bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modern treatment of sinonasal undifferentiated carcinoma
Authors: Neo Wei Li , Hanna Ehab Y. , Kiong Kimberley L. 
Published: March 2023

Purpose of review
Sinonasal undifferentiated carcinomas are rare aggressive tumours with traditionally poor outcomes. Although multimodality treatment has been recommended by most centres, the ideal treatment sequence or regimen has not been established.

Recent findings
Recent evidence suggests that induction chemotherapy may be used for chemoselection and cytoreduction prior to definitive chemoradiotherapy. Where there is a favourable response, concurrent chemoradiotherapy is favoured, with an improved overall survival and improved rates of organ preservation.

Summary
Induction chemotherapy may be a useful guide for selection of patients for chemoradiotherapy or surgery and has shown encouraging results. Further research is required to establish the ideal induction chemotherapy regimen for this rare group of tumours.
The role of transoral surgery in the diagnosis of the carcinoma of unknown origin of the head and neck
Authors: Mehanna Hisham 
Published: March 2023

Purpose of review
The aim of this article is to update readers on the most recent evidence on the role of trans oral surgery (TOS) in the diagnosis of carcinoma of the unknown primary of the head and neck.

Recent findings
Tongue base mucosectomy has an important role in identifying the primary in patients who have had negative imaging, PET CT scans and ipsilateral tonsillectomy. In patients with bilateral nodal disease, tongue base mucosectomy should precede tonsillectomy. There are several unanswered questions that remain regarding sequencing of operations and use of intraoperative frozen section.

Summary
An evidence-based approach to diagnosis is important to ensure the highest detection rates, and least morbidity, in patients with head and neck carcinoma of the unknown primary.
Addressing patients’ concerns in speech and language therapy consultations following the diagnosis and treatment of head and neck cancer
Authors: Zuydam Annette C. , Rogers Simon N. , Roe Justin W.G. 
Published: March 2023

Purpose of review
Head and neck cancer (HNC) and its treatment impacts profoundly on patients’ functional abilities, emotional well being and social interactions. Communication and swallowing are fundamental to everyday life, and the Speech and Language Therapist (SLT) has a critical role for both patients and their carers. In clinical practice, patient-reported outcome measures (PROMs) are a key part of the armamentarium of the SLT. The purpose of the review is to summarize how these measures can be beneficial in the context of time pressured SLT outpatient consultations.

Recent findings
Unmet needs in HNC are common and impact negatively on quality of life. There is an ever-increasing number of articles in this area, and it can be a challenge to identify, distil and summarize those specific to SLT.

Summary
In this review, we discuss the scope of holistic evaluation, strengths and limitations of PROMs, the Patient Concerns Inventory-Head and Neck, barriers to the use of outcome measures, the carers perspective and surveillance. SLT are uniquely placed members of the multidisciplinary team and provide expert advice and intervention. The inclusion of PROMs in routine consultations provides a model of follow up, which helps address patients and carers complex and unmet needs, ultimately promoting better outcomes.
Patient Empowerment in Cancer Care
Authors: Kim Soo Hyun , Choe Yu Hyeon , Kim Da Hye 
Published: March 2023

Background
Patient empowerment is receiving increasing attention in cancer care, and its relevance has led to a growing body of literature. Empowerment-related evidence, however, has not been comprehensively reviewed.

Objective
The purpose of this scoping review was to summarize the available evidence on patient empowerment in cancer care. Specifically, we examined how patient empowerment has been defined and measured and what we have learned.

Methods
We searched 6 databases (MEDLINE, PubMed, CINAHL, EMBASE, Cochrane Library, and PsycINFO), adapting key search terms (eg, “neoplasm,” “empowerment”) to each. Extracted data included author, publication year, country of data collection, main study purpose, study design, sampling method, setting, cancer trajectory, definition of empowerment and its source, measurement of empowerment, correlates, intervention (if applicable), and major results.

Results
Of the 2987 articles we initially identified, we included 64 studies (18 quantitative, 9 qualitative, 9 psychometric validation, 8 mixed methods, 6 reviews, and 14 others). Across designs, randomized controlled trials were the most frequent. A comprehensive summary by study designs was provided.

Conclusions
The review highlights the importance of defining the empowerment concept, which is generally vague. There is a paucity of research on examining the relationship between empowerment and its related concepts. More nonexperimental studies (eg, cross-sectional, longitudinal, case-control studies) are required.

Implications for Practice
Nurses are in an optimal position to engage in the process of empowerment, leading to its benefits. To achieve the best outcomes, nurses need to clarify the definition, select an appropriate measurement, and be trained in empowerment strategies.
The Effect of the Breast Cancer Risk Reduction Program on Women With High Breast Cancer Risk in Terms of Their Participation in Screening and Their Health Beliefs and Behavior
Authors: Ozcelik Habibe , Gozum Sebahat 
Published: March 2023

Background
First-degree biological relatives of individuals with breast cancer have a higher risk of breast cancer.

Objective
The purpose of this study was to create a protocol for evaluating the effect of the Breast Cancer Risk Reduction Program (BrCaRRP) on the participation of women at risk in screening and on their health beliefs and risk reduction behaviors.

Methods
The research was planned as a single-site, single-blind randomized controlled experimental study with a parallel group. Participants will be assigned to intervention and control groups using the Stratified Permuted Block Randomization method. The BrCaRRP will be applied to the intervention group within the theoretical framework of the Health Belief Model and the Health Promotion Model. The BrCaRRP is a 12-week program that encompasses 6 meetings, the first being face-to-face and the others via phone. Multidisciplinary experts calculated the content validity index of BrCaRRP as being 0.954 (high); its weighted kappa statistic is 0.70 (high).

Results
The difference in the likelihood of participation in breast cancer screening between the BrCaRRP and control groups will be evaluated after the interventions. Findings will be presented in terms of our hypotheses.

Conclusions
The BrCaRRP is a nurse-led program based on the Health Belief Model and the Health Promotion Model. The BrCaRRP has high content validity and interrater reliability.

Implications for Practice
This protocol can be tested as an intervention in a randomized controlled study.
“The Lasso Suture: Ex vivo testing of an alternative to the high-tension deep dermal stitch”
Authors: Ross Colton J. , Miyake Bradley A. , Marsh Henry R. , Bryant Parker R. , Lee Chung-Hao , Barreiro Guilherme C. 
Published: March 2023

Summary:
Wound dehiscence is generally under-reported, with an estimated >4% occurrence rate in plastic surgery and can be an indicator of increased mortality or remission. In this work, we developed the Lasso suture as a stronger alternative to the current standard patterns that is also faster to perform than the standard “high-tension” wound repair method. To examine this, we dissected caprine skin specimens (SI, VM, HM, DDR, n=10; Lasso, n=9) to create full thickness skin wounds for suture repair using our Lasso technique and four traditional methods: simple interrupted (SI), vertical mattress (VM), horizontal mattress (HM), and deep dermal with running intradermal (DDR). We then conducted uniaxial failure testing to quantify the suture rupture stresses/strains. We also measured the suture operating time with medical students/residents (PGY or MS programs) performing wound repair (10 cm wide, 2 cm deep, 2-0 polydioxanone sutures) on soft-fixed human cadaver skin. Our developed Lasso stitch demonstrated a larger first suture rupture stress compared to all other patterns (p<0.001): 2.46 ± 0.27 MPa vs. SI, 0.69 ± 0.14 MPa; VM, 0.68 ±0.13 MPa; HM, 0.50 ±0.10 MPa; DDR, 1.17 ±0.28 MPa. The Lasso suture was also 28% faster to perform than the gold-standard DDR (264±21s vs. 349±25 s, p=0.027). In summary, we showed that the Lasso has superior mechanical properties compared to all the other studied (traditional) sutures and that the new technique can be performed faster than the current gold-standard (DDR stitch) used for high-tension wounds. Future animal and in-clinic studies will be helpful to confirm our findings in this proof-of-concept study.
Secondary Surgery after Lower Extremity Free Flap Reconstruction.
Authors: Wong Frankie K. , Christensen Joani M. , Meulendijks Mara Z. , Iskhakov David , Ahn Leah , Fruge Seth , Cetrulo Curtis L. , Helliwell Lydia A. , Winograd Jonathan M. , Valerio Ian L. , Eberlin Kyle R. 
Published: March 2023

Background:
Microsurgical free tissue transfer may be the only reconstructive option for lower extremity limb salvage. However, the functional and aesthetic results following free tissue transfer after initial salvage may be suboptimal, thus requiring secondary surgeries to facilitate definitive wound healing and/or refinement.

Methods:
A multi-institutional retrospective cohort study was performed including patients who underwent lower extremity free tissue transfer from January 2002 to December 2020. Our primary outcome variable was the presence of secondary surgery after free tissue transfer for lower extremity reconstruction. Independent variables (wound etiology, flap, donor type, recipient, co-morbidities, etc.) were collected. Secondary surgery was categorized as (1) procedures for definitive wound closure and (2) refinement procedures. Multivariable logistic regression was performed to determine which variables were independently associated with the outcome.

Results:
Four-hundred-and-twenty free tissue transfers for lower extremity reconstruction were identified. Secondary surgery was performed in over half (57%) of the patients. Presence of diabetes (OR: 2.0, p: 0.01, 95% CI: 1.2-3.5) and use of a latissimus dorsi donor (OR: 2.4, p: 0.037, 95% CI: 1.1-5.4) were predictors of wound closure procedures. Fasciocutaneous (OR 3.6, p: <0.001, 95% CI 1.8-7.2) and myocutaneous (OR: 3.0, p=0.005, 95% CI 1.5-9.9) flaps were predictors of refinement procedures when compared to muscle-only flaps with skin grafts.

Conclusions:
The majority of lower extremity free tissue reconstructions required secondary procedures to provide definitive wound closure and/or refinement. Overall, this study provides predictors of secondary surgery that will help formulate patients’ expectations of lower extremity limb salvage.
Preventing Postoperative Urinary Retention (POUR) in Patients Undergoing Elective Lumbar Surgery: A Quality Improvement Project
Authors: Jasinski Jacob , Tong Doris , Yoon Elise , Claus Chad , Lytle Evan , Houseman Clifford , Bono Peter , Soo Teck M. 
Published: March 2023

Background and Objectives:
Postoperative urinary retention (POUR) is associated with significant morbidity. Our institution's POUR rate was elevated among patients undergoing elective lumbar spinal surgery. We sought to demonstrate that our quality improvement (QI) intervention would significantly lower our POUR rate and length of stay (LOS).

Methods:
A resident-led QI intervention was implemented from October 2017 to 2018 on 422 patients in an academically affiliated community teaching hospital. This consisted of standardized intraoperative indwelling catheter utilization, postoperative catheterization protocol, prophylactic tamsulosin, and early ambulation after surgery. Baseline data on 277 patients were collected retrospectively from October 2015 to September 2016. Primary outcomes were POUR and LOS. The focus, analyze, develop, execute, and evaluate (FADE) model was used. Multivariable analyses were used. P value <.05 was considered significant.

Results:
We analyzed 699 patients (277 pre-intervention vs 422 post-intervention). The POUR rate (6.9% vs 2.6%, Δ confidence interval [CI] 1.15-8.08, P = .007) and mean LOS (2.94 ± 1.87 days vs 2.56 ± 2.2 days, Δ CI 0.066-0.68, P = .017) were significantly improved following our intervention. Logistic regression demonstrated that the intervention was independently associated with significantly decreased odds for developing POUR (odds ratio [OR] = 0.38, CI 0.17-0.83, P = .015). Diabetes (OR = 2.25, CI 1.03-4.92, P = .04) and longer surgery duration (OR = 1.006, CI 1.002-1.01, P = .002) were independently associated with increased odds of developing POUR.

Conclusions:
After implementing our POUR QI project for patients undergoing elective lumbar spine surgery, the institutional POUR rate significantly decreased by 4.3% (62% reduction) and LOS, by 0.37 days. We demonstrated that a standardized POUR care bundle was independently associated with a significant decrease in the odds of developing POUR.
Perioperative Comparison Between Open Cranial Vault Remodeling and Distraction Osteogenesis for Unilateral Lambdoid Craniosynostosis
Authors: Belza Caitlyn C. , Modi Rishi N. , Kamel George N. , McKee Ryan M. , Carbullido Mary K. , Kim Erinn , Gosman Amanda A. 
Published: March 2023

There are multiple treatment options for unilateral lambdoid craniosynostosis (ULS) including open posterior cranial vault remodeling (OCVR) and distraction osteogenesis (DO). There is a paucity of data comparing these techniques in the treatment of ULS. This study compared the perioperative characteristics of these interventions for patients with ULS. An IRB-approved chart review was performed from January 1999 to November 2018 at a single institution. Inclusion criteria included the diagnosis of ULS, treatment with either OCVR or DO using a posterior rotational flap technique, and a minimum 1-year follow-up. Seventeen patients met the inclusion criteria (12 OCVR and 5 DO). Patients in each cohort were found to have a similar distribution in sex, age at the time of surgery, synostosis laterality, weight, and length of follow-up. There was no significant difference in mean estimated blood loss/kg, surgical time, or transfusion requirements between cohorts. Distraction osteogenesis patients had a longer mean hospital length of stay (3.4 +/− 0.6 d versus 2.0 +/− 0.6 d, P = 0.0004). All patients were admitted to the surgical ward postoperatively. In the OCVR cohort, complications included 1 dural tear, 1 surgical site infection, and 2 reoperations. In the DO cohort, 1 patient had a distraction site infection, treated with antibiotics. There was no significant difference in estimated blood loss, volume of blood transfusion, or surgical time between OCVR and DO. Patients who underwent OCVR had a higher incidence of postoperative complications and the need for reoperation. This data provides insight into the perioperative differences between OCVR and DO in patients with ULS.
Morphological and Metrical Relationships Between Sphenoid Sinus and Sella Turcica: Possible Applications in Transnasal Transsphenoidal Surgery
Authors: Lazzeroni Matteo , Accorona Remo , Capaccio Pasquale , Pignataro Lorenzo , Cellina Michaela Iva , Gibelli Daniele Maria , Sforza Chiarella 
Published: March 2023

Introduction:
Transsphenoidal surgeries imply the risk of intraoperative lesions to the neurovascular structures surrounding the sphenoid sinus (SS). Aim of the present study is to assess the metrical and morphologic relationships existing between SS and sella turcica (ST).

Materials and Methods:
Two hundred computed tomography-scans of patients were selected. For each patient volumes of SS were calculated from their 3-dimensional models segmented through ITK-SNAP program. Variants of SS in pneumatisation and sellar diameters [antero-posterior (AP) diameter, depth, and length] were evaluated on each computed tomography-scan. Correlations among different measurements were assessed through Spearman test (P<0.01), whereas associations between sellar parameters and presence of pneumatisation variants were assessed through Mann-Whitney test (P<0.01).

Results:
In males, pneumatization of the greater wings was related to smaller AP diameter (P<0.01) and depth of ST (P<0.01), whereas in females lower values of depth were found in patients with pneumatization of the pterygoid processes (P<0.01). In both sexes, a positive correlation was found between AP diameter and, respectively, length and depth of ST (P<0.01), together with a negative correlation between volume of SS and depth of ST (P<0.01). Lastly, in females a positive correlation was found between age and, respectively, length and depth of ST (P<0.01).

Conclusions:
The present study highlighted new metrical and morphologic relationships between volume and pneumatisation of SS and diameters of ST. Knowledge of these correlations allows to understand more clearly, in the preoperative setting, the surgical working space. Further studies are needed, especially for what concerns the relationship between sellar measurements and age in females.
Current Outcome after Surgery for Type A Aortic Dissection
Authors: Biancari Fausto , Juvonen Tatu , Fiore Antonio , Perrotti Andrea , Hervé Amélie , Touma Joseph , Pettinari Matteo , Peterss Sven , Buech Joscha , Dell’Aquila Angelo M. , Wisniewski Konrad , Rukosujew Andreas , Demal Till , Conradi Lenard , Pol Marek , Kacer Petr , Onorati Francesco , Rossetti Cecilia , Vendramin Igor , Piani Daniela , Rinaldi Mauro , Ferrante Luisa , Quintana Eduard , Pruna-Guillen Robert , Rodriguez Lega Javier , Pinto Angel G. , Acharya Metesh , El-Dean Zein , Field Mark , Harky Amer , Nappi Francesco , Gerelli Sebastien , Di Perna Dario , Gatti Giuseppe , Mazzaro Enzo , Rosato Stefano , Raivio Peter , Jormalainen Mikko , Mariscalco Giovanni 
Published: March 2023

Objective:
The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD).

Summary Background Data:
The optimal extent of aortic resection during surgery for acute TAAD is controversial.

Methods:
This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals.

Results:
Out of 3902 consecutive patients, 689 (17.7%) died during the index hospitalization. Among 2855 patients who survived 3 months after surgery, 10-year observed survival was 65.3%, while country-adjusted, age-adjusted, and sex-adjusted expected survival was 81.3%, yielding a relative survival of 80.4%. Among 558 propensity score-matched pairs, total aortic arch replacement increased the risk of in-hospital (21.0% vs. 14.9%, P=0.008) and 10-year mortality (47.1% vs. 40.1%, P=0.001), without decreasing the incidence of distal aortic reoperation (10-year: 8.9% vs. 7.4%, P=0.690) compared with ascending aortic replacement. Among 933 propensity score-matched pairs, in-hospital mortality (18.5% vs. 18.0%, P=0.765), late mortality (at 10-year: 44.6% vs. 41.9%, P=0.824), and cumulative incidence of proximal aortic reoperation (at 10-year: 4.4% vs. 5.9%, P=0.190) after aortic root replacement was comparable to supracoronary aortic replacement.

Conclusions:
Replacement of the aortic root and aortic arch did not decrease the risk of aortic reoperation in patients with TAAD and should be performed only in the presence of local aortic injury or aneurysm. The relative survival of TAAD patients is poor and suggests that the causes underlying aortic dissection may also impact late mortality despite surgical repair of the dissected aorta.
The Thresholds of Caprini Score Associated With Increased Risk of Venous Thromboembolism Across Different Specialties
Authors: Lobastov Kirill , Urbanek Thomasz , Stepanov Eugeniy , Lal Brajesh K. , Marangoni Jim , Krauss Eugene S. , Cronin MaryAnne , Dengler Nancy , Segal Ayal , Welch Harold J. , Gianesini Sergio , Chen Xiaolan , Caprini Joseph A. 
Published: March 2023

Objective:
Estimation of the specific thresholds of the Caprini risk score (CRS) that are associated with the increased incidence of venous thromboembolism (VTE) across different specialties, including identifying the highest level of risk.

Background:
Accurate risk assessment remains an important but often challenging aspect of VTE prophylaxis. One well-established risk assessment model is CRS, which has been validated in thousands of patients from many different medical and surgical specialties.

Methods:
A search of MEDLINE and the Cochrane Library was performed in March 2022. Manuscripts that reported on (1) patients admitted to medical or surgical departments and (2) had their VTE risk assessed by CRS and (3) reported on the correlation between the score and VTE incidence, were included in the analysis.

Results:
A total of 4562 references were identified, and the full text of 202 papers was assessed for eligibility. The correlation between CRS and VTE incidence was reported in 68 studies that enrolled 4,207,895 patients. In all specialties, a significant increase in VTE incidence was observed in patients with a CRS of ≥5. In most specialties thresholds of ≥7, ≥9, and ≥11 to 12 were associated with dramatically increased incidences of VTE. In COVID-19, cancer, trauma, vascular, general, head and neck, and thoracic surgery patients with ≥9 and ≥11 to 12 scores the VTE incidence was extremely high (ranging from 13% to 47%).

Conclusion:
The Caprini score is being used increasingly to predict VTE in many medical and surgical specialties. In most cases, the VTE risk for individual patients increases dramatically at a threshold CRS of 7 to 11.
The Enterococcus secretome inhibits the growth of Mycobacterium tuberculosis complex mycobacteria.
Authors: ACHACHE Wafaa , MEGE Jean Louis , FELLAG Mustapha , DRANCOURT Michel 
Published: March 2023

Abstract
Enterococcus mundtii (E. mundtii), a commensal intestinal bacterium, was demonstrated to inhibit the growth of some Mycobacterium tuberculosis (M. tuberculosis) complex (MTC) species that cause tuberculosis in humans and mammals. To further expand this preliminary observation, we cross-investigated five E. mundtii strains and seven MTC strains representative of four MTC species using a standardized quantitative agar well diffusion assay. All five E. mundtii strains, calibrated at 3.109 colony forming units/mL, inhibited the growth of all M. tuberculosis strains with various susceptibility profiles, but no inhibition was observed with lower inoculums. Further, 9 Enterococcus species freeze-dried cell-free culture supernatants (CFCS) including Enterococcus avium, Enterococcus devriesei, Enterococcus durans, Enterococcus dispar, Enterococcus hirae, Enterococcuscasseliflavus, Enterococcus faecalis, Enterococcus faecium, and E. mundtii, inhibited the growth of M. tuberculosis, Mycobacterium africanum (M. africanum), Mycobacterium bovis (M. bovis) and Mycobacterium canettii (M. canettii), the most susceptible MTC species (inhibition diameter 25 ±1 mm), proportionally to CFCS protein concentrations. Data reported here indicated that the Enterococcus secretome inhibits growth of main MTC species of medical interest, which broadens previously reported data. In the gut, the Enterococcus secretome may modulate the expression of tuberculosis, exhibiting an anti-tuberculosis effect, with some protective roles in human and animal health.