bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytoreductive radical prostatectomy or radiation therapy for metastases prostate cancer: Evidence from meta-analysis
Authors: Peng Zhixiong , Huang Andong 
Published: September 2022

Background:
Cytoreductive radical prostatectomy (RP), transurethral resection of the prostate, and radiation therapy were the main local treatments for oligometastatic prostate cancer (PCa). An optimal local treatment for metastases PCa was not consensus. The purpose of this study was to evaluate the effect on these local treatments for patients with metastases PCa.

Methods:
All relevant studies were systematically searched through PubMed, Web of Science through November 1, 2021. Studies were screened by inclusion and exclusion criteria. Progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) were evaluated by this meta-analysis.

Results:
Eleven studies were identified that met the inclusion criteria. 644 patients received cytoreductive surgery, 8556 patients received no surgery or radiation therapy (RT), and 461 patients received RP + androgen deprivation therapy compared with 746 patients who received RT. Pooled data indicated that cytoreductive surgery significantly prolonged the PFS (OR = 0.65, 95% CI 0.53–0.80, P < .0001), CSS and OS (OR = 0.49, 95% CI 0.43–0.56, P < .00001; and OR = 0.80, 95% CI 0.72–0.88, P < .00001; respectively). Comparing cytoreductive surgery with RT, CSS, and OS were similar (OR = 0.82, 95% CI 0.67–1.01, P = .06; and OR = 0.93, 95% CI 0.79–1.09, P = .39; respectively).

Conclusions:
Cytoreductive radical prostatectomy significantly prolonged the PFS for metastatic PCa. Although OS was considered a-not-so significant difference between cytoreductive surgery and non-local therapy, non-local treatment was not recommended.
Preoperative walking intervention did not appear to improve patient-reported postoperative recovery in older adults with frailty traits: Randomized trial
Authors: Sadiq Hammad , Rampam Sanjeev , Patel Jay , Crawford Sybil , Walz Matthias , Kapoor Alok 
Published: September 2022

Objectives:
To assess the impact of a preoperative walking intervention on improving postoperative recovery in at-risk frail older adult patients.

Study Type:
Unblinded, randomized controlled trial which assigned patients to intervention versus control.

Population:
Patients aged 60+ scheduled for surgery 3–8 weeks from randomization scoring 4+ on the Edmonton Frail Scale.

Intervention:
Preoperative walking enhanced by goal setting with an activity monitor and telephonic coaching.

Main Outcomes:
Quality of Recovery 9-item instrument total score and a modified version of the Abdominal Surgery Impact Scale total score

Results:
A total of 83 patients were analyzed. Postoperative recovery scores were similar in intervention vs control – Quality of Recovery-9 item instrument total score 14.1 vs. 14.1 (P = .94) and modified Abdominal and Surgery Impact Scale total score 82.8 vs. 79.2 (P = .93). Few intervention patients met their daily step count goals. Despite this, intervention patients improved average daily step counts significantly.

Conclusions:
Preoperative walking bolstered with activity monitor and remote coaching did not appear to lead to improved postoperative recovery in older adults with frailty traits. Further research is necessary to see if a similar intervention in specific surgery types or a more intense version of the intervention can improve recovery.
Risk factors for postoperative delirium in elderly urological patients: A meta-analysis
Authors: Hua Yaqi , Chen Shoulin , Xiong Xiaoyun , Lin Chuyang , Li Dongying , Tu Ping 
Published: September 2022

Background:
Avoiding postoperative delirium (POD) can have a significant detrimental effect on the rehabilitation and prognosis of elderly urological patients. It is necessary to explore the risk factors associated with POD in elderly urology to provide a basis for clinical recognition of delirium.

Methods:
For relevant studies, we comprehensively searched Embase, MEDLINE, Ovid, PubMed, Scopus, The Cochrane Library, and Web of Science. The search deadline was September 2021.

Results:
We identified 2046 studies, 8 of which were included in the ultimate analysis. A total of 8 articles, including 356 cases in the delirium group and 1813 cases in the non-delirium group, were included in the relevant literature. The 2 groups mentioned above differed significantly in the following factors: history of delirium (odds ratio [OR] = 6.98, 95% confidence interval [CI]: 1.63–29.86, P = .009); Preoperative use of psychotropic drugs (OR = 1.97, 95% CI: 1.11–3.52, P = .02); age (OR = 3.10, 95% CI: 2.08–4.12, P < .0001). The meta-analysis demonstrated that smoking, alcohol consumption, gender (male), mode of anesthesia (general anesthesia) and being unmarried did not have a significant effect on POD in elderly urological patients.

Conclusion:
The risk factors for POD in elderly urological patients include history of delirium, preoperative use of psychotropic drugs, and age. The present study provides guidance for taking targeted preventive measures to reduce risks.
Effect of chrono-moxibustion and its influence on circadian rhythm for rheumatoid arthritis: A study protocol for a randomized controlled trial
Authors: Yu Mingfang , Yang Shenqiao , Chen Bailu , Gan Lu , He Xinling , Wang Aiyang , Wu Xiao 
Published: September 2022

Background:
Rheumatoid arthritis (RA) is a chronic disease which is characterized by a circadian variation of key clinical symptoms and findings, with prominent joint swelling, stiffness and pain occurring in the early morning and light clinical symptoms during the day. Chrono-moxibustion is carried out at different time, which could result in dissimilar therapeutic effects. However, its efficacy has seldom been systematically demonstrated and few studies have reported that Chrono-moxibustion may regulate the circadian rhythm of RA. We therefore designed a randomized trial to explore the effective difference of Chrono-moxibustion in RA treatment, as well as to study its influence on circadian rhythm of RA patients.

Methods:
This study is a randomized controlled trial involving 120 participants, and a total of 90 eligible RA patients will be randomly allocated to three groups in a 1:1:1 ratio as moxibustion at 7 to 9 am, moxibustion at 5 to 7 pm, and waiting list group, meanwhile, 30 healthy people will be divided into the control group. Patients in moxibustion groups will be treated for 30 minutes per session, 3 times a week, lasting 6 weeks. All of RA patients will be evaluated with questionnaires and laboratory tests before treatment, as well as 3 weeks, 6 weeks, and 3 months after treatment. One way analysis of variance (ANOVA) with multiple comparisons will be applied to identify differences more than two groups. Halberg cosiner software will be used to analysis the circadian rhythm.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
This study will provide evidence-based evidence for the effective difference of Chrono-moxibustion in RA treatment and its influence on circadian rhythm of RA patients.
Typeable ampicillin-resistant Haemophilus influenzae strains in Tunisian’s children
Authors: Mzilem Sabrine , Boukhchina Sadok 
Published: September 2022

Background:
Here, we report the frequency of capsulated ampicillin-resistant Haemophilus influenzae strains isolated from children in Tunisia, particularly capsular serotype b, by polymerase chain reaction (PCR) to determine the molecular mechanisms underlying ampicillin resistance.

Methods:
We considered 22 capsulated H influenzae strains selected from a series of 91 ampicillin-resistant H influenzae strains isolated from children between 2010 and 2011 in Tunisia. The capsular serotypes of these strains were identified by slide agglutination and PCR.

Results:
By PCR, 19 (20.88%) serotype b, 1 (1.1%) serotype a, 2 (2.2%) serotypes d and f and 69 (75.82%) non-typeable strains were found among the 91 ampicillin-resistant H influenzae strains. 100% of the assumption between the consequences of antigenic examinations and PCR was found. The serotype b strains showed biotypes I, II, III, IV, VI, and VIII. The other capsulated strains showed biotypes IV and VIII. Thirteen of the serotype b strains created β-lactamase (14.28%). The 19 serotype b ampicillin-resistant H influenzae strains were subdivided into 3 bunches as indicated: The gathering of the β-lactamase positive, ampicillin-resistant where 11 strains (57.89%) were β-lactamase positive bla
TEM-1 (+) and ftsI (+). The second gathering of the β-lactamase negative, ampicillin-resistant strains, where 6 isolates (31.58%) were β-lactamase negative bla
TEM-1 (−) and ftsI (−), and lastly, the gathering of the β-lactamase positive, amoxicillin-clavulanate resistant where 2 isolates (10.52%) were β-lactamase positive bla
TEM-1 (+) and ftsI (−).

Conclusion:
PCR should be used in our country because it may contribute to decreasing the probability of transmission of these strains, especially those showing the two mechanisms of resistance among children in Tunisia.
A clinical study to observe the efficacy and safety of Besunyen Detox Tea for constipation
Authors: Fei Wenting , Zhang Jianjun , Wang Linyuan , Yang Yi , Chen Yan , Chen Yawen , Tao Ran , Zhu Yingli 
Published: September 2022

Introduction:
Functional constipation (FC) is a common functional gastrointestinal disease and is one of the most common outpatient diseases. The purpose of this study was to investigate the efficacy and safety of the traditional Chinese medicine Besunyen Detox Tea (BDT) for FC and to compare the effect of BDT between constipation patients with and non-dryness-heat syndrome.

Methods and analysis:
This multicenter, prospective, observational registry study included 1000 participants diagnosed with FC. This study will collaborate with 3 comprehensive hospitals and 15 community hospitals and recruit patients into the registry between July 2022 and July 2023. After enrollment, we will collect the individual characteristics of each patient, anthropometric data and general condition, bowel movement, patient assessment of constipation symptoms, patient assessment of constipation quality of life, TCM syndrome scale, and time to take the laxative product again after treatment. We will also record adverse events and economic indicators at each visit.

Discussion:
This is the first registry-based study to collect real-world data of participants diagnosed with FC receiving BDT treatment. The results of this registry may also reflect these characteristics and provide direct clinical evidence to verify the importance of syndrome differentiation and treatment for the use of TCM health care products.
Sintilimab combined with chidamide in the treatment of extranodal nature killer/T-cell lymphoma with secondary hemophagocytic lymphohistiocytosis: Two case reports and literature review
Authors: Xu Qing-Yuan , Yang Hai-Yan , Li Mei-Wei , He Zhen-Dong , Hong Hao-Yuan , Peng Zhi-Gang 
Published: September 2022

Rationale:
Extranodal nature killer/T-cell lymphoma (ENKTL) failing in asparaginase-containing treatments is fatal, it has a higher mortality rate when accompanied by secondary hemophagocytic lymphohistiocytosis (HLH). The study reported 2 ENKTL-related HLH patients.

Patient concerns:
Patient 1 visited for nasal congestion and runny nose for 6 months then got a fever and serious myelosuppression after P-GEP (pegaspargase, gemcitabine, etoposide, and methylprednisolone) chemotherapy. Patient 2 complained of painless lymphadenectasis in the right neck for 4 months and experienced recurrent fever and poor performance status after 3 cycles of P-Gemox (pegaspargase, gemcitabine, and oxaliplatin) chemotherapy.

Diagnoses:
Patient 1 and patient 2 were diagnosed as ENKTL failing in asparaginase-based chemotherapy and involving secondary HLH.

Interventions:
The dose of chidamide was 20 mg twice a week for 2 weeks and sintilimab was 200 mg once every 3 weeks.

Outcomes:
ENKTL was relieved and the HLH was resolved after the therapy of sintilimab and chidamide. The patients had achieved durable survival without immune-related adverse events.

Lessons:
ENKTL-related HLH needs early diagnosis and treatment. The combined strategy of sintilimab plus chidamide help deal with HLH and solve ENKTL, it may be a useful treatment option for ENKTL-related HLH.
The efficacy of parecoxib in improving pain after total knee or total hip arthroplasty: Systematic review and meta-analysis
Authors: Hong Chuan , Xie Hai-Yan , Ge Wu-Kun , Yu Min , Lin Shuai-nan , Liu Cheng-Jiang 
Published: September 2022

Background:
The cyclooxygenase-2 (COX-2) selective inhibitor parecoxib is widely used in the treatment of pain and inflammation. Parecoxib has been adopted for use for postoperative analgesia following a range of surgical procedures (orthopedic, general, gynecological, and dental surgery). Total knee or total hip arthroplasty (THA) surgery is mostly done in older patients, so postoperative analgesics need to be used more carefully, and the safety and efficacy of parecoxib in this type of surgery need to be further verified. The aim of this study was to investigate the effects of parecoxib on patient safety, cumulative morphine consumption and was at 24 and 48 hours in the analgesic treatment of total knee or THA for meta-analysis and systematic review, with few studies in this area so far.

Methods:
We searched the Online Database Cochrane Library, PubMed, Web of Science, EMBASE, and CBM (SinoMed), CNKI, VIP, WANFANG up to January 2021. According to the value of I
2, the random-effect model or fixed-effect model was supposed to combine data from studies, respectively. Publication bias was assessed through funneling plot and Beggs test. Review Manager 5.3 and Stata 16.0 software were applied to perform the statistical analyses.

Results:
Eleven RCTs which involved 1690 participants were included in this study. The meta-analysis indicated parecoxib sodium could not significantly reduce the incidence of adverse events after total knee or THA compared with placebo. There was no statistical significance in incidence of nausea and vomiting. 24 hours resting VAS score was statistically significant between the group. The 48-hour resting VAS scores did not indicate a significant difference between the groups.

Conclusion:
Parecoxib can reduce the incidence of adverse events after total knee or total hip surgery to some extent but cannot reduce the incidence of nausea and vomiting. Twenty-four hour postoperative analgesia is better than placebo, but 48 hours after operation analgesia is the same as placebo.
Efficacy of immune checkpoint inhibitor as maintenance therapy for advanced or metastatic cancers: A meta-analysis of randomized controlled trials
Authors: Mo Dun-Chang , Huang Jian-Feng , Luo Peng-Hui , Huang Shang-Xiao , Wang Han-Lei 
Published: September 2022

Background:
This study aimed to evaluate the efficacy of immune checkpoint inhibitors (ICIs) as maintenance therapy for advanced or metastatic cancers.

Methods:
The PubMed, Embase, and Cochrane Library databases were searched for eligible randomized controlled trials. A meta-analysis of eligible studies investigating the outcomes including progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) with a significance level set to 0.05 was performed.

Results:
Five RCTs (n = 2828) were identified in this analysis. The pooled hazard ratios (HRs) of PFS and OS for ICI maintenance therapy were 0.88 (95% CI: 0.68–1.13, P = .31) and 0.82 (95% confidence interval [CI]: 0.74–0.92, P = .0005), respectively; the pooled odds ratio (OR) of ORR was 2.24 (95% CI: 1.23–4.09, P = .0008). Subgroup analysis indicated that anti-PD-L1 antibody significantly improved the OS (P = .0008), while anti-PD-1 and anti-PD-1 plus anti-cytotoxic T lymphocyte antigen 4 antibodies significantly prolonged the PFS of patients.

Conclusion:
ICI maintenance therapy enhanced the survival of patients with advanced or metastatic cancers.
Brief Report: Use of Pre-Exposure Prophylaxis to Prevent Rapid HIV Transmission Among People Who Inject Drugs in Rural Counties in the United States: A Modeling Study
Authors: Jacka Brendan P. , Nolen Shayla , Bessey Sam E. , Zang Xiao , Goedel William C. , Yedinak Jesse L. , Marshall Brandon D.L. 
Published: September 2022

Background:
Despite recent HIV outbreaks among people who inject drugs (PWID) in nonurban US settings, syringe service programs (SSP) are often inaccessible in these communities. Furthermore, pre-exposure prophylaxis (PrEP) awareness and coverage for PWID is limited. We aimed to model the impact of PrEP on HIV transmission among PWID in a rural setting.

Setting:
Using a calibrated agent-based model, we simulated HIV transmission in an adult population (n = 14,573 agents) in Scott County, Indiana between 2015 and 2024.

Methods:
We modeled PrEP eligibility according to CDC guidelines for PWID. PrEP coverage increased by 15% points in the range 10%–70%. Two counterfactual scenarios were modeled: Unrestricted access for PWID and PrEP for SSP attendees. We calculated the number of new HIV infections and number of person-years on PrEP per averted infection.

Results:
In the status quo scenario, 153 (95% Simulation Interval: 85, 259) new HIV infections occurred among PWID over 10 years. Compared with the status quo, 40% PrEP coverage resulted in 25% fewer HIV infections in the Unrestricted access for PWID scenario and 10% fewer HIV infections in the PrEP for SSP attendees scenario. The PYPAI was 21 and 43 in the Unrestricted access for PWID and PrEP for SSP attendees scenarios, respectively.

Conclusion:
Our modeling suggests that PrEP provides substantial benefit to PWID in rural US communities, with fewer restrictions on access providing the greatest effect. Control of HIV outbreaks will require expansion of public health interventions that meet the needs of all individuals.
Limited Impact of First-Line Drug Resistance Mutations on Virologic Response Among Patients Receiving Second-Line Antiretroviral Therapy in Rural Uganda
Authors: Moore David M. , Nanfuka Mastula , Zhang Wendy , Okoboi Steven , Kaleebu Pontiano , Kapaata Anne , Zhu Julia , Tibengana Baker , Birungi Josephine 
Published: September 2022

Background:
Delayed detection of ART failure in settings without access to viral load (VL) monitoring has been hypothesized to lead to suboptimal response to second-line therapy due to accumulated drug resistance mutations (DRMs). We tested this hypothesis in a program setting in rural Uganda.

Methods:
From June 2012 to January 2014, we enrolled participants receiving nonnucleoside reverse transcriptase inhibitor–based first-line ART for ≥4 years, without access to VL monitoring. Participants who had a measured VL ≥ 1000 copies/mL on two occasions were switched to protease inhibitor–based regimens and followed every 6 months until September 2016. We measured VL at study exit. We conducted DRM testing at enrollment and study exit and examined factors associated with virologic failure.

Results:
We enrolled 137 participants (64.3% female) with a median age of 44 years and a median duration on ART of 6.0 years. In a median of 2.8 years of follow-up, 7 (5%) died, 5 (3.6%) voluntarily withdrew, and 9 (6.6%) became lost to follow-up. Of 116 participants with a VL result at study exit, 20 (17%) had VL > 1000 copies/mL. Virologic failure was associated with reporting suboptimal adherence (P = 0.028). Of patients with DRM data at enrollment, 103 of 105 (98%) had at least 1 DRM. Participants with thymidine analog mutations at enrollment were less likely to have virologic failure at study exit (11% vs. 36%; P = 0.007). No other DRMs were associated with failure.

Conclusion:
Even in the presence of multiple DRMs on first-line therapy, virologic failure after 3 years of protease inhibitor–based ART was infrequent. Suboptimal adherence to ART was associated with virologic failure.
A Modified Scapular-Parascapular Flap Design for Optimal Coverage of the Residual Limb
Authors: Wade Sean M. , Brandenburg Larissa R. , Michael Nicholas L. , Souza Jason M. 
Published: September 2022

Background
Large soft tissue defects associated with major limb amputation pose a challenge to the reconstructive surgeon due to the 3-dimensional contour of the residual limb and the need to withstand the unnatural shear forces imparted by prosthetic sockets. Fasciocutaneous flaps based on the circumflex scapular system have proven useful for residual limb coverage due to the durability of the tissue provided, the absence of functional morbidity, and the ease of reelevation. A modified, bilobed flap design that incorporates large Burrow triangles into each limb serves to leverage the perforasome anatomy of the posterior trunk to provide maximal 3-dimensional coverage and favorable flap geometry while also facilitating donor site closure.

Methods
A retrospective medical record review was performed for all patients who underwent reconstruction of a residual limb after major amputation using the modified, bilobed scapular-parascapular free flap design at Walter Reed National Military Medical Center between 2018 and 2021. A computer-based application was used to calculate flap area and dimensions based on photographs of preoperative and intraoperative markings.

Results
Six patients with varying amputation levels (2 transtibial, 1 transfemoral, 1 hip-disarticulation, 1 hemipelvectomy, 1 transradial) underwent soft tissue coverage using the modified flap design. Mean flap area was 318.4 cm2 with 51.1 cm2 attributable to the modified design. This represents a 16% increase over a conventional bilobed design. There were no partial or complete flap failures.

Conclusions
The modified scapular-parascapular flap design enables harvest of a larger and more versatile fasciocutaneous flap with geometry that is well suited for coverage of the residual limb.