bluuebunny/crossref_metadata_2025_split huggingface dataset:
National clinical practice guidelines for the treatment of symptomatic gallstone disease: 2021 recommendations from the Danish Surgical Society
Authors: Shabanzadeh Daniel Mønsted , Christensen Dorthe Wiinholdt , Ewertsen Caroline , Friis-Andersen Hans , Helgstrand Frederik , Nannestad Jørgensen Lars , Kirkegaard-Klitbo Anders , Larsen Anders Christian , Ljungdalh Jonas Sanberg , Nordblad Schmidt Palle , Therkildsen Rikke , Vilmann Peter , Vogt Jes Sefland , Sørensen Lars Tue 
Published: August 2022

Background and objective: Gallstones are highly prevalent, and more than 9000 cholecystectomies are performed annually in Denmark. The aim of this guideline was to improve the clinical course of patients with gallstone disease including a subgroup of high-risk patients. Outcomes included reduction of complications, readmissions, and need for additional interventions in patients with uncomplicated gallstone disease, acute cholecystitis, and common bile duct stones (CBDS). Methods: An interdisciplinary group of clinicians developed the guideline according to the GRADE methodology. Randomized controlled trials (RCTs) were primarily included. Non-RCTs were included if RCTs could not answer the clinical questions. Recommendations were strong or weak depending on effect estimates, quality of evidence, and patient preferences. Results: For patients with acute cholecystitis, acute laparoscopic cholecystectomy is recommended (16 RCTs, strong recommendation). Gallbladder drainage may be used as an interval procedure before a delayed laparoscopic cholecystectomy in patients with temporary contraindications to surgery and severe acute cholecystitis (1 RCT and 1 non-RCT, weak recommendation). High-risk patients are suggested to undergo acute laparoscopic cholecystectomy instead of drainage (1 RCT and 1 non-RCT, weak recommendation). For patients with CBDS, a one-step procedure with simultaneous laparoscopic cholecystectomy and CBDS removal by laparoscopy or endoscopy is recommended (22 RCTs, strong recommendation). In high-risk patients with CBDS, laparoscopic cholecystectomy is suggested to be included in the treatment (6 RCTs, weak recommendation). For diagnosis of CBDS, the use of magnetic resonance imaging or endoscopic ultrasound prior to surgical treatment is recommended (8 RCTs, strong recommendation). For patients with uncomplicated symptomatic gallstone disease, observation is suggested as an alternative to laparoscopic cholecystectomy (2 RCTs, weak recommendation). Conclusions: Seven recommendations, four weak and three strong, for treating patients with symptomatic gallstone disease were developed. Studies for treatment of high-risk patients are few and more are needed. Endorsement: The Danish Surgical Society.
Medium-Term Survival After Unrepaired Ruptured Abdominal Aortic Aneurysm
Authors: Tham Sarah , Aw Darius , Vijaykumar Kalpana , Cheng Shin Chuen , Tay Jia Sheng , Choke Edward 
Published: August 2022

Purpose: Ruptured abdominal aortic aneurysm (AAA) is almost always considered fatal without open surgical or endovascular repair. We report a case that has defied this norm and explore the possible factors involved in this exceedingly rare outcome. Case Report: An 87 year old gentleman presented with an acute ruptured AAA with left retroperitoneal hematoma. He was counseled for emergent repair, but opted for conservative management instead. He has remained well at the time of writing, 13 months from the rupture, with clinical resolution of symptoms along with radiological resolution of the hematoma. Conclusion: Timely repair remains the mainstay of management for ruptured AAA, although this rare case highlights that it is possible for ruptured AAA to seal spontaneously with patient surviving up to 13 months. We have sought to hypothesize the factors in this case that may have contributed to prolonged survival following untreated ruptured AAA. Clinical Impact Statement While the overwhelming evidence is that a ruptured AAA left unrepaired is fatal, our case report illustrates a rare case that shows it is possible for ruptured AAA to seal spontaneously, with patient surviving up to 13 months. We seek to hypothesize the factors that may contribute to such prolonged survival.
The Reaching Phase of Feeding and Self-Care Actions Optimizes Action Observation Effects in Chronic Stroke Subjects
Authors: Franceschini Marco , Ottaviani Marco , Romano Paola , Goffredo Michela , Pournajaf Sanaz , Lofrumento Margherita , Proietti Stefania , Sterpi Irma , Tricomi Enrica , Tropea Peppino , Corbo Massimo , Fadiga Luciano , Infarinato Francesco 
Published: August 2022

Background The Action Observation Therapy (AOT) is a well-established post-stroke rehabilitation treatment based on the theoretical framework of the Mirror Neuron System (MNS) activation. However, AOT protocols are still heterogeneous in terms of video contents of observed actions. Objective The aim of this study was to analyze electroencephalographic (EEG) recordings in stroke patients during the observation of different videos of task-specific upper limb movements, and to define which category of actions can elicit a stronger cortical activation in the observer’s brain. Methods Signals were analyzed from 19 chronic stroke subjects observing customized videos that represented 3 different categories of upper limb actions: Finalized Actions, Non-Finalized Actions, and Control Videos. The Event-Related Desynchronization in the µ and β bands was chosen to identify the involvement of the cerebral cortex: the area of the normalized power spectral density was calculated for each category and, deepening, for the reaching and completion sub-phases of Finalized Actions. For descriptive purposes, the time course of averaged signal power was described. The Kruskal–Wallis test ( P < .05) was applied. Results The analysis showed a greater desynchronization when subjects observed Finalized Actions with respect to Non-Finalized in all recorded areas; Control videos provoked a synchronization in the same areas and frequency bands. The reaching phase of feeding and self-care actions evoked a greater suppression both in µ and β bands. Conclusions The observation of finalized arm movements seems to elicit the strongest activation of the MNS in chronic stroke patients. This finding may help the clinicians to design future AOT-based stroke rehabilitation protocols. Clinical Trial Registration: Clinical Trial Registration—URL: http://www.clinicaltrials.gov . Unique identifier: NCT04047134.
Patient perceptions after the operative and nonoperative treatment of shoulder instability: A qualitative focus group study
Authors: van Iersel Theodore P , Tutuhatunewa Eric D , Kaman Ithri , Twigt Bas A , Vorrink Sigrid NW , van den Bekerom Michel PJ , van Deurzen Derek FP 
Published: August 2022

Background Little evidence is available regarding patient perceptions of the treatment of shoulder instability. The aim of this study is to investigate patient perceptions regarding the operative and nonoperative treatment of anterior shoulder instability. Methods Patients who presented to the emergency department or outpatient clinic between 2016 and 2020 were retrospectively selected using diagnosis and procedure codes. Online focus groups and semistructured interviews were conducted, systematically recorded and subsequently transcribed to MaxQDA 2007 for qualitative analysis. Coded transcripts of all focus groups were subjected to a grounded theory–based analysis. Results Six focus groups and two semistructured interviews were hosted with 35 included patients. The mean age of included patients was 34.1 years (±11.5). Eight patients were female (23%), and 27 patients were male (77%). Fear of (recurrent) dislocation, preoperative counseling, communication between surgeon and physiotherapists and need for a consistent postoperative rehab protocol turned out to be important patient perceptions. The most crucial factor for discontent was a lack of communication from the surgeon. Discussion This patient-centered focus group study revealed that fear of (recurrent) dislocation, preoperative counseling, communication between surgeons and physiotherapists and the need for a consistent postoperative rehabilitation protocol was the most frequently discussed themes.
Mapping early tumor response to radiotherapy using diffusion kurtosis imaging**
Authors: Goryawala Mohammed , Mellon Eric A , Shim Hyunsuk , Maudsley Andrew A 
Published: August 2022

Purpose In this pilot study, DKI measures of diffusivity and kurtosis were compared in active tumor regions and correlated to radiologic response to radiotherapy after completion of 2 weeks of treatment to derive potential early measures of tumor response. Methods MRI and Magnetic Resonance Spectroscopic Imaging (MRSI) data were acquired before the beginning of RT (pre-RT) and 2 weeks after the initiation of treatment (during-RT) in 14 glioblastoma patients. The active tumor region was outlined as the union of the residual contrast-enhancing region and metabolically active tumor region. Average and standard deviation of mean, axial, and radial diffusivity (MD, AD, RD) and mean, axial, and radial kurtosis (MK, AK, RK) values were calculated for the active tumor VOI from images acquired pre-RT and during-RT and paired t-tests were executed to estimate pairwise differences. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive capabilities of changes in diffusion metrics for progression-free survival (PFS). Results Analysis showed significant pairwise differences for AD ( p = 0.035; Cohen’s d of 0.659) and AK ( p = 0.019; Cohen’s d of 0.753) in diffusion measures after 2 weeks of RT. ROC curve analysis showed that percentage change differences in AD and AK between pre-RT and during-RT scans provided an Area Under the Curve (AUC) of 0.524 and 0.762, respectively, in discriminating responders (PFS>180 days) and non-responders (PFS<180 days). Conclusion This pilot study, although preliminary in nature, showed significant changes in AD and AK maps, with kurtosis derived AK maps showing an increased sensitivity in mapping early changes in the active tumor regions.
A Scoping Review of Non-Pharmacological Health Education Provided to Families of Children With Idiopathic Childhood Constipation Within Primary Health Care
Authors: Houghton Davina , Arabiat Diana , Ireson Deborah , Mörelius Evalotte 
Published: August 2022

Objectives: Idiopathic childhood constipation is a prevalent condition that initially brings the child under the care of the primary health care team. Although it is acknowledged that health education is crucial to reducing chronicity, the range of evidenced-based non-pharmacological health education provided to families has not previously been reviewed. For this scoping review, 4 research questions sought to identify papers that provide information on the utilization of guidelines, the range of health education, who provides it, and whether any gaps exist. Methods: Following a registered protocol and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, searches of 10 online databases, reference lists, Google Scholar, and book chapter references were made. Eligible papers were original research published in English between January 2000 and December 2022. Results: Twelve worldwide studies (2 qualitative and 10 quantitative) reported that: evidence-based guidelines are not consistently used by primary care providers; the range of non-pharmacological health education provided is inconsistent; the non-pharmacological health education is provided by doctors, nurses, and pharmacists; and that gaps exist in non-pharmacological health education provision. Conclusion: This review demonstrates that rather than a lack of guideline-awareness, decreased specific idiopathic childhood constipation knowledge (and possibly time) may be responsible for inconsistent non-pharmacological health education. Inappropriate treatment and management of some children escalates risk for chronicity. Improving health education provision however, may be achieved through: increased collaboration; better utilization of nurses; and through developing the child’s health literacy by involving both child and family in all aspects of health education and decision-making.
Correlation Between Anatomic Landmarks and Bony Trough Position in Lateral Meniscal Allograft Transplant
Authors: Choi Nam-Hong , Yang Bong-Seok , Lee Dong-Min , Lee Jong-Seok , Victoroff Brian N. 
Published: August 2022

Background: Determining the rotational axis of the bony trough during lateral meniscal allograft transplant (MAT) is difficult. The use of anatomic landmarks may help a surgeon determine the rotational alignment of the graft during the procedure. Purpose: To investigate the association between the knee's anatomic landmarks and the position of the bony trough to prevent extrusion after lateral MAT. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Enrolled were 44 patients who underwent lateral MAT between July 2000 and February 2011. The patients’ mean age at the time of surgery was 30.8 years. Extrusion was measured on magnetic resonance imaging (MRI) scans at a mean of 3.6 months postoperatively, and patients were divided into an extrusion group (n = 15) and a no-extrusion group (n = 29). Three coronal MRI scans from each patient were selected, each from the region at the level of the tibial tuberosity (TT), the anterior bony trough, and the posterior bony trough. We measured the distance between the center of the anterior bony trough and the center of the TT (the TT distance) and the distance between the center of the posterior bony trough and the medial border of the lateral femoral condyle (LFC) (the LFC distance). Results: The mean center of the anterior bony trough was in a more medial position relative to the center of the TT in the no-extrusion group (–2.9 ± 4.8 mm) compared with the extrusion group (1.3 ± 4.9 mm; P = .010). The mean center of the posterior bony trough was in a more medial position relative to the medial border of the LFC in the no-extrusion group (–1.7 ± 3.9 mm) compared with the extrusion group (1.0 ± 3.2 mm; P = .027). Both TT distance and LFC distance were significantly correlated with extrusion ( P = .005 and .025, respectively). The cutoff value was –0.24 mm for the anterior bony trough and –0.58 mm for the posterior bony trough (negative values indicate that the trough was medial to the respective landmarks). Conclusion: To prevent extrusion of the allograft, the center of the anterior bony trough needs to be aligned with the center of the TT, and the center of the posterior bony trough needs to be aligned with the medial border of the LFC.
Do Age, Demographics, and Tear Characteristics Affect Outcomes After Rotator Cuff Repair? Results of Over 2000 Rotator Cuff Repairs at 5-Year Follow-up
Authors: Maher Anthony , Leigh Warren , Young Simon , Caughey William , Hoffman Thomas , Brick Matthew , Caughey Michael 
Published: August 2022

Background: The New Zealand Rotator Cuff Registry represents the largest prospective cohort of rotator cuff repairs. Despite this, there are limited medium- to long-term data of rotator cuff repair outcomes. Purpose: To (1) analyze the pain and functional outcomes of a large cohort of primary rotator cuff repairs and (2) evaluate the effect of patient factors and tear characteristics on medium-term outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: This was a multicenter, multisurgeon prospective cohort study of rotator cuff repairs from March 2009 until December 2010. Surgical data were collected by the operating surgeon. Primary outcome measures were the Flexilevel Scale of Shoulder Function (FLEX-SF) and a pain score, collected at baseline, 6, 12, and 24 months, and 5 years. Univariate and multivariate analyses were carried out. Results: Overall, 2533 primary rotator cuff repairs were analyzed with 81% follow-up at 5 years. The mean age of the cohort was 56 years. In the 2052 patients with final follow-up data, improvement on the FLEX-SF continued until 24 months postoperatively and remained high at 5 years. Mean improvement in FLEX-SF from baseline to 5 years was 15 points. Patients aged >70 years had lower FLEX-SF scores but no significant difference in improvement compared with patients ≤70 years. The mean anteroposterior tear size was 2.2 cm, and on multivariate analysis, tears >4 cm had worse 5-year FLEX-SF scores. If the affected tendon was easily reducible, there was no difference in FLEX-SF score for retracted or larger tears compared with smaller tears. The reoperation rate was 6.2%. Conclusion: Results indicated that rotator cuff repairs provide a sustained clinical improvement out past 5 years. Most functional improvement and pain relief occurred within the first 6 months, but improvement continued out to 24 months. Most population groups did well after rotator cuff repairs, including those >70 years. Tear size >4 cm and tendon reducibility correlated with outcome. Even patients with large tear sizes had clinically significant improvement in FLEX-SF scores after repair.
How Long is Long Enough? A Closer Look at Proximal Margin Length for Esophageal Adenocarcinoma
Authors: Alvarado Christine E. , Luo Xun , Linden Philip A. , Towe Christopher W. , Sarode Anuja L. , Argote-Greene Luis M. , Perry Yaron , Worrell Stephanie G. 
Published: August 2022

Background: Esophagectomy approach for patients with esophageal adenocarcinoma (EAC) is determined by location of tumor and surgeon preference. Furthermore, type of esophagectomy affects the proximal margin length able to be achieved. Current guidelines for proximal margin length do not exist. We hypothesized that shorter proximal margin length would be associated with increased recurrence among EAC patients. Methods: A retrospective review of adult patients undergoing esophagectomy for EAC at a single institution (2007-2020) was performed. Primary outcome of interest was risk of disease recurrence based on proximal margin length. Spline term of proximal margin length was determined by locally weighted smoothing exploration. Cox regression was used to assess time to recurrence and overall survival based on proximal margin length. Results: In total, 165 patients met inclusion criteria with 72 (43.6%) recurrences. After adjustment, longer proximal margin was associated with significantly lower risk of recurrence when proximal margin length was >3.5 cm. At 5 years, recurrence was 64.7% for proximal margins <3.5 cm versus 47.6% for proximal margins ≥3.5 cm. For proximal margin length <3.5 cm, risk of recurrence did not decrease with longer margins (HR = 1.01, P = .95). When proximal margin length was ≥3.5 cm, every additional 1 cm was associated with lower risk of recurrence (HR = 0.90, P = .02). Proximal margin was not associated with survival (HR 0.97, P = 0.30). Conclusions: Patients with EAC have high risk of recurrence. Shorter proximal margins were significantly associated with increased recurrence. Proximal margins <3.5 cm are inadequate and additional margin >3.5 cm is associated with favorable reduction in disease recurrence.
Genomic profiling for clinical decision making in lymphoid neoplasms
Authors: de Leval Laurence , Alizadeh Ash A. , Bergsagel P. Leif , Campo Elias , Davies Andrew , Dogan Ahmet , Fitzgibbon Jude , Horwitz Steven M. , Melnick Ari M. , Morice William G. , Morin Ryan D. , Nadel Bertrand , Pileri Stefano A. , Rosenquist Richard , Rossi Davide , Salaverria Itziar , Steidl Christian , Treon Steven P. , Zelenetz Andrew D. , Advani Ranjana H. , Allen Carl E. , Ansell Stephen M. , Chan Wing C. , Cook James R. , Cook Lucy B. , d’Amore Francesco , Dirnhofer Stefan , Dreyling Martin , Dunleavy Kieron , Feldman Andrew L. , Fend Falko , Gaulard Philippe , Ghia Paolo , Gribben John G. , Hermine Olivier , Hodson Daniel J. , Hsi Eric D. , Inghirami Giorgio , Jaffe Elaine S. , Karube Kennosuke , Kataoka Keisuke , Klapper Wolfram , Kim Won Seog , King Rebecca L. , Ko Young H. , LaCasce Ann S. , Lenz Georg , Martin-Subero José I. , Piris Miguel A. , Pittaluga Stefania , Pasqualucci Laura , Quintanilla-Martinez Leticia , Rodig Scott J. , Rosenwald Andreas , Salles Gilles A. , San-Miguel Jesus , Savage Kerry J. , Sehn Laurie H. , Semenzato Gianpietro , Staudt Louis M. , Swerdlow Steven H. , Tam Constantine S. , Trotman Judith , Vose Julie M. , Weigert Oliver , Wilson Wyndham H. , Winter Jane N. , Wu Catherine J. , Zinzani Pier L. , Zucca Emanuele , Bagg Adam , Scott David W. 
Published: August 2022

AbstractWith the introduction of large-scale molecular profiling methods and high-throughput sequencing technologies, the genomic features of most lymphoid neoplasms have been characterized at an unprecedented scale. Although the principles for the classification and diagnosis of these disorders, founded on a multidimensional definition of disease entities, have been consolidated over the past 25 years, novel genomic data have markedly enhanced our understanding of lymphomagenesis and enriched the description of disease entities at the molecular level. Yet, the current diagnosis of lymphoid tumors is largely based on morphological assessment and immunophenotyping, with only few entities being defined by genomic criteria. This paper, which accompanies the International Consensus Classification of mature lymphoid neoplasms, will address how established assays and newly developed technologies for molecular testing already complement clinical diagnoses and provide a novel lens on disease classification. More specifically, their contributions to diagnosis refinement, risk stratification, and therapy prediction will be considered for the main categories of lymphoid neoplasms. The potential of whole-genome sequencing, circulating tumor DNA analyses, single-cell analyses, and epigenetic profiling will be discussed because these will likely become important future tools for implementing precision medicine approaches in clinical decision making for patients with lymphoid malignancies.
Does pulmonary rehabilitation address treatable traits? A systematic review
Authors: Holland Anne E. , Wageck Bruna , Hoffman Mariana , Lee Annemarie L. , Jones Arwel W. 
Published: August 2022

BackgroundThere is growing interest in a “treatable traits” approach to pulmonary rehabilitation in chronic airways disease. The frequency with which pulmonary rehabilitation programmes address treatable traits is unknown.MethodsRandomised controlled trials of pulmonary rehabilitation compared to usual care in patients with stable chronic airways disease were included. The components of pulmonary rehabilitation delivered were extracted and mapped to treatable traits in pulmonary, extrapulmonary and behavioural/lifestyle domains. Meta-analysis was used to evaluate the impact of addressing >1 treatable trait on exercise capacity and health-related quality of life (HRQoL).Results116 trials were included (6893 participants). Almost all pulmonary rehabilitation programmes addressed deconditioning (97% of trials). The most commonly addressed extrapulmonary traits were nutritional status (obesity and cachexia, 18% each) and mood disturbance (anxiety and depression, 10% each). Behavioural/lifestyle traits most frequently addressed were nonadherence (46%), poor inhalation technique (24%) and poor family/social support (19%). Exercise capacity and HRQoL outcomes did not differ between studies that addressed deconditioning alone and those that targeted additional traits, but heterogeneity was high.ConclusionAside from deconditioning, treatable traits are infrequently addressed in existing trials of pulmonary rehabilitation. The potential of the treatable traits approach to improve pulmonary rehabilitation outcomes remains to be explored.