calcium scoring (CACS) using a virtual noniodine (VNI) reconstruction algorithm on a first-generation, clinical, photon counting detector computed tomography system.Materials and MethodsCoronary artery calcium scoring was evaluated in an anthropomorphic chest phantom simulating 3 different patient sizes by using 2 extension rings (small: 300 × 200 mm, medium: 350 × 250 mm, large: 400 × 300 mm) and in patients (n = 61; final analyses only in patients with coronary calcifications [n = 34; 65.4 ± 10.0 years; 73.5% male]), who underwent nonenhanced and contrast-enhanced, electrocardiogram-gated, cardiac computed tomography on a photon counting detector system. Phantom and patient data were reconstructed using a VNI reconstruction algorithm at different VMI (55–80 keV) and QIR (strength 1–4) levels (CACSVNI). True noncontrast (TNC) scans at 70 keV and QIR “off” were used as reference for phantom and patient studies (CACSTNC).ResultsIn vitro and in vivo CACSVNIshowed strong correlation (r> 0.9,P< 0.001 for all) and excellent agreement (intraclass correlation coefficient > 0.9 for all) with CACSTNCat all investigated VMI and QIR levels. Phantom and patient CACSVNIsignificantly increased with decreasing keV levels (in vitro: from 475.2 ± 26.3 at 80 keV up to 652.5 ± 42.2 at 55 keV; in vivo: from 142.5 [7.4/737.7] at 80 keV up to 248.1 [31.2/1144] at 55 keV;P< 0.001 for all), resulting in an overestimation of CACSVNIat 55 keV compared with CACSTNCat 70 keV in some cases (in vitro: 625.8 ± 24.4; in vivo: 225.4 [35.1/959.7]). In vitro CACS increased with rising QIR at low keV. In vivo scores were significantly higher at QIR 1 compared with QIR 4 only at 60 and 80 keV (60 keV: 220.3 [29.6–1060] vs 219.5 [23.7/1048]; 80 keV: 152.0 [12.0/735.6] vs 142.5 [7.4/737.7];P< 0.001). CACSVNIwas closest to CACSTNCat 60 keV, QIR 2 (+0.1%) in the small; 55 keV, QIR 1 (±0%) in the medium; 55 keV, QIR 4 (−0.1%) in the large phantom; and at 60 keV, QIR 1 (−2.3%) in patients.ConclusionsVirtual monoenergetic imaging reconstructions have a significant impact on CACSVNI. The effects of different QIR levels are less consistent and seem to depend on several individual conditions, which should be further investigated.
Combined Ablation and Resection for Colorectal Liver Metastases in the Minimally Invasive Surgical Era
Authors: Vandeputte Mathieu , Saveyn Thiebault , Lutin Bart , De Meyere Celine , Parmentier Isabelle , D’Hondt Mathieu 
Published: February 2023

Background:
Thermal ablation is an accepted treatment modality for small and central liver tumors. In extensive colorectal liver metastatic disease (CRLM), hepatectomy can be combined with ablation, resulting in a parenchymal-sparing strategy. This may increase salvageability rates in case of recurrence.

Methods:
All patients with advanced CRLM that underwent combined ablation and resection between April 2012 and April 2021, were retrospectively analyzed from a prospectively maintained database. Primary endpoints include postoperative 30-day morbidity and ablation-site recurrence (ASR). The surgical approaches were compared. Ablated lesions were screened for ASR on postoperative follow-up imaging.

Results:
Of 54 patients that underwent combined ablation and resection, 32 (59.3%) were performed through a minimally invasive approach. Eleven (20.4%) were minor resections, 32 (59.3%) were technically major and 11 (20.4%) were anatomically major resections. Twelve complications occurred (22.2%), among which 2 (3.8%) major complications (Clavien-Dindo ≥IIIa). Ninety-day mortality rate was 1.9%. Out of 82 ablated lesions, 6 ASRs (11.1%) occurred. Median blood loss was significantly lower in the minimally invasive group, compared with open [90 mL (32.5 to 200) vs. 200 mL (100 to 400), P=0.005]. Pringle maneuver was significantly performed less in the minimally invasive group [8 (25.0%) vs. 16 (72.7%), P=0.001], but took more time [36.1 min (±15.6) vs. 21.6 (±9.9); P=0.011]. Short-term (1 y) overall and disease-free survival were respectively 81.4% and 50.0%.

Conclusion:
Combining microwave ablation and liver resection is a feasible and safe parenchymal-sparing technique, through both minimally invasive and open approach for treating extended CRLM disease. It has a low ablation-related complication rate and acceptable ablation-site recurrence rate.
The Role of Pretransplant Infections in Pediatric Receiving LDLT in Indonesia: A 7-y Retrospective Study
Authors: Alatas Fatima Safira , Karyanti Mulya Rahma , Nugraha Marcel Aditya , Tartila Tartila , Pudjiadi Antonius Hocky 
Published: February 2023

Background.
Liver transplantation is the definitive treatment for pediatric end-stage liver disease. Infections posttransplantation might significantly affect the outcome of the surgery. This study aimed to identify the role of pretransplant infection among children who underwent living donor liver transplantation (LDLT) in Indonesia.

Methods.
This is an observational, retrospective cohort study. A total of 56 children were recruited between April 2015 and May 2022. Patients were categorized into 2 according to the presence of pretransplantation infections requiring hospitalization before the surgery. Diagnosis of posttransplantation infection was observed for up to 1 y based on the clinical features and laboratory parameters.

Results.
The most common indication for LDLT was biliary atresia (82.1%). Fifteen of 56 patients (26.7%) had a pretransplant infection, whereas 73.2% of patients were diagnosed with a posttransplant infection. There was no significant association between pretransplant and posttransplant infection in all 3-time points (≤1 mo, 2–6 mo, and 6–12 mo). The most common organ involvement posttransplantation was respiratory infections (50%). The pretransplant infection did not significantly affect posttransplant bacteremia, length of stay, duration of mechanical ventilation, initiation of enteral feeding, hospitalization cost, and graft rejection.

Conclusions.
Our data showed that pretransplant infections did not significantly affect clinical outcomes in post-LDLT procedures. A prompt and sufficient diagnosis and treatment before and after the LDLT procedure is the best way to obtain an optimal outcome.