bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative resection of the primary tumour improves survival in incurable metastatic colorectal cancer
Authors: Inci Kamuran , Nilsson Bengt , Lyckenblad Klara , Lindskog Stefan , Giglio Daniel 
Published: July 2023

AbstractBackgroundStudies show conflicting results on whether primary tumour resection (PTR) in metastatic colorectal cancer (mCRC) prolongs survival. The aim of this study was to analyse prognostic factors and the effects of PTR on overall survival (OS) in mCRC patients.MethodsIn this population‐based cohort study, factors associated with PTR and OS were assessed in 188 mCRC patients with mCRC treated with palliative chemotherapy between 2008 and 2019. The Chi‐square test and Mann–Whitney U‐test were used to assess factors associated with PTR. The log‐rank test was used to compare Kaplan–Meier estimates for OS. Cox regression was used to identify factors predicting OS.ResultsPatients undergoing PTR had significantly better performance status, fewer metastatic sites, lower CEA levels, and more often had left‐sided CRC than patients not undergoing PTR. OS was longer in palliative mCRC patients undergoing PTR (P < 0.01) and PTR was an independent variable in the Cox regression analysis (P < 0.05). Median OS was 22.9 ± 1.9 months for the PTR group and 14.5 ± 1.5 months for the non‐operated group. Poor performance status and liver metastases were significantly associated with poor prognosis.ConclusionThis study shows that PTR had a positive effect on OS and may be considered in patients suitable for surgery. PTR was offered to palliative mCRC patients with prognostic factors associated with better prognosis.
Eventration of diaphragm with ectopic thoracic kidney: A cause of chronic debilitating flank pain, managed via robot‐assisted approach
Authors: Kumar Santosh , Deshpande Rohit Sanjay 
Published: July 2023

AbstractUsually, flank pain signifies the presence of a renal/ureteric pathology. Here, we highlight an unusual cause of flank pain, which can be an important differential to be borne in mind while evaluating the causes of flank pain. Anatomical variants of the kidneys are very common, but rarely do they cause flank pain unless associated with an ongoing pathological process within them. We describe a case wherein an anatomical variant of the kidney, without any pathology, led to unremitting flank pain, purely due to its location and associated “vascular drag.” Correction of the underlying anatomical defect afforded significant symptomatic relief.
Chasing footprints in time – reframing our understanding of human foot function in the context of current evidence and emerging insights
Authors: Behling Anja‐Verena , Rainbow Michael J. , Welte Lauren , Kelly Luke 
Published: July 2023

ABSTRACTIn this narrative review we evaluate foundational biomechanical theories of human foot function in light of new data acquired with technology that was not available to early researchers. The formulation and perpetuation of early theories about foot function largely involved scientists who were medically trained with an interest in palaeoanthropology, driven by a desire to understand human foot pathologies. Early observations of people with flat feet and foot pain were analogized to those of our primate ancestors, with the concept of flat feet being a primitive trait, which was a driving influence in early foot biomechanics research. We describe the early emergence of the mobile adaptor–rigid lever theory, which was central to most biomechanical theories of human foot function. Many of these theories attempt to explain how a presumed stiffening behaviour of the foot enables forward propulsion. Interestingly, none of the subsequent theories have been able to explain how the foot stiffens for propulsion. Within this review we highlight the key omission that the mobile adaptor–rigid lever paradigm was never experimentally tested. We show based on current evidence that foot (quasi‐)stiffness does not actually increase prior to, nor during propulsion. Based on current evidence, it is clear that the mechanical function of the foot is highly versatile. This function is adaptively controlled by the central nervous system to allow the foot to meet the wide variety of demands necessary for human locomotion. Importantly, it seems that substantial joint mobility is essential for this function. We suggest refraining from using simple, mechanical analogies to explain holistic foot function. We urge the scientific community to abandon the long‐held mobile adaptor–rigid lever paradigm, and instead to acknowledge the versatile and non‐linear mechanical behaviour of a foot that is adapted to meet constantly varying locomotory demands.
Parents' perceptions: Participation patterns and desires for change for children and adolescents with autism spectrum disorder—A descriptive population‐based study from Switzerland
Authors: Krieger Beate , Piškur Barbara , Beurskens Anna J. H. M. , Moser Albine 
Published: July 2023

AbstractBackgroundLow participation in youth with autism spectrum disorder (ASD) has been reported, but age‐related and contextual information is rare.ObjectiveThis study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5–11) and adolescents (age: 12–17) with ASD in Switzerland.MethodA cross‐sectional design used the German version of the Participation and Environment Measure‐Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change.ResultsParticipation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement.ConclusionsThis study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD.
Real or fake? Sourcing and marketing of non‐prescribed benzodiazepines amongst two samples of people who regularly use illicit drugs in Australia
Authors: Grigg Jodie , Peacock Amy , Lenton Simon , Salom Caroline , Agramunt Seraina , Thomas Natalie , Lyons Tom , Sutherland Rachel 
Published: July 2023

AbstractIntroductionThere is concern around non‐prescribed benzodiazepine use, particularly with increasing detections of counterfeit products containing high‐risk novel compounds. The aims of this study were to investigate how and which non‐prescribed benzodiazepines are being sourced; forms, appearance and packaging; and awareness of risks associated with non‐prescribed benzodiazepines.MethodsData were collected from a sample of Australians who inject drugs or use ecstasy and/or other illicit stimulants on a monthly or more frequent basis, and who reported past 6‐month use of non‐prescribed benzodiazepines (n = 235 and n = 250, respectively). Data were collected on source, diversion from a known/trusted prescription, product name and aesthetic characteristics for the last non‐prescribed benzodiazepine obtained.ResultsAmongst participants who injected drugs, 71% reported that their last non‐prescribed benzodiazepines were diverted from a known/trusted prescription, compared to 59% of participants who used ecstasy/other stimulants. Sourcing via cryptomarkets was rare. Across both samples, the majority reported last obtaining substances sold/marketed as diazepam or alprazolam. Participants sourcing via non‐diverted means were twice as likely to obtain alprazolam. Known sourcing of novel compounds was rare. Amongst participants who used ecstasy/other stimulants, 36% reported confidence in the content/dose of non‐prescribed benzodiazepines even when the source is unknown.Discussion and ConclusionsMost participants obtained substances sold as classic/registered benzodiazepines, mostly via diverted prescriptions, with a substantial minority potentially unaware of counterfeits circulating. While diverted use undeniably presents risks, tightening of prescriptions in Australia could inadvertently lead to greater supply of novel benzodiazepines as seen internationally, reinforcing prioritisation of demand and harm reduction strategies.
Childhood outcomes after low‐grade intraventricular haemorrhage: A systematic review and meta‐analysis
Authors: Rees Philippa , Callan Caitriona , Chadda Karan R. , Diviney James , Harnden Fergus , Gardiner Julian , Battersby Cheryl , Gale Chris , Sutcliffe Alastair 
Published: July 2023

AbstractAimTo undertake a systematic review and meta‐analysis exploring school‐age neurodevelopmental outcomes of children after low‐grade intraventricular haemorrhage (IVH).MethodThe published and grey literature was extensively searched to identify observational comparative studies exploring neurodevelopmental outcomes after IVH grades 1 and 2. Our primary outcome was neurodevelopmental impairment after 5 years of age, which included cognitive, motor, speech and language, behavioural, hearing, or visual impairments.ResultsThis review included 12 studies and over 2036 infants born preterm with low grade IVH. Studies used 30 different neurodevelopmental tools to determine outcomes. There was conflicting evidence of the composite risk of neurodevelopmental impairment after low‐grade IVH. There was evidence of an association between low‐grade IVH and lower IQ at school age (−4.23, 95% confidence interval [CI] –7.53, −0.92, I2 = 0%) but impact on school performance was unclear. Studies reported an increased crude risk of cerebral palsy after low‐grade IVH (odds ratio [OR] 2.92, 95% CI 1.95, 4.37, I2 = 41%). No increased risk of speech and language impairment or behavioural impairment was found. Few studies addressed hearing and visual impairment.InterpretationThis systematic review presents evidence that low‐grade IVH is associated with specific neurodevelopmental impairments at school age, lending support to the theory that low‐grade IVH is not a benign condition.What this paper adds

The functional impact of low‐grade intraventricular haemorrhage (IVH) at school age is unknown.
Low‐grade IVH is associated with a lower IQ at school age.
The risk of cerebral palsy is increased after low‐grade IVH.
Low‐grade IVH is not associated with speech and language impairment.
Hotspots: Adherence in home foot temperature monitoring interventions for at‐risk feet with diabetes—A narrative review
Authors: Jones Petra J. , Lavery Lawrence , Davies Melanie J. , Webb David , Rowlands Alex V. 
Published: July 2023

AbstractBackgroundHome foot temperature monitoring (HFTM) is recommended for those at moderate to high ulcer risk. Where a > 2.2°C difference in temperature between feet (hotspot) is detected, it is suggested that individuals (1) notify a healthcare professional (HCP); (2) reduce daily steps by 50%. We assess adherence to this and HFTM upon detecting a recurrent hotspot.MethodsPubMed and Google Scholar were searched until 9 June 2023 for English‐language peer‐reviewed HFTM studies which reported adherence to HFTM, daily step reduction or HCP hotspot notification. The search returned 1030 results excluding duplicates of which 28 were shortlisted and 11 included.ResultsTypical adherence among HFTM study participants for >3 days per week was 61%–93% or >80% of study duration was 55.6%–83.1%. Monitoring foot temperatures >50% of the study duration was associated with decreased ulcer risk (Odds Ratio: 0.50, p < 0.001) in one study (n = 173), but no additional risk reduction was found for >80% adherence. Voluntary dropout was 5.2% (Smart mats); 8.1% (sock sensor) and 4.8%–35.8% (infrared thermometers). Only 16.9%–52.5% of participants notified an HCP upon hotspot detection. Objective evidence of adherence to 50% reduction in daily steps upon hotspot detection was limited to one study where the average step reduction was a pedometer‐measured 51.2%.ConclusionsUlcer risk reduction through HFTM is poorly understood given only half of the participants notify HCPs of recurrent hotspots and the number of reducing daily steps is largely unknown. HFTM adherence and dropout are variable and more research is needed to determine factors affecting adherence and those likely to adhere.
Opicapone versus entacapone: Head‐to‐head retrospective data‐based comparison of healthcare resource utilization in people with Parkinson's disease new to catechol‐O‐methyltransferase (COMT) inhibitor treatment
Authors: Harrison‐Jones Glynn , Marston Xiaocong Li , Morgante Francesca , Chaudhuri K. Ray , Castilla‐Fernández Guillermo , Di Foggia Valentina 
Published: July 2023

AbstractBackground and purposeMotor fluctuations are a significant driver of healthcare resource utilization (HCRU) in people with Parkinson's disease (pwPD). A common management strategy is to include catechol‐O‐methyltransferase (COMT) inhibition with either opicapone or entacapone in the levodopa regimen. However, to date, there has been a lack of head‐to‐head data comparing the two COMT inhibitors in real‐world settings. The aim of this study was to evaluate changes in HCRU and effect on sleep medications when opicapone was initiated as first COMT inhibitor versus entacapone.MethodsIn this retrospective cohort study, we assessed HCRU outcomes in pwPD naïve to COMT inhibition via UK electronic healthcare records (Clinical Practice Research Datalink and Hospital Episodes Statistics databases, June 2016 to December 2019). HCRU outcomes were assessed before (baseline) and after COMT inhibitor prescription at 0–6 months, 7–12 months and 13–18 months. Opicapone‐treated pwPD were algorithm‐matched (1:4) to entacapone‐treated pwPD.ResultsBy 6 months, treatment with opicapone resulted in 18.5% fewer neurology outpatient visits compared to entacapone treatment; this effect was maintained until the last follow‐up (18 months). In the opicapone group, the mean levodopa equivalent daily dose decreased over the first year and then stabilized, whereas the entacapone‐treated group showed an initial decrease in the first 6 months followed by a dose increase between 7 and 18 months. Neither COMT inhibitor had a significant impact on sleep medication use.ConclusionsThis head‐to‐head study is the first to demonstrate, using ‘real‐world’ data, that initiating COMT inhibition with opicapone is likely to decrease the need for post‐treatment HCRU versus initiation of COMT inhibition with entacapone.
Real‐world considerations regarding the use of the combination of levodopa, carbidopa, and entacapone (Stalevo®) in Parkinson's disease
Authors: Reichmann Heinz 
Published: July 2023

AbstractAn important aim in long‐term levodopa therapy is to prolong the duration of symptomatic efficacy of each dose without increasing peak plasma concentrations above the threshold for the emergence of dyskinesias. One strategy is to enhance levodopa delivery to the brain by co‐administering it with inhibitors of peripheral dopa‐decarboxylase and catechol‐O‐methyltransferase (COMT). Levodopa, carbidopa and entacapone (LCE), available in a range of fixed‐dose combinations as the branded formulation Stalevo® (Orion Pharma), has been developed to address this requirement and has been in general use for 20 years, having first been evaluated in randomized controlled trials. Experience with LCE has established that improved levodopa pharmacokinetics achieved with dual‐enzyme inhibition are translated into improved clinical efficacy, including the possibility of reducing total levodopa dosage with no loss of therapeutic effect. The ease and tolerability of switching to LCE has been affirmed in the SIMCOM trial and by personal experience detailed in this review. Some 300,000 patient‐years of safety data are available for LCE, including trial data for up to 5 years. Most adverse effects associated with LCE are attributable to the levodopa component rather than the enzyme inhibitors. The hepatotoxicity observed with the class comparator tolcapone has not been observed with entacapone, the COMT inhibitor in LCE, and there is no formal requirement to monitor liver function during LCE therapy. Other common side effects include diarrhoea, which is one of the more prominent non‐dopaminergic adverse events, and urine discolouration, which is harmless but about which patients may require reassurance.
Comparison of cone‐beam and fan‐beam computed tomography and low‐field magnetic resonance imaging for detection of proximal phalanx dorsoproximal osteochondral defects
Authors: Lin Szu‐Ting , Bolas Nicholas M. , Sargan David R. , Restif Olivier , Peter Vanessa G. , Pokora Rachel , Patrick Hayley , Foote Alastair K. , Murray Rachel C. 
Published: July 2023

AbstractBackgroundDorsoproximal osteochondral defects commonly affect the proximal phalanx, but information about diagnosis on computed tomography (CT) and magnetic resonance imaging (MRI) is limited.ObjectivesTo assess CT and MRI diagnoses of osteochondral defects, describe the lesions and compare sensitivity and specificity of the modalities using macroscopic pathology as gold standard.Study designCross‐sectional study.MethodsThirty‐five equine cadaver limbs underwent standing cone‐beam CT (CBCT), fan‐beam CT (FBCT), low‐field MRI and pathological examination. CT and MR images were examined for proximal phalanx dorsomedial and dorsolateral eminence osteochondral defects. Defect dimensions were measured. Imaging diagnoses and measurements were compared with macroscopic examination.ResultsFifty‐six defects were seen over 70 potential locations. On CBCT and FBCT, osteochondral defects appeared as subchondral irregularity/saucer‐shaped defects. On MRI, osteochondral defects were a combination of articular cartilage defect on dorsal images and subchondral flattening/irregularity on sagittal images. Subchondral thickening and osseous short tau inversion recovery hyperintensity were found concurrent with osteochondral defects. Compared with pathological examination, the sensitivity and specificity of diagnosis were 86% (95% confidence interval [95% CI] 75%–93%) and 64% (95% CI 38%–85%) for FBCT; 64% (95% CI 51%–76%) and 71% (95% CI 46%–90%) for CBCT; and 52% (95% CI 39%–65%) and 71% (95% CI 46%–90%) for MRI. Sensitivity of all modalities increased with defect size. Macroscopic defect dimensions were strongly correlated with CBCT (r = 0.76, p < 0.001) and moderately correlated with FBCT and MRI (r = 0.65, p < 0.001). Macroscopic measurements were significantly greater than all imaging modality dimensions (p < 0.001), potentially because macroscopy included articular cartilage pathology.Main limitationsInfluence of motion artefact could not be assessed.ConclusionsOsteochondral defects could be visualised using both CT and MRI with sensitivity increasing with defect size. Diagnostic performance was best using FBCT, followed by CBCT then MRI, but CBCT‐measured defect size best correlated with macroscopic examination. MRI provided useful information on fluid signal associated with defects, which could represent active pathology.
Analysis of various ATP‐binding cassette transporters revealed quantification of ABCB4 as a potential diagnostic tool in primary sclerosing cholangitis (PSC)
Authors: Thoeni Cornelia , Perciani Catia T , Nakib Diana , Camat Damra , McGilvray Ian D , MacParland Sonya A , Fischer Sandra 
Published: July 2023

AimsATP‐binding cassette transporters are important proteins in regulating bile constituent transport between hepatocytes and the bile canalicular system. Dysfunctional transporters lead to accumulation of toxic bile components within hepatocytes or the biliary system, known as cholestasis, resulting in liver damage. It has been previously reported that two particular ATP‐binding cassette transporters, ABCB4 and ABCB11, have altered expression in patients with primary sclerosing cholangitis (PSC). Interested in further analysis of expression patterns of ATP‐binding cassette transporters in PSC patients, we investigated liver samples from 201 patients, including 43 patients with PSC and 51 patients with primary biliary cholangitis patients (PBC). In addition to ABCB4 and ABCB11, we also included other ATP‐binding cassette transporters, to determine if upregulation of ABCB4 and ABCB11 is specifically found in the liver of patients with PSC.Methods and resultsRetrospectively, formalin‐fixed and paraffin‐embedded liver biopsies, resections, and explants were selected to investigate the expression of ABCB1, ABCB4, ABCB11, ABCG5/8, and FXR1 using nanoString nCounter and immunohistochemistry for validation of differently expressed transporters seen in PSC liver samples in comparison to non‐PSC liver specimens. Strikingly, ABCB4 was the only ATP‐binding cassette transporter showing increased gene and protein expression in hepatocytes of PSC livers when compared to non‐PSC liver specimens. Furthermore, ABCB4 protein expression also correlated with disease stage in PSC.ConclusionOur study concluded that altered ABCB4 expression is specifically seen in liver specimens of PSC patients. Therefore, quantitative ABCB4 analysis may be an additional useful tool for the histopathological diagnosis of PSC to distinguish this entity from other cholangiopathies.
Relapse of neurosymptomatic cerebrospinal fluid HIV RNA escape
Authors: Chan Terrence Y.‐H. , Marta Monica , Rackstraw Simon 
Published: July 2023

AbstractObjectivesOur objectives were to investigate the characteristics of people living with HIV who presented with new or recurrent symptoms in the context of re‐emergence of cerebrospinal fluid HIV RNA escape after antiretroviral therapy (ART) modification (termed relapse of CSF HIV RNA escape).MethodsPeople living with HIV‐1 with known CSF HIV RNA escape were identified, with clinical and laboratory data obtained from records in a tertiary centre. CSF HIV RNA escape was defined as quantifiable CSF HIV RNA in the presence of unquantifiable plasma HIV‐RNA or CSF HIV RNA greater than plasma HIV RNA in cases where plasma HIV‐RNA was quantifiable. Relapse was defined as a re‐emergence of CSF HIV RNA escape with new symptoms after ART therapy intensification post‐initial CSF HIV RNA escape.ResultsAmong 40 people living with HIV who presented with neurosymptomatic CSF HIV RNA, eight (20%) presented with a relapse of CSF HIV RNA escape. Symptoms on relapse included confusion (n = 2), cognitive decline (n = 2), cerebellar dysfunction (n = 2) and worsening of pre‐existing seizures (n = 1). Prior to their relapse, three people underwent drug therapy modification, with two people stopping raltegravir intensification, and one person switched from tenofovir alafenamide, emtricitabine and raltegravir for a new regimen.ConclusionsPeople with a relapse of CSF HIV RNA escape within this cohort presented with varied symptoms similar to their initial CSF HIV RNA escape. Clinicians should be vigilant of relapse of symptoms, particularly when simplifying ART regimens in people with CSF HIV RNA escape.