bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selection, Confounding, and Attrition Biases in Randomized Controlled Trials of Rehabilitation Interventions
Authors: Armijo-Olivo Susan , de Oliveira-Souza Ana Izabela Sobral , Mohamad Norazlin , de Castro Carletti Ester Moreira , Fuentes Jorge , Ballenberger Nikolaus 
Published: January 2022

Abstract
A thorough knowledge of biases in intervention studies and how they influence study results is essential for the practice of evidence-based medicine. The objective of this review was to provide a basic knowledge and understanding of the concept of biases and associated influence of these biases on treatment effects, focusing on the area of rehabilitation research. This article provides a description of selection biases, confounding, and attrition biases. In addition, useful recommendations are provided to identify, avoid, or control these biases when designing and conducting rehabilitation trials. The literature selected for this review was obtained mainly by compiling the information from several reviews looking at biases in rehabilitation. In addition, separate searches by biases and looking at reference lists of selected studies as well as using Scopus forward citation for relevant references were used. If not addressed appropriately, biases related to intervention research are a threat to internal validity and consequently to external validity. By addressing these biases, ensuring appropriate randomization, allocation concealment, appropriate retention techniques to avoid dropouts, appropriate study design and statistical analysis, among others, will generate more accurate treatment effects. Based on their impact on clinical results, a proper understanding of these concepts is central for researchers, rehabilitation clinicians, and other stakeholders working on this field.
Effects of Stroke Lesions and Timing of Rehabilitation on the Compensatory Movement Patterns During Stroke Recovery
Authors: Lee Kyoung-hee , Jeong Eun-Hwa , Joa Kyung-Lim 
Published: January 2022

Objectives
The aims of this study were to distinguish between behavioral compensation and behavioral recovery and to determine the role of stroke lesions and the optimal timing of rehabilitation in true recovery.

Design
Single pellet reaching test has been performed to analyze both quantitative and qualitative measures of forelimb function in a stroke animal model with lesions in the motor cortex, somatosensory cortex, or sensorimotor cortex. The four gestures of compensatory movement patterns that comprised a reach were head lift, limb withdrawal, pellet chasing, and phantom grasp.

Results
Functional recovery improved in all the stroke groups after rehabilitation (P < 0.001). However, the compensatory movement patterns of the motor cortex and somatosensory cortex stroke groups initially increased and subsequently decreased (P = 0.0054), whereas those of the sensorimotor cortex stroke group increased and persisted (P = 0.0063). In the sensorimotor cortex stroke group, compensatory movement patterns significantly decreased when training was initiated 5 and 14 days after stroke (P = 0.0083, P = 0.0226, respectively), while they increased and persisted when training was initiated 1 day after stroke.

Conclusions
These findings suggest that true recovery by task-specific training after stroke depends, probably, on the lesion size and the timing of rehabilitation.
From Histoanatomy to Sonography in Myofascial Pain Syndrome
Authors: Ricci Vincenzo , Ricci Costantino , Gervasoni Fabrizio , Cocco Giulio , Andreoli Arnaldo , Özçakar Levent 
Published: January 2022

Abstract
Myofascial pain is a common clinical condition, whereby accurate physical examination is usually considered as the cornerstone to identify/diagnose the “trigger point complex,” that is, the characteristic finding of this syndrome. Considering the emerging role of ultrasound examination as the natural extension of physical assessment for musculoskeletal disorders, we briefly revise the histological/anatomical features of trigger points and propose a standardized, multistep sonographic approach to myofascial pain. We also imply that the integrated clinical-ultrasound evaluation could be considered as a potential tool to discriminate different phases/subsets of this challenging pathology.
The Prevalence and Incidence of Irritable Bowel Syndrome and Inflammatory Bowel Disease in Depression and Bipolar Disorder: A Systematic Review and Meta-Analysis
Authors: Nikolova Viktoriya L. , Pelton Lucy , Moulton Calum D. , Zorzato Daniele , Cleare Anthony J. , Young Allan H. , Stone James M. 
Published: January 2022

ABSTRACT

Objective
The increased prevalence and incidence of affective disorders among patients with gastrointestinal disease have been well established. However, few studies have investigated the inverse relationship. We aimed to identify all pieces of evidence of the prevalence and incidence of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in people with depression and bipolar disorder.

Methods
We conducted a systematic review of studies reporting the association between affective disorders (exposure) and IBS or IBD (outcome) in adults. Evidence was evaluated for quality using Joanna Briggs Institute Critical Appraisal tools. Where suitable data were available, meta-analyses were performed.

Results
We identified 18 studies that met the selection criteria, of which 11 provided data on IBS, 5 on IBD, and 2 on both. Overall, people with depression were significantly more likely to have comorbid IBS (risk ratio = 2.42, 95% confidence interval = 1.98–2.96) and to develop new-onset IBS (risk ratio = 1.90, 95% confidence interval = 1.41–2.56) compared with people without depression. They were also more likely to have and develop IBD, and among patients with IBD, significantly increased rates of depression were observed as early as 5 years before diagnosis. Bipolar disorder was not consistently associated with risk of either condition.

Conclusions
People with depression are at an increased risk of both having and developing lower gastrointestinal disorders. These findings have important implications for how we understand, manage, and prevent this comorbidity in clinical practice. Further studies are needed to improve our understanding of the relationship between bipolar disorder and bowel disease as well as the role of psychotropic medication, particularly selective serotonin reuptake inhibitors.
Psychological Distress During Pregnancy and the Development of Pregnancy-Induced Hypertension: A Prospective Study
Authors: Pop Victor J.M. , Boekhorst Myrthe G.B.M. , Deneer Rianne , Oei Guid , Endendijk Joyce J. , Kop Willem J. 
Published: January 2022

ABSTRACT

Objective
Pregnancy-induced hypertension (PIH) is associated with serious complications in both the mother and the unborn child. We examined the possible association between trajectories of maternal psychological distress symptoms and PIH separately in primiparous and multiparous women.

Methods
Pregnancy-specific negative affect (P-NA) and depressive symptoms were assessed prospectively at each trimester using the Tilburg Pregnancy Distress Scale pregnancy negative affect subscale (P-NA) and the Edinburgh Depression Scale (EDS). Data on PIH were collected from medical records. Growth mixture modeling analysis was used to identify trajectories of P-NA and EDS. The independent role of P-NA and EDS symptom trajectories on developing PIH was examined using multivariate logistic regression models.

Results
One hundred (7.6%) women developed PIH and were compared with 1219 women without hypertension or other complications during pregnancy. Three P-NA trajectories were identified: low stable (reference group; 90%), decreasing (5.2%), and increasing (4.8%). The latter two classes showed persistently and significantly higher P-NA symptoms during pregnancy compared with the reference group. In multiparous women, high P-NA scores (belonging to classes 2 and 3) were related to PIH (odds ratio [OR] = 6.91, 95% confidence interval [CI] = 2.26–21.2), independent of body mass index (OR = 1.17, 95% CI = 1.06–1.27) and previous PIH (OR = 14.82, 95% CI = 6.01–32.7). No associations between P-NA and PIH were found in primiparous women. EDS trajectories were not related to PIH in both primiparous and multiparous women.

Conclusions
In multiparous women, persistently high levels of P-NA symptoms but not depressive symptoms were independently associated with development of PIH.
Is Elective Nighttime Operation Associated With Adverse Outcomes? Analysis in Immediate Tissue Expander–Based Breast Reconstruction
Authors: Kim Woo-Ju , Pyon Jai-Kyong , Mun Goo-Hyun , Bang Sa-Ik , Jeon Byung-Joon , Lee Kyeong-Tae 
Published: January 2022

Background
Despite the long-standing presumption that nighttime surgery could affect adverse outcomes, its association independent of patient’s general condition and disease severity remains unclear. We hypothesized that conducting elective surgery for subjects with good physical status at nighttime was not associated with increased risks of postoperative complications and aimed to examine it in tissue-expander-insertion (TEI) operation for breast reconstruction.

Method
Patients who underwent immediate unilateral TEI-based breast reconstruction between 2014 and 2019 were enrolled. They were categorized into 3 groups based on the starting time of the TEI operation: 8 am to 6 pm (group 1), 6 pm to 8 pm (group 2), and after 8 pm (group 3). The postoperative complication rates were compared among the groups. The independent associations of each variable, including the operation starting time and adverse outcomes, were analyzed.

Results
In total, 1458 patients were analyzed, including 970 in group 1, 358 in group 2, and 130 in group 3. The groups showed similar baseline characteristics regarding comorbidities and the American Society of Anesthesiologists classification. Compared with group 1, group 3 was associated with significantly increased rates of overall complications including infection, reoperation, and premature removal of the tissue expander. These differences retained influences in the multivariable analyses. Group 3 showed a significantly longer hospitalization period than the other 2 groups. The complication rates did not differ between groups 1 and 2.

Conclusions
Conducting TEI operation at nighttime seems to be associated with increased risks of adverse postoperative outcomes compared with conducting it during regular working hours.
Are Operating Rooms With Laminar Airflow a Risk for Inadvertent Perioperative Hypothermia During Ureterorenoscopic Lithotripsy Under Spinal Anesthesia? A Prospective Randomized Clinical Trial
Authors: Dagli Recai , Bağbancı Muhammet Şahin , Dadalı Mümtaz , Erşekerci Erol 
Published: January 2022

Objectives
Inadvertent perioperative hypothermia (IPH), defined as a core temperature <36°C, is common during a surgical procedure and is associated with high morbidity and mortality. Laminar (LAS) and conventional airflow systems (CAS) are used frequently for clean microenvironmental surgical areas in operating rooms. In LAS, the cold airflow is directed toward the patient, unlike CAS. Does this airflow in LAS cause heat loss from the patient by convection more than CAS? We aimed to compare the IPH frequencies of these airflow systems on patients who underwent ureterorenoscopic lithotripsy (ureterorenoscopic surgery) under spinal anesthesia.

Methods
The study was a prospective, parallel-group, randomized trial. A total of 246 volunteers were included in the study and divided into group LAS (n = 123) and group CAS (n = 123). Randomization of patients was performed using the closed-envelope method (as 1:1).
The tympanic membrane temperature of patients was measured before spinal anesthesia (T
0) and then every 15 minutes (Tn
) during the procedure. The IPH ratio and the change of the tympanic temperatures (Δ
T
) were recorded (clinical trial number: IRCT20180324039145N5).

Results
In total, there were no statistical differences between the IPH ratios of group LAS and group CAS (61.2% [71 of 116] versus 49.6% [57 of 115], respectively; P = 0.075). The IPH ratio was 55.4% (128 of 231). The tympanic temperatures of patients decreased about 0.64°C (0.45°C) at the 30th minute. In both groups, Δ30 was similar (0.62; 95% confidence interval, 0.52–0.72 [P = 0.65]; 95% confidence interval, 0.55–0.74 [P = 0.236], respectively).

Conclusions
The risk for IPH of both LAS and CAS in the operating room is similar during ureterorenoscopic surgery.
Fibroblast Activation Protein Inhibitor Imaging and Therapy in a Patient With Multiple Endocrine Neoplasia Type 2A Syndrome
Authors: Barashki Somaye , Divband Ghasemali , Askari Emran , Amini Hamidreza , Aryana Kamran 
Published: January 2022

Abstract
A patient with multiple endocrine neoplasia type 2A syndrome who had exhausted several surgeries and radiotherapy was referred to nuclear medicine department for theranostic approaches. [68Ga]-DOTATATE PET/CT and [131I]I-mIBG SPECT/CT were performed, but the degree of uptake was insufficient for using the treatment companion of these tracers. Finally, 1 year later, [68Ga]-FAPI-46 PET/CT showed progressive disease with metastases to the lung, liver, bone, and lymph nodes with intense [68Ga]-FAPI-46 uptake. Treatment with [177Lu]Lu-FAPI-46 was done, and the patient tolerated treatment and showed evidence of clinical improvement following therapy.
68Ga-PSMA PET/CT Scan Leading to Diagnosis of PSMA-Positive Rectal Adenocarcinoma in a Patient With Prostate Cancer
Authors: Norouzi Ghazal , Rezaei Alireza , Adinehpour Zohreh , Amini Hamidreza , Vali Reza 
Published: January 2022

Abstract
A 59-year-old prostate cancer patient, status post radical prostatectomy, was referred to our department for restaging with 68Ga–prostate-specific membrane antigen (PSMA) PET/CT scan. Aside multiple metastatic lesions involving pelvic lymph nodes as well as the right femoral trochanter, a PSMA-positive rectal wall thickening was detected. Colonoscopy correlation and tissue diagnosis, recommended to rule out accompanying primary malignancy, confirmed the presence of rectal adenocarcinoma. This case signifies the importance of requesting pathological correlation for unexplained PSMA-positive lesions, emphasizing the potential role PSMA ligands may play in detecting occult second primary malignancies, especially synchronous/metachronous colorectal cancers.
Primary Adrenal Sarcomatoid Carcinoma Detected by 18F-FDG PET/CT
Authors: Zhang Jinxin , Gong Weidong , Zhang Wenwen , Zhang Chunyin , Zhang Guoxu 
Published: January 2022

Abstract
Adrenal sarcomatoid carcinoma is extremely rare. A 53-year-old man was admitted to our hospital due to pain in the upper right abdomen for 1 month. Abdominal CT revealed a huge mass in the right adrenal gland, and a malignancy was suspected. 18F-FDG PET/CT showed a mass in the right adrenal gland with intense FDG uptake. Finally, postoperative pathology confirmed the diagnosis of adrenal sarcomatoid carcinoma.
First-in-Human Intrathoracic Implantation of Multidrug-Eluting Microdevices for In Situ Chemotherapeutic Sensitivity Testing as Proof of Concept in Nonsmall Cell Lung Cancer
Authors: Tsai Lillian L. , Phillips William W. , Hung Yin P. , Dominas Christine , Deans Kyle , Ahn Sebastian , Ferland Benjamin , Weiss Kathleen , Lanuti Michael , Auchincloss Hugh , Schumacher Lana , Jonas Oliver , Colson Yolonda L. 
Published: January 2022

Objective:
To evaluate the safety and feasibility of implantation and retrieval of a novel implantable microdevice (IMD) in NSCLC patients undergoing operative resection.

Background:
Adjuvant therapy has limited impact on postsurgical outcomes in NSCLC due to the inability to predict optimal treatment regimens.

Methods:
An IMD measuring 6.5 mm by 0.7 mm, containing micro-reservoirs allowing for high-throughput localized drug delivery, was developed and loaded with 12 chemotherapeutic agents. Five patients with peripheral lung lesions larger than 1.0 cm were enrolled in this phase 1 clinical study. IMDs were inserted into tumors intraoperatively under direct vision, removed with the resected specimen, and retrieved in pathology. Surrounding tissues were sectioned, stained, and analyzed for tissue drug response to the IMD-delivered microdoses of these agents by a variety of pharmacodynamic markers.

Results:
A total of 14 IMDs were implanted intraoperatively with 13 (93%) successfully retrieved. After technique refinement, IMDs were reliably inserted and retrieved in open, Video-Assisted Thoracoscopic Surgery, and robotic cases. No severe adverse reactions were observed. The one retained IMD has remained in place without movement or any adverse effects. Analysis of patient blood revealed no detection of chemotherapeutic agents. We observed differential sensitivities of patient tumors to the drugs on the IMD.

Conclusions:
A multi-drug IMD can be safely inserted and retrieved into lung tumors during a variety of surgical approaches. Future studies will encompass preoperative placement to better examine specific tumor responsiveness to therapeutic agents, allowing clinicians to tailor treatment regimens to the microenvironment of each patient.
Advanced bleeding control in combat casualty care: An international, expert-based Delphi consensus
Authors: Vrancken Suzanne M. , Borger van der Burg Boudewijn L.S. , DuBose Joseph J. , Glaser Jacob J. , Hörer Tal M. , Hoencamp Rigo 
Published: January 2022

BACKGROUND
Hemorrhage from truncal and junctional injuries is responsible for the vast majority of potentially survivable deaths in combat casualties, causing most of its fatalities in the prehospital arena. Optimizing the deployment of the advanced bleeding control modalities required for the management of these injuries is essential to improve the survival of severely injured casualties. This study aimed to establish consensus on the optimal use and implementation of advanced bleeding control modalities in combat casualty care.

METHODS
A Delphi method consisting of three rounds was used. An international expert panel of military physicians was selected by the researchers to complete the Delphi surveys. Consensus was reached if 70% or greater of respondents agreed and if 70% or greater responded.

RESULTS
Thirty-two experts from 10 different nations commenced the process and reached consensus on which bleeding control modalities should be part of the standard equipment, that these modalities should be available at all levels of care, that only trained physicians should be allowed to apply invasive bleeding control modalities, but all medical and nonmedical personnel should be allowed to apply noninvasive bleeding control modalities, and on the training requirements for providers. Consensus was also reached on the necessity of international registries and guidelines, and on certain indications and contraindications for resuscitative endovascular balloon occlusion of the aorta (REBOA) in military environments. No consensus was reached on the role of a wound clamp in military settings and the indications for REBOA in patients with chest trauma, penetrating axillary injury or penetrating neck injury in combination with thoracoabdominal injuries.

CONCLUSION
Consensus was reached on the contents of a standard bleeding control toolbox, where it should be available, providers and training requirements, international registries and guidelines, and potential indications for REBOA in military environments.
Influence of Calcineurin Inhibitor Choice on Outcomes in Kidney Transplant Recipients Aged ≥60 Y: A Collaborative Transplant Study Report
Authors: Echterdiek Fabian , Döhler Bernd , Latus Joerg , Schwenger Vedat , Süsal Caner 
Published: January 2022

Background.
Patients aged ≥60 y represent the fastest growing population among kidney transplant recipients and waitlist patients. They show an elevated infection risk and are frequently transplanted with multiple human leukocyte antigen mismatches. Whether the choice of calcineurin inhibitor influences graft survival, mortality, or key secondary outcomes such as infections in this vulnerable recipient population is unknown.

Methods.
A total of 31 177 kidney transplants from deceased donors performed between 2000 and 2019 at European centers and reported to the Collaborative Transplant Study were analyzed using multivariable Cox and logistic regression analyses. All recipients were ≥60 y old and received tacrolimus (Tac) or cyclosporine A on an intention-to-treat basis, combined with mycophenolic acid or azathioprine plus/minus steroids.

Results.
The risk of 3-y death-censored graft loss and patient mortality did not differ significantly between Tac- and cyclosporine A-treated patients (hazard ratio 0.98 and 0.95, P = 0.74 and 0.20, respectively). No difference was found in the overall risk of hospitalization for infection (hazard ratio = 0.95, P = 0.19); however, a lower incidence of rejection treatment (hazard ratio = 0.81, P < 0.001) was observed in Tac-treated patients. Assessment of pathogen-specific hospitalizations revealed no difference in the risk of hospitalization due to bacterial infection (odds ratio = 1.00, P = 0.96), but a significantly higher risk of hospitalization due to human polyomavirus infection was found among Tac-treated patients (odds ratio = 2.45, P = 0.002). The incidence of de novo diabetes was higher for Tac-based immunosuppression (odds ratio = 1.79, P < 0.001).

Conclusions.
Calcineurin inhibitor selection has no significant influence on death-censored graft survival, mortality, and overall infection risk in ≥60-y-old kidney transplant recipients.
Neuropathology and epilepsy surgery
Authors: Hoffmann Lucas , Blümcke Ingmar 
Published: January 2022

Purpose of review
Neurosurgical treatment of patients suffering from drug-resistant focal epilepsy is recognized as a successful, yet underutilized medical treatment option. By searching PubMed for articles published between January 2020 and September 2021 with the broad search terms ‘neuropathology’ AND ‘epilepsy surgery’, this review highlights the active field of etiology-based epilepsy research in human tissue.

Recent findings
All papers addressing the most common epileptogenic human brain disease entities, i.e. focal cortical dysplasia (FCD), brain tumors or hippocampal sclerosis, and written in English language were eligible for our review. We can conclude from this review that etiology-based studies are of foremost interest for (1) the development of prediction models for postsurgical seizure outcome; (2) decipher genetic and molecular alterations to better define disease entities and underlying molecular pathomechanisms, and (3) the translation of human tissue-derived biomarker into clinically useful diagnostics or novel therapeutic targets in the near future.

Summary
Highlighting FCD brain somatic gain-of-function variants in mammalian target of Rapamycin are a leading pathway to better classify FCD. An integrated genotype-phenotype analysis enables to classify the broad spectrum of low-grade and epilepsy-associated brain tumors. Further DNA-methylation-based disease classification will increase the mechanistic understanding and diagnostic precision of difficult to classify pathologies in the future.