bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Internal Negative Pressure Delivery System in Prepectoral Breast Reconstruction—Preliminary Experience
Authors: Paul Robert 
Published: January 2022

Background:
Seroma remains a common complication after breast surgery, despite meticulous surgical technique to obliterate dead space and use of standard postsurgical drains for fluid evacuation. Therefore, novel approaches are needed. The Interi System is an internal, negative-pressure delivery system consisting of a manifold that is a silicone tubing with a central trunk and three peel-apart channeled branches connected to an external therapy unit, which simultaneously delivers continuous negative pressure of 125 mm Hg and removes excess fluid from internal tissue planes. This retrospective study evaluated the safety and effectiveness of Interi compared with standard drains in consecutive patients undergoing immediate, prepectoral, acellular dermal matrix-assisted, and implant-based breast reconstruction.

Methods:
Patient records were reviewed, and data on demographics, mastectomy, and reconstructive variables, postoperative complications, fluid output volume, and manifold/drain duration were retrieved and compared between the two groups.

Results:
Interi was used in 23 patients (38 breasts) and standard drains in 23 patients (39 breasts). Patients in both groups were well matched in all demographic, reconstructive, and mastectomy variables. Interi duration was significantly shorter than drains (16.7 versus 19.7 days; P = 0.020). There were no instances of seroma formation after removal of the manifold, edematous flap, or reconstructive failure with Interi. Seroma rate was 20.5% after drain removal (P = 0.005). All other complications were similar between the two groups.

Conclusion:
Interi effectively removed excess fluid from internal tissue compartments in prepectoral breast reconstruction and may offer significant improvement over current standards of care for seroma prevention in this procedure.
The Effect of the Coal Industry on Indoor Radon Concentrations in eMalahleni, Mpumalanga Province of South Africa
Authors: le Roux Rikus 
Published: January 2022

Abstract
South Africa has rich coal deposits concentrated in the northeast of the country, and as a result, most of the country’s coal mining is located in this region. Two of the principal coalfields exploited are the Witbank and Highveld coalfields, located in the Mpumalanga province. Coal contains trace quantities of the naturally occurring radionuclides whose mass concentration can be enhanced by anthropogenic activity. The radioactive fallout from these activities could lead to elevated radon concentrations indoors. Two towns, Secunda and eMalahleni, were identified due to their proximity to coal-based industries. A previous study investigated whether these industries caused elevated radon levels in Secunda homes but found a lower-than-expected average concentration of 76.4 ± 7.6 Bq m−3. This was attributed to either the prevailing wind depositing the radioactive fallout to neighboring towns, such as eMalahleni, or the type of industrial activity. This paper builds on this study by investigating whether elevated radon levels are found in homes in eMalahleni. Measurements were performed in 22 homes during December 2019, and the average indoor radon concentration was calculated as 122.1 ± 8.5 Bq m−3. The cause of these elevated levels was then investigated, and it was found that even though the coal industry contributes to elevated radon levels, the town’s underlying geology seems to be the primary contributor.
Radiopharmaceutical Extravasation: Pragmatic Radiation Protection
Authors: Fisher Darrell R. , Liverett Misty 
Published: January 2022

Abstract
Inadvertent injection of a radiopharmaceutical agent into a patient's arm tissue instead of into the appropriate blood vessel can cause the injection to infiltrate underlying tissue and produce a potentially substantial, localized irradiation to the patient's arm and skin tissue. When this type of misadministration occurs, called an extravasation, it should be recognized, mitigated, and monitored for patient health and safety. Immediate symptoms of radiopharmaceutical extravasation may include swelling, edema, pain, or numbness in the vicinity of the extravasation site; inflammation; and drainage from the site. Some infiltrations may go unnoticed until later. Pragmatic elements of radiation safety include imaging to assess the geometry, volume, and anatomic distribution of activity, collection of tissue count-rate data over retention times, calibration against known activity levels, and dosimetry to help clinicians determine whether an extravasation is severe and whether the patient should be followed for adverse tissue reactions.
Glaucoma Progression After Lens Extraction in Primary Angle-closure Glaucoma According to Angle-closure Mechanism
Authors: Song Min Kyung , Sung Kyung Rim , Shin Joong Won 
Published: January 2022

Précis:
Long-term prognosis of primary angle-closure was assessed after lens extraction (LE) according to different mechanisms of angle closure (AC). Patients with pupillary block (PB) had a higher probability of glaucomatous progression than patients with plateau iris configuration (PIC).

Purpose:
The aim was to investigate and compare the clinical characteristics and long-term prognosis of primary angle-closure disease (PACD) after LE according to different mechanisms of AC.

Methods:
In this retrospective observational cohort study, 118 eyes with PACD that underwent LE (mean follow-up; 6.0±3.5 y after surgery) were included. PACD eyes were categorized into three subgroups according to their dominant AC mechanisms, determined by anterior segment optic coherent tomography obtained before LE; PB, PIC, and exaggerated lens vault (ELV). Postoperative glaucomatous progression was determined according to functional (visual field) or structural (optic disc photographs or optic coherent tomography measured retinal nerve fiber layer thickness) criteria. Univariate and multivariate logistic regression analysis was performed to determine the risk factors associated with glaucomatous progression.

Results:
Fifty-two, 51, and 15 eyes with PB, PIC, and ELV, respectively, were included. All eyes showed significant intraocular pressure reduction, with a greater reduction in the ELV group than in the PB group after LE (27.0% vs. 12.5%, P=0.018). Lower baseline retinal nerve fiber layer thickness [odds ratio (OR): 0.966, P=0.004] and thinner central corneal thickness (OR: 0.985, P=0.021), and the PB group (OR: 2.891, P=0.022, reference to PIC group) were significantly associated with glaucomatous progression after LE.

Conclusions:
In eyes with PACD, glaucoma progression was observed following LE despite reduced intraocular pressure. The probability of progression was highest in eyes with pupil block as a mechanism of AC. Close monitoring of glaucoma in these patients is suggested.
How do placebo effects contribute to mindfulness-based analgesia? Probing acute pain effects and interactions using a randomized balanced placebo design
Authors: Davies Jonathan N. , Sharpe Louise , Day Melissa A. , Colagiuri Ben 
Published: January 2022

Abstract
Recent sham-controlled studies suggest placebo effects contribute to acute pain relief after mindfulness interventions. However, the specific effects of mindfulness processes and their interaction with placebo effects remain unclear. This study aimed to characterize the role of mindfulness and placebo processes underlying mindfulness-based pain attenuation. Both treatment (focused attention mindfulness vs sham) and instruction (told mindfulness vs told sham) were manipulated in a balanced placebo design. Changes in acute heat pain were evaluated in 153 healthy adults randomized to receive 6 × 20 minutes of 1 of 4 treatment by instruction interventions or no treatment. Participants receiving any intervention demonstrated improved pain outcomes (unpleasantness, intensity, and tolerance) relative to those receiving no treatment. The instruction manipulation increased expectation for pain relief in those told mindfulness relative to those told sham, but there were no main effects or interactions of treatment or instruction on pain outcomes. However, irrespective of actual intervention received, the belief of receiving mindfulness predicted increased pain threshold and tolerance, with expectancy fully mediating the effect on pain tolerance. These findings suggest a lack of specific effects of mindfulness and instruction on acute pain. Nonetheless, participants' expectancies and beliefs about the treatment they received did predict pain relief. Together with the overall improvement after any intervention, these findings suggest that expectancy and belief may play a stronger role in attenuating acute pain in novices following brief mindfulness interventions than the actual mindfulness-specific processes or instructions delivered.
Individually unique dynamics of cortical connectivity reflect the ongoing intensity of chronic pain
Authors: Mayr Astrid , Jahn Pauline , Deak Bettina , Stankewitz Anne , Devulapally Vasudev , Witkovsky Viktor , Dietrich Olaf , Schulz Enrico 
Published: January 2022

Abstract
Chronic pain diseases are characterised by an ongoing and fluctuating endogenous pain, yet it remains to be elucidated how this is reflected by the dynamics of ongoing functional cortical connections. In this study, we investigated the cortical encoding of 20 patients with chronic back pain and 20 chronic migraineurs in 4 repeated fMRI sessions. A brain parcellation approach subdivided the whole brain into 408 regions. Linear mixed-effects models were fitted for each pair of brain regions to explore the relationship between the dynamic cortical connectivity and the observed trajectory of the patients' ratings of fluctuating endogenous pain. Overall, we found that periods of high and increasing pain were predominantly related to low cortical connectivity. The change of pain intensity in chronic back pain was subserved by connections in left parietal opercular regions, right insular regions, as well as large parts of the parietal, cingular, and motor cortices. The change of pain intensity direction in chronic migraine was reflected by decreasing connectivity between the anterior insular cortex and orbitofrontal areas, as well as between the PCC and frontal and anterior cingulate cortex regions. Of interest, the group results were not mirrored by the individual patterns of pain-related connectivity, which rejects the idea of a common neuronal core problem for chronic pain diseases. The diversity of the individual cortical signatures of chronic pain encoding results adds to the understanding of chronic pain as a complex and multifaceted disease. The present findings support recent developments for more personalised medicine.
Effectiveness of different acupuncture therapies for chronic cancer pain
Authors: Wan Qingyun , Chen Hao , Wang Xiaoqiu , Xi Hanqing , Zheng Shiyu , Luo Shuting , Wu Wenzhong , Pan Rui 
Published: January 2022

Abstract

Background:
Pain is a common and distressing symptom experienced by cancer patients. Previous research found acupuncture was associated with significant reductions in pain intensity and opioid use. Acupuncture therapies are various, and the difference in efficacy and safety has never been assessed. This paper aims to assess and rank the effectiveness of the different acupuncture methods and provide an acupuncture treatment guideline for relieving chronic pain in cancer survivors.

Methods:
Four English databases (PubMed, Embase, Cochrane library, and Web of Science) and 4 Chinese databases (China National Knowledge Infrastructure, Wanfang Data, and Chinese Biomedical Literature Database) will be searched for randomized controlled trials (RCTs) published from the database inception to November 30, 2021. The primary outcomes will be patient-reported pain intensity measured by the Brief Pain Inventory, Visual Analog Scale, Verbal Rating Scale, Numerical Rating Scale, and other valid outcome measures. The Grading of Recommendations Assessment, and Development and Evaluation System will evaluate the quality of evidence. Bayesian network meta-analysis will be performed in WinBUGS V.1.4.3 to determine the comparative effectiveness of the acupuncture therapies.

Results:
This study will quantify the effectiveness of each acupuncture intervention for chronic cancer pain with pain scores and the use of analgesics. The adverse events of acupuncture treatment for cancer pain will also be reported.

Conclusion:
The conclusion of our study will help physicians and patients choose suitable acupuncture methods to manage cancer pain.
Cyclosporin-A reduced the cytotoxicity of propranolol in HUVECs via p38 MAPK signaling
Authors: Lv Zhong , Xie Guanhao , Cui Haowen , Yao Zhi , Shao Congxiang , Yuan Weiquan , Chen Bailing 
Published: January 2022

Abstract
Propranolol (PROP) is a nonselective β-adrenergic receptor antagonist used to treat hypertension and cardiac arrhythmias. Oral administration of PROP has recently emerged as a new treatment modality for hemangiomas. However, the side effects of PROP at the cellular level have not been adequately described.
The present study investigates and highlights the mechanisms of coupling of the drugs cyclosporin-A (CyA) and PROP on cell proliferation and the occurrence of apoptosis. It also relays the antioxidant effect of PROP on human umbilical vein endothelial cells (HUVECs).
HUVECs were treated with CyA and PROP. At 24 hours after treatment, the levels of reactive oxygen species (ROS), cell proliferation, and apoptosis were determined using the ROS kit, MTT assay, and Annexin V staining. In addition, the related proteins of phospho-p38 mitogen-activated protein kinase were determined by western blotting. Subsequently, HUVECs pretreated with CyA or PROP were treated with the p38 inhibitor (SB203580). Finally, the ROS level, cell proliferation, and apoptosis were measured again in both active HUVECs and HUVECs, in which the p38 proteins were inhibited.
The combination of CyA and PROP reversed the effect of CyA on cell viability, reduced the ROS level and the cell apoptosis induced by PROP. Moreover, inhibition of p38 protein catalase activity immediately stopped the effect of CyA–propranolol in HUVECs.
The effect of the CyA–propranolol combination on HUVECs is associated with the p38 pathway changes, which is proven to be a potential chemotherapeutic agent that minimizes the side effects of PROP in hemangioma therapy.
Predictive value of liver cirrhosis using metabolite biomarkers of bile acid in the blood
Authors: Han Xu , Wang Juan , Gu Hao , Liao Xing , Jiang Miao 
Published: January 2022

Abstract

Background:
Previous studies have indicated that the changes of bile acids are associated with liver cirrhosis. The objective of our study is to perform a systematic review to explore the relationship between bile acids and the pathologic process of cirrhosis, and to find minimally invasive, accurate and reliable potential biomarkers for predicting cirrhosis.

Methods:
EMBASE, the Cochrane Library, PubMed, Web of Science, WanFang Data and Chinese National Knowledge Infrastructure (CNKI) will be searched, using the search strategy of liver cirrhosis, bile acids and metabolomic. The screening process will be conducted strictly based on inclusion and exclusion criteria. Clinical studies based on human including randomized controlled trial, cohort study and case control study will be included without restriction of time. Cochrane collaboration's tool for assessing risk of bias and Newcastle-Ottawa Scale (NOS) will be applied to assess the risk of bias to randomized controlled trial and observational study, respectively. The bile acids and their concentrate which are different between liver cirrhosis and control group will be the mainly outcome. A qualitative analysis will be performed to profile the trajectory change of bile acids, then the meta-analysis will be done for quantitative analysis.

Results:
The bile acids profile of liver cirrhosis that has potential predictive value for cirrhosis will be identified.

Conclusion:
The conclusion of this systematic review will finding potential biomarkers for predicting cirrhosis.

Ethics and dissemination:
This systematic review is based on published researches, so there is no ethical approval required. We intend to disseminate our findings in a peer-reviewed journal.
Comparison of clinical outcome between stereotactic body radiotherapy and radiofrequency ablation for unresectable hepatocellular carcinoma
Authors: Ji Ren , Ng Kelvin K. , Chen Wenqi , Yang Weihong , Zhu Hongtao , Cheung Tan-To , Chiang Chi-Leung , Wong Tiffany C.L. , Kong Feng-Ming , Wu G. , Lo Chung-Mau 
Published: January 2022

Abstract
Stereotactic body radiotherapy (SBRT) is a novel noninvasive treatment for unresectable hepatocellular carcinoma (HCC). Whether its efficacy is comparable to radiofrequency ablation (RFA), a recommended therapy for unresectable HCC, is unknown. The present study aims to compare the clinical outcome between SBRT and RFA for patients with unresectable HCC.
The clinical data of 60 patients with unresectable HCC from January 2018 to January 2021 were retrospectively reviewed. There were 22 cases treated by SBRT and 38 cases by RFA. The short-term and long-term clinical outcomes were compared.
There was no significant difference in the baseline demographic characteristics between two groups. The complete remission rate at 3 months was comparable between SBRT group (81.8%) and RFA group (89.4%). Local tumor control rate was also similar between two groups (90.9% vs. 94.7%). There was no severe complication (grade IIIa or above) in both groups. The 1-year and 2-year overall survival rates were 88.2% and 85.7% in SBRT group and 100% and 75% in RFA group, respectively. There was no statistical significant difference between groups (P = .576).
SBRT can achieve similar short and long-term clinical outcome as RFA for unresectable HCC. Future prospective clinical study is needed to justify its role in patients with HCC.
Serum cadmium is associated with hepatic steatosis and fibrosis
Authors: Han Seogoo , Sung Gi-Ho , Lee Sangheun , Han Ki Jun , Han Hyun-Jeong 
Published: January 2022

Abstract
Although cadmium (Cd) is correlated with elevated levels of hepatic amino transferases, its influence on the degree of liver steatosis and fibrosis are unknown yet. We aimed to investigate the associations between the serum level of Cd and degree of liver steatosis/fibrosis.
Clinical data were obtained from Korean National Health and Nutrition Examination Surveys IV–VII. Alanine aminotransferase (ALT) elevation was defined as ≥ 33 IU/L for men and ≥ 25 IU/L for women. Significant steatosis was defined as a hepatic steatosis index ≥ 36, while significant fibrosis was defined as a fibrosis index (FIB-4) ≥ 2.67 and as an aspartate aminotransferase and platelet ratio index ≥ 0.7. Adjusted odds ratios and 95% confidence intervals were calculated after adjustment.
The levels of serum Cd were assessable in 15,783 subjects. The serum cadmium concentrations were significantly associated with ALT elevation, significant liver steatosis and fibrosis. Multivariate logistic regression analysis demonstrated serum Cd level in the forth quartile had a positive correlation with ALT elevation, hepatic steatosis index ≥ 36, FIB-4 ≥ 2.67 and aspartate aminotransferase-to-platelet ratio ≥ 0.7 using the first quartile of serum Cd level as the reference, (adjusted odds ratios 1.90, 1.26, 1.73, and 2.53, respectively; P values <.001).
The serum level of Cd was associated with liver steatosis and fibrosis. The evaluation of serum Cd may help for assessing an unexplained liver steatosis and fibrosis, and further prospective studies are needed to confirm our findings.
Factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty
Authors: Jang Jae Seok , Choi Won Kee 
Published: January 2022

Abstract
We researched on the factors affecting the duration of antibiotic use due to surgical site inflammation after complication-free classical total knee arthroplasty (TKA).
Four hundred and eighty-nine cases who underwent primary TKA performed by 1 surgeon from January 2015 to December 2018 were enrolled. Including the day of operation, first-generation cephalosporin was injected intravenously for 3 days for antimicrobial prophylaxis. At the third postoperative day, we inspected the surgical wound for any signs of inflammation. If there were any signs of redness, pain, heatness, or swelling, which are the cardinal signs of superficial incisional surgical site infection defined by the Centers of Disease Control (CDC), additional antibiotics were injected until the symptoms of surgical site inflammation improved. We presumed that the duration of antibiotic use was affected by factors including gender, age, body mass index, whether operating on both legs or one leg, predisposing diabetes mellitus, preoperative glomerular filtration rate, preoperative serum albumin level, prior history of anticoagulant usage including anti-platelet agents, allogenic blood transfusion during admission, and total operative time.
Average duration of intravenous antibiotic use in 489 cases was 5.73 ± 4.03 days. Pearson correlation analysis showed significant correlation (P < .01) between operative time and duration of antibiotic use due to surgical site inflammation. In univariate analysis, total operative time and transfusion were factors affecting the duration of antibiotic use due to surgical site inflammation (<6 days or ≥6 days). Multivariate analysis of age, gender, body mass index, staged bilateral TKA, diabetes mellitus, preoperative glomerulus filtration rate, preoperative albumin level, prior history of anticoagulant usage, allogenic blood transfusion during admission, and total operative time revealed that longer operative time was related to higher likelihood of antibiotic use for >6 days during admission.
When prophylactic antibiotics are prescribed, surgeons must note that signs of superficial incisional surgical site inflammation after classical complication free TKA may manifest more often in patients with longer operative time.
Long-term treatment with streptozocin/5-fluorouracil chemotherapy in patients with metastatic pancreatic neuroendocrine tumors
Authors: Müller Christian , Kreissl Michael C. , Klose Silke , Krause Andreas , Keitel Verena , Venerito Marino 
Published: January 2022

Abstract

Rationale:
Pancreatic neuroendocrine tumors (pNETs) are rare entities representing 1% to 3% of all malignant pancreatic neoplasms. Current guidelines recommend a combination of streptozocin (STZ) and 5-fluorouracil (5-FU) for patients with metastatic well-differentiated pNETs requiring systemic therapy. The highest median progression-free survival rate reported in previous studies for this combination was 23 months (95% confidence interval 14.5–31.5). However, it remains unclear for how long this regimen can be safely administered.

Patient concerns:
We report about 3 therapy-naïve patients with metastatic G2 (Ki67 10%–15%) pNETs treated with STZ/5-FU, that achieved sustained disease control for longer than 36 months.

Diagnosis:
Metastatic, well-differentiated G2 pNETs

Interventions:
Systemic chemotherapy with STZ/5-FU was administered until the disease progressed. In 1 case showing a mixed response, selected metastases of increasing size were additionally treated with surgery and brachytherapy.

Outcomes:
In our 3 patients with metastatic G2 pNETs, STZ/5-FU induced long-term disease control over 44, 42, and 95 months, respectively. No side effects that led to treatment discontinuation were observed.

Lessons:
In patients with metastatic G2 pNETs achieving disease control, STZ/5-FU can be safely administered.