bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Breast Magnetic Resonance Imaging as a Predictor of Response to Neoadjuvant Chemotherapy
Authors: Browne Robert , McAnena Peter , O’Halloran Niamh , Moloney Brian M , Crilly Emily , Kerin Michael J , Lowery Aoife J 
Published: June 2022

Introduction: The ability to accurately predict pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer would improve patient selection for specific treatment strategies, would provide important information for patients to aid in the treatment selection process, and could potentially avoid the need for more extensive surgery. The diagnostic performance of magnetic resonance imaging (MRI) in predicting pCR has previously been studied, with mixed results. Magnetic resonance imaging performance may also be influenced by tumour and patient factors. Methods: Eighty-seven breast cancer patients who underwent NAC were studied. Pre-NAC and post-NAC MRI findings were compared with pathologic findings postsurgical excision. The impact of patient and tumour characteristics on MRI accuracy was evaluated. Results: The mean (SD) age of participants was 48.7 (10.3) years. The rate of pCR based on post-NAC MRI was 19.5% overall (19/87). The sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy in predicting pCR were 52.9%, 77.1%, 36.0%, 87.1%, and 72.4%, respectively. Positive predictive value was the highest in nonluminal versus Luminal A disease (45.0% vs 25.0%, P < .001), with higher rates of false positivity in nonluminal subtypes ( P = .002). Tumour grade, T category, and histological subtype were all independent predictors of MRI accuracy regarding post-NAC tumour size. Conclusion: Magnetic resonance imaging alone is insufficient to accurately predict pCR in breast cancer patients post-NAC. Magnetic resonance imaging predictions of pCR are more accurate in nonluminal subtypes. Tumour grade, T category, and histological subtype should be considered when evaluating post-NAC tumour sizes.
Chronic Uptake of A Probiotic Nutritional Supplement (AB001) Inhibits Absorption of Ethylalcohol in the Intestine Tract – Results from a Randomized Double-blind Crossover Study
Authors: Pfützner Andreas , Hanna Mina , Andor Yuriko , Sachsenheimer Daniela , Demircik Filiz , Wittig Tobias , de Faire Johan 
Published: June 2022

Background: Regular alcohol consumption, e.g. by social drinking, is a potential source of consecutive health problems in many countries worldwide. A probiotic nutritional supplement (AB001) has been developed to reduce alcohol absorption from the intestine tract and to mitigate potential health care risks. Methods: This randomized placebo-controlled double-blind crossover study was conducted with 24 healthy subjects (13 male, 11 female, age: 25.4 ± 7.7 years, BMI: 23.6 ± 2.5 kg/m²). The subjects were randomized to take 2 capsules/day of AB001 or placebo for 1 week prior to an alcohol exposure experiment. On the experimental day, they ingested a light breakfast and drank a moderate glass of spirit (0.3 g/kg body weight). Breath alcohol tests and blood draws for determination of blood alcohol levels were performed for up to 6 hours. After crossover, the experiment was repeated in the following week. Areas under the curves were calculated to determine alcohol absorption rates. Results: A significant reduction of blood alcohol levels by 70.3% ( P < 0.005 vs. placebo) was seen with AB001, (breath test: −30.7%; P < 0.005 vs. placebo). No difference was seen in a cognitive function test performed 60 minutes after alcohol ingestion (22.4 ± 7.7 seconds vs. 22.7 ± 5.6 seconds, n.s.). There were no adverse events or serious adverse events reported in this study Conclusions: One week of supplementation with AB001 resulted in a substantially reduced absorption of alcohol into the body. Regular uptake of AB001 may help to prevent liver and other organ damage, and may reduce the negative medical and economical impact of social drinking on the individual and the society.
Combination of Palliative Thoracic Radiotherapy With Bevacizumab for Stage IV Nonsquamous NSCLC: Is There Any Impact of Time Interval on Survival?
Authors: Xiu Weigang , Guo Xiaotong , Yu Min , Li Yanying , Xu Yong , Zhu Jiang , Luo Jingjing 
Published: June 2022

Background: The time interval between palliative thoracic radiotherapy and bevacizumab treatment strongly influences the frequency of adverse events (AEs) when both are concurrently applied to patients with advanced lung cancer. Herein, we aimed to elucidate the optimal time interval between the treatments in these patients. Methods: The medical records of patients with stage IV nonsquamous non–small-cell lung cancer (NSCLC) without epidermal growth factor receptor and anaplastic lymphoma kinase alteration who underwent palliative thoracic radiotherapy and bevacizumab treatment from January 2008 to January 2020 were collected and analyzed. Patients were divided into 2 groups based on the time interval between treatments: <3 weeks (⩽3W group) and >3 weeks (>3W group). The progression-free survival (PFS) and overall survival (OS) for the time intervals were evaluated using the Kaplan-Meier method and Cox proportional hazard models. Adverse events were assessed by the fifth version of the Common Terminology Criteria for Adverse Events. Results: In total, 72 patients with stage IV NSCLC (⩽3W group, 37 patients; >3W group, 35 patients) who concurrently or sequentially received palliative thoracic radiotherapy and bevacizumab treatment were included in this study. In the >3W and ⩽3W groups, the median PFS (8 vs 6 months, respectively) and OS (15 vs 12 months, respectively) differed significantly. Multivariate analyses findings revealed significantly shorter OS in the latter group. In addition, the frequency of most AEs was marginally higher in the latter group ( P > .05). Conclusions: The time interval between palliative thoracic radiotherapy and bevacizumab treatment that offers optimal safety is >3 weeks.
Incidence of parastomal and incisional hernia following emergency surgery for Hinchey III-IV diverticulitis: A systematic review
Authors: Mäkäräinen Elisa , Rautio Tero , Rintala Jukka , Muysoms Filip , Kauppila Joonas H. 
Published: June 2022

Purpose: The aim of this systematic review was to evaluate the risk of parastomal (PSH) and incisional hernias (IH) after emergency surgery for Hinchey III–IV diverticulitis, with comparison between the Hartmann procedure and other surgical techniques. Methods: The Cochrane Library, Embase, PubMed (MEDLINE), Web of Science and Scopus databases were systematically searched. The primary endpoint was parastomal hernia incidence. The secondary endpoint was incisional hernia incidence. Results: Five studies (four randomized controlled trials and one retrospective cohort) with a total of 699 patients were eligible for inclusion. The PSH rate was 15%–46% for Hartmann procedure, 0%–85% for primary anastomosis, 4% for resection, and 2% for laparoscopic lavage. The IH rates were 5%–38% for Hartmann procedure, 5%–27% for primary anastomosis, 9%–12% for primary resection, and 3%–11% for laparoscopic lavage. Conclusions: Both the parastomal and incisional hernia incidences are poorly evaluated and reported, and varied greatly between the studies.
Chimney endovascular aortic repair is a viable salvage technique in a paravisceral pseudoaneurysm secondary to acute on chronic pancreatitis
Authors: Lovell Janaka , Lovelock Thomas , Slater Jacqueline , Thoo Catherine 
Published: June 2022

Background Pseudoaneurysms of the abdominal aorta secondary to pancreatitis are an extremely rare clinical entity, however, can result in life threatening complications. Objective To describe a chimney endovascular aneurysm repair (Ch-EVAR) for an acute pancreatitis related paravisceral aortic pseudoaneurym. Method Prospective data collected from subject. Results We present a case of 23-year-old female who underwent a successful salvage Ch-EVAR for a ruptured paravisceral pseudoaneurysm secondary to acute on chronic pancreatitis. Conclusion Ch-EVAR may present a viable temporizing or definitive therapeutic treatment option for a paravisceral pseudoaneurysm, particularly in the setting of acute pancreatitis. Further studies are warranted to elucidate the long term viability of Ch-EVAR grafts in the suprarenal, paravisceral aortic position.
Peripheral artery disease independently associated with significantly higher risk for COVID-19 mortality: Evidence based on adjusted effect estimates
Authors: Ren Jiahao , Hao Yuqing , Nan Lan , Wang Yadong , Yang Haiyan 
Published: June 2022

Objective To investigate the influence of peripheral artery disease (PAD) on the risk of mortality among coronavirus disease 2019 (COVID-19) patients based on adjusted effect estimates. Methods Systematic searches were performed through electronic databases. A random-effect model was applied to calculate the pooled effect and corresponding 95% confidence interval (CI). Inconsistency index (I2) was used to evaluate the heterogeneity across studies. Sensitivity analysis, subgroup analysis, and Begg’s test were all implemented. Results On the basis of 16 eligible studies with 142,832 COVID-19 patients, the meta-analysis showed that PAD significantly increased the risk for mortality among COVID-19 patients (pooled effect = 1.29, 95% CI: 1.10–1.51). The significant association was also observed in the subgroup analysis stratified by hospitalized patients, mean age ≥ 60 years, Europe and North America. Sensitivity analysis verified the robustness of our findings. Begg’s test ( P = 0.15) showed there was no potential publication bias. Conclusions COVID-19 patients with PAD may have a greater risk of mortality. Clinicians and nursing staff are supposed to identify and monitor these high-risk patients in a timely manner and provide appropriate clinical treatment for them.
Cost-effectiveness of testing for CYP2C19 loss-of-function carriers following transient ischemic attack/minor stroke: A Canadian perspective
Authors: Micieli Andrew , Singh Nishita , Jahn Beate , Siebert Uwe , Menon Bijoy K , Demchuk Andrew M 
Published: June 2022

Background: The CHANCE-2 study compared 3 weeks of aspirin–ticagrelor to aspirin–clopidogrel in CYP2C19 loss-of-function (LOF) allele carriers following a transient ischemic attack (TIA)/minor stroke and demonstrated a modestly lower risk of stroke recurrence with aspirin–ticagrelor. This stroke protection was largely for minor stroke and came at an increased risk of bleeding. The cost-effectiveness of implementing testing for LOF allele status to personalize antiplatelet regimen for secondary stroke prevention after a TIA/minor stroke in the Canadian health care context is unknown. Methods: Cost-effectiveness analysis using a decision-analytic Markov cohort model with a lifetime horizon was performed to determine the costs and health benefits of testing for LOF allele status compared with no testing (current standard of care). The population of interest was patients living in Canada who suffered a TIA/minor stroke. Outcomes of interest were life-years gained (LYG), quality-adjusted life years (QALY) gained, costs (reported in 2022 Canadian dollars), and the incremental cost-effectiveness ratio (ICER). We adopted the perspective of the Federal, Provincial, and Territorial Ministries of Health and used a 1.5% annual discount rate. Sensitivity analyses were performed to assess uncertainty. Results: Compared to standard of care, LOF allele testing leads to 0.14 LYG (undiscounted), 0.12 QALYs gained (undiscounted), and additional lifetime costs of CAD$432 (discounted) per patient. The ICER of the LOF allele testing strategy is CAD$4310 per QALY gained compared with standard of care. The probabilistic sensitivity analyses demonstrated that LOF allele testing was cost-effective in more than 99.99% of simulations using a willingness-to-pay threshold of CAD$50,000 per QALY. Conclusion: Based on available evidence, testing for LOF allele followed by short duration 3 weeks of aspirin–ticagrelor compared to standard-of-care aspirin–clopidogrel can lead to prolonged life and improved quality of life and can be considered very cost-effective when compared with other well-accepted technologies in health and medicine.
Differential Effects of a Global Public Health Crisis on Physical Activity: Evidence From a Statewide Survey From the United States
Authors: Towne Samuel D. , Xu Minjie , Zhu Xuemei , Ory Marcia G. , Lee Sungmin , Lee Chanam 
Published: June 2022

Aim: We aimed to identify how the COVID-19 lockdown affected changes, including the potential for longer term sustained changes, in physical activity, as compared to immediately prior to the pandemic. Background: Physical activity’s significant role in overall health is known to be influenced by the surrounding environment, such as one’s neighborhood, prompting this study of physical activity and its relationship with individual-level and neighborhood-level factors within the pandemic timeline. Methods: A statewide online survey assessed adults’ self-reported weekly minutes of moderate-to-vigorous physical activity (MVPA) comparing a typical week immediately prior to the pandemic and during the pandemic (prewidespread vaccination) using negative binomial models. Results: Overall, MVPA decreased during the pandemic, though the decrease was driven largely by the reduction in MVPA outside one’s neighborhood. In contrast, MVPA done within one’s neighborhood increased over time. This change in MVPA done within one’s neighborhood was not uniform across several characteristics including income level favoring those with the highest income ( p < .05) and race/ethnicity favoring those self-reporting as non-Hispanic White ( p < .05). While several factors, including higher Walk Scores, were associated with higher levels of MVPA without evidence of change over time, evidence of a differential effect over time was seen for other key indicators of social and structural determinants of health including income and race/ethnicity. Conclusions: This study can add to the existing literature surrounding not only COVID-19 but also neighborhood built environmental research seeking to identify factors associated with changes in MVPA, a known indicator of overall health and health-related outcomes.
Role of NLRP3 Inflammasome on Different Phenotypes of Chronic Rhinosinusitis
Authors: Yang Yang , Chen Haihong , Zhong Jiangtao , Shen Lifang , Zheng Xiu 
Published: June 2022

Background The pathophysiologic mechanisms of human chronic rhinosinusitis (CRS) are highly complex, and sinonasal colonization with pathogens is the first and most important step in this process. NLRP3, the main receptor activated by pathogen-associated molecular patterns (PAMPs), is associated with a variety of inflammatory diseases, including airway inflammation; however, the understanding of its role in CRS is limited. Objective By detecting the differential expression of the NLRP3 inflammasome and its downstream cytokines IL-1β and IL-18 between CRS patients and controls, between different CRS phenotypes (CRSsNP and CRSwNP), between mucosal tissue and polyp tissue, and further its relationship with neutrophilic/eosinic infiltration, we aimed to elucidate the biological role of the NLRP3 inflammasome in the pathophysiologic mechanisms of CRS. Methods Fifteen cases in each control, CRSsNP, and CRSwNP groups (subdivided into mucosa tissue and polyp tissue) were included in this study. Differential expression of NLRP3/caspase-1 and its downstream cytokines IL-1β and IL-18 was investigated, and its relationship with neutrophilic and eosinophilic infiltration was analyzed. Fluorescent immunohistochemistry (F-IHC) was used to assess NLRP3 and caspase-1 expression, RT-PCR was used for mRNA level quantitation, and western blotting was employed to analyze the protein concentrations. Results NLRP3 and cleaved caspase-1 were expressed at higher levels in both the CRSsNP and CRSwNP phenotypes than in the control nasal mucosa and at much higher levels in polyp tissue of CRSwNP ( P < .05), which was in line with the expression of cleaved IL-1β and cleaved IL-18 ( P < .05). Higher expression of NLRP3 had a mild correlation with neutrophilic infiltration but highly correlated with eosinophilic infiltration (R = 0.607, P < .01). Conclusions NLRP3 is involved in the pathogenesis of CRS, most likely by the NLRP3/caspase-1/IL-1β and IL-18 response. It induced eosinophilic infiltration in CRSwNP, especially in polyp tissue. As for whether NLRP3 induces neutrophilic infiltration, further experiments are needed to confirm.
Safety and efficacy of dual lumen balloon catheters for the Treatment of cerebral vascular malformations: A systematic review, pooled analysis, and meta-analysis
Authors: Matsoukas Stavros , Siddiqui Neha , Scaggiante Jacopo , Bageac Devin V , Shigematsu Tomoyoshi , DeLeacy Reade , Mocco J , Majidi Shahram , Kellner Christopher P , Fifi Johanna T 
Published: June 2022

Background There is little evidence in scientific literature assessing the safety and efficacy of dual-lumen balloon catheters (DLBCs) and their performance compared to single-lumen catheters (SLCs). Methods In this PROSPERO-registered, PRISMA-compliant systematic review, we identified all MEDLINE and EMBASE single-arm (DLBCs) and double-arm (DLBCs vs SLCs) cohorts where DLBCs were used for the treatment of cerebral arteriovenous malformations (AVMs) or dural arteriovenous fistulas (dAVFs). Immediate angiographic outcome, vascular complications, technical failures, reflux episodes and entrapment were the primary outcomes. A meta-analysis of the double-arm studies summarized the primary outcomes of total procedural time and immediate angiographic outcome. Results The authors identified 18 studies encompassing 209 treated lesions with reported outcomes. Complete occlusion was achieved in 108/132 treated dAVFs (81.8%, 95% CI: [74–87.8%]) and in 45/77 treated AVMs (58.4%, [46.7–69.4%]). The proportion of completely occluded dAVFs was statistically significantly higher than that of AVMs, p < .001. There were eight reported vascular complications (3.8%, [1.8–7.7%]), five technical failures (2.4%, [0.9–5.8%]), 14 reflux events (6.7%, [3.9–11.2%]), two entrapment events (1%, [0.2–3.8%]) and 0 deaths (mortality rate 0%, [0–2.3%]). In a meta-analysis for the treatment of dAVFs, the total procedural time was significantly less for DLBCs compared to SLCs (64.9 vs 125.7 min, p < .0001). The odds of complete immediate occlusion were significantly higher with DLBCs compared to SLCs (odds ratio (OR) 4.6, [1.5–14.3], p = .008). Conclusion Dual-lumen balloon catheters are safe and effective for the embolization of cerebral AVMs and dAVFs and can achieve faster and potentially superior results compared to SLCs. Registration-URL https://www.crd.york.ac.uk/prospero/ Unique Identifier: CRD42021269096
Poor adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia
Authors: Tegegne Degu , Mamo Galana , Negash Belay , Habte Sisay , Gobena Tesfaye , Letta Shiferaw 
Published: June 2022

Objective: Sustained adherence to highly active antiretroviral therapy is necessary to suppress viral replication and improve immunological and clinical outcomes. Although different studies tried to identify factors affecting adherence to highly active antiretroviral therapy, there are few studies after initiation of test and start strategy and the first-line drug regimen change in the study area. Therefore, this study aimed to determine the level of adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia. Methods: Institutional-based cross-sectional study design was conducted from 2 March 2020, to 30 March 2020. A total of 501 study participants were recruited using systematic random sampling. Data were collected using face-to-face interviews at the end of the clinic visit and a review of participants’ medical records. The level of adherence to highly active antiretroviral therapy was measured using the eight-item Morisky Medication Adherence Scale. The score ranges from 0 to 8, and a score of less than 8 indicates poor adherence. The data were entered into EpiData and exported to STATA for further analysis. The binary logistic regression analysis model was employed to identify associated factors. The association was reported with an adjusted odds ratio and a 95% confidence level. The significance level was declared at p = 0.05. Results: A total of 501 participants participated in the study, giving a response rate of 98.2%. The majority (314 or 62.7%) of study participants were females. The participants’ mean (standard deviation) age was 38.17 (8.75). The level of poor adherence to highly active antiretroviral therapy was found to be 33.73% (confidence interval: 29.70, 38.00). Age category 35 to 44 (1.65 (confidence interval: 1.02, 2.69)), no shortage of highly active antiretroviral therapy (0.46 (confidence interval: 0.28, 0.75)), substance use (1.67 (confidence interval: 1.11, 2.25)), having moderate depressive symptoms (4.00 (confidence interval: 1.94, 8.48)), and moderate anxiety symptoms (5.22 (confidence interval: 2.31, 8.84)) were significantly associated with the poor adherence to highly active antiretroviral therapy among adult people living with HIV. Conclusion: The level of poor adherence to highly active antiretroviral therapy was found to be high in this study. Poor adherence to highly active antiretroviral therapy was significantly associated with age, availability of highly active antiretroviral therapy drugs, substance usage, depressive symptoms, and anxiety symptoms. Improving the adherence levels requires stringent counseling, assuring continuous drug availability, and timely screening and management of depression and anxiety.
“A case of vanishing bone disease complicated by chylothorax- diagnosis and treatment”
Authors: Suzuki N , Cintra FF , Cintra ML , Maciel MG , Amstalden EMI , Teixeira F , Kubba F 
Published: June 2022

Summary A 16-year old girl with Gorham-Stout disease is presented. She had progressive replacement of the bones of her left arm and shoulder girdle by fibroadipose tissue and numerous proliferated, non-neoplastic, lymphatic channels. The clinico-pathologic features of this condition are discussed, as are its possible complications and available therapeutic modalities.