bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Intravenous Lidocaine, Ketamine, and Lidocaine–Ketamine Combination in Colorectal Cancer Surgery: A Randomized Controlled Trial
Authors: Ostović Helena , Šimac Brankica , Pražetina Marko , Bradić Nikola , Peršec Jasminka 
Published: May 2023

BACKGROUND:
Colorectal resections are associated with a pronounced inflammatory response, severe postoperative pain, and postoperative ileus. The aim of this study was to evaluate the main effects of lidocaine and ketamine, and their interaction in colorectal cancer (CRC) patients after open surgery. The interaction could be additive if the effect of 2 drugs given in combination equals the sum of their individual effects, or multiplicative if their combined effect exceeds the sum of their individual effects. We hypothesized that the combination of lidocaine and ketamine might reduce the inflammatory response additively or synergistically.

METHODS:
Eighty-two patients undergoing elective open colorectal resection were randomized to receive either lidocaine or placebo and either ketamine or placebo in a 2 × 2 factorial design. After induction of general anesthesia, all subjects received an intravenous bolus (lidocaine 1.5 mg/kg and/or ketamine 0.5 mg/kg and/or a matched saline volume) followed by a continuous infusion (lidocaine 2 mg·kg−1·h−1 and/or ketamine 0.2 mg·kg−1·h−1 and/or a matched saline volume) until the end of surgery. Primary outcomes were serum levels of white blood cell (WBC) count, interleukins (IL-6, IL-8), and C-reactive protein (CRP) measured at 2 time points: 12 and 36 hours after surgery. Secondary outcomes included intraoperative opioid consumption; visual analog scale (VAS) pain scores at 2, 4, 12, 24, 36, and 48 hours postoperatively; cumulative analgesic consumption within 48 hours after surgery; and time to first bowel movement. We assessed the main effects of each of lidocaine and ketamine and their interaction on the primary outcomes using linear regression analyses. A Bonferroni-adjusted significance level was set at .05/8 = .00625 for primary analyses.

RESULTS:
No statistically significant differences were observed with either lidocaine or ketamine intervention in any of the measured inflammatory markers. No multiplicative interaction between the 2 treatments was confirmed at 12 or 36 hours after surgery: WBC count, P = .870 and P = .393, respectively; IL-6, P = .892 and P = .343, respectively; IL-8, P = .999 and P = .996, respectively; and CRP, P = .014 and P = .445, respectively. With regard to inflammatory parameters, no evidence of additive interactions was found. Lidocaine and ketamine, either together or alone, significantly reduced intraoperative opioid consumption versus placebo, and, except for lidocaine alone, improved pain scores. Neither intervention significantly influenced gut motility.

CONCLUSIONS:
Our study results do not support the use of an intraoperative combination of lidocaine and ketamine in patients undergoing open surgery for CRC.
Trends of Axillary Treatment in Sentinel Node-Positive Breast Cancer Patients Undergoing Mastectomy
Authors: Verreck Eline E. F. , van Steenhoven Julia E. C. , Kuijer Anne , van Maaren Marissa C. , Simons Janine M. , Siesling Sabine , van Dalen Thijs 
Published: May 2023

Abstract
Background
The ACOSOG-Z0011- and the AMAROS-trial obviated the need for axillary surgery in most sentinel node-positive (SLN+) breast cancer patients undergoing breast-conserving surgery (BCS). Data for patients who undergo mastectomy is scarce. The purpose of this study was to investigate patterns of axillary treatment in SLN+ patients treated by mastectomy in the years after the publication of landmark studies regarding axillary treatment in SLN+ breast cancer patients undergoing BCS.

Methods
This was a population-based study in cT1-3N0M0 breast cancer patients treated by mastectomy and staged as SLN+ between 2009 and 2018. The performance of an axillary lymph node dissection (ALND) and/or administration of postmastectomy radiotherapy (PMRT) were primary outcomes and were studied over time.

Results
The study included 10,633 patients. The frequency of ALND performance decreased from 78% in 2009 to 10% in 2018, whereas PMRT increased from 4 to 49% (P < 0.001). In ≥N1a patients, ALND performance decreased from 93 to 20%, whereas PMRT increased to 70% (P < 0.001). In N1mi and N0itc patients, ALND was abandoned during the study period, whereas PMRT increased to 38% and 13% respectively (P < 0.001), respectively. Age, tumor subtype, N-stage, and hospital type affected the likelihood that patients underwent ALND.

Conclusions
In this study in SLN+ breast cancer patients undergoing mastectomy, use of ALND decreased drastically over time. By the end of 2018 most ≥N1a patients received PMRT as the only adjuvant axillary treatment, whereas the majority of N1mi and N0itc patients received no additional treatment.
Therapeutic monitoring of anti-seizure medications in low- and middle-income countries: a systematic review
Authors: Odhiambo Mercy , Kariuki Symon M. , Newton Charles R. 
Published: May 2023

Background: The treatment gap for epilepsy is large in low- and middle-income countries (LMICs) and the effectiveness and safety of the available anti-seizure medication (ASMs) is not fully understood. We systematically reviewed available evidence on therapeutic drug monitoring (TDM) of ASM in LMIC. Methods: We searched four main databases (PubMed, Psych-Info, CINAHL and Embase) up to 31st December 2020, with eligible articles screened using a PRISMA checklist and a set of exclusion and inclusion criteria. Full texts were examined to evaluate the extent and practice of TDM in LMICs. Analyses were performed using Stata 13 and descriptive statistics were used to pool median distribution of TDM across studies. Results: Of the 6,309 articles identified in the initial search, 65 (1.0%) met the eligibility criteria. TDM of ASMs was mostly done to assess toxicity (42.8%), but rarely to monitor adherence (9.0%). TDM differed by economic status and infrastructural status with majority of the studies coming from Europe (53.8%) and upper-middle-income countries (87.6%). First generation ASMs (82.3%) were more likely to be monitored than second generation ASMs (17.6%) and carbamazepine was the most frequently monitored drug. Fluorescence Polarization Immunoassay (FPIA) was the most common technique used for TDM (41.5%) followed by High-Performance Liquid Chromatography (HPLC) (16.9%). In addition, FPIA was the cheapest method of TDM based on approximated costs ($1000, TDx system). Assay validation and quality control were reported variably, and reference ranges used during TDM of ASMs were relatively uniform. Conclusions: TDM is mostly done to evaluate ASM toxicity, but rarely for other reasons such as evaluating adherence or assessing clinical efficacy. There is a need for more investment in comprehensive and targeted TDM in LMICs when initiating treatment, switching therapies, adding or removing ASM and evaluating treatment response and safety of both first generation and second generation ASMs.
Case Report: Intrahepatic cholestasis: a diagnostic dilemma
Authors: Acharya Udit , Panthi Ram Chandra , Shrestha Roshan , Pandey Bimal , Adhikari Sudeep , Koirala Janak , Basnyat Buddha 
Published: May 2023

Cholestasis is an impairment of bile formation or bile flow. The mechanisms of cholestasis can be broadly classified into intrahepatic and extrahepatic. Most of the time, etiology can be determined with proper history, physical examination and diagnostic testing including laboratory and imaging tests. This is a case report of a patient with severe cholestasis who underwent extensive evaluation to determine the etiology of intrahepatic cholestasis. This Case Report details a 28-year-old male who presented with seven days’ history of yellowish discoloration of eyes, passage of dark colored urine, generalized body itching, and passage of clay colored stool. Patient had no similar episode in the past. Laboratory investigations showed unconjugated hyperbilirubinemia and increased alkaline phosphatase. Magnetic resonance cholangiopancreaticography was unremarkable and liver biopsy was suggestive of cholestatic pattern and negative for acute hepatitis. The bilirubin level started decreasing after a month. The etiology of intrahepatic cholestasis remained unknown. Genotyping could not be done due to limited available resources. It may have helped to diagnose familial hepatocellular cholestasis such as benign recurrent intrahepatic cholestasis (BRIC) and progressive familial intrahepatic cholestasis. Gamma glutamyl transferase is normal or mildly elevated in patients with BRIC. A similar picture was seen in our case as well. If the patient presents again with similar symptoms and findings, we can consider the diagnosis of BRIC.
Nonprofit Organizations’ Financial Obligations and the Paycheck Protection Program
Authors: Neely Daniel G. , Saxton Gregory D. , Wong Paul A. 
Published: May 2023

We examine nonprofit organizations’ involvement in the Paycheck Protection Program (PPP). The PPP provided participants with forgivable loans to pay employee salaries, increasing participants’ financial flexibility during the pandemic. We examine the associations between nonprofits’ prepandemic financial obligations (e.g., long-term debt and donor-restricted net assets) and PPP participation and participants’ loan characteristics. First, we find nonprofit organizations participated at a lower rate than other small business industries and that nonprofits with greater financial obligations were more likely to participate in the program. Second, we find financial obligations were positively associated with the loan amount received as a percentage of total payroll costs. Last, although approximately 11% of nonprofits failed to obtain loan forgiveness, we find nonprofits with restricted net assets were more likely to have their loans forgiven. Our results suggest nonprofits with greater debt and donor obligations used the PPP to increase their financial flexibility. This paper was accepted by Ranjani Krishnan, accounting. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4804 .
The need of patients living with cancer for palliative care
Authors: Alnajar Malek Kh , Abdalrahim Maysoon S , Mosleh Sultan M , Farhan Mohammad , Amro Khadijah , Darawad Muhammad W 
Published: May 2023

Background: A comprehensive assessment of patients' problems and needs is essential for all patients with chronic diseases, including cancer. Aim: This study assesses the problems, unmet needs and requirement for palliative care (PC) among patients with cancer. Method: A descriptive cross-sectional design was employed using a valid self-reported questionnaire. Results: On average, 62% of patients had problems that were unresolved. The need for patients to have more information about their health was identified (75.1%), followed by financial problems because of the illness and ability to afford healthcare (72.9%), and psychological issues, such as depression, anxiety and stress (67.1%). Patients stated that their spiritual needs were not being met (78.8%), and that they were experiencing psychological distress and problems with daily living that needed to be addressed through PC (78%, 75.1%, respectively). A chi-square test revealed that all problems are significantly associated with the need for PC (P<.001). Conclusion: Patients needed more assistance in psychological, spiritual, financial and physical domains, and this can be provided by palliative care. Palliative care in low-income countries is a human right for patients with cancer.
“I feel good because I have saved their lives”: Acceptability of assisted partner services among female index clients and male sexual partners in Kenya
Authors: Naughton Brienna , Owuor Mercy , Wamuti Beatrice , Katz David A. , Sharma Monisha , Liu Wenjia , Lagat Harison , Kariithi Edward , Mugambi Mary , Bosire Rose , Masyuko Sarah , Farquhar Carey , Weiner Bryan J. 
Published: May 2023

IntroductionAssisted partner services (APS), or notification for sexual partners of people diagnosed with HIV, is an efficient, effective, and high yield strategy to identify people living with HIV and is recommended by the World Health Organization (WHO). However, there remains a need to further understand the acceptability of APS qualitatively from a client lens, particularly when APS is integrated into the national health system. We investigated acceptability of APS when integrated into HIV services in Kenya.MethodsStarting in May 2018, APS was implemented in 31 health facilities in Kisumu and Homa Bay counties in western Kenya. From January to December 2019, we conducted in-depth interviews (IDIs) with female index clients (n = 16) and male sexual partners (n = 17) in 10 facilities participating in an APS scale up study. Interviews assessed APS satisfaction, perceived benefits of the intervention, and challenges that may affect delivery or uptake. We applied the Theoretical Framework of Acceptability by Sekhonet al. (2017) as a guide to organize our findings.ResultsWe find that views of APS are often guided by an individual’s trust in the intervention’s design and implementation, and an interest to preserve one’s health and that of one’s family and children. There were strong and consistent acceptable views of APS as “doing good” and “saving a life” and as a means of showing love towards one’s partner(s). The initial acceptability framing of individuals engaging with APS was predicated either on a feeling of comfort with the intervention, or a wariness of divulging sex partner personal information. Health care workers (HCWs) were seen to play an important role in mitigating participant fears linked with the intervention, particularly around the sensitive nature of HIV disclosure and sexual partners. Clients noted considerable challenges that affected acceptability, including the risk to the relationship of disclosing one’s HIV status, and the risk of intimate partner violence.DiscussionWe found that APS is acceptable as a strategy to reach male sexual partners of females diagnosed with HIV, and these findings provide opportunities to inform recommendations for further scale-up. Opportunities such as focusing on intervention confidentiality and appropriate counseling, excluding female clients at risk of IPV from this intervention, and highlighting the altruistic benefits of APS to potential clients. Understanding the perspectives of clients receiving APS in a real-world setting may be valuable to policy-makers and stakeholders interested in scaling up or enhancing APS within health systems.
The level of health anxiety before and during the COVID-19 pandemic
Authors: Norbye Anja Davis , Farbu Erlend Hoftun , Terjesen Christoffer Lilja , Fleten Nils , Höper Anje Christina 
Published: May 2023

Background
Concerns about disease and an increase in health anxiety levels are expected consequences of the COVID-19 pandemic. However, there have been few longitudinal studies of health anxiety in the general population during this time period. The aim of this study was to examine health anxiety levels before and during the COVID-19 pandemic in an adult, working population in Norway.

Material and methods
This study included 1012 participants aged 18–70 years with one or more measurements of health anxiety (1402 measurements total) from the pre-pandemic period (2015 to March 11, 2020) and/or during the COVID-19 pandemic (March 12, 2020 to March 31, 2022). Health anxiety was measured with the revised version of the Whiteley Index-6 scale (WI-6-R). We estimated the effect of the COVID-19 pandemic on health anxiety scores with a general estimation equation analysis, and age, gender, education, and friendship were included in subgroup analyses.

Results
We found no significant change in health anxiety scores during the COVID-19 pandemic compared to the pre-pandemic period in our adult, working population. A sensitivity analysis restricted to participants with two or more measurements showed similar results. Moreover, the effect of the COVID-19 pandemic on health anxiety scores was not significant in any subgroup analysis.

Conclusion
Health anxiety remained stable, with no significant change observed between the pre-pandemic period and the first 2 years of the COVID-19 pandemic in an adult, working population in Norway.
Association between patient, clinic, and geographical-level factors and 1-year surveillance colonoscopy adherence
Authors: Savage Talicia , Sun Qin , Bell-Brown Ari , Katta Anjali , Shankaran Veena , Fedorenko Catherine , Ramsey Scott D. , Issaka Rachel B. 
Published: May 2023

Abstract

Introduction:
Surveillance colonoscopy 1-year after surgical resection for patients with stages I-III colorectal cancer (CRC) is suboptimal and data on factors associated with lack of adherence are limited. Using surveillance colonoscopy data from Washington state, we aimed to determine the patient, clinic, and geographical factors associated with adherence.

Methods:
Using administrative insurance claims linked to Washington (WA) cancer registry data we conducted a retrospective cohort study of adult patients diagnosed with stage I-III CRC between 2011 and 2018 with continuous insurance for at least 18 months after diagnosis. We determined the adherence rate to 1-year surveillance colonoscopy and conducted logistic regression analysis to identify factors associated with completion.

Results:
Of 4,481 stage I-III CRC patients identified, 55.8% completed a 1-year surveillance colonoscopy. The median time to colonoscopy completion was 370 days. On multivariate analysis, older age, higher stage CRC, Medicare insurance or multiple insurance carriers, higher Charlson Comorbidity Index score and living without a partner were significantly associated with decreased adherence to 1-year surveillance colonoscopy. Among 29 eligible clinics, 51% (n=15) reported lower than expected surveillance colonoscopy rates based on patient mix.

Conclusion:
Surveillance colonoscopy 1-year after surgical resection is sub-optimal in WA state. Patient and clinic factors, but not geographic factors (Area Deprivation Index), were significantly associated with surveillance colonoscopy completion. This data will inform the development of patient and clinic level interventions to address an important quality of care issue across Washington.
Post-vaccination and post-infectious immune response against new coronavirus infection on the background of obesity and overweight
Authors: Klimchuk A. V. , Beloglazov V. A. , Yatskov I. A. , Agzamova Yu. M. , Kamshii A. A. , Zayaeva A. A. 
Published: May 2023

In the fall of 2019, global health was confronted with a new RNA virus — severe acute respiratory syndrome coronavirus 2 SARS-CoV-2. Against the background of the rapid spread of infection, research centers around the world began to develop specific vaccines against COVID-19, using the accumulated experience and empirical data on the stereotypes of the structure and physiology of other viral agents of this family (severe acute respiratory syndrome virus (SARS) and Middle East respiratory syndrome (MERS). However, even before the development of anti-COVID vaccines, it was suggested that they are probably less effective in a number of individuals, in particular, in people who are overweight or obese. This hypothesis arose on the basis of past studies using vaccines for other purposes in this categories of people, as well as in numerous experiments on mice, thanks to which scientists came to the conclusion that, due to an excess amount of adipose tissue in the body, there is a state of a permanent inflammatory process, some immune dysfunction, and, as a result, a reduced local and systemic response. resistance against bacterial and viral agents.In this literature review, using current publications obtained by searching for “covid-19 vaccination and obesity” and “vaccination and obesity” in the PubMed databases and “covid-19 vaccination and obesity” and “vaccination and obesity” in the e- Library discusses changes in the immune response both to infection itself and to immunization in the presence of overweight or obesity.
Agreement of body adiposity index (BAI), bioimpedance analysis and ultrasound scanning in determining body fat
Authors: Bondareva E. A. , Parfenteva O. I. , Vasileva A. A. , Kulemin N. A. , Gadzhiakhmedova A. N. , Kovaleva O. N. , Sultanova B. A. , Mazurina N. V. , Troshina E. A. 
Published: May 2023

BACKGROUND: The steadily increasing number of people with obesity requires the development of simple and accurate methodological approaches to assess the absolute and relative amount of body fat mass. The body adiposity index (BAI) is one of the indices proposed to assess the body fat percentage. However, the comparison analysis of common methods, i.e., of bio-electrical impedance analysis and ultrasound scanning, and BAI was not performed for the Russian population.AIM: Comparison analysis of the body fat percentage estimates by bio-electrical impedance analysis, ultrasound scanning, and body adiposity index in the group of adult male and females.MATERIALS AND METHODS: An examination of healthy males and females from Moscow was conducted. Height, weight, waist and hip circumferences were measured. The body fat percentage was obtained by bio-electrical impedance analysis — BIA (ABC-02 Medas), ultrasound scanning — US (BodyMetrixTM, IntelaMetrix), and body adiposity index.RESULTS: 263 females and 134 males aged 18 to 73 years participated in the study. Correlation coefficients between BAI values and the body fat percentage obtained by BIA and US were 0.749 and 0.763 (p<0.000), respectively. Comparison of body fat percentage measurements obtained by BAI, BIA and US showed the low agreement (ССС<0.90) between BAI and other methods in pooled sample as well as in the female and male groups. Comparison of the US and BAI methods revealed higher level of agreement (ССС=0.84 [0.80–0.86]) and no systematic bias. Lower level of agreement was obtained in the group of males.CONCLUSION: Conducted study allows to conclude that, at the individual level, BAI is not an appropriate method for estimating the body fat percentage relatively to other indirect methods. However, all three methods can be used in the group of pooled males and females when testing at the population level.