bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicophysiological and hematobiochemical effect of dexmedetomidine or diazepam with ketamine and propofol in total intravenous anesthesia in goats
Authors: Ragab G. , Hassan S. E. , Fathi M. Z. , Hagag U. 
Published: April 2022

AbstractBackgroundTotal intravenous anesthesia (TIVA) is a well-documented anesthetic concept for some animal species, including dogs and horses; however, information about TIVA protocols in goats is currently inadequate. Therefore, this study aimed to compare the clinicophysiological and hematobiochemical effects of dexmedetomidine (DEX) and diazepam premedication with ketamine and propofol.ResultThe DEX-treated group showed a significantly decreased heart rate compared with the diazepam-treated group. Onset of anesthesia and sedation in group I was significantly faster than that in group II (0.33 ± 0.08 and 0.25 ± 0.08 min vs. 3.33 ± 1.53 and 2.0 ± 1.0 min, respectively). Duration of anesthesia and sedation in group I was significantly longer than that in group II (66.67 ± 7.64 and 161.3 ± 43.3 min vs. 37.0 ± 5.19 and 60.33 ± 7.57 min, respectively). The total recovery period in group II was significantly shorter than that in group I (47.0 ± 7.21 vs. 98.33 ± 15.27 min).Smooth induction and recovery occurred in all goats in group I, whereas most goats in group II exhibited slightly prolonged induction with mild excitation and presence of swallowing reflex and prolonged struggling during recovery.ConclusionIn TIVA, premedication with DEX produces excellent quality anesthesia, analgesia, sedation, and muscle relaxation. Furthermore, it produces a longer duration of anesthesia, sedation, and analgesia than premedication with diazepam. For these reasons, DEX is more suitable for long surgical procedures, whereas diazepam can be used in minor surgical procedures in goats. Both drug combinations produce hemodynamic stability.
Conventional 3-port vs. single-incision laparoscopic oophorectomy for ovarian cryopreservation in paediatric surgery: a retrospective case-note review
Authors: Metcalfe Kiloran , Ghattaura Harmit , Elbourne Ceri , Ashour Khaled , Lane Sheila , Lakhoo Kokila 
Published: April 2022

Abstract
Objective
We aim to compare conventional 3-port with single-incision laparoscopic surgery (SILS) for oophorectomy in patients undergoing ovarian cryopreservation.

Background
Demand for cryopreservation of ovarian tissue prior to the initiation of gonadotoxic treatment has risen significantly since its introduction in England in 2013. Traditionally, laparoscopic oophorectomy is performed using a 3-port technique with an umbilical port and 2 smaller 5-mm working ports. Energy devices can be used to allow haemostatic dissection of the ovary and this is delivered through the umbilical port site. In an attempt to improve efficiency, post-operative outcomes, and enhance cosmesis; our department initiated the use of the Applied Medical GelPoint Mini Advanced Access Platform single port technique using a vertical trans-umbilical approach for ovarian cryopreservation.

Methods
All patients undergoing laparoscopic oophorectomy for cryopreservation between September 2013 and August 2017 were included. The patients were consented for SILS, 3-port and open oophorectomies. All patients received maximum local anaesthetic wound infiltration intra-operatively. Case notes and theatre electronic data were reviewed and data was collected on additional procedure, conversion rate, operative time, post-operative analgesia requirement, complications and length of hospital stay.

Results
A total of 106 patients underwent laparoscopic oophorectomy during the study period. Of these, 40 underwent conventional 3-port, 65 had SILS and 1 patient had open. No cases were converted from the intended method. There was a statistically significant difference in the mean operative time; with SILS being faster than the conventional 3-port method (SILS: 40.4 min; 3-port: 51.7 min; p = 0.017). There was no difference in length of stay or perioperative analgesics, and complication rates in both groups were low. Informal qualitative feedback included surgeons stating that the ovary was much easier to deliver using the SILS technique. Patients were also happy with a single cosmetically appeasing scar hidden within the umbilicus.

Conclusion
SILS is an acceptable technique in ovarian cryopreservation allowing a quicker operative time, easier delivery of the ovary, and better cosmesis. A learning curve is recognised due to the ergonomics of single port laparoscopy; however, the technique can be established easily in departments with existing laparoscopic capabilities. This is the first paper which establishes this within a Paediatric Surgical setting, and adult literature suggests that further prospective trials may prove some benefit in ovarian tissue volume or time to initiation of treatment due to enhanced recovery.
Dysphonia of exceptional origin: lichen planus of the vocal fold — a case report of a very uncommon area affected by lichen planus
Authors: Pino Gisela Risson , Pérez Irene Rodríguez , Guede Beatriz Bhathal , Navarro José Granell 
Published: April 2022

AbstractBackgroundLichen planus is an immune-mediated chronic inflammatory condition of unknown origin that affects the skin and the mucosa. Lichen planus in the larynx is not common, and there are few cases reported in literature. We report an unusual case of lichen planus in the vocal fold.Case presentationWe present a case of a 62-year-old Caucasian male with a 2-month history of persistent dysphonia and a smoking habit of about 10 cigarettes per day. He has no previous history of systemic disease, and he was not taking any drug for treatment. Fiber-optic laryngoscopy showed a single white rough lesion in the middle third of the right vocal fold. The diagnosis was performed with direct laryngoscopy. Complete excisional biopsy was used as a treatment method. Chest X-ray and blood test were normal. The biopsy reported lichen planus and mild dysplasia. The voice quality improved after the laryngeal microsurgery, and a close follow-up was advised.ConclusionsThere are few cases of lichen planus in the vocal fold reported in the literature, presenting as a unilateral and isolated lesion or concomitant with oral and genital lesions. Other cases mainly report lesions that affect more than one area of the larynx, with undefined margins or with marked cicatrization. Oral or topical corticosteroids, in this case, were not required because of total extirpation of the lesion but may be necessary in case of recurrence. Although lichen planus of vocal fold is very uncommon, it should be consider in differential diagnosis of leukoplakia of the larynx and once diagnosed could be manage with corticosteroid drugs avoiding aggressive treatment.
Dissociative identity state-dependent working memory in dissociative identity disorder: a controlled functional magnetic resonance imaging study
Authors: Vissia Eline M. , Lawrence Andrew J. , Chalavi Sima , Giesen Mechteld E. , Draijer Nel , Nijenhuis Ellert R. S. , Aleman André , Veltman Dick J. , Reinders Antje A. T. S. 
Published: April 2022

Background
Memory function is at the core of the psychopathology of dissociative identity disorder (DID), but little is known about its psychobiological correlates.

Aims
This study aims to investigate whether memory function in DID differs between dissociative identity states

Method
Behavioural data and neural activation patterns were assessed in 92 sessions during an n-back working memory task. Participants were people with genuine diagnosed DID (n = 14), DID-simulating controls (n = 16) and a paired control group (post-traumatic stress disorder (n = 16), healthy controls (n = 16)). Both DID groups participated as authentic or simulated neutral and trauma-related identity states. Reaction times and errors of omission were analysed with repeated measures ANOVA. Working memory neural activation (main working memory and linear load) was investigated for effects of identity state, participant group and their interaction.

Results
Identity state-dependent behavioural performance and neural activation was found. DID simulators made fewer errors of omission than those with genuine DID. Regarding the prefrontal parietal network, main working memory in the left frontal pole and ventrolateral prefrontal cortex (Brodmann area 44) was activated in all three simulated neutral states, and in trauma-related identity states of DID simulators, but not those with genuine DID or post-traumatic stress disorder; for linear load, trauma-related identity states of those with genuine DID did not engage the parietal regions.

Conclusions
Behavioural performance and neural activation patterns related to working memory in DID are dependent on the dissociative identities involved. The narrowed consciousness of trauma-related identity states, with a proneness to re-experiencing traumatising events, may relate to poorer working memory functioning.
Clinical Benefit of Comprehensive Genomic Profiling for Advanced Cancers in India
Authors: Mathew Aju , Joseph Serena , Boby Jeffrey , Benny Steve , Veedu Janeesh , Rajappa Senthil , Rohatgi Nitesh , Sirohi Bhawna , Jain Reetu , Agarwala Vivek , Shukla Deepak Kumar , Mehta Anurag , Pramanik Raja , Talwar Vineet , Maka Vinayak , Raut Nirmal 
Published: April 2022

PURPOSE Comprehensive genomic profiling (CGP) assay is increasingly used in low-middle–income countries to detect clinically relevant genomic alterations despite its clinical benefits not being well known. Here, we describe the proportion of patients with advanced cancer in India who received targeted therapy for an actionable genetic alteration identified on CGP assays. METHODS This was a multicenter, retrospective cohort study in adult patients with advanced nonhematologic malignancies who underwent a CGP test. If patients received a targeted therapy for ≥ 6 months, they were considered to have obtained a clinical benefit from the medication, whereas those continuing for ≥ 12 months were considered to have attained an exceptional response. Descriptive statistics were used to describe the proportion of patients with subsequent targeted therapy. RESULTS During 2019-2020, 12 medical oncologists provided CGP reports for 297 patients; 221 met the inclusion criteria. Patients received a median of two lines (range: 0-5) of prior systemic therapy. On the basis of the CGP assay, 21 patients (10%) received targeted therapy. Among them, 33% was for human epidermal growth factor receptor 2 (HER2) amplification (nonbreast cancer) and 19% for HER2 or epidermal growth factor receptor exon 20 insertion mutation (lung cancer). After excluding patients with HER2 or epidermal growth factor receptor exon 20 insertions, 8% of 217 patients received targeted therapy. In the overall cohort of 221 patients, clinical benefit was seen in nine patients (4%), of whom two were exceptional responders (1%). CONCLUSION We observed that in a low-middle–income country setting, 10% of patients received targeted therapy on the basis of CGP assay. Only 4% of patients who underwent CGP testing obtained a clinical benefit.
Fuzuloparib Maintenance Therapy in Patients With Platinum-Sensitive, Recurrent Ovarian Carcinoma (FZOCUS-2): A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase III Trial
Authors: Li Ning , Zhang Youzhong , Wang Jing , Zhu Jianqing , Wang Li , Wu Xiaohua , Yao Desheng , Wu Qiang , Liu Jihong , Tang Junying , Yin Rutie , Lou Ge , An Ruifang , Zhang Guonan , Xia Xiaoping , Li Qingshui , Zhu Yaping , Zheng Hong , Yang Xinfeng , Hu Yuanjing , Zhang Xin , Hao Min , Huang Yi , Lin Zhongqiu , Wang Dong , Guo Xiaoqing , Yao Shuzhong , Wan Xiaoyun , Zhou Huaijun , Yao Liangqing , Yang Xielan , Cui Heng , Meng Yuanguang , Zhang Songling , Qu Jing , Zhang Ben , Zou Jianjun , Wu Lingying 
Published: April 2022

PURPOSE This phase III trial aimed to explore the efficacy and safety of fuzuloparib (formerly fluzoparib) versus placebo as a maintenance treatment after response to second- or later-line platinum-based chemotherapy in patients with high-grade, platinum-sensitive, recurrent ovarian cancer. PATIENTS AND METHODS Patients with platinum-sensitive, recurrent ovarian cancer previously treated with at least two platinum-based regimens were assigned (2:1) to receive fuzuloparib (150 mg, twice daily) or matching placebo for 28-day cycles. The primary end points were progression-free survival (PFS) assessed by blinded independent review committee (BIRC) in the overall population and PFS by BIRC in the subpopulation with germline BRCA 1/2 mutation. RESULTS Between April 30, 2019, and January 10, 2020, 252 patients were randomly assigned to the fuzuloparib (n = 167) or placebo (n = 85). As of July 1, 2020, the median PFS per BIRC assessment in the overall population was significantly improved with fuzuloparib treatment (hazard ratio [HR], 0.25; 95% CI, 0.17 to 0.36; one-sided P < .0001) compared with that with placebo. The HR derived from a prespecified subgroup analysis showed a consistent trend of benefit in patients with germline BRCA 1/2 mutations (HR, 0.14; 95% CI, 0.07 to 0.28) or in those without mutations (HR, 0.46; 95% CI, 0.29 to 0.74). The most common grade ≥ 3 treatment-emergent adverse events reported in the fuzuloparib group were anemia (25.1%), decreased platelet count (16.8%), and decreased neutrophil count (12.6%). Only one patient (0.6%) discontinued fuzuloparib because of treatment-related toxicity (concurrent decreased white blood cell count and neutrophil count). CONCLUSION Fuzuloparib as maintenance therapy achieved a statistically significant and clinically meaningful improvement in PFS for patients with platinum-sensitive, recurrent ovarian cancer versus placebo, regardless of germline BRCA 1/2 mutation, and showed a manageable safety profile.
Extreme Variations in Muscle Fiber Composition Enable Detection of Insulin Resistance and Excessive Insulin Secretion
Authors: Blackwood Sarah J , Horwath Oscar , Moberg Marcus , Pontén Marjan , Apró William , Ekblom Maria M , Larsen Filip J , Katz Abram 
Published: April 2022

Abstract

Context
Muscle fiber composition is associated with peripheral insulin action.

Objective
We investigated whether extreme differences in muscle fiber composition are associated with alterations in peripheral insulin action and secretion in young, healthy subjects who exhibit normal fasting glycemia and insulinemia.

Methods
Relaxation time following a tetanic contraction was used to identify subjects with a high or low expression of type I muscle fibers: group 1 (n = 11), area occupied by type I muscle fibers = 61.0 ± 11.8%, and group 2 (n = 8), type I area = 36.0 ± 4.9% (P &lt; 0.001). Biopsies were obtained from the vastus lateralis muscle and analyzed for mitochondrial respiration on permeabilized fibers, muscle fiber composition, and capillary density. An intravenous glucose tolerance test was performed and indices of glucose tolerance, insulin sensitivity, and secretion were determined.

Results
Glucose tolerance was similar between groups, whereas whole-body insulin sensitivity was decreased by ~50% in group 2 vs group 1 (P = 0.019). First-phase insulin release (area under the insulin curve during 10 minutes after glucose infusion) was increased by almost 4-fold in group 2 vs group 1 (P = 0.01). Whole-body insulin sensitivity was correlated with percentage area occupied by type I fibers (r = 0.54; P = 0.018) and capillary density in muscle (r = 0.61; P = 0.005) but not with mitochondrial respiration. Insulin release was strongly related to percentage area occupied by type II fibers (r = 0.93; P &lt; 0.001).

Conclusions
Assessment of muscle contractile function in young healthy subjects may prove useful in identifying individuals with insulin resistance and enhanced glucose-stimulated insulin secretion prior to onset of clinical manifestations.
Disjoint Bilinear Optimization: A Two-Stage Robust Optimization Perspective
Authors: Zhen Jianzhe , Marandi Ahmadreza , de Moor Danique , den Hertog Dick , Vandenberghe Lieven 
Published: April 2022

In this paper, we focus on a subclass of quadratic optimization problems, that is, disjoint bilinear optimization problems. We first show that disjoint bilinear optimization problems can be cast as two-stage robust linear optimization problems with fixed-recourse and right-hand-side uncertainty, which enables us to apply robust optimization techniques to solve the resulting problems. To this end, a solution scheme based on a blending of three popular robust optimization techniques is proposed. For disjoint bilinear optimization problems with a polyhedral feasible region and a general convex feasible region, we show that, under mild regularity conditions, the convex relaxations of the original bilinear formulation and its two-stage robust reformulation obtained from a reformulation-linearization-based technique and linear decision rules, respectively, are equivalent. For generic bilinear optimization problems, the convex relaxations from the reformulation-linearization-based technique are generally tighter than the one from linear decision rules. Numerical experiments on bimatrix games, synthetic disjoint bilinear problem instances, and convex maximization problems demonstrate the efficiency and effectiveness of the proposed solution scheme. Summary of Contribution: Computing solutions for disjoint bilinear optimization problems are of much interest in real-life applications, yet they are, in general, computationally intractable. This paper proposes a computationally tractable approximation as well as a convergent algorithm to the optimal values of such problems. Extensive computational experiments on (i) (constrained) bimatrix games, (ii) synthetic disjoint bilinear problems, and (iii) convex maximization problems are conducted to demonstrate the effectiveness and efficiency of the proposed approach.
Use of injectable acellular dermal matrix combined with negative pressure wound therapy in open diabetic foot amputation
Authors: Ahn Jiyong , Park Ho Youn , Shetty Asode Ananthram , Hwang Wonha 
Published: April 2022

Objective: Skin grafts after negative pressure wound therapy (NPWT) and acellular dermal matrix (ADM) usage have both been useful for treating diabetic foot amputation. We hypothesised that injectable ADM combined with NPWT would be more useful than NPWT only for healing after amputation in patients with diabetic foot ulcers (DFUs). The aim of this study was to investigate the clinical outcomes of injectable ADM combined with NPWT in patients with DFU who have undergone amputation. Method: This retrospective study reviewed patients with infected DFUs who were administered NPWT. Patients were divided into two groups: Group 1 included patients who were treated with NPWT only, while Group 2 included patients who were treated with injectable ADM combined with NPWT. Clinical results including the number of NPWT dressing changes, wound healing duration, and full-thickness skin graft (FTSG) incident rate between the two groups were compared. Results: A total of 41 patients took part in the study (Group 1=20, Group 2=21). The mean number of NPWT dressing changes was significantly lower in Group 2 (8.71±3.77) than in Group 1 (13.90±5.62) (p=0.001). Mean wound healing period was shorter in Group 2 (3.17±1.36 weeks) than in Group 1 (5.47±1.68 weeks) (p=0.001). Finally, the rate of patients who underwent FTSG for complete wound closure was 85% in Group 1, whereas it was only 14.3% in Group 2. Conclusion: In this study, the use of injectable ADM combined with NPWT in patients with DFU who underwent amputation favoured complete wound healing, without the need to resort to the use of skin grafts.
Effect of a wound healing protocol on patients with stage III and IV pressure ulcers: a preliminary observational study
Authors: Monaco Dario , Zaghini Francesco , Fiorini Jacopo , Venturini Giulia , Iovino Paolo , Vellone Ercole , Alvaro Rosaria , Sili Alessandro 
Published: April 2022

Objective: To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection. Method: This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter—a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively. Results: Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R2=0.12). Conclusion: Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs.
IV3000 semi-occlusive dressing use in simple and complex fingertip injuries: efficacy and affordability
Authors: Cheang Catherine Jenn Yi , Khan Muhammad Adil Abbas , Jordan Daniel J , Nassar Kazem , Bhatti Dujanah Siddique , Rafiq Sadia , Hogg Fiona J , Waterston Stuart W 
Published: April 2022

Objective: This study aimed to explore the efficacy of the IV3000 semi-occlusive, transparent adhesive film dressing in the non-surgical management of simple as well as more complex fingertip injuries. Method: In this qualitative study, patients with fingertip injuries were prospectively recruited and treated conservatively with the dressing between 2015 and 2017. Inclusion criteria included any fingertip injury with tissue loss and patient consent for non-surgical treatment consistent with the study protocol. Exclusion criteria included injuries needing surgical intervention for tendon injury or exposure, joint dislocations, distal phalangeal fractures requiring fixation, bone exposure, isolated nail bed lacerations and any patients eligible for surgical repair who did not wish to be managed conservatively. Results: A total of 64 patients took part in the study. The patients treated with the dressing were asked to rate functional outcome, of whom 40 (62.5%) patients reported the outcome as ‘excellent’, 19 (29.7%) as ‘satisfactory’, five (7.8%) as ‘indifferent’ and none (0%) as ‘unsatisfactory’. A reduced pulp volume at completion of healing was felt by 21 (32.8%) patients, but all patients were ‘satisfied’ with the aesthetic appearance of their fingertips at final clinical review. Average healing time was 4.5 weeks across the group, with the average time for return to work being just under one week. We estimate a 60% reduction in cost with the conservative versus the surgical management option. Conclusion: This study showed that, for participants, the IV3000 dressing was an affordable and effective option for the conservative treatment of simple fingertip injuries and in the management of more complex fingertip injuries.