bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Frailty on Treatment Outcome in Nongeriatric Patients With Head and Neck Cancer and Esophageal Cancer Undergoing Curative-Intent Concurrent Chemoradiotherapy
Authors: Chou Wen-Chi , Lai Cheng-Chou , Hung Chia-Yen , Hsueh Shun-Wen , Yeh Kun-Yun , Lu Chang-Hsien , Tsang Ngan-Ming , Chang Pei-Hung , Ho Ya-Wen , Chen Shih-Ying , Lin Yu-Ching , Hung Yu-Shin 
Published: January 2022

Background Whether the prevalence of frailty and its clinical significance are relevant to treatment outcomes in younger (aged < 65 years) cancer patients remains uncertain. This study aimed to evaluate the impact of frailty on treatment outcomes in younger cancer patients with head and neck and esophageal malignancy. Material and methods This multicenter prospective study recruited 502 patients with locally advanced head and neck and esophageal cancer during 2016–2017 in Taiwan, aged 20–64 years who received curative-intent concurrent chemoradiotherapy (CCRT) as first-line antitumor treatment. Baseline frailty assessment using geriatric assessment (GA) was performed for each patient within 7 days before CCRT initiation. Results Frailty was observed in 169 (33.7%) of 502 middle-aged patients. Frail patients had significantly higher incidences of chemotherapy incompletion (16.6% versus 3.3%, P < .001) and radiotherapy incompletion (16.6% versus 3.6%, P < .001) than fit patients. During CCRT, frail patients had a significantly higher percentage of hospitalizations (42.0% versus 24.6%, P < .001) and a trend toward a higher percentage of emergency room visits (37.9% versus 30.0%, P = .08) than fit patients. Frail patients more likely had a significantly higher incidence of grade ≥ 3 adverse events than fit patients during CCRT. The 1-year survival rate was 68.7% and 85.2% (hazard ratio 2.56, 95% confidence interval 1.80–3.63, P < .001) for frail and fit patients, respectively. Conclusions This study demonstrated the significance of pretreatment frailty on treatment tolerance, treatment-related toxicity, and survival outcome in younger patients with head and neck and esophageal cancer undergoing CCRT. While GA is commonly targeted toward the older population, frailty assessment by GA may also be utilized in younger patients for decision-making guidance and prognosis prediction.
Impact of Homoarginine on Myocardial Function and Remodeling in a Rat Model of Chronic Renal Failure
Authors: Koch Vitali , Weber Christophe , Riffel Johannes H. , Buchner Kristina , Buss Sebastian J. , Hein Selina , Mereles Derliz , Hagenmueller Marco , Erbel Christian , März Winfried , Booz Christian , Albrecht Moritz H. , Vogl Thomas J. , Frey Norbert , Hardt Stefan E. , Ochs Marco 
Published: January 2022

Purpose: Low plasma concentrations of the amino acid homoarginine (HA) have been shown to correlate with adverse cardiovascular outcome, particularly in patients with chronic kidney disease. The present study sought to investigate the effect of HA treatment on cardiac remodeling in rats undergoing artificially induced renal insufficiency by 5/6 nephrectomy (5/6 Nx). Methods: A total of 33 male Wistar rats were randomly divided into sham and 5/6 Nx groups, receiving either placebo treatment or 400 mg·kg−1·day−1 HA over a 4-week period. Results: 5/6 Nx per se resulted in adverse myocardial remodeling with aggravated cardiac function and associated cardiac overload as the most obvious alteration (−23% ejection fraction, P < 0.0001), as well as increased myocardial fibrosis (+80%, P = 0.0005) compared to placebo treated sham animals. HA treatment of 5/6 Nx rats has led to an improvement of ejection fraction (+24%, P = 0.0003) and fractional shortening (+21%, P = 0.0126), as well as a decrease of collagen deposition (−32%, P = 0.0041), left ventricular weight (−14%, P = 0.0468), and myocyte cross-sectional area (−12%, P < 0.0001). These changes were accompanied by a downregulation of atrial natriuretic factor (−65% P < 0.0001) and collagen type V alpha 1 chain (−44%, P = 0.0006). Sham animals revealed no significant changes in cardiac function, myocardial fibrosis, or any of the aforementioned molecular changes after drug treatment. Conclusion: Dietary HA supplementation appears to have the potential of preventing cardiac remodeling and improving heart function in the setting of chronic kidney disease. Our findings shed new light on HA as a possible new therapeutic agent for patients at high cardiovascular risk.
Lateral tarsal strip through osteotomies for recurrent ectropion and eyelid laxity correction
Authors: Mora Amparo M , Córdoba Carlos M , Padilla Fabio D , Duran Diego F 
Published: January 2022

Objective to present a surgical technique for treating patients with recurrent ectropion and severe lower eyelid laxity. Methods Lateral tarsal strip and canthal fixation by osteotomy was performed in 6 patients with recurrent ectropion and 1 patient with extreme lower eyelid laxity secondary to an anophthalmic socket. Preoperative and postoperative photographs were evaluated in order to assess the outcomes of the procedure. Patients were followed up 4 weeks, 6 months, 12 months and 24 months of the postoperative period. The initial symptoms of the patients were eye redness, epiphora, foreign body sensation, aesthetic complaints, and facial asymmetry. Symptoms and aesthetic results were assessed by questioning, photographs, and fluorescein and lissamine green stains taken in each visit. Results No postoperative complications were observed. No recurrence episodes were reported during the follow-up period and physical appearance improvement and symptom severity reduction were maintained during the observation. Conclusion Lateral tarsal strip through osteotomies is an effective surgical procedure for treating severe recurrent ectropion cases or lower eyelid laxity and could be considered as an alternative treatment option or even a primary surgical technique in selected difficult cases.
Cardiac implications of upper-arm arteriovenous fistulas: A case series
Authors: Pucchio Aidan , McIntyre Christopher , Lok Charmaine , Moist Louise 
Published: January 2022

Background: Cardiovascular disease is a major cause of morbidity and mortality in patients with end-stage kidney disease. Arterio-venous fistulas (AVF), the gold standard for hemodialysis vascular access, are known to alter cardiac morphology and circulatory hemodynamics. We present a prospective case series of patients after creation of an AVF, explore the timeline for changes in their cardiac morphology, and detail considerations for clinicians. Methods: Patients were recruited in 2010 at multiple centers immediately prior to the creation of an upper-arm AVF and the initiation of hemodialysis. Cardiovascular magnetic resonance images were taken at intake before the creation of the AVF, 6-month follow-up, and 12-month follow-up. Image segmentation was used to measure left ventricular volume and mass, left atrial volume, and ejection fraction. Results: Eight patients met eligibility criteria. All eight patients had a net increase in left ventricular mass over enrollment, with a mean increase of 9.16 g (+2.96 to +42.66 g). Five participants had a net decrease in ejection fraction, with a mean change in ejection fraction of −5.4% (−21% to +5%). Upon visual inspection the patients with the largest ejection fraction decrease had noticeably hypertrophic and dilated ventricles. Left atrial volume change was varied, decreasing in five participants, while increasing in three participants. Changes in morphology were present at 6-month follow-up, even in patients who did not maintain AVF patency for the entirety of the 6-month period. Conclusion: All patients included in this prospective case series had increases in left ventricular mass, with variability in the effects on the ejection fraction and left atrial volume. As left ventricular mass is an independent predictor of morbidity and mortality, further research to determine appropriate vascular access management in both end-stage kidney disease and kidney transplant populations is warranted.
Immunoglobulin G immune response to SARS-CoV-2 vaccination in people living with multiple sclerosis within Multiple Sclerosis Partners Advancing Technology and Health Solutions
Authors: Cohen Jeffrey A , Bermel Robert A , Grossman Cynthia I , Hersh Carrie M , Hyland Megan , Mowry Ellen M , Naismith Robert , Naylor Maria L , Nicholas Jacqueline , Rajbhandar Rajani , Singh Carol M , Tintorè Mar , Zabalza Ana , Ziemssen Tjalf , Williams James R , Montalban Xavier 
Published: January 2022

Background: The impact of multiple sclerosis (MS) disease-modifying therapies (DMTs) on SARS-CoV-2 vaccination response is uncertain. Methods: Post-SARS-CoV-2 vaccination blood samples across multiple DMTs were tested for SARS-CoV-2 immunoglobulin G (IgG) response. Results: Three hundred twenty-two people with MS were included; 91.9% received an mRNA vaccine. Post-vaccination reactive IgG rates (IgG index > 1) were 40% for anti-CD20 (32/80 patients); 41% for sphingosine 1-phosphate receptor modulators (S1PRM, 16/39); and 100% for all other classes, including the no DMT group. Conclusion: Anti-CD20 therapies and S1PRMs reduce IgG response to SARS-CoV-2 vaccination; IgG response is preserved with other DMTs.
Iterative redesign of a caregiver-mediated intervention for use in educational settings
Authors: Bearss Karen , Tagavi Daina , Lyon Aaron R , Locke Jill 
Published: January 2022

Teachers endorse disruptive behavior as a considerable concern for autistic students, which is compounded by the lack of adequate resources for behavioral intervention planning in the classroom. The RUBI program is an evidence-based, low-intensity manualized intervention, initially developed for parents of autistic children ages 3–14 and co-occurring disruptive behavior. Utilizing the Discover, Design/Build, Test (DDBT) framework, which combines user-centered design and implementation science, RUBI intervention content was collaboratively and iteratively redesigned with elementary school stakeholders (40 school staff from 28 schools) to ensure the feasibility, acceptability, and appropriateness of the redesigned intervention, RUBI in Educational Settings (RUBIES). Iterative quantitative and qualitative methods were conducted with stakeholders to identify targets for RUBI redesign. Conventional content analysis was used to code qualitative data and identify usability issues. Recommendations were provided for modifications to RUBI sessions to address the needs of the school context and end-users to develop RUBIES. Feasibility scores improved following the redesign. The use of the DDBT framework to redesign the RUBI intervention may promote greater usefulness and usability in school contexts. Lay abstract Teachers often report concerns about behavior challenges in their students with autism spectrum disorder (ASD) in the school setting. Furthermore, teachers often report that they do not have adequate training in how to manage these challenging behaviors effectively. The RUBI program is an intervention initially developed for parents of children with ASD and co-occurring challenging behavior in clinic settings. The present project used school staff input to systematically redesign RUBI to be used with educators in schools. School staff gave input at multiple stages of development to ensure the adapted intervention was appropriate to use in a school setting. Responses were coded and analyzed to identify strengths and weaknesses of the RUBI manual in schools and adaptations were made accordingly. Scores of how appropriate, possible, likable, and usable RUBI would be in schools rose after the intervention was redesigned. The redesigned RUBIES manual may give school staff the tools they need to manage disruptive behaviors. In addition, collaborating with providers over multiple stages to redesign established interventions for new contexts may be a promising way to help bring research tools to practice in the future.
Investigation of code-switching cost in conversation and self-paced reading tasks
Authors: Faroqi-Shah Yasmeen , Wereley Sophie 
Published: January 2022

Aims and objectives: Studies of code-switching (CS) in bilingual speakers using laboratory tasks have been equivocal on whether CS is cognitively demanding. The goal of this study was to examine time costs at the juncture of a CS in a more ecologically valid experimental paradigm. Methodology: English (L1)–French (L2) bilingual speakers performed two tasks. The primary experimental task was a novel paradigm that elicited voluntary code-switches in conversation with a bilingual interlocutor. A silent self-paced reading task was used to compare with a laboratory task with involuntary switches. Data and analysis: Intersyllabic durations (conversation task) and reading times (reading task) were analyzed. CS cost was the time difference between code-switches and matched non-switches. Cost-switching costs for each switch direction (English-to-French and French-to-English) and type of switch (alternations and insertions) were also compared. Findings: Code-switches in conversation were associated with a time cost, and the magnitude was comparable in both directions although speakers more frequently switched from French-to-English. In self-paced reading, switching costs were observed only for switches into the dominant language. Across both tasks, there were no differences in CS time cost between insertions and alternations. Originality: This study reports a novel measure of CS costs in conversation, intersyllabic duration, and provides a cross-task comparison in the same group of bilingual speakers to better inform theories of CS. Implications: Bilingual speakers experience a time cost when making voluntary switches in conversations. The symmetrical switch costs suggest that both languages have similar activation levels throughout the conversation, and the cognitive costs arise from the act of momentarily switching languages, irrespective of their dominance. In self-paced reading, cognitive costs arise from disturbing the status quo of relative activation-inhibition of each language adopted to perform the task. The comparable CS time cost for insertions and alternations suggests similar cognitive control and linguistic planning mechanisms for both types of switches.
Endovascular Treatment of Renal Artery Thrombosis in Living-Donor Kidney Transplant Recipient With Severe COVID-19 Disease
Authors: Veterano Carlos , Antunes Inês , Coelho Andreia , Silva Ivone , Almeida Rui , Pinto Pedro Sá 
Published: January 2022

Purpose: Coronavirus disease 2019 (COVID-19) patients have a higher prevalence of micro-and macrovascular thrombotic events. However, the underlying mechanism for the increased thrombotic risk is not completely understood. Solid organ transplant recipients infected with SARS-CoV-2 may have an exponential increase in thrombotic risk and the best management strategy is unknown. Case Report: A female kidney transplant recipient presented with allograft’s renal artery thrombosis after a recent COVID-19 infection. Due to the risk of kidney failure or exclusion, catheter directed thrombolysis was performed. Residual thrombus was excluded using an endoprosthesis with an excellent result. There were no adverse events and kidney function improved. Conclusion: This paper reports the endovascular treatment of renal artery thrombosis in a living-donor kidney transplant recipient with severe COVID-19 disease.
Investigation of Chemopreventive and Antiproliferative Potential of Dicliptera roxburghiana
Authors: Ahmad Bushra , Khan Muhammad Rashid , Shah Naseer Ali , Kondratyuk Tamara P. , Ahmed Nadeem , Pezzuto John M. , Gul Asma , Khattak Aishma 
Published: January 2022

Context: Carcinogenesis causes much human misery. It is a process involving multistage alterations. Medicinal plants are candidates for beneficial anticancer agents. Objectives: Investigation of anticancer proficiencies of the plant Dicliptera roxburghiana. Material and methods: Crude extract and derived fractions were inspected for their inhibitory potential against nuclear factor KB (NFκB), nitric oxide synthase inhibition, aromatase inhibition and induction of quinone reductase 1 (QR 1). Antiproliferative activity was determined by using various cancer cell lines for example hormone responsive breast cancer cell line MCF-7, estrogen receptor negative breast cancer cell line MDA-MB-231, murine hepatoma cells Hepa 1c1c7, human neuroblastoma cells SK-N-SH and neuroblastoma cells MYCN-2. Results: Ethyl acetate and n-butanol fractions of D. roxburghiana were strongly active against NFκB with IC50 of 16.6 ± 1.3 and 8.4 ± 0.7 µg/ml respectively with 100% survival. Chloroform fraction of the plant exhibited an induction ratio of 2.4 ± 0.09 with CD value of 17.7 µg/ml. Regarding the nitrite assay, the n-hexane fraction exhibited significant inhibition of NO activity with IC50 of 17.8 ± 1.25 µg/ml. The n-butanol fraction exhibited strong antiproliferative activity against IcIc-7 cell lines with IC50 values of 13.6 ± 1.91 µg/ml; against MYCN-2 a cytotoxic effect developed with dose dependence, with IC50 of 12.6 ± 1.24 µg/ml. In antiproliferative activity against SK-N-SH cell lines, chloroform, ethyl acetate and n-butanol fractions were efficiently active with IC50 values of 11.2 ± 0.84, 14.6 ± 1.71 and 16.3 ± 1.57 respectively. Discussion and Conclusion: It was demonstrated that various fractions of D. roxburghiana displayed appreciable anticancer characteristics and could be a potent source for the development of anticancer leads.
Magnetic Resonance Imaging to Investigate the Clinical Applicability of the Medial Femoral Trochlea Osteochondral Flap Within the Wrist
Authors: Daruwalla Jimmy H. , Skrok Jan , Pet Mitchell A. , Giladi Aviram M. , Higgins James P. 
Published: January 2022

Background: The medial femoral trochlea (MFT) osteochondral flap is employed for reconstruction of unsalvageable scaphoid proximal pole nonunions. The convex surface of the cartilage-bearing proximal trochlea is used to replace the similarly contoured proximal scaphoid and articulate with the concave scaphoid fossa of the radius. A magnetic resonance imaging (MRI) comparison of the shape of the MFT as it relates to the native proximal scaphoid has not been previously performed. Our study aimed to quantifiably compare the shape of the MFT, proximal scaphoid, and scaphoid fossa. Methods: Using imaging processing software, we measured radius of curvature of the articular segments in MRI scans of 10 healthy subjects’ wrists and knees. Results: Compared with the scaphoid fossa, average ratio of the radius of circumference of the proximal scaphoid was 0.79 and 0.78 in the coronal and sagittal planes, respectively. Compared with the scaphoid fossa, average ratio of the radius of circumference of the MFT was 0.98 and 1.31 in the coronal and sagittal planes, respectively. The radius of curvature of the MFT was larger than the proximal scaphoid, in the coronal and sagittal planes. In the coronal plane, the MFT radius of curvature is nearly identical to the scaphoid fossa, a closer match than the scaphoid itself. In the sagittal plane, the radius of curvature of the MFT was larger than the radius of curvature of the scaphoid fossa. Conclusions: Our data suggest that the radius of curvature, in the sagittal and coronal planes, of the MFT and proximal scaphoid is disparate.
Prescription Opioids and Patient-Reported Outcomes and Satisfaction After Carpal Tunnel Release Surgery
Authors: Shetty Pragna N. , Sanghavi Kavya K. , Mete Mihriye , Giladi Aviram M. 
Published: January 2022

Background: Amount of opioid use correlates poorly with procedure-related pain; however, prescription limits raise concerns about inadequate pain control and impacts on patient-reported quality indicators. There remain no consistent guidelines for postoperative pain management after carpal tunnel release (CTR). We sought to understand how postoperative opioid use impacts patient-reported outcomes after CTR. Methods: This is a pragmatic cohort study using prospectively collected data from all adult patients undergoing uncomplicated primary CTR over 17 months at our center. Patients were categorized as having received or not received a postoperative opioid prescription, and then as remaining on a prescription opioid at 2-week follow-up or not. Questionnaires were completed before surgery and at 2-week follow-up. We collected brief Michigan Hand questionnaire (bMHQ) score, Patient-Reported Outcomes Measurement Information System Global Health score, satisfaction, and pain score. Results: Of 505 included patients, 405 received a postoperative prescription and 67 continued use at 2-weeks. These 67 patients reported lower bMHQ, lower satisfaction, and higher postoperative pain compared to those that discontinued. Multivariable regressions showed that receiving postoperative prescriptions did not significantly influence outcomes or satisfaction. However, remaining on the prescription at 2 weeks was associated with significantly lower bMHQ scores, particularly in patients reporting less pain. Conclusions: Patients remaining on a prescription after CTR reported worse outcomes compared to those who discontinued. Unexpectedly, the widest bMHQ score gap was seen across patients reporting lowest pain scores. Further research into this high-risk subgroup is needed to guide policy around using pain and patient-reported outcomes as quality measures. Level of Evidence: Level III.
Initiation of hemodialysis at one month following fistulogram in patients with advanced kidney disease
Authors: Wilson Eelin , Sacknovitz Yoni , Dalmia Varun , Sanon Omar , Hatch Ayesha , Dauer Marc , Scher Larry , Lipsitz Evan , Koleilat Issam 
Published: January 2022

Objective Previous studies have demonstrated that low contrast volume used in access-related interventions had limited effects on the progression of chronic kidney disease (CKD) after fistulography, but studies are limited and heterogeneous. We sought to evaluate the rate of and factors associated with progression to dialysis (HD) within 1 month after fistulography for patients with advanced CKD. Methods A single-institution retrospective cohort analysis of patients with CKD stage IV and V, not yet on HD, undergoing fistulography from 1 January 2014 to 31 December 2018 was performed. The primary outcome was progression to HD within 1 month. Additional variables and the association with the primary outcome such as medical comorbidities, contrast type or volume were assessed. Results A total of 34 patients underwent 41 fistulograms prior to HD initiation. Progression to HD within 1 month of fistulogram occurred in seven patients (all CKD V). The mean time between fistulogram and HD was 271 days for 31 of 34 patients who ultimately progressed to HD. Those with CKD IV began HD in 549 days on average, while those with CKD V began HD in 190 days on average. Three patients had not initiated HD at a mean of 539 days of follow-up. The only factors associated with progression to HD within 1 month included use of isovue ( p = .005) and elevated contrast volume, with a mean of 40 mL ( p = .027). Conclusion Although none of the patients with CKD IV required HD within 1 month after fistulogram, the use of larger iodinated contrast volume was associated with progression to HD within 1 month of fistulography for patients with CKD V. Further studies should investigate the safety of iodinated and alternative (e.g., carbon dioxide) contrast media in fistulography or duplex-based HD access procedures for CKD patients, especially CKD V, not yet on HD.