bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profunda Artery Perforator Flaps From the Posteromedial Region of the Thigh for Head and Neck Reconstruction
Authors: Ma Chunyue , Gao Weijin , Zhu Dan , Zhang Jianfei , Shen Yi , Wang Liang , Wang Jinbing , Haugen Thorsen W. , Sun Jian , Zhu Yaxin 
Published: July 2022

AbstractObjectiveProfunda femoris artery perforator flaps (PAPFs) have not been widely used in head and neck reconstructions. The feasibility and outcomes of PAPFs for various head and neck reconstructions need to be investigated.Study DesignRetrospective analysis.SettingA single‐institution review.MethodsPAPFs were utilized in head and neck reconstructions from 2019 to 2021. Local anatomy, surgical technique, and complications were discussed. Chimeric PAPF applications with muscle components were described for coverage of extensive multiunit defects. Additionally, aesthetic and functional outcomes were compared with anterolateral thigh perforator flaps.ResultsA total of 33 cases were included. The average age was 54.2 years (range, 30‐74). The most common underlying pathology was oral squamous cell carcinoma (n = 26, 78.8%), while the mean ± SD body mass index was 25.4 ± 2.8 kg/m2. Middle perforators (n = 14, 42.4%) were the most commonly utilized ones. The perforator‐based chimeric/composite applications were used in 9 (27.3%), with the muscular components consisting of gracilis (n = 3, 9.1%), adductor magnus (n = 5, 15.2%), or semimembranosus muscles (n = 1, 3.0%). Venous thromboses of the PAPFs were found in 2 (6.1%), though salvaged. The occurrence of postoperative 90‐day morbidity (complication) was related to mandibulectomy/maxillectomy (P = .020). Postoperative validated questionnaires showed a trend of intermediate to high scores, indicating noninferior outcomes in several categories, when compared with the anterolateral thigh perforator flap counterparts.ConclusionPAPFs are a good reconstructive alternative for intermediate to large head and neck reconstructions. Besides, PAPFs can provide sufficient tissue volume and versatility of potentially incorporating adjacent muscle components.
Evaluating the topographical measurements and tear function status in patients with hemifacial spasm: A comparative fellow eye study
Authors: Bayraktar Bilen Neslihan , Bilen Sule 
Published: July 2022

Objective To investigate the effect of eyelid spasm on corneal and tear film characteristics in patients with hemifacial spasm (HFS) and compare these data with those of the contralateral eyes of the same patients. Methods This prospective study is comprised of 64 eyes of 32 HFS patients, 32 eyes on the spasm side (Group 1) and 32 contralateral eyes (Group 2). Corneal tomographic analyses were performed; corneal power of flat axis (K1) and steep axis (K2), astigmatism and thinnest pachymetry; anterior, posterior and total corneal aberrometry [spherical aberration (SA), vertical coma (vcoma), horizontal coma (hcoma), total higher order aberration (THOA) and total RMS], and corneal densitometry values were evaluated and compared between groups. Tear meniscus height and depth (TMH, TMD) were measured using anterior segment optic coherence tomography. Tear function tests including TMH and TMD, the Schirmer I test, and tear break-up time (TBUT) were compared between the groups. Results K1, K2, astigmatism and corneal densitometry values were similar between groups (p > 0.05). Thinnest pachymetry values were significantly thinner on the spasm side (p = 0.040). Anterior and total corneal SA and RMS were significantly higher on the spasm side (p = 0.032, p = 0.005; p = 0.015, p = 0.006, respectively). TMH, TMD and TBUT were significantly lower in Group 1 (p = 0.01, p = 0.02 and p = 0.03, respectively). Schirmer I test values were similar between groups (p > 0.05). Conclusion In HFS patients, there are changes in corneal parameters and tear film in the eye on the spasm side compared to unaffected eye.
Treatment of hypertrophic scar with injection of triamcinolone leads to increased microRNA-26a in a rabbit ear model
Authors: Zhang Xiong , Lai Ya-Qun , Guo Ling 
Published: July 2022

Objectives: Differential expression of microRNAs (miRNAs) has been confirmed to promote hypertrophic scar (HS) formation. However, this mechanism remains to be further elucidated. This paper investigated the effects of microRNA26a on HS of rabbit ears or its mechanism. Methods: The rabbit HS models were established and randomly assigned to either the experimental group (20 rabbits with treatment through triamcinolone acetonide) or the scar group (20 rabbits without treatment). In addition, 10 unmodeled rabbits were served as control group. The expression of microRNA-26a in HS tissues was detected via a stem-loop real-time polymerase chain reaction (RT-PCR). Results: According to RT-PCR, we showed the decreased expression of microRNA-26a in the scar group compared with that in the experimental group, and in the experimental group compared with that in the control group ( p < .01). In addition, the expression of microRNA-26a was negatively correlated with scar thickness (STs), number of fibroblasts (NFs), Collagen I (Col I) level, Collagen III (Col III) level, Interleukin-6 (IL-6) level, and Tumor necrosis factor-alpha (TNF-α) level (all p < .01). Conclusions: Our findings revealed that the increase of microRNA-26a expression might alleviate excessive inflammation during the HS formation, inhibit fibroblast proliferation and collagen deposition in HS, and promote the treatment of HS.
Adopting mobile health applications by nurses: a scoping review
Authors: Nezamdoust Soghra , Abdekhoda Mohammadhiwa , Ranjbaran Fatemeh , Azami-Aghdash Saber 
Published: July 2022

Background The concept of mobile health has attracted considerable attention across the globe, as it provides both healthcare professionals and patients with a distinct means of information and resources. Aim This study was conducted with the aim of utilising mobile health (mHealth) applications by nurses and presenting a scenario of how and why they are utilised. Methods This study was a scoping review. Data collection was carried out by searching the related keywords in Google Scholar, Scopus, Cochrane, EMBASE, Ovid, and PubMed databases from January 2000 to March 2019. Results Regarding the reasons for using mobile applications by nurses, five objectives were identified, including learning and knowledge enhancement, treatment and improvement of the patient care process, diagnostic process, data and patient management, and health promotion. Effective factors in the nurses’ use of mobile applications were categorised into eight themes: ease of use, usefulness, security and confidentiality, feasibility and functionality, design and use—interface, effectiveness, infrastructure, versatility, and social norms. Conclusions Mobile health applications have considerable potential in enhancing nurses’ professional activities. This study contributes to both nursing and health policy by providing a scenario of how and why nurses use mobile health applications.
Patient Controlled Analgesia and its effect on postoperative outcomes in an older cohort of patients undergoing orthopaedic procedures: A retrospective observational study
Authors: Iddagoda Mayura Thilanka , Nienaber Andrew , Pretorius Carina , Flicker Leon 
Published: July 2022

Background: Patient Controlled Analgesia is a popular technique used to manage postoperative pain. The suitability of Patient Controlled Analgesia in older patients after surgical procedures and its effect on postoperative outcomes are not clear. Method: The records of 305 older patients undergoing orthopaedic surgeries in a single tertiary centre were reviewed. Postoperative outcomes were compared between those given Patient Controlled Analgesia and those who were not, using multinomial logistic regression adjusted by propensity scores. Results: Physical function on day 3 after surgery is worse, and risk of requiring personal assistance is higher if the patient had Patient Controlled Analgesia (p = 0.01). Length of stay in patients using patient-controlled analgesia was longer than patients not using patient-controlled analgesia (p = 0.002), and patients given Patient Controlled Analgesia had higher odds of needing support on discharge (p = 0.01). Surprisingly, pain control is poor in the Patient Controlled Analgesia group (p = 0.009). Conclusion: In this review, Patient Controlled Analgesia use was common (40% of our sample), and postoperative outcomes such as physical function on day 3, length of stay and discharge destination were unfavourable in patients who had Patient Controlled Analgesia.
The link between indoor air pollution from cooking fuels and anemia status among non-pregnant women of reproductive age in Ethiopia
Authors: Kanno Girum Gebremeskel , Geremew Temesgen , Diro Tesfaye , Musarapasi Stephen Vincent , Wyk Renay Van , Seboka Binyam Tariku , Alembo Awash , Hussen Robel , Soboksa Negasa Eshete , Aregu Mekonnen Birhane 
Published: July 2022

Objective: The effect of indoor air pollution from different fuel types on the anemia status among non-pregnant women is rarely studied. This study aimed to assess the link between indoor air pollution from different fuel types and anemia among non-pregnant women of reproductive ages in Ethiopia. Method: The secondary data from the 2016 Ethiopian Demographic and Health Survey data have been employed for this study. The anemia status of women in reproductive age was the outcome variable with multiple outcomes as (moderate to severe, mild, and no anemia) and households using biomass fuel and clean fuel were selected for this study. Multinomial logistic regression was employed to estimate the association of biomass fuel use with the anemia status controlling for the predictor variables. Relative risk ratio was calculated at 95% confidence interval. An independent-sample t-test was used to assess the mean difference in blood hemoglobin level (g/dL) between the two fuel users. A p value < 0.05 was considered significant. Result: From the total of 10,961 participants included in this study, the proportion of anemia in women of non-reproductive age was 41.8% and 19.4% among biomass fuel and clean fuel users, respectively, with a mean blood hemoglobin level of 12.71 (±1.81) g/dL. In the final model, women using biomass fuel for cooking were 47% more likely to have mild anemia than households who use cleaner fuels, whereas the association was insignificant for moderate to severe anemia. Biomass fuel users were also found to have 5.8 g/dL lower blood hemoglobin level than the clean fuel user (p < 0.001). Conclusion: The use of biomass fuel was associated with reduced blood hemoglobin levels and significantly associated with mild anemia levels in women of reproductive age in Ethiopia. National efforts should be in place to reduce indoor air pollution from biomass fuels.
Developments in quality of stroke care in Estonia
Authors: Kõrv Janika , Antsov Katrin , Gross-Paju Katrin , Kalju Inga , Kreis Andrus , Liigant Aive , Vibo Riina 
Published: July 2022

Background: Monitoring and measuring different aspects of stroke care pathway is the cornerstone for improvement of quality. We aim to analyze and give an overview of improvements of stroke care quality in Estonia. Patients and methods: National stroke care quality indicators are collected and reported using reimbursement data and include all adult stroke cases. In Estonia, five stroke-ready hospitals are participating in Registry of Stroke Care Quality (RES-Q), providing data on all stroke patients 1 month every year. Data from the national quality indicators and RES-Q from 2015 to 2021 are presented. Results: The proportion of intravenous thrombolysis for all Estonian hospitalized ischemic stroke cases increased from 16% (95% Confidence Interval, CI 15%–18%) in 2015 to 28% (95% CI 27%–30%) in 2021. Mechanical thrombectomy was provided to 9% (95% CI 8%–10%) in 2021. The 30-day mortality rate has decreased from 21% (95% CI 20%–23%) to 19% (95% CI 18%–20%). More than 90% of patients with cardioembolic stroke are prescribed anticoagulants at discharge, but only 50% are on anticoagulant treatment 1 year after stroke. Also, the availability of inpatient rehabilitation needs improvement, being 21% (95% CI 20%–23%) in 2021. A total of 848 patients are included in the RES-Q. The proportion of patients receiving recanalization therapies was comparable to the national stroke care quality indicators. All stroke-ready hospitals show good onset-to-door times. Conclusion: The overall stroke care quality in Estonia is good, especially the availability of recanalization treatments. However, secondary prevention and the availability of rehabilitation services need improvement in the future.
Non-Operative Management of Symptomatic Hallux Limitus: A Novel Approach of Foot Core Stabilization and Extracorporeal Shockwave Therapy
Authors: Reilly Tom , Wasserman Lindsay , Tenforde Adam S. 
Published: July 2022

Background: This video presents assessment and management of hallux limitus using intrinsic foot strengthening and joint mobilization techniques with combination of extracorporeal shockwave therapy (ESWT). Indications: Clinical history includes pain with walking, running, jumping, or loaded plantarflexion localized to the first metatarsophalangeal (MTP) joint. Indications for our treatment approach of hallux limitus include pain localized to the first MTP joint, corresponding lack of active range of motion/passive range of motion, and reduced foot/ankle strength often with joint space narrowing on imaging. Technique Description: Our program uses the principle of foot core exercises that enhance intrinsic muscles of the foot to assist in medial longitudinal arch stabilization and hallux strengthening. Progression of these exercises can be done in weight-bearing and impact activities specific to patient goals. In addition to these foot intrinsic exercises, calf raises should be incorporated to strengthen the gastroc-soleus complex to both improve plantar foot strength and facilitate extension of the first MTP joint. Manual therapy techniques reduce the rigidity of the first MTP joint and restore appropriate medial-lateral and plantar-dorsal balance. With severe limitations in mobility or pain limitations, ESWT can be incorporated to treat the joint and surrounding soft tissue restrictions. Results: Increased first MTP extension is observed. Reduced symptoms of first MTP joint pain with activity allow patients to return to walking and other physical activities with improved comfort. Complications are rare. Pain over the first MTP joint is expected during ESWT. Rarely, irritation of the plantar components of the first MTP joint, including the tibial and fibular sesamoid bones, may occur. Discussion/Conclusion: Non-surgical management of hallux limitus may improve using the described technique of intrinsic foot strengthening with focus on stabilization of the medial longitudinal arch and strategies of improved mobility of the first MTP joint. Adding ESWT may address joint limitations and facilitate gains in exercise and mobility.
Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse
Authors: Rusconi Chiara , Cheah Chan Y. , Eyre Toby A. , Tucker David , Klener Pavel , Giné Eva , Crucitti Lara , Muzi Cristina , Iadecola Sara , Infante Gabriele , Bernard Sophie , Auer Rebecca L. , Pagani Chiara , Duglosz-Danecka Monika , Mocikova Heidi , van Meerten Tom , Cencini Emanuele , Marin-Niebla Ana , Williams Michael E. , Angelillo Piera , Nicoli Paolo , Arcari Annalisa , Morello Lucia , Mannina Donato , Vitagliano Orsola , Sartori Roberto , Chiappella Annalisa , Sciarra Roberta , Stefani Piero M. , Dreyling Martin , Seymour John F. , Visco Carlo 
Published: July 2022

AbstractCentral nervous system (CNS) relapse of mantle cell lymphoma (MCL) is a rare phenomenon with dismal prognosis, where no standard therapy exists. Since the covalent Bruton tyrosine kinase (BTK) inhibitor ibrutinib is effective in relapsed/refractory MCL and penetrates the blood–brain barrier (BBB), on behalf of Fondazione Italiana Linfomi and European Mantle Cell Lymphoma Network we performed a multicenter retrospective international study to investigate the outcomes of patients treated with ibrutinib or chemoimmunotherapy. In this observational study, we recruited patients with MCL with CNS involvement at relapse who received CNS-directed therapy between 2000 and 2019. The primary objective was to compare the overall survival (OS) of patients treated with ibrutinib or BBB crossing chemotherapy. A propensity score based on a multivariable binary regression model was applied to balance treatment cohorts. Eighty-eight patients were included. The median age at study entry was 65 years (range, 39-87), 76% were males, and the median time from lymphoma diagnosis to CNS relapse was 16 months (range, 1-122). Patients were treated with ibrutinib (n = 29, ibrutinib cohort), BBB crossing chemotherapy (ie, high-dose methotrexate ± cytarabine; n = 29, BBB cohort), or miscellaneous treatments (n = 30, other therapy cohort). Both median OS (16.8 vs 4.4 months; P = .007) and median progression-free survival (PFS) (13.1 vs 3.0 months; P = .009) were superior in the ibrutinib cohort compared with the BBB cohort. Multivariable Cox regression model revealed that ibrutinib therapeutic choice was the strongest independent favorable predictive factor for both OS (hazard ratio [HR], 6.8; 95% confidence interval [CI], 2.2-21.3; P &lt; .001) and PFS (HR, 4.6; 95% CI, 1.7-12.5; P = .002), followed by CNS progression of disease (POD) &gt;24 months from first MCL diagnosis (HR for death, 2.4; 95% CI, 1.1-5.3; P = .026; HR for death or progression, 2.3; 95% CI, 1.1-4.6; P = .023). The addition of intrathecal (IT) chemotherapy to systemic CNS-directed therapy was not associated with superior OS (P = .502) as the morphological variant (classical vs others, P = .118). Ibrutinib was associated with superior survival compared with BBB-penetrating chemotherapy in patients with CNS relapse of MCL and should be considered as a therapeutic option.
International consensus statement on the management of cardiovascular risk of Bruton’s tyrosine kinase inhibitors in CLL
Authors: Awan Farrukh T. , Addison Daniel , Alfraih Feras , Baratta Sergio J. , Campos Rodrigo Noronha , Cugliari María Silvana , Goh Yeow Tee , Ionin Valery Alexandrovich , Mundnich Stefanie , Sverdlov Aaron L. , Tam Constantine , Ysebaert Loïc 
Published: July 2022

Abstract
Bruton’s tyrosine kinase inhibitors (BTKis) have altered the treatment landscape for chronic lymphocytic leukemia (CLL) by offering effective and well-tolerated therapeutic options. However, since the approval of ibrutinib, concern has risen regarding the risk of cardiovascular (CV) adverse events, including atrial fibrillation (AF), hypertension, and heart failure. Newer BTKis appear to have lower CV risks, but data are limited. It is important to understand the risks posed by BTKis and how those risks interact with individual patients, and we convened a panel of physicians with expertise in CLL and CV toxicities in oncology to develop evidence-based consensus recommendations for community hematologists and oncologists. Care providers should thoroughly assess a patient’s CV risk level before treatment initiation, including established CV diseases and risk factors, and perform investigations dependent on preexisting diseases and risk factors, including an electrocardiogram (ECG). For patients with high CV risk, BTKi treatment is often appropriate in consultation with a multidisciplinary team (MDT), and more selective BTKis, including acalabrutinib and zanubrutinib, are preferred. BTKi treatment should generally be avoided in patients with a history of heart failure. Ibrutinib should be avoided in patients with a history of ventricular arrhythmias, but the risk of newer drugs is not yet known. Finally, an MDT is crucial to help manage emerging toxicities with the goal of maintaining BTKi therapy, if possible. Optimizing heart failure, arrhythmia, and hypertension control will likely improve tolerance and maintenance of BTKi therapy. However, additional studies are needed to identify the most optimal strategy for these drugs.
Green nanopriming: responses of alfalfa (Medicago sativa L.) seedlings to alfalfa extracts capped and light-induced silver nanoparticles
Authors: Song Kexiao , Zhao Donghao , Sun Haoyang , Gao Jinzhu , Li Shuo , Hu Tianming , He Xueqing 
Published: July 2022

AbstractThe application of nanotechnology in agriculture can remarkably improve the cultivation and growth of crop plants. Many studies showed that nanoparticles (NPs) made plants grow more vigorously. Light can make NPs aggregated, leading to the reduction of the NPs toxicity. In addition, treatment with NPs had a “hormesis effect” on plants. In this study, light-induced silver nanoparticles (AgNPs) were synthesized by using the alfalfa (Medicago sativa L.) extracts, and then the optimal synthetic condition was determined. Light-induced AgNPs were aggregated, spherical and pink, and they were coated with esters, phenols, acids, terpenes, amino acids and sugars, which were the compositions of alfalfa extracts. The concentration of free Ag+ was less than 2 % of the AgNPs concentration. Through nanopriming, Ag+ got into the seedlings and caused the impact of AgNPs on alfalfa. Compared with the control group, low concentration of light-induced AgNPs had a positive effect on the photosynthesis. It was also harmless to the leaf cells, and there was no elongation effect on shoots. Although high concentration of AgNPs was especially beneficial to root elongation, it had a slight toxic effect on seedlings due to the accumulation of silver. With the increase of AgNPs concentration, the content of silver in the seedlings increased and the silver enriched in plants was at the mg/kg level. Just as available research reported the toxicity of NPs can be reduced by using suitable synthesis and application methods, the present light induction, active material encapsulation and nanopriming minimized the toxicity of AgNPs to plants, enhancing the antioxidant enzyme system.
Graphical Abstract