bluuebunny/crossref_metadata_2025_split huggingface dataset:
No association of postoperative opioid usage with long-term surgery outcomes in patients with liver cancer: a population-based retrospective cohort study
Authors: Yeh Pin-Hung , Yeh Han-Wei , Yang Shun-Fa , Wang Yu-Hsun , Chou Ming-Chih , Tsai Ping-Kun , Yeh Chao-Bin 
Published: September 2022

Abstract
Hepatocellular carcinoma (HCC) is a fatal cancer worldwide, and surgical resection remains the standard treatment. Postoperative opioid prescription has been believed to affect cancer recurrence through complex biological pathways. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database of Taiwan to evaluate the relationship between postoperative opioid use and long-term surgical outcomes of patients with HCC. This study had a retrospective cohort design. In total, 812 patients older than 20 years who underwent hepatectomy because of HCC were included. The exposure group comprised patients who used opioids during hospitalization postoperatively. The comparison group included those who never used opioids during hospitalization postoperatively. A Cox proportional hazards model was used to evaluate the overall survival or recurrence-free survival rate between the opioid group and the nonopioid group. A total of 530 patients received opioids postoperatively and 282 patients did not. The hazard ratios of overall survival and recurrence-free survival were 1.10 (95% confidence interval [CI], 0.85-1.41) and 1.15 (95% CI, 0.91-1.46), respectively. Total postoperative opioids were converted into oral morphine milligram equivalents and then divided into 3 equal subgroups: low dose, <40 mg; medium dose, 40 to 144 mg; and high dose, ≥145 mg. The hazard ratios of overall survival were 0.88 (95% CI, 0.63-1.24) for the low-dose group, 1.27 (95% CI, 0.92-1.74) for the medium-dose group, and 1.14 (95% CI, 0.83-1.58) for the high-dose group. Postoperative opioids do not affect overall and recurrence-free survival in patients undergoing hepatectomy or liver transplantation because of HCC. Cancer recurrence should not be a clinical concern regarding postoperative opioid prescription.
Efficacy of semi-customized exercises in preventing low back pain in high school volleyball players: A randomized controlled trial
Authors: Mizoguchi Yasuaki , Akasaka Kiyokazu , Otsudo Takahiro , Shimada Naoki , Naka Hiroyuki 
Published: September 2022

Background:
Low back pain (LBP) is a common injury in high school volleyball players. We hypothesized that a prevention program could decrease the incidence of LBP in high school volleyball players. This study was an in-season cluster-randomized controlled trial.

Methods:
We block-randomized 8 high school volleyball teams comprising 70 players aged 15 to 17 years into the intervention (4 teams, 34 players) and control (4 teams, 36 players) groups. The intervention program consisted of 9 physical function tests as well as 1 or 2 self-selected preventive exercises, including dynamic thoracic mobility, trunk stabilization exercises, and static stretching, performed during warm-up. Both groups were followed up for 4 weeks, during which the incidence of LBP was recorded. Physical function tests (back endurance; spinal and back flexibility; active or passive shoulder and trunk range of motion; ankle joint mobility; and iliopsoas, quadriceps, and hamstrings flexibility) were conducted before and after the intervention.

Results:
The intervention group had a significantly lower incidence of LBP (8.8%) than the control group (33.3%) (relative risk, 3.78; 95% confidence interval, 1.17–12.23; P = .017, 1 − β = 0.99). Lumbar extension accounted for nearly 70% of LBP incidences. Most players in the intervention group demonstrated improved physical function associated with the exercises.

Conclusion:
The semi-customized prevention program decreased the incidence of LBP and enhanced the physical function parameter in high school volleyball players.
The relationship between air pollutant levels and aneurysmal subarachnoid hemorrhage
Authors: Kim Jang Hun , Lee Sang-Hoon , Park Se-Heum , Lim Dong-Jun , Park Dong-Hyuk 
Published: September 2022

Background:
The relationship between air pollutants, including fine particles (particulate matter [PM] < 10 μm and < 2.5 μm), and aneurysmal subarachnoid hemorrhage (SAH) has been inadequately studied, and the results remain inconclusive. In this study, we attempted to investigate the relationship between air pollutant levels and aneurysmal SAH.

Methods:
Ninety-two patients diagnosed with aneurysmal SAH were retrospectively included in the study. Medical records were reviewed, and levels of pollutants, including those of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and PM with an aerodynamic diameter < 10 and 2.5 μm (PM10 and PM2.5), were collected from the open-source Air Korea website for a period of 4 days. Independent t-tests were conducted to identify the difference in the pollutant levels between the data obtained on the day of aneurysm rupture (D-0) and the other 3 days (D-7, D-2, and D-1).

Results:
A majority (40.2%) of the patients experienced aneurysm rupture during the fall season when the mean daily pollutant levels were 0.004 ± 0.001 (ppm, SO2), 0.517 ± 0.218 (ppm, CO), 0.02056 ± 0.012 (ppm, O3), 0.02628 ± 0.015 (ppm, NO2), 36.36957 ± 24.538 (μg/m3, PM10), and 19.75581 ± 13.494 (μg/m3, PM2.5), respectively. The level of NO2 was significantly higher on the day of aneurysm rupture (P = .035) than on the other days, while the levels of CO and O3 were nonsignificantly higher (P = .081, P = .055, respectively) on the day of aneurysm rupture than on the other days. There was no significant differences in the PM levels between the 4 days.

Conclusion:
A relationship between PM levels and aneurysm rupture was not identified. Only the levels of classic air pollutant (CO, O3, and NO2) were higher on the aneurysm rupture day than on the other days.
US Generalist Physicians and Groups That Focused Practice in a Single Care Setting
Authors: Ryskina Kira L. , Unruh Mark Aaron , Qian Yuting , Jung Hye-Young 
Published: September 2022

Background:
Some generalist physicians whose training prepared them for primary care practice increasingly practice in a facility (eg, hospitals, nursing homes); however, whether this trend was accompanied by a complimentary rise in generalist physicians who focused their practice on office-based care is unknown.

Objectives:
Our objective in this study was to examine trends in the prevalence of generalist physicians and physician groups that practice in a single setting.

Research Design:
This was a retrospective cross-sectional study of generalist physicians trained in family medicine, internal medicine, or geriatrics. We used 2014–2017 billing data for Medicare fee-for-service beneficiaries to measure the proportion of all patient visits made by physicians in the following care settings: office, outpatient hospital department, inpatient hospital, and other sites.

Results:
From 2014 to 2017, the proportion of generalist physicians who narrowed their practice to a single setting increased by 6.69% (from 62.80% to 67.00%, pfor trend<0.001). In 2017, 4.63% of physician groups included more than 1 type of setting-based physicians.

Conclusions:
Generalist physicians treating older adults increasingly narrowed their practice focus to a single type of health care setting. This trend was not accompanied by growth among physician groups that included different types of setting-based physicians. Further evaluation of the consequences of these trends on the fragmentation of primary care delivery across different health care settings and primary care outcomes is needed.
Resolution of apolipoprotein A1 and A2 proteoforms: their cardiometabolic correlates and implications for future research
Authors: Wilkins John T. , Rohatgi Anand 
Published: September 2022

Purpose of review
A ‘proteoform’ is defined as one specific protein structural form that results from the combination of allelic variation, alternative RNA splicing, and/or posttranslational modifications (PTMs) in specific locations on the amino acid backbone. Apolipoproteins A1 and A2 are highly abundant apolipoproteins that mediate HDL structure and function. ApoA1 and apoA2 are known to undergo PTMs, which results in multiple proteoforms. However, the catalogue of apoA1 and apoA2 proteoforms as well as their associations with cardiometabolic health characteristics has not been described until recently. In this brief review, we discuss recent efforts to catalogue the spectrum of apoA1 and apoA2 proteoforms, to understand the relationships between the relative abundance of these proteoforms with cardiometabolic phenotypic characteristics, and we will discuss the implications of these findings to future research.

Recent findings
A broad spectrum of apoA1 and apoA2 proteoforms has been characterized. Although, the types of apoA1 and A2 proteoforms are consistent across individuals, the relative abundances of proteoforms can vary substantially between individuals. Proteoform-specific associations with cardiometabolic characteristics in humans, independent of absolute apolipoprotein abundance, have been described. These recent findings suggest multiple levels of protein structural variation that arise from known and unknown metabolic pathways may be important markers or mediators of cardiometabolic health.

Summary
Understanding the associations between apolipoprotein proteoforms and phenotype may lead to enhanced understanding of how apolipoproteins mediate lipid metabolism and affect atherosclerotic cardiovascular disease (ASCVD) risk, which may lead to discovery of novel markers of risk and/or key mechanistic insights that may drive further druggable targets for modifying lipid metabolism and reducing ASCVD risk.
Prenatal genetic testing 1: screening tests
Authors: Jenkins Morgan , Seasely Angela R. , Subramaniam Akila 
Published: September 2022

Purpose of review
Prenatal genetic testing can be divided into two categories: screening and diagnostic. This article will focus on reviewing prenatal genetic screening tests.

Recent findings
Cell-free DNA (cfDNA) is a new prenatal genetic screening test with a high degree of accuracy for identifying certain genetic conditions like trisomy 21, 18, and 13. However, cfDNA has also been applied in the screening of other genetic conditions without similar research support.

Summary
Prenatal genetic screening evaluates at risk pregnancies - including both carrier screening, which can be done at any point in a person's life, and aneuploidy screening, which is done during pregnancy. Within screening, there is a new noninvasive technology that has revolutionized prenatal screening called cfDNA testing. Compared to previous methods, this technology is easier to administer and more accurate for certain genetic conditions. However, cfDNA has also been applied to test for less common genetic conditions without efficacious research support. In this time of expansion in genetic testing, it is important that providers educate themselves on the research support behind each type of genetic test. It is vital that professional organizations continuously update their testing approach to match these rapidly evolving technologies and the patient population they serve.
Metabolic syndrome, obesity and cancer risk
Authors: Belladelli Federico , Montorsi Francesco , Martini Alberto 
Published: September 2022

Purpose of review
This review aims to report the latest discoveries regarding the relationship between BMI, obesity, and cancer development and treatment.

Recent findings
Obesity and metabolic syndrome relationships with cancer have been deeply investigated in the literature but their association is still debated. Currently, it has been recorded an association between BMI and endometrial, colorectal, gastric, liver, bladder, and prostate cancer. The mechanisms behind this association have also been investigated. It has been hypothesized that chronic inflammation determined by obesity may concur to the development of tumors and that Insulin Resistance may enhance cell proliferation directly or indirectly. Moreover, different studies suggest that the relationship between higher BMI and cancer may include metabolic disturbances comparable to those linked to metabolic syndrome. However, greater weight has been linked to a better overall prognosis in patients with advanced disease, a concept called the obesity paradox. This paradox has been recently investigated in the context of urological malignancies, such as bladder, prostate, and kidney cancer.

Summary
Patients’ metabolic and morphological status may impact their risk of developing different types of tumors and the response to systemic therapy. However, further research is necessary to better delineate the mechanisms behind these associations and how they could or should affect medical decision.
The underlying mechanisms of sports injuries in Paralympic Goalball – a mixed-method study
Authors: Rebai Malek , Tan Rin , Vanlandewijck Yves , Derman Wayne , Webborn Nick , Fagher Kristina 
Published: September 2022

Abstract

Objective
Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport Goalball, but the mechanisms behind have not been explored. The aims of this study were to; i) quantitatively analyze Goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, ii) qualitatively explain the differences between both Games, and iii) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball.

Design
This was a mixed-method study. Injury incidence rate (IR) were analysed from data collected during the 2012 and 2016 Paralympic Games. Then, semi-structured interviews of Games participants qualitatively explored injury mechanisms and prevention opportunities.

Results
A reduction of injuries occurred from 2012 (IR: 19.5; 95% CI 12.5- 26.5) to 2016 (IR: 5.6; 95% CI 1.7-9.5). In both Games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared to males (p = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse and poor physical conditioning. The differences between the two Games were explained by equipment, environment, and preparations.

Conclusion
The result from this study indicates that injuries in Goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context to develop prevention measures.
Improving Vitamin D Screening in a Pediatric Rheumatology Clinic Using Structured Quality Improvement Process
Authors: Sarkissian Aliese , Oberle Edward , Al Ahmed Ohoud , Piccinich Dawn , Barbar-Smiley Fatima , Zak Helen , Sivaraman Vidya 
Published: September 2022

Introduction:
Monitoring levels of 25-hydroxyvitamin D (25-OHD) is an integral part of bone health assessment in the general pediatric population, especially in at-risk populations such as children with juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (c-SLE), and juvenile dermatomyositis (JDM). However, only 38% of the patients with JIA, c-SLE, and JDM receiving care at Nationwide Children’s Hospital Rheumatology clinic in 2016 had a 25-OHD level ordered in the preceding year. The objective of this project was to increase the percentage of 25-OHD levels ordered in patients with JIA, c-SLE, and JDM from 38% to 80% in 11 months and sustain it for 6 months.

Methods:
A multidisciplinary team initiated a continuous improvement project utilizing the Lean Six Sigma methodology. The team diagrammed the clinical process and identified steps that needed improvement. In addition, the team completed a root cause analysis of the process and brainstormed subsequent countermeasures.

Results:
The team did not meet the 80% target but did order a 25-OHD level on 61% of patients by the end of the study period compared to 38% at the start of the study (P value 0.001). The level was sustained after the study period, with 68% of these children having a 25-OHD level ordered.

Conclusion:
The team successfully improved the screening processes for vitamin D deficiency in a busy subspecialty clinic setting using Lean Six Sigma methodology.
18F-FDG and 68Ga-FAPI-04 PET/CT Imaging of a Case With Immunoglobulin G4–Related Disease Presenting as Hepatic Masses
Authors: Zhang Zeyu , Jiang Hui , Zhang Lu , Cheng Chao , Zuo Changjing 
Published: September 2022

Abstract
Two hepatic masses were discovered through ultrasonography in a 50-year-old man with increased CA19-9, which is highly suspicious for malignancy. PET/CT images revealed intense 18F-FDG and 68Ga-FAPI-04 uptake in intrahepatic lesions. Histopathology with biopsy confirmed the diagnosis of immunoglobulin G4 (IgG4)–related disease. Here, we reported a case of IgG4-related primary localized pseudotumor without any other organ involvement. We concluded that in clinical work, if intrahepatic masses show high uptake of 18F-FDG or 68Ga-FAPI-04, intrahepatic IgG4-related disease should be considered for differential diagnosis.
FDG PET of Isolated Right Ventricular Sarcoidosis
Authors: Siegel Alan , Hoegemann Savellano Dagmar 
Published: September 2022

Abstract
A 62-year-old man with a history of allergic rhinitis and lightheadedness was admitted after an episode of sustained ventricular tachycardia detected by Holter monitor. A chest CT revealed peribronchial nodules, and mediastinal and hilar lymphadenopathy. The findings raised concern for sarcoidosis. MRI and FDG PET/CT were performed and revealed cardiac sarcoidosis isolated to the right ventricle only. Sarcoidosis of the right ventricle, sparing the left ventricle, is an extremely uncommon entity.
To Identify Small Bowel Metastasis From Lobular Breast Cancer on 18F-Fluoroestradiol PET/CT
Authors: Lu Yang 
Published: September 2022

Abstract
A 61-year-old woman was incidentally found to have small bowel metastasis from an undiagnosed lobular breast cancer in a workup for her acute presentation of small bowel obstruction. However, outside-hospital mammogram and breast ultrasound failed to reveal primary breast cancer. At 3.5 months postsurgery, the patient transferred her care to our hospital and received initial staging 18F-fluoroestradiol (FES) PET/CT. The occult primary right breast cancer and previously biopsied right axilla lymph node were visualized on FES PET/CT. The intense small bowel uptake of FES was initially considered as physiological; however, after readjusting the background FES level on PET, an intense focus at small bowel anastomosis site became obvious.
Understanding Nasal Valve Compromise in Nasal Airway Obstruction: A New Classification System
Authors: AlQuniabut Ibrahim , Oh Jung-Hyun , Choi Ji-Yun 
Published: September 2022

Objectives:
A key aspect of rhinoplasty is integrity of nasal valves area because of its fundamental role in patent nasal airway. furthermore, nasal obstruction is a dominant feature in patient with nasal valves dysfunction (NVD) which can be devastating outcome after rhinoplasty.

Methods:
Nonetheless, NVD has been widely investigated regarding their etiologies and management. However, it has been assumed that the anatomical complexity and interplay between its structures causing a confusion for a beginner surgeon to diagnose and treat NVD. This study was approved by the institutional review board of Chosun University Hospital, Gwangju, Korea (2022-11-005).

Results:
To date, the lack of consensus on nasal valve pathologies and corrective procedures has led to its underestimations during analysis and management. As result, we proposed a classification system based on its affected anatomical part, location, and their management. Thus, implementing a classification system for NVD will help guide the practice of rhinoplasty and introduce a more structured approach.

Conclusion:
This approach will prove useful in expanding our understanding of how important to locate the pathology of NVD and apply the most relevant management options, particularly for a beginner surgeons.

Level of Evidence:
V.
Perioperative Morbidity of Secondary Frontal Orbital Advancement After Initial Frontal Orbital Advancement
Authors: Grove Austin M. , Sitzman Thomas J. , Kurnik Nicole M. , Singh Davinder J. 
Published: September 2022

Frontal orbital advancement (FOA) is frequently performed for patients with syndromic and/or multisuture craniosynostosis. A small proportion of patients who undergo FOA have unfavorable growth and subsequently require a second FOA later in life; however, the perioperative risks associated with this second procedure are not well studied. We report results from a retrospective review of FOAs conducted from 2007 to 2022 at a single site with the same craniofacial surgeon. A total of 33 patients were included. Perioperative outcomes were compared between primary and secondary FOA procedures. The two groups were similar in regard to suture involvement and diagnosis, although the secondary FOA group was older at the time of their FOA (1.23 versus 7.07 y, P<0.001). There was no significant difference between groups in operating time, volume of blood transfusion by weight, or in the incidence of postoperative wound complications (P>0.05). Primary FOA procedures had significantly higher weight-adjusted blood loss (28 versus 18 mL/kg, P=0.014), with a higher proportion of patients receiving a blood transfusion (95% versus 62%, P=0.025). There was no significant difference between groups in the incidence of intraoperative dural injury (50% versus 84%, P=0.067). Our findings suggest that secondary procedures appear to impose less of a surgical risk relative to primary FOA traditionally performed in infancy, likely because of the advanced age at the time of secondary FOA.
The uncemented Avenir® stem covered with hydroxyapatite in a septic environment in the revision of an infected total hip arthroplasty : a report on 40 cases
Authors: Mangin Matthieu , Aouzal Zouhair , Leclerc Grégoire , Sergent Anne Pauline , Bouiller Kévin , Patry Isabelle , Garbuio Patrick 
Published: September 2022

SummaryDoes the implantation of an uncemented hydroxyapatite-coated first-line stem in a septic environment during a one-stage total hip arthroplasty revision (THAR) for periprosthetic joint infection on total hip arthroplasty provide good results in terms of healing the infection and osteointegration of the stem ?We retrospectively reviewed 40 patients operated on for septic THAR with placement of the cementless Avenir® stem - between 2008 and 2018 at the Besançon University Hospital - with a minimum follow-up of 2 years necessary to define cure in the absence of infectious recurrence. Clinical outcome was assessed using the Harris, Oxford and Merle D’Aubigné scores. Osteointegration was analyzed by the Enhg radiographic score.Mean follow-up was 4.5 years (0-11). Cure of infection was achieved in 35 of 40 (87.5%). The median Harris score was 74/100, Oxford score 45/60, and Merle d’Aubigné score 15/18. Of 37 femoral stems, 36 (97%) had radiographically stable osteointegration. An age of 80 years is a risk factor for failure of septic THAR with implantation of an uncemented stem in one stage. The cementless Avenir® stem has its place in one-stage septic THAR. It gives good results on the healing of the infection and the integration of the stem in the context of femoral bone loss rated Paprosky 1.