bluuebunny/crossref_metadata_2025_split huggingface dataset:
Yoga Therapy During Chemotherapy for Early-Stage and Locally Advanced Breast Cancer
Authors: Greaney Samantha K. , Amin Neha , Prudner Bethany C. , Compernolle Maggie , Sandell Linda J. , Tebb Susan C. , Weilbaecher Katherine N. , Abeln Peri , Luo Jingqin , Tao Yu , Hirbe Angela C. , Peterson Lindsay L. 
Published: November 2022

Background: Chemotherapy is associated with decreased quality of life (QOL), fatigue, depression, and weight gain in patients with breast cancer. Weight gain is associated with poorer prognosis. Yoga improves QOL, fatigue, and mood in women with breast cancer but its effect on treatment-related weight gain has not been studied. The aim of this trial was to determine the feasibility of personalized yoga therapy in women receiving treatment for early-stage or locally advanced breast cancer and assess its impact on weight gain. Methods: Thirty women were randomized 1:1 to receive yoga therapy by a certified yoga therapist during treatment or a control group. Participants in the yoga arm were asked to complete three 30 minute yoga sessions weekly (which included movement, breath work, mindfulness, and relaxation) throughout adjuvant or neoadjuvant chemotherapy (N = 29) or endocrine (N = 1); the control arm received breast cancer treatment without yoga. For comparability between participants randomized to yoga therapy, the single patient treated with endocrine therapy was excluded from the analysis. Primary outcomes were feasibility and weight change. Additional outcomes were mood, fatigue, QOL, serum tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP) as immune mediator biomarkers. Results: Mean age was 51.6 years, 75.9% were white and 24.1% were people of color, reflecting the cancer center population. 80% had stage II-III disease. Enrollment was completed in 9 months. Compliance was lower than predicted; however, participants participated in on average 1.7 yoga sessions/week for a mean 15.6 weeks duration. There were no adverse events. Control arm participants gained on average 2.63% body weight during treatment while yoga participants lost 0.14% body weight (weight change = −0.36 in yoga arm vs. 2.89 in standard of care arm, Wilcoxon rank sum test P = .024). Control participants reported increased fatigue and decreased QOL, while yoga participants reported no change in QOL. No significant change in TNF-alpha or CRP was noted in either arm. Conclusion: This feasibility study suggests that personalized yoga therapy is beneficial for QOL and weight maintenance among women undergoing chemotherapy for early-stage or locally advanced breast cancer. Weight maintenance associated with yoga therapy may be of clinical significance in this population given the poorer prognosis associated with weight gain in breast cancer survivors. Trial Registration: NIH Clinicaltrials.gov #NCT03262831; August 25, 2017. https://clinicaltrials.gov/ct2/show/NCT03262831
Mindfulness-based Interventions and Yoga for Managing Obesity/Overweight After Breast Cancer: A Scoping Review
Authors: Vuong Vicki , Rao Vibhuti , Ee Carolyn 
Published: November 2022

Introduction Weight gain after breast cancer is common, and obesity after breast cancer increases breast cancer recurrence and mortality. Mindfulness-based interventions (MBIs) and yoga have been shown to be effective in managing obesity/overweight in people without breast cancer. There is a need to systematically map the extent and range of evidence on yoga and MBIs for managing obesity/overweight after breast cancer in order to aid planning and commissioning of future research. Methods We conducted a scoping review informed by methods described by Levac et al. Five electronic databases were searched for any peer-reviewed original research (including systematic reviews) that examined the role of yoga and/or MBIs for managing overweight/obesity after breast cancer. Data were extracted on study, population, intervention, comparator and outcome characteristics, and described narratively. Results: We found 18 publications representing 15 unique studies (11 clinical trials, 2 systematic reviews, and 2 observational studies). There were 10 studies on yoga, and 5 on MBIs. Of the clinical trials, only 4/11 examined a weight-related outcome as the primary outcome. The remaining trials examined lifestyle or metabolic outcomes (5/11) or unrelated outcomes such as psychological health (2/11). Gaps in the literature included small sample sizes, lack of cultural diversity amongst participants, inadequate reporting of the intervention, few lifestyle co-interventions offered, lack of active comparator groups, and inadequate safety reporting. Conclusions: There is a need for adequately-powered RCTs that adhere to reporting guidelines. The use of gold-standard methods for measuring outcomes, and active comparator groups, is also recommended.
Hepatoprotective Effect of Grape Seed and Skin Extract Against Lithium Exposure Examined by the Window of Proteomics
Authors: Mezni Ali , Khazri Olfa , Jarnier Frédérique , Hardouin Julie , Limam Ferid , Jouenne Thierry , Aouani Ezzeddine , Cosette Pascal 
Published: November 2022

Context The liver is the organ by which the majority of substances are metabolized, including psychotropic drugs. Lithium (Li) used as drug for many neurological disorders such as bipolar disorders. Objective This study aims to assess lithium toxicity and to evaluate the hepatic-protective properties of a grape skin seed and extract (GSSE). Materials and methods Twenty-four male Wistar rats were exposed for 30 days to either various lithium concentrations, GSSE alone, or lithium supplemented with GSSE. The proteomic analysis revealed alterations of liver protein profiles after lithium treatments that were successfully identified by mass spectrometry. Results Lithium treatment induced an oxidative damage by the alteration of antioxidant enzymes activities such as superoxide dismutase, CAT, and Gpx. The regulated proteins are mainly involved in the respiratory electron transport chain, detoxification processes, ribosomal stress pathway, glycolysis, and cytoskeleton. Proteins were differentially expressed in a dose-dependent manner. Interestingly, GSSE reversed the situation and restored the level of liver proteins whose abundance was modified after lithium treatment, arguing for its protective activity. Conclusion Our data demonstrated the ability of proteomic analysis to underline the toxicity mechanisms of lithium in animal models. Based on these results, GSSE may be envisaged as a nutritional supplement to weaken the liver toxicity of lithium.
Refining the upper limit of normal for the ascending aorta: In search of optimal criteria ‐‐ a large database study of normal individuals
Authors: Yoon Ji Ae , Ahmad Mirza Mujadil , Syed Muhammad Nabeel , Ahmad Mirza Nubair , Hussaini Sharmeen Fatima , Muhammad Mustafa Noor , Pir Syed Haris A , Khandheria Bijoy K , Tajik A. Jamil , Ammar Khawaja Afzal 
Published: November 2022

Objectives The cutoff for dilated mid-ascending aorta (mAA) is controversial and has several definitions. The present study was carried out to determine the prevalence of mAA dilation based on published definitions and to identify the optimal cutoff. Methods Echocardiographic studies of patients >15 years of age performed at a large tertiary care center over 4 years, n = 49,330, were retrospectively evaluated. Leading-edge-to-leading-edge technique was used to measure the mAA in diastole. Several cutoff criteria were included. In addition, we defined normals in our database as those who, after 28 causes of dilated aorta were excluded, were normal both clinically and echocardiographically ( n = 2334). Results The mean age was 64.2 ± 17.1 years, and 31.5% were men. The prevalence of dilated mAA based on absolute criteria with sex stratification varied between 17% and 23% and based on relative criteria (to age, body surface area, and sex) varied between 6% and 11%. It further decreased to 7.6% on the addition of narrow age stratification (10 year intervals) performed on normals in our database. The multivariate adjusted R2 (for variation in mAA diameter) was 0.25 for age, decreasing to 0.12 for weight and 0.07 for sex and height. Conclusions The lowest prevalence of 7.6% probably represents the optimal cutoff for dilated mAA because it includes age, which explains most of the variation in mAA, in narrow (10 year) intervals only performed in our normals, which represents the largest sample size to date.
Clinical course and outcomes of cancer patients admitted in medical ICU with sepsis
Authors: Beniwal Anisha , Singh Omender , Juneja Deven , Beniwal Hemant Kumar , Kataria Sahil , Bhide Madhura , Yadav Devraj 
Published: November 2022

Background and aims: Sepsis is not only a leading cause of intensive care unit (ICU) admission but also one of the variables which affect outcomes of cancer patients. We aimed to assess the clinical characteristics, clinical course, mortality and risk factors associated with 30-day mortality in medical oncology patients admitted in a multi-disciplinary medical ICU. Methods: We conducted a retrospective analysis of 435 consecutive cancer patients admitted in medical ICU over a 28 months period. Patients were divided into two groups based on the presence of sepsis at the time of ICU admission. Data regarding baseline patient characteristics, clinical and laboratory data, need for organ support and 30-day mortality were collected. Sepsis patients were further classified as 30-day survivors and non-survivors and risk factors for mortality in these patients were determined. Results: Overall 30-day mortality was 57.8%. It was significantly higher in sepsis group patients (73.9%) as compared to non-sepsis patients (46.6%) ( p < 0.001). Most common reason for ICU admission in non-sepsis group was respiratory distress (51.4%) followed by altered sensorium (28.4%). Presence of metastasis [odds ratio, OR: 3.89 (95% confidence interval, CI: 1.536–9.901)], high lactate [OR: 1.374 (95% CI: 1.024–1.843)] and need of invasive mechanical ventilator (IMV) support [OR: 7.634 (95% CI: 2.519–23.256)] or vasopressor support [OR: 3.268 (95% CI: 1.179–9.090)] were directly associated with 30-day mortality. Conclusion: Critically ill cancer patients admitted with sepsis had high mortality. Presence of metastasis, high lactate and need of IMV or vasopressor support was associated with worse prognosis in cancer patients admitted with sepsis in ICU.
Predictors of early response to balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension
Authors: Li Xin , Zhang Yi , Jin Qi , Luo Qin , Zhao Qing , Yang Tao , Zeng Qixian , Yan Lu , Duan Anqi , Huang Zhihua , Hu Meixi , Xiong Changming , Zhao Zhihui , Liu Zhihong 
Published: November 2022

Background: To achieve favorable hemodynamics, the number of balloon pulmonary angioplasty (BPA) sessions varied significantly among patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Increased BPA sessions burdened patients financially and psychologically. We aim to identify baseline characteristics that could predict early BPA response. Methods: Consecutive patients who were diagnosed with inoperable CTEPH and received BPA between May 2018 and October 2021 at Fuwai Hospital were retrospectively collected. Patients were categorized into ‘Early BPA responders’ or ‘Non-early BPA responders’ according to the hemodynamic outcome within the first three BPA sessions. Results: In total, 101 patients were included into analysis. At baseline, non-early BPA responders had lower female proportion, longer disease duration, and poorer laboratory test results compared with early responders, whereas hemodynamics were comparable. After the first three BPA sessions, hemodynamic improvement was more significant in early responders. Incidence of complication was comparable between the two groups. Multivariable logistic analysis identified that female sex (odds ratio [OR]: 7.155, 95% confidence interval [CI]: 1.323-38.692, p = 0.022), disease duration (OR: 0.851, 95% CI: 0.727-0.995, p = 0.043), baseline total bilirubin (OR: 0.934, 95% CI: 0.875-0.996, p = 0.038), and baseline NT-proBNP (OR: 0.473, 95% CI: 0.255-0.879, p = 0.018) were independently associated with early BPA response. Combination of these four parameters could predict 90% early BPA response. Conclusions: Patients with shorter disease duration, female sex, lower baseline NT-proBNP, and lower baseline total bilirubin are more likely to achieve early hemodynamic response to BPA. Moreover, early hemodynamic response was not accompanied with increased incidence of procedure-related complications.
Anatomic Structures at Risk When Utilizing Percutaneous Intramedullary Fibular Screw Fixation for Lateral Malleolus Fractures: A Cadaveric Study
Authors: Shah Ashish , Littlefield Zachary , Boyd Brandon , Patch David A. , Jacob Roshan , Prahad Srihari R. , Reed Logan , Elphingstone Joseph , Young Sean M. , Sanchez Thomas , Sankey Turner 
Published: November 2022

Category: Ankle Introduction/Purpose: Isolated lateral malleolus fractures are a common ankle fracture that a foot and ankle surgeon will encounter. Retrograde intramedullary fixation for unstable lateral malleolus fractures has become a viable option for patients at higher risk for potentially devastating wound complications. The aim of this cadaveric study was to assess the relative risk of injuring adjacent anatomic structures with percutaneous implantation of an intramedullary fibular screw for lateral malleolus fractures to minimize iatrogenic injury. Methods: Seven fresh-frozen below-the-knee cadaver specimens were used for this study. Prior to investigations, specimens were inspected with fluoroscopic radiographs for preexisting pathology or prior surgical intervention. Lateral dissection of the lateral malleolus was performed after screw placement to determine the proximity of the peroneus longus (PL), peroneus brevis (PB), and sural nerve (SN) to the inserted hardware. The mean, standard deviation, and range for distances were calculated for all structures. Analysis of variance (ANOVA) was used to determine statistical significance. Results: Percutaneous intramedullary fibular screw placement was performed in seven specimens, six females and one male, with an average age of 79.3 +- 8.1 years. Amongst the seven specimens, only one resulted in an injury to a structure of interest (sural nerve). The peroneus longus and peroneus brevis were not injured in any of the specimens. Table 1 shows the average distance between the guidewire and each structure of interest. Conclusion: This study shows the potential risks to lateral structures when placing an intramedullary fibular screw for unstable lateral malleolus fractures. We suggest that orthopedic surgeons exercise caution when performing critical steps of the procedure to minimize avoidable injury to structures of importance that may increase the morbidity of the patient.
Medial Structures at Risk During Sinus Tarsi Approach for Fixation of Sustentaculum Tali Fractures: A Cadaveric Study
Authors: Shah Ashish , Kothari Ezan A. , Young Sean M. , Sanchez Thomas , Sankey Turner , Murali Sudarsan , Littlefield Zachary , Luque-Sanchez Kevin S. , Prahad Srihari R. , Young Matthew 
Published: November 2022

Category: Hindfoot; Trauma; Other Introduction/Purpose: Calcaneal fractures are a common injury with potential for concomitant involvement of the sustentaculum tali. Common surgical repair involves a sinus tarsi approach with placement of a lag screw from lateral to medial. There is no current study that focuses on the potential damage to the medial structures after screw placement. The goal of this paper was to describe the incidence in which medial structures were damaged using a sinus tarsi approach for lateral to medial screw fixation of the sustentaculum tali. Methods: Seven fresh-frozen below-the-knee cadaver specimens were used for the present anatomic dissection study. Prior to investigations, specimens were inspected with fluoroscopic radiographs for any pathology or prior operational intervention Each specimen underwent screw placement using the sinus tarsi approach. Medial dissection of the calcaneus was performed after screw placement to determine the proximity of the anatomical structures of interest to the inserted hardware. The four anatomical structures of interest were the tibialis posterior tendon, flexor hallucis longus, flexor digitorum longus, and posterior neurovascular bundle. Distance from the 4.0 mm screw to the previously mentioned anatomic structures was measured with a scientific ruler and recorded to the nearest millimeter. The mean, standard deviation, and range for distances were calculated for all structures. Analysis of variance (ANOVA) was used to determine statistical significance. Results: The average patient age, height, and weight were 79.3 years, 5 feet 4 inches, and 127 lbs respectively. The primary outcome of interest was the longitudinal distance between the medial aspect of the screw to the anatomical structures of interest. On average, the posterior neurovascular bundle had the closest proximity to the medial aspect of the screw for all seven specimens with a mean distance of 6.4 mm. The second closest structure was the FHL with a mean distance of 7 mm, followed by the FDL and tibialis posterior tendon, with mean distances of 9.9 mm and 13.9 mm respectively. The posterior neurovascular bundle was hit by the screw on one occasion, whereas the hardware contacted the FDL on two separate occasions. The screw was placed through the FDL in one of the two occasions; however, the FDL was not transected or ruptured. Conclusion: This study sheds more light on the potential risks to medial structures when placing the sustentacular screw during open reduction and internal fixation of displaced intraarticular calcaneal fractures. We urge the orthopedic surgeon to exercise extreme caution when performing this critical step of the procedure to minimize avoidable injury to structures of importance that may increase the morbidity of the patient.
Biomechanical Study of Syndesmotic Stability in AITFL and PITFL Injury Models
Authors: Takahashi Katsunori , Teramoto Atsushi , Murahashi Yasutaka , Shiwaku Kosuke , Nabeki Shogo , Kamiya Tomoaki , Watanabe Kota , Yamashita Toshihiko 
Published: November 2022

Category: Basic Sciences/Biologics; Trauma Introduction/Purpose: Severe ankle syndesmotic injuries can cause not only anterior inferior tibiofibular ligament (AITFL) injury but also posterior inferior tibiofibular ligament (PITFL) injury. However, the biomechanical stability and the best surgical treatment method for PITFL injuries are unknown. This study aimed to evaluate the stability of AITFL and PITFL injury models and the treatment models with suture-button (SB) fixation, AITFL augmentation with suture-tape (aST), and PITFL augmentation with suture-tape (pST). We hypothesized that PITFL injury causes posterior instability of syndesmosis and that this can be stabilized with pST fixation Methods: This study was approved by our institution's ethics review board. Ten normal fresh-frozen cadaver legs (4 males and 6 females) that were donated to our university's department of anatomy were used. The specimens were tested with the application of traction and rotational forces for dorsiflexion and external and internal rotation of the ankle joint. The fibular rotational angle related to the tibia (FRA), anterior tibiofibular diastasis (aTFD), and posterior tibiofibular diastasis (pTFD) were measured using the magnetic tracking system. Intact, injured (AITFL, PITFL and IOM resection), SB fixation, SB + aST fixation, and SB + aST + pST fixation models were made and loaded with forces. One-way ANOVA was used to evaluate the relationship between the models. Post-hoc analysis of the differences between the models was performed using Dunnett's test. A p value of 0.05 was chosen as the level of significance. Results: In the injured model, both FRA and TFD were significantly increased compared with those of the intact model in all directions. In the SB fixation model, only FRA with an external rotation force was significantly increased compared with that of the intact model. In the SB+aST model, both FRA and aTFD were not significantly different from those in the intact model. Conclusion: The results of this study showed that there was external and internal rotational instability in the AITFL and PITFL injury models, while there was stability in the SB + aST model. SB fixation alone did not reduce FRA with an external rotation force and there was no significantly different FRA with an internal rotation force. With SB fixation alone, anterior instability was found to be greater than posterior stability, while aST fixation was associated with anterior stability. In this study, the change in syndesmosis stability after pST fixation was found to be restrictive.
Hounsfield Unit Assessed Bone Density Amongst Non-Traumatic and Post-Traumatic Arthritic Total Ankle Arthroplasty Patients
Authors: Thompson John M. , Hyer Christopher F. , Berlet Gregory C. , Houng Brian E. , Perkins Jacob M. 
Published: November 2022

Category: Ankle Arthritis; Ankle; Hindfoot; Trauma Introduction/Purpose: The etiology of ankle arthritis is multifactorial and secondary osseous changes to the tibiotalar joint can be variable. The relationship of bone density within the tibia and talus with respect to type of ankle arthritis is not well understood. Improved insight of osseous characteristics amongst ankle arthritis patients is helpful in determining optimal implant selection for total ankle arthroplasty. The purpose of this study is to retrospectively analyze pre-operative total ankle arthroplasty patients' films for osseous characteristics associated traumatic ankle arthritis compared to other forms of arthritis using computed tomography (CT) generated Hounsfield units (HU) to analyze bone mineral density and rate of cyst formation. Methods: A retrospective analysis was performed of 440 patients, under a single orthopedic practice, who underwent primary TAA between 2013-2019. Pre-operative HU of tibia and talus were analyzed amongst two groups (Non-traumatic OA, Post- traumatic OA) within one year prior to TAA. Results: Forty-nine qualified patients (23 NTA, 26 PTA) with mean follow-up in months of 19.98 (SD 15.22) were analyzed. Cystic changes at level of TAA cuts or retained bone: 5 tibia (10.2%), 7 talus (14.29%), 16 combined (32.65%). Overall tibial HU mean 270.23 (SD 91.28) and talus 463.26 (103.65). HU of the tibia amongst post-traumatic and non-traumatic patients was 257.21 (SD 93.9) and 284.94 (SD 87.9) (p=0.29137) and talus 434.53 (104.7) and 495.75 (94.33) (p=0.0365). Conclusion: Our results suggest with tibiotalar arthritis HU is a useful tool to predict bone quality. Clinical results amongst the NTA and PTA groups was comparable. Significantly lower HU values were recorded for the PTA groups. Rate of cystic formation within bone of distal tibia does not necessarily correlate with overall HU measured bone mineral density.