bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACR–ARS Practice Parameter for the Performance of Total Body Irradiation
Authors: Reilly Michael , Dandapani Savita V. , Kumar Kiran A. , Constine Louis , Fogh Shannon E. , Roberts Kenneth B. , Small William , Schechter Naomi R. 
Published: March 2023

Objectives:
This practice parameter was revised collaboratively by the American College of Radiology (ACR) and the American Radium Society (ARS). This practice parameter provides updated reference literature regarding both clinical-based conventional total body irradiation and evolving volumetric modulated total body irradiation.

Methods:
This practice parameter was developed according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website (https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters—Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS

Results:
This practice parameter provides a comprehensive update to the reference literature regarding conventional total body irradiation and modulated total body irradiation. Dependence on dose rate remains an active area of ongoing investigation in both the conventional setting (where instantaneous dose rate can be varied) and in more modern rotational techniques, in which average dose rate is the relevant variable. The role of imaging during patient setup and the role of inhomogeneity corrections due to computer-based treatment planning systems are included as evolving areas of clinical interest notably surrounding the overall dose inhomogeneity. There is increasing emphasis on the importance of evaluating mean lung dose as it relates to toxicity during high-dose total body irradiation regimens.

Conclusions:
This practice parameter can be used as an effective tool in designing and evaluating a total body irradiation program that successfully incorporates the close interaction and coordination among the radiation oncologists, medical physicists, dosimetrists, nurses, and radiation therapists.
Discrepancy between Radiographic and Arthroscopic Findings of Thumb Basilar Joint Arthritis: A Preliminary Clinical Report
Authors: Sun Michael , Yoshida Ryu , Tsai Eugene , Kulber David 
Published: March 2023

Background:
The radiographic staging of arthritic changes in the thumb carpometacarpal (CMC) joint is known to have poor correlation with pain level. This may be due to the limited ability of radiographs to evaluate degenerative changes. The purpose of this study was to examine the relationship between radiographic versus arthroscopic findings of thumb CMC and scaphotrapeziotrapezoidal (STT) joint arthritis.

Methods:
Twenty patients with symptomatic thumb CMC arthritis underwent arthroscopy of thumb CMC and STT joints with concomitant synovectomy or arthroplasty depending on the degree of articular degeneration found. All patients had preoperative radiographs of the thumb CMC and STT joints. Radiographic degeneration was graded based on the Eaton-Glickel classification. Intraoperative arthroscopic images were reviewed and graded based on the Brown grading system.

Results:
At the thumb CMC joint, five patients had discordant radiographic and arthroscopic findings of arthritis. At the STT joint, one patient had discordant radiographic and arthroscopic findings of arthritis.

Conclusions:
In comparing the two staging systems, we found a small subset of patients that demonstrated significant discrepancies. Clinical evaluation remains essential, and patients should be informed that radiographs may underestimate the actual severity of arthritis.
Efficacy of surgical treatment for post-prostatectomy urinary incontinence: a systematic review and network meta-analysis
Authors: Park Jae Joon , Hong Yejoon , Kwon Allison , Shim Sung Ryul , Kim Jae Heon 
Published: March 2023

Objectives:Post-prostatectomy urinary incontinence (PPUI) is a major complication that reduces the quality of life in patients undergoing prostatectomy for benign prostatic hyperplasia and prostate cancer. However, there are currently limited guidelines on which surgical techniques are preferred after conservative treatment for PPUI. In this study, a systematic review and network meta-analysis (NMA) that can help determine the priority for the selection of surgical methods were performed.Materials and methods:We retrieved data from electronic literature searches of PubMed and the Cochrane Library through August 2021. We searched for randomized controlled trials studies on the surgical treatment of PPUI after surgery for benign prostatic hyperplasia or prostate cancer and included the terms artificial urethral sphincter (AUS), adjustable sling, nonadjustable sling, and injection of the bulking agent.The NMA pooled the odds ratios and 95% credible intervals (CrIs) using the number of patients achieving urinary continence, weight of pads used per day, number of pads used per day, and the International Consultation on Incontinence Questionnaire score. The therapeutic effect of each intervention on PPUI was compared and ranked using the surface under the cumulative ranking curve.Results:A final 11 studies, including 1116 participants, were included in our NMA. The pooled overall odds ratios of patients achieving urinary continence compared with no treatment was 3.31 (95% CrI: 0.749, 15.710) in AUS, 2.97 (95% CrI: 0.412, 16.000) in adjustable sling, 2.33 (95% CrI: 0.559, 8.290) in nonadjustable sling, and 0.26 (95% CrI: 0.025, 2.500) in injection of bulking agent. In addition, this study shows the surface under the cumulative ranking curve values of ranking probabilities for each treatment performance, which indicated that AUS ranked first in terms of continence rate, International Consultation on Incontinence Questionnaire, pad weight, and pad use count.Conclusion:The results of this study suggested that only AUS had a statistically significant effect compared to the nontreatment group and the highest PPUI treatment effect ranking among other surgical treatments.
Impact of guideline recommendation for novel surgical procedures on surgeons’ decisions: a time series analysis of gastric cancer surgeries from a nationwide cohort study
Authors: Honda Michitaka , Yasunaga Hideo , Michihata Nobuaki , Miyakawa Teppei , Kumazawa Ryosuke , Matsui Hiroki , Imaizumi Takahiro 
Published: March 2023

Background:
Since two Japanese guidelines, for gastric cancer treatment and for minimally invasive surgery, were simultaneously revised in 2014, laparoscopic distal gastrectomy has been a standard procedure for clinical stage I gastric cancer.

Materials and methods:
We evaluated the impact of this revision on surgeons’ decision-making using a nationwide inpatient database in Japan. We described the time trends in the proportion of laparoscopic surgery from January 2011 to December 2018. We performed an interrupted time series analysis; the exposure time point was August 2014, and the main outcome was the change in slope before and after the revision of the guidelines. We performed a subgroup analysis of hospital volume and the odds ratio (OR) for postoperative complications according to exposure.

Results:
A total of 64 910 patients who underwent subtotal gastrectomy for stage I disease were identified. During the study period, the proportion of laparoscopic surgery showed a consistent increase from 47.4 to 81.2%. After the revision, the slope of the increase was rather slow; the OR [95% CI] was 0.601 [0.548–0.654] before the revision and 0.219 [0.176–0.260] after the revision. The adjusted ORs were 0.642 [0.575–0.709] before the revision and 0.240 [0.187–0.294] after the revision.

Conclusion:
The revision of the guidelines recommending laparoscopic surgery had little impact on surgeons’ decisions regarding the choice of procedure.
Impacts of ischemic preconditioning in liver resection: systematic review with meta-analysis
Authors: de Oliveira Glauber C. , de Oliveira Walmar K. , Yoshida Winston B. , Sobreira Marcone L. 
Published: March 2023

Objective:
To assess the beneficial effects of ischemic preconditioning (IPC) in liver resection and evaluate its applicability in clinical practice.

Summary Background Data:
Liver surgeries are usually associated with intentional transient ischemia for hemostatic control. IPC is a surgical step that intends to reduce the effects of ischemia–reperfusion; however, there is no strong evidence about the real impact of the IPC, and it is necessary to effectively clarify what its effects are.

Methods:
Randomized clinical trials were selected, comparing IPC with no preconditioning in patients undergoing liver resection. Data were extracted by three independent researchers according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, Supplemental Digital Content 1, http://links.lww.com/JS9/A79. Several outcomes were evaluated, including postoperative peaks of transaminases and bilirubin, mortality, length of hospital stay, length of stay in the ICU, bleeding, and transfusion of blood products, among others. Bias risks were assessed using the Cochrane collaboration tool.

Results:
Seventeen articles were selected, with a total of 1052 patients. IPC did not change the surgical time of the liver resections while these patients bled less (Mean Difference: −49.97 ml; 95% CI: −86.32 to −13.6; I
2: 64%), needed less blood products [relative risk (RR): 0.71; 95% CI: 0.53–0.96; I
2=0%], and had a lower risk of postoperative ascites (RR: 0.40; 95% CI: 0.17–0.93; I
2=0%). The other outcomes had no statistical differences or could not have their meta-analyses conducted due to high heterogeneity.

Conclusions:
IPC is applicable in clinical practice, and it has some beneficial effects. However, there is not enough evidence to encourage its routine use.
Comparison of risk of complication between neuraxial anaesthesia and general anaesthesia for hip fracture surgery: a systematic review and meta-analysis
Authors: Chen Xi , Li Hairui , Li Songlin , Wang Yiou , Ma Ruichen , Qian Wenwei , Chen Gang , Li Jian 
Published: March 2023

Background:Controversy remains over the choice of anaesthetic technique for patients undergoing surgery for hip fracture.Aim:The aim was to compare the risk of complication of neuraxial anaesthesia with that of general anaesthesia in patients undergoing hip fracture surgery.Methods:This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and was registered at PROSPERO (CRD42022337384). The study included eligible randomised controlled trials published before February 2022. Data synthesis was performed to compare the differences between general and neuraxial anaesthesia. Meta-regression analysis was performed to investigate the influence of the publication year. A subgroup analysis was performed based on patient age and the anaesthetic technique used. A grading of recommendations, assessment, development and evaluations assessment was performed to assess the quality of each outcome.Results:Twenty randomised controlled trials and 4802 patients were included. Data synthesis revealed significant higher risk of acute kidney injury in the general anaesthesia group (P=0.01). There were no significant differences between the two techniques in postoperative short-term mortality (P=0.34), delirium (P=0.40), postoperative nausea and vomiting (P=0.40), cardiac infarction (P=0.31), acute heart failure (P=0.34), pulmonary embolism (P=0.24) and pneumonia (P=0.15). Subgroup analysis based on patient age and use of sedative medication did not reveal any significant differences. Meta-regression analysis of the publication year versus each adverse event revealed no statistically significant differences.Conclusion:A significantly higher risk of postoperative acute kidney injury was found in patients receiving general anaesthesia. This study revealed no significant differences in terms of postoperative mortality and other complications between general and neuraxial anaesthesia. The results were consistent across the age groups.
Comparative analysis of prevalence, evaluation, management, and rehabilitation outcome of spontaneous isolated visceral artery dissection: a systematic review and meta-analysis of 80 reports
Authors: Shi Yan , Guo Jiangzhou , Dong Jige , Chen Xueli , Luo Lihua , Shen Yan 
Published: March 2023

Background:
Because of relatively little data for management and evaluation surrounding spontaneous isolated visceral artery dissection (IVAD), existing studies have failed to provide comprehensive analysis for the management, evaluation, prevalence, as well as natural course of the disease. Therefore, we collected and analyzed current evidence on spontaneous IVAD with the aim of providing quantitative pooled data for the natural course and treatment standardization of the disease.

Methods:
A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science up to 1 June 2022, was conducted for relevant studies that investigating the natural course, treatment, classification, and outcomes of IVAD. The primary outcomes were to determine the difference in prevalence, risk factors, and characteristics between different spontaneous IVAD. Two reviewers assessed the trial quality and extracted the data independently. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2 and Stata 12.0.

Results:
A total of 80 reports with 1040 patients were identified. The pooled results indicated that in IVAD, isolated superior mesenteric artery dissection (ISMAD) was more prevalent, with a pooled prevalence of 60% (95% CI: 50–71%), followed by isolated celiac artery dissection (ICAD) (prevalence: 37%; 95% CI: 27–46%). IVAD was male predominated with a pooled proportion of 80% (95% CI: 72–89%). Similar results were found in ICAD (prevalence: 73%; 95% CI: 52–93%). More IVAD patients were diagnosed with symptoms than ICAD (64 vs. 59%). Regarding to the risk factors, this pooled analysis found smoking and hypertension were the top two conditions in both spontaneous IVAD and ICAD patients, with proportion of 43, 41, 44, and 32%, respectively. It was observed that ICAD appeared shorter dissection length (mean difference: −3.4 cm; 95% CI: −4.9 to −2.0; P<0.0001), higher prevalence of Sakamoto’s classification Π (odds ratio: 5.31; 95% CI: 1.77−15.95; P=0.003) and late progression (odds ratio: 2.84; 95% CI: 1.02−7.87; P=0.05) than ISAMD.

Conclusions:
Spontaneous IVAD was male predominant and ISMAD was most prevalent followed by ICAD. Smoking and hypertension were the top two conditions in both spontaneous IVAD and ICAD patients. The majority of patients diagnosed with IVAD received observation and conservative treatment and experienced a low proportion of reintervention or progression, especially for ICAD patients. In addition, ICAD and ISMAD had several differences in clinical features and dissection characteristics. Future studies with enough sample size and long follow-up are required to clear the management, long-term outcome, and risk factors of the IVAD prognosis.
Textbook outcome as a composite outcome measure in laparoscopic pancreaticoduodenectomy: a multicenter retrospective cohort study
Authors: Wu Yi , Peng Bing , Liu Jianhua , Yin Xinmin , Tan Zhijian , Liu Rong , Hong Defei , Zhao Wenxing , Wu Heshui , Chen Rufu , Li Dewei , Huang Heguang , Miao Yi , Liu Yahui , Liang Tingbo , Wang Wei , Yuan Jingxiong , Li Shizhen , Zhang Hang , Wang Min , Qin Renyi ,   on behalf of the Minimally Invasive Treatment Group in the Pancreatic DiseaseBranch of China’s International Exchange and Promotion Association for Medicine and Healthcare (MITG-P-CPAM)
Published: March 2023

Background:
Textbook outcome (TO) is a composite outcome measure for surgical quality assessment. The aim of this study was to assess TO following laparoscopic pancreaticoduodenectomy (LPD), identify factors independently associated with achieving TO, and analyze hospital variations regarding the TO after case-mix adjustment.

Methods:
This multicenter cohort study retrospectively analyzed 1029 consecutive patients undergoing LPD at 16 high-volume pancreatic centers in China from January 2010 to August 2016. The percentage of patients achieving TO was calculated. Preoperative and intraoperative variables were compared between the TO and non-TO groups. Multivariate logistic regression was performed to identify factors independently associated with achieving TO. Hospital variations regarding the TO were analyzed by the observed/expected TO ratio after case-mix adjustment. Differences in expected TO rates between different types of hospitals were analyzed using the one-way analysis of variance test.

Results:
TO was achieved in 68.9% (n=709) of 1029 patients undergoing LPD, ranging from 46.4 to 85.0% between different hospitals. Dilated pancreatic duct (>3 mm) was associated with the increased probability of achieving TO [odds ratio (OR): 1.564; P=0.001], whereas advanced age (≥75 years) and concomitant cardiovascular disease were associated with a lower likelihood of achieving TO (OR: 0.545; P=0.037 and OR: 0.614; P=0.006, respectively). The observed/expected TO ratio varied from 0.62 to 1.22 after case-mix adjustment between different hospitals, but no significant hospital variations were observed. Hospital volume, the surgeon’s experience with open pancreaticoduodenectomy and minimally invasive surgery, and surpassing the LPD learning curve were significantly correlated with expected TO rates.

Conclusion:
TO was achieved by less than 70% of patients following LPD. Dilated pancreatic ducts, advanced age, and concomitant cardiovascular disease were independently associated with achieving TO. No significant hospital variations were observed after case-mix adjustment.
Cervical exenteration and its variants for locally advanced thyroid cancer: when, why, and how?
Authors: Piazza Cesare , Lancini Davide , Paderno Alberto 
Published: March 2023

Purpose of review
To describe the modern surgical approach for management of advanced thyroid cancers infiltrating the cervicovisceral axis with special attention to well differentiated tumors not amenable to organ-sparing techniques. In particular, cervical exenteration, herein defined as the sum of total thyroidectomy, central compartment and lateral neck dissections, variously associated with total laryngectomy and possible partial or total pharyngoesophagectomy, represents an extreme surgical procedure that, in properly selected cases, allows for reasonable palliation of central compartment life-threatening signs/symptoms if not cure for an advanced oncologic condition.

Recent findings
Cervical exenteration is not contraindicated by the presence of limited distant metastases at presentation. Even though it requires that the patient is in general good health as it can be associated with a number of complications and long in-hospital stay, when appropriately planned and performed according to the most recent reconstructive nuances, it allows good oncologic outcomes that are not inferior to those described for similarly advanced primaries of the upper aerodigestive tract. In addition, quality of life and functional results are not significantly different from those described after total laryngectomy for primary laryngeal squamous cell carcinomas.

Summary
Cervical exenteration requires a tertiary, expert, multidisciplinary effort in terms of diagnosis, surgical performance, and postoperative care. A patient-centered decision process is strongly warranted taking into consideration alternative therapeutic and symptom-based palliative strategies.
Thyroid lymphoma
Authors: Rovira Aleix , Carroll Paul , Simo Ricard 
Published: March 2023

Purpose of review
To highlight recent advances in our understanding of the epidemiology, incidence, evaluation, management and outcomes of primary thyroid lymphoma (PTL), and highlight the indications and limitations of surgery.

Recent findings
The differential diagnosis of a rapidly enlarging thyroid mass with or without obstructive symptoms should include PTL and anaplastic thyroid cancer. When PTL is suspected, initial investigations should include blood tests and ultrasound-guided biopsy preferably core need biopsy to allow tissue typing and immunohistochemistry analysis. Systemic imaging with FDG PET-CT is required for staging. Surgery is not recommended for treatment purposes and should be reserved for diagnosis and airway management. Treatment includes chemotherapy and radiotherapy and offer an excellent prognosis.

Summary
PTL is a rare malignancy making diagnosis and management challenging. Initial investigations of suspected PTL should include blood tests and ultrasound-guided biopsy, preferably core needle biopsy and systemic imaging is required for staging. Surgery is reserved for diagnosis and airway management. Chemotherapy and radiotherapy are the treatment of choice.
Adherence to swallowing recommendations during (chemo)radiotherapy in head and neck cancer survivors: a scoping review
Authors: Rowe Elizabeth A. , Dunton Jane , Cooke Samuel , Laparidou Despina , Patterson J. M. 
Published: March 2023

Purpose of review
There is a paucity of knowledge regarding patient adherence to dysphagia recommendations. It is recognized that unique barriers and facilitators contribute to poor treatment adherence in head and neck cancer (HNC) survivors. This review aims to identify the key themes and knowledge gaps regarding adherence to swallowing recommendations in HNC survivors during (chemo)radiotherapy (C)RT.

Recent findings
Seven studies were identified. Six facilitators to adherence were extracted, namely pain relief, behavioural intervention, attendance at multidisciplinary clinic, individualised swallowing therapy, absence of prophylactic percutaneous endoscopic gastronomy (PEG) and positive social control from a spouse. Barriers to adherence included pain, depression and presence of prophylactic PEG. Adherence to swallowing recommendations positively impacted swallowing outcomes in one study.

Summary
Little is known about adherence to swallowing recommendations during (C)RT in HNC survivors. Capturing adherence is challenging. Several knowledge gaps were identified. Further research is needed to better understand the barriers and facilitators from the survivors’ perspective. This will inform development of best practice regarding how swallowing recommendations are provided to promote adherence and improve outcomes.
Update on the treatment of chronic pulmonary aspergillosis
Authors: Armstrong-James Darius , Kosmidis Chris , Bromley Mike 
Published: March 2023

Purpose of review
Chronic pulmonary aspergillosis is a major global infection in individuals with preexisting structural lung diseases and those with immunodeficiencies, in particular cytokine defects. Current treatment options are confined to just three drug classes, the triazoles, the echinocandins and amphotericin B. However, antifungal resistance is rapidly emerging for the triazoles, the only available oral therapy for this chronic condition.

Recent findings
Fortunately, there are now a number of novel antifungals in the development pipeline, mostly now in Phase 3 studies, with a potential for the treatment of chronic pulmonary aspergillosis. However, almost all current randomized triazoles of novel antifungals are primarily undertaken in patients with invasive candidiasis or invasive mould infections. Given the poor outcomes from treatment with antifungals in chronic pulmonary aspergillosis, in part associated with triazole resistance, we urgently need clinical trials of novel agents either as monotherapy or in combination for this disease. In addition, there is an emerging understanding of the role of immunotherapies for the treatment of chronic pulmonary aspergillosis, especially in the context of cytokine defects. Therefore, better understanding of the role of adjunctive immunotherapies such as interferon-gamma is also required.

Summary
In this review, we give an overview of current management of chronic pulmonary aspergillosis, and novel antifungals and immunotherapies for the future.