bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observation versus intervention for Borden type I intracranial dural arteriovenous fistula: A pooled analysis of 469 patients
Authors: Schartz Derrek , Rahmani Redi , Gunturi Aditya , Kohli Gurkirat Singh , Akkipeddi Sajal Medha K , Ellens Nathaniel R , Romiyo Prasanth , Kessler Alex , Bhalla Tarun , Mattingly Thomas K , Bender Matthew T 
Published: September 2022

Background While it is thought that Borden Type I intracranial dural arteriovenous fistula (dAVF) have a benign clinical course, their management remains controversial. Methods A comparative meta-analysis was completed to evaluate the outcomes of intervention verses observation of Borden Type I intracranial dAVF. Outcome measures included: grade progression, worsening symptoms, death due to dAVF, permanent complications other than death, functional independence (mRS 0–2), and rate of death combined with permanent complication, were evaluated. Risk differences (RD) were determined using a random effects model. Results Three comparative studies combined with the authors’ institutional experience resulted in a total of 469 patients, with 279 patients who underwent intervention and 190 who were observed. There was no significant difference in dAVF grade progression between the intervention and observation arms, 1.8% vs. 0.7%, respectively (RD: 0.01, 95% CI: −0.02 to 0.04, P = 0.49), or in symptom progression occurring in 31/279 (11.1%) intervention patients and 11/190 (5.8%) observation patients (RD: 0.03, CI: −0.02 to 0.09, P = 0.28). There was also no significant difference in functional independence on follow up. However, there was a significantly higher risk of dAVF related death, permanent complication from either intervention or dAVF related ICH or stroke in the intervention group (11/279, 3.9%) compared to the observation group (0/190, 0%) (RD: 0.04, CI: 0.1 to 0.06, P = 0.007). Conclusion Intervention of Borden Type I dAVF results in a higher risk of death or permanent complication, which should be strongly considered when deciding on management of these lesions.
Implementing an infection control checklist May not be effective in reducing the incidence of surgical site infections in spinal surgery
Authors: Kavak Gizem , Kırçıl Cihan , Pelgur Hatice , Topçu Eylem , Yanmaz Erdoğmuş Evrim , Ayabakan Tuba , Acaroglu Emre R 
Published: September 2022

Background Surgical site infections (SSI) in instrumented spine surgery remains as a major complication with increased morbidity. Although implementation of surgical safety checklists has been reported to lower the rates of SSI, reproducibility of these remain unclear. Objective The specific aim of this study was to explore the results of implementation of a SSI control protocol in regard to its efficacy in decreasing the rate of SSI. Methods A total of 140 instrumented spinal surgery cases between 2018 and 2021 were divided into two groups as Group 1 (checklist implemented) and Group 2 (control) and these were compared regarding SSI rates, patient rand surgery related factors, laboratory findings and infecting microorganisms. Results Ten SSIs were encountered in Group 1 (20.8%), whereas only nine in Group 2 (9.8%). Although not statistically significant ( p > .05), these results highly favor the non-checklist implemented group regarding the development of SSI. A definitive infective microorganism could be identified in five out of 10 SSI in Group 1 and 6 out of nine in Group 2. Whereas only three out of 11 (27.3%) involved Gr (+) agents, rest of eight out of 11 (72.7%) involved Gr (−) agents. Discussion A failure in decreasing the SSI rate through the implementation of a SSI prevention checklist may be due to several factors pertaining to the study design, patient characteristics and the Gr (−) dominance in SSIs in our center. Nevertheless, this suggests that checklist implementation to prevent SSI in instrumented spine surgery may not be effective in all contexts.
Efficacy of Hyaluronic Acid in Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-Analysis
Authors: Li Jia , Wang Jihong , Sun Changling 
Published: September 2022

Objective The aim of this meta-analysis is to compare the surgical results of endoscopic dacryocystorhinostomy (Endo-DCR) for chronic dacryocystitis (CD) with and without intraoperative hyaluronic acid (HA) application. Methods An electronic literature search was performed using the PubMed, Embase, Cochrane Library, CNKI, and Wan Fang databases in April 1, 2022. Review Manager software version 5.4 was used for data synthesis and a forest plot was generated for each outcome measure. Results Seven randomized control trials (RCTs), which involved 739 eyes, were included in this meta-analysis. Overall, compared with the control group, intraoperative HA application significantly enhance the success rate (odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.15–4.98, P < .00001), promote re-epithelization (OR = 2.93, 95% CI: 1.83–4.68, P < .00001), reduce granulation (OR = 0.41, 95% CI: 0.21–0.80, P = .008), and scar (OR = 0.39, 95% CI: 0.22–0.68, P = .001) formation after Endo-DCR. Conclusion Intraoperative HA application seems to be a useful adjuvant that could enhance success rate by promoting re-epithelization and inhabiting granulation and scar formation around the ostium.
Integrated fan cooling of the lower back for wheelchair users
Authors: Griggs Katy E , Vanheusden Frederique J 
Published: September 2022

Introduction A large proportion of a wheelchair user’s body is in contact with their wheelchair. Integrated fan cooling systems fitted to a wheelchair’s backrest aim to alleviate the build-up of heat at the skin-chair interface. The aim of this pilot study was to evaluate the effectiveness of an integrated fan cooling system at cooling the user during daily pushing activity. Methods Eight male able-bodied participants completed two conditions, with (FAN) and without (CON) fan cooling, pushing for four 15 min blocks. The fan was turned on (highest setting) at the end of block 1 (FAN), whilst in CON the fan remained off. Skin temperature was measured over the back and chest throughout alongside heart rate and perceptual responses (rating of perceived exertion, thermal sensation, thermal comfort, wetness sensation) at the end of each 15 min block. Results Wetness sensation and lower back skin temperature were lower in FAN (both p < 0.02), with the difference in lower back skin temperature between the two conditions being 2.20°C at the end of block 4. Conclusion The integrated fan cooling system provided significant cooling to the lower back without affecting any other physiological or perceptual response, besides wetness sensation.
A contemporary snippet on clinical presentation and management of toxic epidermal necrolysis
Authors: Naik Piyu Parth 
Published: September 2022

Introduction Toxic epidermal necrolysis (TEN) is one of the most severe cutaneous adverse reactions with a mortality rate of 30%. Due to a lack of consensus regarding the treatment and management of TEN, therapy is individualized on a case-to-case basis. Purpose The scientific literature about Stevens-Johnson Syndrome (SJS) and TEN is summarized and assessed to aid and assist in determining the optimal course of treatment. Methods PubMed and Google Scholar, among others, were searched with the keywords: “Toxic Epidermal Necrolysis”, “corticosteroids”, “cyclosporine”, “etanercept”, “intravenous immunoglobulin”, “Stevens-Johnson syndrome” and filtered by year. The research articles generated by the search, and their references, were reviewed. Results TEN is a severe dermatological condition that is mainly caused by medicines. World-wide guidelines differ in care plans. As there is no consensus on the management of TEN, this article aims to summarize the efficacy and feasibility of the management aspect of TEN from previous studies. Supportive care is highly accepted, along with early discontinuation of all medicines (hydration & electrolytes). Corticosteroids and cyclosporine have been used in therapy. Intravenous immunoglobulin (IVIG) is currently being administered; however, their efficacy by themselves and in combination remains uncertain. Conclusion Current evidence predominantly from retrospective studies suggests no individual treatment has sufficient efficacy and a multi-faceted regimen stands to be favored. Therapeutic regimens from corticosteroids to IVIG are under constant evaluation. The life-threatening nature of TEN warrants further confirmation with more extensive, robust randomized, controlled trials. Lay Summary Toxic epidermal necrolysis (TEN) is a serious skin reaction with a 30% chance of mortality. Commonly TEN is caused by medicines and results in a burn like appearance and sensation in patients. Usually administered medicine is cleared effectively by the human body but when the clearance of few metabolites from medicine is disrupted due to few genes, it leads to an ominous response by the body. This response involves several intermediate chemicals that primarily attack skin cells. Treatment guidelines differ globally. Supportive care is highly accepted, along with early discontinuation of all medicine. Currently, a multi-faceted treatment regimen is favored. Treatments like corticosteroids to immunoglobulins are under constant evaluation. Identification of the perfect combination of treatment needs confirmation from robust randomized controlled trials.
Characterizing Interprofessional Collaboration and Referral to Mindfulness-Based Stress Reduction Programs
Authors: Binda Dhanesh D. , Weinberg Janice M. , Nguyen Tra , Morone Natalia E. 
Published: September 2022

Background In 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress Reduction (MBSR), an eight-week group program, as first-line non-pharmacological treatment for chronic low back pain. However, interprofessional collaboration between mindfulness instructors and Primary Care Providers (PCP) remains largely unknown. Objective We developed a survey to assess communication between mindfulness instructors and PCPs, identify predictors of referral to MBSR, and determine areas where interventions could increase patient access to MBSR. Methods The 25-question survey was sent via email to PCPs at the Division of General Internal Medicine, University of Pittsburgh, PA, the Piedmont Health Services Family Medicine Section, Chapel Hill, NC, the Boston Medical Center General Internal Medicine and Family Medicine Sections, Boston, MA, and the UMass Memorial Medical Center Family Medicine Section, Worcester, MA. We used descriptive statistics and logistic regression to analyze the data. Results Among 118 eligible respondents, 85 (72.0%) were female PCPs, mean age was approximately 41.5±10.1, and the majority (65.2%) had been in medical practice ≤10 years. Of these PCPs, 83 (70.1%) reported familiarity with MBSR (95% CI: 62.1, 78.5), and 49 (59.0%) of them referred patients at least yearly. Of those who referred, 8 (16.3%) reported collaboration with mindfulness instructors. PCPs who were quite a bit or very much familiar with MBSR had 5.10 (1.10, 22.50) times the odds (P=.03), and those who were 50 years or younger had 3.30 times the odds (P=.04) of referring patients to MBSR. Frequency of PCPs’ personal practice of mindfulness was not significantly associated with referrals (P=.30). Conclusion This is the first study to assess interprofessional collaboration between mindfulness instructors and PCPs. Suggestions for a potential integrative health care model are included; further studies on methods to augment communication and education are warranted to improve the referral process and ultimately increase accessibility and utilization of mindfulness-based programs.
Development and validation of a prognostic nomogram for early stage non-small cell lung cancer: a study based on the SEER database and a Chinese cohort
Authors: Zhou Liang , Zhang Yahui , Chen Wenyu , Niu Niu , Zhao Junjie , Qi Weibo , Xu Yufen 
Published: September 2022

Abstract
Objective
This study aimed to construct a nomogram to effectively predict the overall survival (OS) of patients with early-stage non-small-cell lung cancer (NSCLC).

Methods
For the training and internal validation cohorts, a total of 26,941 patients with stage I and II NSCLC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. A nomogram was constructed based on the risk factors affecting prognosis using a Cox proportional hazards regression model. And 505 patients were recruited from Jiaxing First Hospital for external validation. The discrimination and calibration of the nomogram were evaluated by C-index and calibration curves.

Results
A Nomogram was created after identifying independent prognostic factors using univariate and multifactorial factor analysis. The C-index of this nomogram was 0.726 (95% CI, 0.718–0.735) and 0.721 (95% CI, 0.709–0.734) in the training cohort and the internal validation cohort, respectively, and 0.758 (95% CI, 0.691–0.825) in the external validation cohort, which indicates that the model has good discrimination. Calibration curves for 1-, 3-, and 5-year OS probabilities showed good agreement between predicted and actual survival. In addition, DCA analysis showed that the net benefit of the new model was significantly higher than that of the TNM staging system.

Conclusion
We developed and validated a survival prediction model for patients with non-small cell lung cancer in the early stages. This new nomogram is superior to the traditional TNM staging system and can guide clinicians to make the best clinical decisions.
EZH2 mutations at diagnosis in follicular lymphoma: a promising biomarker to guide frontline treatment
Authors: Martínez-Laperche C. , Sanz-Villanueva L. , Díaz Crespo F. J. , Muñiz P. , Martín Rojas R. , Carbonell D. , Chicano M. , Suárez-González J. , Menárguez J. , Kwon M. , Diez Martín J. L. , Buño I. , Bastos Oreiro M. 
Published: September 2022

AbstractEZH2 is mutated in nearly 25% of follicular lymphoma (FL) cases. Little is known about how EZH2 affects patients’ response to therapy. In this context, the aim of this study was to retrospectively analyze the frequency of mutations in EZH2 at diagnosis in tissue and ctDNA in patients with FL and to assess the patients’ outcomes after receiving immunochemotherapy, depending on the EZH2 mutation status. Among the 154 patients included in the study, 27% had mutated EZH2 (46% with high-grade and 26% with low-grade FL). Of the mutated tissue samples, the mutation in ctDNA was identified in 44% of cases. EZH2 mutation in ctDNA was not identified in any patient unmutated in the tissue.Unmutated patients who received R-CHOP had significantly more relapses than patients who received R-Bendamustine (16/49 vs. 2/23, p = 0.040). Furthermore, our results show that patients with mutated EZH2 treated with R-CHOP vs. those treated with R-Bendamustine present a lower incidence of relapse (10% vs. 42% p = 0.09 at 4 years), a higher PFS (92% vs. 40% p = 0.039 at 4 years), and higher OS (100% vs. 78% p = 0.039 at 4 years). Based on these data, RCHOP could be a more suitable regimen for mutated patients, and R-bendamustine for unmutated patients. These findings could mean the first-time identification of a useful biomarker to guide upfront therapy in FL.
Predictive factors for open reduction of flexion-type supracondylar fracture of humerus in children
Authors: Sun Jun , Shan Jing , Meng Lian , Liu Tianjing , Wang Enbo , Jia Guoqiang 
Published: September 2022

AbstractObjectiveThe incidence of open reduction and internal fixation (ORIF) in flexion-type supracondylar humerus fractures (SCHF) in children is significantly higher than that of extension-type fractures. This study aimed to identify risk factors for ORIF in flexion-type SCHF.MethodsOne hundred seventy-one patients with Wilkins type III flexion-type SCHF from January 2012 to December 2021 were retrospectively enrolled in a tertiary paediatric hospital. Patients were divided into ORIF group versus closed reduction and internal fixation (CRIF) group. Then, patients data of age, sex, injury side, obesity, deviation of displacement, fracture level, rotation, nerve injury, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios (OR) of ORIF.ResultsOverall, 171 children with type III flexion-type SCHF were analyzed (average aged 7.9 ± 2.8 years). Displacement was lateral in 151 cases, medial in 20. 20 cases had combined ulnar nerve injury. The failed closed reduction rate was 20%. Univariate analysis indicated age, distal fracture fragment rotation, and ulnar nerve injury were significantly associated with ORIF. (P = 0.047,P = 0.009, andP = 0.001, respectively). Multivariate logistic regression analysis showed that distal fracture fragment rotation (OR, 3.3; 95%CI:1.1–9.5;P = 0.028) and ulnar nerve injury (OR, 6.4; 95%CI:2.3–18.3;P = 0.001) were independent risk factors; however, the age was not an independent one (OR, 1.5; 95%CI:0.6–3.5;P = 0.397) for ORIF in the Wilkins type III flexion-type SCHF.ConclusionDistal fracture fragment malrotation on initial x-rays and ulnar nerve injury were significant risk factors for ORIF in Wilkins type III flexion-type SCHF. Surgeons should prepare tourniquets or other open reduction instruments when treating these types of fractures.Level of evidenceLevel IV
Teaming up to traverse loneliness: a co-creative journey toward a home care work model for supporting social participation among older adults
Authors: Nordin Therese , Coe Anna-Britt , Nilsson Ingeborg 
Published: September 2022

AbstractBackgroundParticipatory research is particularly suitable in adressing know-do gaps in health systems. There is a disparity between what is known about the benefits of social participation and home care’s responsibility to provide conditions amenable to older adults’ social participation, and what is accomplished in home care practice. Home care workers are a large, low-power group, whose competences should be better harnessed. We carried out a participatory action research (PAR) project with the goal of generating an improved structure for identifying and alleviating loneliness. This article aims to explore the co-creative process of designing a work model that guides home care workers in supporting social participation among older care recipients.MethodsMultimodal data from 16 PAR workshops with 14 home care workers were described and explored through the ‘recursive PAR process’ and the ‘framework for occupational enablement for change in community practice”.ResultsThe PAR process is outlined through the objectives, activities, and work model, as well as enablement strategies employed throughout the PAR process; as are its opportunities, challenges and implications. The work model describes how care workers can act as discoverers of care recipients’ unmet social needs, employ intentional communication, and link to relevant professions or community services to alleviate loneliness among older home care recipients.ConclusionsThis research process included opportunities of collaborating with enthusiastic and competent home care workers, but also challenges of moving between theory and practice and maintaining active participation between workshops. The resulting work model is in step with the requirements of elderly care, is unique in its field and could comprise a first step toward a more systematic approach of assessing and addressing loneliness. The vivid delineation of the PAR process provided in this paper can aid other researchers in navigating participatory research in home care contexts.
Gut symbiotic bacteria are involved in nitrogen recycling in the tephritid fruit fly Bactrocera dorsalis
Authors: Ren Xueming , Cao Shuai , Akami Mazarin , Mansour Abdelaziz , Yang Yishi , Jiang Nan , Wang Haoran , Zhang Guijian , Qi Xuewei , Xu Penghui , Guo Tong , Niu Changying 
Published: September 2022

Abstract
Background
Nitrogen is considered the most limiting nutrient element for herbivorous insects. To alleviate nitrogen limitation, insects have evolved various symbiotically mediated strategies that enable them to colonize nitrogen-poor habitats or exploit nitrogen-poor diets. In frugivorous tephritid larvae developing in fruit pulp under nitrogen stress, it remains largely unknown how nitrogen is obtained and larval development is completed.

Results
In this study, we used metagenomics and metatranscriptomics sequencing technologies as well as in vitro verification tests to uncover the mechanism underlying the nitrogen exploitation in the larvae of Bactrocera dorsalis. Our results showed that nitrogenous waste recycling (NWR) could be successfully driven by symbiotic bacteria, including Enterobacterales, Lactobacillales, Orbales, Pseudomonadales, Flavobacteriales, and Bacteroidales. In this process, urea hydrolysis in the larval gut was mainly mediated by Morganella morganii and Klebsiella oxytoca. In addition, core bacteria mediated essential amino acid (arginine excluded) biosynthesis by ammonium assimilation and transamination.

Conclusions
Symbiotic bacteria contribute to nitrogen transformation in the larvae of B. dorsalis in fruit pulp. Our findings suggest that the pattern of NWR is more likely to be applied by B. dorsalis, and M. morganii, K. oxytoca, and other urease-positive strains play vital roles in hydrolysing nitrogenous waste and providing metabolizable nitrogen for B. dorsalis.
Epigenetic machinery is functionally conserved in cephalopods
Authors: Macchi Filippo , Edsinger Eric , Sadler Kirsten C. 
Published: September 2022

AbstractBackgroundEpigenetic regulatory mechanisms are divergent across the animal kingdom, yet these mechanisms are not well studied in non-model organisms. Unique features of cephalopods make them attractive for investigating behavioral, sensory, developmental, and regenerative processes, and recent studies have elucidated novel features of genome organization and gene and transposon regulation in these animals. However, it is not known how epigenetics regulates these interesting cephalopod features. We combined bioinformatic and molecular analysis ofOctopus bimaculoidesto investigate the presence and pattern of DNA methylation and examined the presence of DNA methylation and 3 histone post-translational modifications across tissues of three cephalopod species.ResultsWe report a dynamic expression profile of the genes encoding conserved epigenetic regulators, including DNA methylation maintenance factors in octopus tissues. Levels of 5-methyl-cytosine in multiple tissues of octopus, squid, and bobtail squid were lower compared to vertebrates. Whole genome bisulfite sequencing of two regions of the brain and reduced representation bisulfite sequencing from a hatchling ofO. bimaculoidesrevealed that less than 10% of CpGs are methylated in all samples, with a distinct pattern of 5-methyl-cytosine genome distribution characterized by enrichment in the bodies of a subset of 14,000 genes and absence from transposons. Hypermethylated genes have distinct functions and, strikingly, many showed similar expression levels across tissues while hypomethylated genes were silenced or expressed at low levels. Histone marks H3K27me3, H3K9me3, and H3K4me3 were detected at different levels across tissues of all species.ConclusionsOur results show that the DNA methylation and histone modification epigenetic machinery is conserved in cephalopods, and that, in octopus, 5-methyl-cytosine does not decorate transposable elements, but is enriched on the gene bodies of highly expressed genes and could cooperate with the histone code to regulate tissue-specific gene expression.