bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flavonoid brachydin B decreases viability, proliferation, and migration in human metastatic prostate (DU145) cells grown in 2D and 3D culture models
Authors: Serpeloni Juliana Mara , Ribeiro Diego Luis , Weiss Gabriela Fátima , de Oliveira Larissa Cristina Bastos , Fujiike Andressa Yuri , Nunes Higor Lopes , da Rocha Claudia Quintino , Guembarovski Roberta Losi , Cólus Ilce Mara de Syllos 
Published: April 2023

Abstract
Brachydin B (BrB) is a unique dimeric flavonoid extracted from Fridericia platyphylla (Cham.) LG Lohmann with different biological activities. However, the antitumoral potential of this flavonoid is unclear. In our study, we evaluated the effects of the BrB flavonoid on cell viability (MTT, resazurin, and lactate dehydrogenase assays), proliferation (protein dosage and clonogenic assay), and migration/invasion (3D ECM gel, wound-healing, and transwell assays) of metastatic prostate (DU145) cells cultured both as traditional 2D monolayers and 3D tumor spheroids in vitro. The results showed that the BrB flavonoid promotes cytotoxic effects from ≥1.50 μM after 24 h of treatment in DU145 cells in monolayers. In 3D prostate tumor spheroids, BrB also induced cytotoxic effects at higher concentrations after longer treatment (48, 72, and 168 h). Furthermore, BrB treatment is associated with reduced DU145 clonogenicity in 2D cultures, as well as decreased area/volume of 3D tumor spheroids. Finally, BrB (6 μM) reduced cell migration/invasion in 2D monolayers and promoted antimigratory effects in DU145 tumor spheroids (≥30 μM). In conclusion, the antitumoral and antimigratory effects observed in DU145 cells cultured in 2D and 3D models are promising results for future studies with BrB using in vivo models and confirm this molecule as a candidate for metastatic prostate cancer therapy.
Verbal Behavior of Mothers With Opioid Use Disorder While Feeding Infants With Neonatal Opioid Withdrawal Syndrome
Authors: Rinaldi Kailey , Maguire Denise 
Published: April 2023

Background:
An infant's cognitive development is highly dependent on early interactions with its primary caregiver, often its mother. Feeding, a frequent and early exchange between mothers and infants, is an important time for maternal–infant bonding. Mothers with opioid use disorder have been found to be more physically and verbally stimulating and more active during feeds than mothers with no opioid use.

Purpose:
The purpose of this study was to describe the characteristics of verbal interactions mothers with opioid use disorder expressed while engaged in a feeding encounter with their infant undergoing treatment for neonatal opioid withdrawal syndrome to offer insight into maternal experiences and potential challenges of feeding infants experiencing withdrawal.

Methods:
A qualitative descriptive analysis of maternal verbalizations during the feeding was used in a secondary analysis using the Barnard Model as the theoretical framework for maternal–infant interaction.

Results:
A theory-driven deductive approach was assumed to organize the identified subthemes within the concepts of the Barnard Model. Mothers frequently commented on hunger, satiation, and stress cues, while providing consolation, praise, and encouragement. Mothers expressed concerns regarding feeding volume and pace, and consequences related to feeding.

Implications for Practice and Research:
It is crucial that clinicians remember that feeding is an important time for maternal–infant bonding. Further research into the feeding interactions of mother–infant dyads with opioid exposure is warranted. As infants may present with subacute signs of withdrawal, including persistent feeding difficulties for months, further investigation into feeding challenges dyads experience after discharge from the hospital is needed.
Practice Changes Among Patients Without COVID-19 Receiving Mechanical Ventilation During the Early COVID-19 Pandemic
Authors: Shankar Divya A. , Bosch Nicholas A. , Walkey Allan J. , Law Anica C. 
Published: April 2023

OBJECTIVES:
The COVID-19 pandemic led to rapid changes in care delivery for critically ill patients, due to factors including increased numbers of ICU patients, shifting staff roles, and changed care locations. As these changes may have impacted the care of patients without COVID-19, we assessed changes in common ICU practices for mechanically ventilated patients with non-COVID acute respiratory failure at the onset of and during the COVID-19 pandemic.

DESIGN:
Interrupted time series analysis, adjusted for seasonality and autocorrelation where present, evaluating trends in common ICU practices prior to the pandemic (March 2016 to February 2020), at the onset of the pandemic (April 2020) and intra-pandemic (April 2020 to December 2020).

SETTING:
Premier Healthcare Database, containing data from 25% of U.S. discharges from January 1, 2016, to December 31, 2020.

PATIENTS:
Patients without COVID-19 receiving mechanical ventilation for acute respiratory failure.

INTERVENTIONS:
We assessed monthly rates of chest radiograph (CXR), chest CT scans, lower extremity noninvasive vascular testing (LENI), bronchoscopy, arterial catheters, and central venous catheters.

MEASUREMENTS AND MAIN RESULTS:
We identified 742,096 mechanically ventilated patients without COVID-19 at 545 hospitals. At the onset of the pandemic, CXR (–0.5% [–0.9% to –0.2%; p = 0.001]), LENI (LENI: –2.1% [–3.3% to –0.9%; p = 0.001]), and bronchoscopy rates (–1.0% [–1.5% to –0.6%; p < 0.001]) decreased; use of chest CT increased (1.5% [0.5–2.5%; p = 0.006]). Use of arterial lines and central venous catheters did not change significantly. Intra-pandemic, LENI (0.5% [0.3–0.7%; p < 0.001]/mo) and bronchoscopy (0.1% [0.05–0.2%; p < 0.001]/mo) trends increased relative to pre-pandemic trends, while the remainder of practices did not change significantly.

CONCLUSIONS:
We observed several statistically significant changes to practice patterns among patients without COVID-19 early during the pandemic. However, most of the changes were small or temporary, suggesting that routine practices in the care of mechanically ventilated patients in the ICU was not drastically affected by the pandemic.
Cytoplasmic poly(A)-binding protein 1 as a biomarker to assist early diagnosis and prognosis of esophageal squamous cell carcinoma in endoscopic biopsy fragments
Authors: Li Xiaochen , Xu Shengen , Sun Xingwang , Long Wenbo 
Published: April 2023

Objective
Esophageal squamous cell carcinoma (ESCC) has high mortality worldwide, but its early diagnosis and prognosis are very difficult. Cytoplasmic poly(A)-binding protein 1 (PABPC1) plays an important role in regulating most cellular processes, resulting in a close relationship to tumor genesis and malignant development. Therefore, this work aimed to evaluate the clinical value of PABPC1 as a biomarker for the early diagnosis and prognosis of ESCC in endoscopic patients.

Methods
A total of 185 patients with lesions found by endoscopy were involved in this study, including 116 finally diagnosed with ESCCs and 69 with nonmalignant lesions. Biopsy fragments and surgical specimens were collected to assess PABPC1 expression by immunohistochemistry, and the association between the expression and survival was analyzed and compared in both samples.

Results
The average ratio of positive tumor cells to total tumor cells in the biopsy fragments was lower than that in surgical specimens, leading to a cutoff value of only 10% for the former in ROC analysis (AOC = 0.808, P < 0.001). However, PABPC1 high expression (PABPC1-HE) in both biopsy fragments and surgical specimens was associated with poor survival. When PABPC1 expression was used as a biomarker to diagnose ESCC in biopsy fragments, sensitivity, specificity, positive predictive value, and negative predictive value reached 44.8, 100.0, 100.0, and 51.9%, respectively. Among the 116 ESCC patients, 32 received postoperative concurrent chemoradiotherapy. Postoperative treatment increased the overall survival (OS) but not disease-free survival in lymph node-positive patients (P = 0.007 and 0.957, respectively). Nevertheless, PABPC1-HE predicted shorter OS regardless of the postoperative treatment in both endoscopic biopsy samples and surgical specimens.

Conclusion
PABPC1 expression can be used as a biomarker to detect ESCC from endoscopic lesions. At the same time, PABPC1-HE is a predictor of poor survival regardless of postoperative chemoradiotherapy in endoscopic biopsy samples of ESCC.
Patterns of Opioid Demand after Operative Treatment of Distal Radius Fractures
Authors: Lee Nayun , Le Elliot L.H. , Constantine Ryan , Iorio Matthew L. 
Published: April 2023

Background:
The purpose of this study was to evaluate opioid demand after open reduction and internal fixation of distal radius fractures in patients with and without a diagnosis of cannabis use.

Methods:
The PearlDiver database was queried for all patients who underwent open reduction and internal fixation of distal radius fractures between 2010 and 2020. Patients were categorized into two groups: (1) those with an active diagnosis of cannabis use (case) and (2) those without (control). The primary outcome measure was morphine milligram equivalents per prescription filled within 30 days after surgery. A logistic regression was used to determine potential risk factors associated with increased opioid filling patterns.

Results:
The rates of prescription refills before and after surgery were congruent in both the case and control populations and did not show significant differences (P > 0.05). The average morphine milligram equivalents of patients’ first opioid prescription was significantly reduced in the case population compared with the control (352.26 versus 480.61 morphine milligram equivalents/prescription, P = 0.005). A history of chronic opioid use was the strongest predictor of prolonged opioid prescription refills after surgery.

Conclusions:
This study found a significant reduction in opioid volume in patients with a diagnosis of cannabis use who filled an opioid prescription after open reduction and internal fixation of distal radius fractures. Mental health diagnoses, specifically depression, showed an increased risk of multiple opioid prescription refills in patients without a diagnosis of cannabis use.
Thread Lifting of the Nose: Fully Comprehensive Approach to the Technique
Authors: Sulamanidze Constantin , Lanfranchi Luciano , Diaspro Alberto 
Published: April 2023

Background:
Nose thread lifting is a relatively recent technique. It offers a chance to approach nose morphology defects without turning to surgery to obtain a temporary improvement. Nevertheless, it lacks standardization and it can therefore offer quite variable results and short durability. The authors’ experience is presented here along with a recommended methodological approach to deliver reliable techniques for predictable results. Thread lifting techniques for nose reshaping by means of insertion of poly-L-lactic/poly-caprolactone threads are presented, based on principles of graft-based techniques, to obtain temporary morphological correction of selected nose deformities.

Methods:
A total of 553 patients underwent nose reshaping using poly-L-lactic/poly-caprolactone threads. Of the procedures, 471 were primary treatment, and 82 were secondary treatment after a previous rhinoplasty. The mean follow-up period was carried out through patient photographs and lasted 33.4 months (range 2–60 months). Clinical examinations and patient satisfaction surveys were done at 6 months and 1 year from thread lifting.

Results:
The Freiburg questionnaire survey (subjective Global Aesthetic Improvement Scale) allowed the authors to confirm a 95% satisfaction rate after 6 months, and 62% at 1 year after treatment. A flow chart based on the recorded results is presented to support operators in selecting the proper correction method to adopt, based on the different listed indications.

Conclusions:
Nose reshaping techniques with poly-L-lactic/poly-caprolactone threads are presented together with patients’ treatment satisfaction. Standardization is based upon the authors’ experience. Contraindications and encountered complications are discussed, so as to provide the readers with a complete “state-of-the art” presentation of these techniques. In the authors’ experience, this is a reliable and safe approach to obtain temporary amelioration of selected nose defects via a nonsurgical and minimally invasive method.
Association Between Caregiver Burden and Patient Recovery After Left Ventricular Assist Device Implantation
Authors: Thomas Merrill , Spertus John A. , Andrei Adin-Cristian , Wu Tingqing , Farr Stacy L. , Warzecha Anna , Grady Kathleen L. 
Published: April 2023

Introduction
After left ventricular assist device (LVAD) implantation, caregivers may experience increasing burden because of new roles and responsibilities. We examined the association between caregiver burden at baseline and patient recovery after long-term LVAD implantation in patients ineligible for heart transplantation.

Methods
Between October 1, 2015, and December 31, 2018, data from 60 patients with a long-term LVAD (age, 60–80 years) and caregivers through 1 postoperative year were analyzed. Caregiver burden was measured using the Oberst Caregiving Burden Scale, a validated instrument used for measuring caregiver burden. Patient recovery post–LVAD implantation was defined by change in Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) overall summary score and rehospitalizations over 1 year. Multivariable regression models (least-squares for change in KCCQ-12 and Fine-Gray cumulative incidence for rehospitalizations) were used to assess for association with caregiver burden.

Results
Patients were 69.4 ± 5.5 years old, 85% men, and 90% White. Over the first year post–LVAD implantation, there was a 32% cumulative probability of rehospitalization; 72% (43/60) of patients had an improvement of ≥5 points in KCCQ-12 scores. Caregivers were 61.2 ± 11.5 years old, 93% women, 81% White, and 85% married. Median Oberst Caregiving Burden Scale Difficulty and Time scores at baseline were 1.13 and 2.27, respectively. Higher caregiver burden was not significantly associated with hospitalizations or change in patient health-related quality of life during the first year post–LVAD implantation.

Conclusions
Higher caregiver burden at baseline was not associated with patient recovery in the first year after LVAD implantation. Understanding the associations between caregiver burden and patient outcomes after LVAD implantation is important as excessive caregiver burden is a relative contraindication for LVAD implantation.
Provider and Patient Experiences of Delays in Primary Care During the Early COVID-19 Pandemic
Authors: Muellers Kimberly A. , Andreadis Katerina , Ancker Jessica S. , Horowitz Carol R. , Kaushal Rainu , Lin Jenny J. 
Published: April 2023

ABSTRACT

Background:
The necessary suspension of nonacute services by healthcare systems early in the COVID-19 pandemic was predicted to cause delays in routine care in the United States, with potentially serious consequences for chronic disease management. However, limited work has examined provider or patient perspectives about care delays and their implications for care quality in future healthcare emergencies.

Objective:
This study explores primary care provider (PCP) and patient experiences with healthcare delays during the COVID-19 pandemic.

Methods:
PCPs and patients were recruited from four large healthcare systems in three states. Participants underwent semistructured interviews asking about their experiences with primary care and telemedicine. Data were analyzed using interpretive description.

Results:
Twenty-one PCPs and 65 patients participated in interviews. Four main topics were identified: (1) types of care delayed, (2) causes for delays, (3) miscommunication contributing to delays, and (4) patient solutions to unmet care needs.

Conclusions:
Both patients and providers reported delays in preventive and routine care early in the pandemic, driven by healthcare system changes and patient concerns about infection risk. Primary care practices should develop plans for care continuity and consider new strategies for assessing care quality for effective chronic disease management in future healthcare system disruptions.
Weight loss during neoadjuvant therapy and short-term outcomes after esophagectomy: a retrospective cohort study
Authors: Hirano Yuki , Konishi Takaaki , Kaneko Hidehiro , Itoh Hidetaka , Matsuda Satoru , Kawakubo Hirofumi , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Daiko Hiroyuki , Itano Osamu , Yasunaga Hideo , Kitagawa Yuko 
Published: April 2023

Background:
Neoadjuvant therapy (NAT) has become common worldwide for resectable advanced esophageal cancer and frequently involves weight loss. Although failure to rescue (death after major complications) is known as an emerging surgical quality measure, little is known about the impact of weight loss during NAT on failure to rescue. This retrospective study aimed to investigate the association of weight loss during NAT and short-term outcomes, including failure to rescue after esophagectomy.

Materials and methods:
Patients who underwent esophagectomy after NAT between July 2010 and March 2019 were identified from a Japanese nationwide inpatient database. Based on quartiles of percent weight change during NAT, patients were grouped into four categories of gain, stable, small loss, and loss (>4.5%). The primary outcomes were failure to rescue and in-hospital mortality. The secondary outcomes were major complications, respiratory complications, anastomotic leakage, and total hospitalization costs. Multivariable regression analyses were used to compare outcomes between the groups, adjusting for potential confounders, including baseline BMI.

Results:
Among 15 159 eligible patients, in-hospital mortality and failure to rescue occurred in 302 (2.0%) and 302/5698 (5.3%) patients, respectively. Weight loss (>4.5%) compared to gain was associated with increased failure to rescue and in-hospital mortality [odds ratios 1.55 (95% CI: 1.10–2.20) and 1.53 (1.10–2.12), respectively]. Weight loss was also associated with increased total hospitalizations costs, but not with major complications, respiratory complications, and anastomotic leakage. In subgroup analyses, regardless of baseline BMI, weight loss (>4.8% in nonunderweight or >3.1% in underweight) was a risk factor for failure to rescue and in-hospital mortality.

Conclusion:
Weight loss during NAT was associated with failure to rescue and in-hospital mortality after esophagectomy, independent of baseline BMI. This emphasizes the importance of weight loss measurement during NAT to assess the risk for a subsequent esophagectomy.
A case series of pediatric neurobrucellosis: a rare complication to a common disease
Authors: Osman Mohammed Rayan Abdelwahab , Ayesh Ezzatly Ahmed Mohamed , Banaga Siddiq Neema Siddiq , Alagraa Thnaa , Yahia Elhassan Maha Abdalla , Hussain Idres Roua Mohammedali , Salaheldin Mohamed Elhassan Baraa Mohamed , Hussien Mohamed Ahmed Khabab Abbasher , Mahmmoud Fadelallah Eljack Mohammed 
Published: April 2023

Introduction and importance:
Neurobrucellosis (NB) is a rare complication of the most common zoonotic infection worldwide. Meningitis and encephalitis are the most common manifestations. While it is endemic in many countries, it is frequently misdiagnosed due to its nonspecific presentations, and it requires a high index of suspicion and special care to be cured.

Case presentation:
The first case is from a rural area and presented with a prolonged fever associated with profuse sweating, which was complicated later by headache and sudden left-sided weakness associated with urine incontinence without signs of meningeal irritation. Laboratory and radiological tests confirmed the diagnosis of NB after other cerebral infections were ruled out, and the patient received the full brucella regimen and recovered well. The second patient presented with a gradual onset of fever that did not respond to conventional treatment. Days later, his condition was complicated by a convulsion that was not preceded by an aura and was not accompanied by symptoms of weakness, increased intracranial pressure, or sphincteric disturbances. He has a history of drinking raw milk, and tests for brucella were positive, ruling out other intracranial infections and masses. He received full brucella treatment and showed good recovery.

Conclusion:
A patient from an endemic area who has a prolonged fever and neurological symptoms should be considered positive for NB until it is ruled out.
Antinuclear antibodies positive acute nonfulminant hepatitis A associated with acute renal failure and hives: a case report
Authors: Kliea Marwa , Alsultan Mohammad , Basha Kassem 
Published: April 2023

Introduction:
Acute hepatitis A (AHA) is a self-limited illness. While the prognosis for hepatitis A is generally good, complications with acute renal failure can have a negative impact.

Presentation of case:
A 60-year-old male was admitted due to fever and malaise for a week, accompanied by jaundice and reduced urine output over the past 3 days. The patient was exhausted with icteric skin and sclera, dark urine, bilateral pretibial grade II pitting edema, and a urinary output of nearly 1 l/day. Laboratory findings on admission showed acute liver injury and acute kidney injury with positive hepatitis A virus immunoglobulin M. Liver and kidney function tests were augmented gradually aligned with oliguria. Thereafter, the patient had an itchy rash on his back and abdomen. Screening for immune diseases came back negative except for positive antinuclear antibodies. The authors continued conservative management with dialysis, diuretics, and restricted hydration. After five hemodialysis sessions, urinary output improved and liver function tests were improved, however, kidney function tests were slowly improved. One month later, serum creatinine was reduced to 1.4 mg/dl, and 2 months later, it was 1.1 mg/dl.

Conclusion:
The authors experienced a rare case of nonfulminant AHA that resulted in severe acute renal failure and needed dialysis. Several hypotheses had been postulated for AHA-related nephropathy; however, hyperbilirubinemia-induced acute tubular necrosis was the most acceptable theory in the patient. Since AHA associated with antinuclear antibodies positive and hives rash could confuse the diagnosis, clinicians should consider extrahepatic manifestations associated with hepatitis A virus infection in such conditions after excluding immune disorders.
Primary anorectal melanoma mimicking polyp in a scleroderma patient: a case report
Authors: Alazki Osama , Othman Hasan , Mohammad Rita , Al-Dabbagh Jacob , Al-Soufi Lina , Alshehabi Zuheir , Kanaan Samir 
Published: April 2023

Introduction:
Primary anorectal melanoma is an extremely rare malignancy of the gastrointestinal tract with a very poor prognosis. Due to the late presentation, most patients with primary anorectal melanoma are diagnosed at advanced stages. Scleroderma is an autoimmune disease characterized by fibrosis of the skin and visceral organs. There is an increased risk of developing cancer in scleroderma patients.

Case Presentation:
A 57-year-old Syrian female diagnosed with localized scleroderma complained of a sensation of a mass in her anal area. She was diagnosed with primary rectal melanoma and was put on neoadjuvant radiotherapy. Following the radiotherapy, the endoscopy revealed several black lesions in her anal canal, and thus abdominoperineal resection was conducted.

Discussion and Conclusion:
Malignant melanoma can occur in unsuspected locations such as the anal canal. Novel therapies like anti-CTLA4 drugs have proven efficient in controlling the disease. The lack of data in the literature on this malignancy and the absence of guidelines make it challenging for an optimal approach.