bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver Venous Deprivation for Rapid Liver Hypertrophy Before Major Hepatectomy: A Case Report
Authors: John Nathan , Montorfano Lisandro , Nagarajan Arun , Simpfendorfer Conrad H , Wexner Steven D , Amin Parag , Roy Mayank 
Published: November 2022

Liver venous deprivation (LVD) is an emerging, minimally invasive strategy to induce rapid liver hypertrophy of the future liver remnant (FLR) before a major hepatectomy. LVD (aka “double vein embolization”) entails same-session percutaneous embolization of the portal and hepatic veins of the planned liver resection. This report discusses LVD’s utilization and technical challenges in managing a 49-year-old male with recurrent multifocal colorectal liver metastases (CRLM). The patient initially underwent neoadjuvant FOLFOX chemotherapy followed by a simultaneous laparoscopic sigmoid colectomy and liver surgery (microwave ablation of segment V and wedge resections of segment one and IVb), followed by completion of chemotherapy. The patient had an R0 resection with clear colon and liver surgical margins. Nine months after the initial surgery, the patient had a rise in tumor markers, and surveillance imaging demonstrated recurrence of liver metastases in segments I and V. LVD was performed by interventional radiology, which led to a 28% increase in FLR (segments II, III, and IV); initially measuring 464 cm3 before LVD and measuring 594 cm3 on post-procedure day 21. The patient underwent right hemi-hepatectomy and caudate resection on post-procedure day 29. The patient did not have any complications and was discharged on postoperative day 6. The patient remains disease-free with no evidence of recurrence at 12 months follow-up.
Outcomes of Anastomotic Evaluation Using Indocyanine Green Fluorescence during Minimally Invasive Esophagectomy
Authors: Banks Kian C. , Barnes Katherine E. , Wile Rachel K. , Hung Yun-Yi , Santos Jesse , Hsu Diana S. , Choe Giye , Elmadhun Nassrene Y. , Ashiku Simon K. , Patel Ashish R. , Velotta Jeffrey B. 
Published: November 2022

Background Limited evidence exists assessing whether anastomotic evaluation using indocyanine green fluorescence (IGF) during minimally invasive esophagectomy (MIE) predicts or improves outcomes. We hypothesized that IGF helps surgeons predict anastomotic complications and reduces anastomotic leaks after MIE. Methods In September 2019, our institution began routinely using IGF for intraoperative evaluation of anastomoses during MIE. Data were collected from patients undergoing MIE in the two years before and after this technology began being routinely used. Baseline characteristics and outcomes, including anastomotic leak, in patients who underwent indocyanine green fluorescence evaluation (ICG) and those who did not (nICG) were compared. Outcomes were also compared between ICG patients with normal versus abnormal fluorescence. Results Overall, 181 patients were included. Baseline demographic and clinical characteristics did not differ between the ICG and nICG groups. ICG patients experienced higher rates of anastomotic leak (10.2% vs. 1.6%, P = .015) and 90-day mortality (8.5% vs. 1.6%, P = .04) compared to nICG patients. Due to lack of equipment availability, 19 nICG patients underwent MIE after the use of IGF became routine, and none developed leaks. ICG patients with abnormal fluorescence had higher rates of anastomotic leak (71.4% vs 1.9%, P < .001) and 30-day mortality (28.6% vs 0%, P = .012) compared to those with normal fluorescence. Discussion Abnormal intraoperative IGF was associated with increased rate of anastomotic leak, suggesting predictive potential of IGF. However, its use was associated with an increased leak rate and higher mortality. Further studies are warranted to assess possible physiologic effects of indocyanine green on the esophageal anastomosis.
Mental health disorders in English newspapers of India: A retrospective study
Authors: Arneaud Gervan J , Kar Anindya , Majumder Sunrit , Molodynski Andrew , Lovett Kate , Kar Satyabrata 
Published: November 2022

Background: In recent years there has been significant coverage of mental health in Indian newspapers; the media can play a significant role in perpetuating as well as reducing stigma towards people with mental illness. This paper analyses the content, context and type of newspaper coverage of various mental health disorders in English language newspapers in India between 2016 and 2021. Methods: A detailed analysis was performed on a sample of articles about mental illness in a range of English language Indian newspapers. Results: Depression was the most prevalent topic amongst the articles followed by anxiety, schizophrenia and bipolar disorder. Our study describes a wide range of use of mental health disorders in various newspapers. All diagnoses were generally described in a criminal context like homicide, sexual assault and other crimes. Over time newspaper coverage of mental illness has become less stigmatising. Further exploration of non-English medium newspapers is required to fully understand the extent of the role of print media in perpetuating unhelpful stereotypes of people with mental illness in India.
Method for Calculating the Simultaneous Maximum Acceptable Risk Threshold (SMART) from Discrete-Choice Experiment Benefit-Risk Studies
Authors: Fairchild Angelyn Otteson , Reed Shelby D. , Gonzalez Juan Marcos 
Published: November 2022

Background Medical decisions require weighing expected benefits of treatment against multiple adverse outcomes under uncertainty (i.e., risks) that must be accepted as a bundle. However, conventional maximum acceptable risk (MAR) estimates derived from discrete-choice experiment benefit-risk studies evaluate the acceptance of individual risks, assuming other risks are fixed, potentially leading decision makers to misinterpret levels of risk acceptance. Design Using simulations and a published discrete-choice experiment, we demonstrate a method for identifying multidimensional risk-tolerance measures given a treatment level of benefit. Results Simultaneous Maximum Acceptable Risk Thresholds (SMART) represents combinations of risks that would be jointly accepted in exchange for specific treatment benefits. The framework shows how the expectation of utility associated with treatments that involve multiple risks are related even when preferences for potential adverse events are independent. We find that the form of the marginal effects of adverse-event probabilities on the expected utility of treatment determines the magnitude of differences between SMART and conventional single-outcome MAR estimates. Limitations Preferences for potential adverse events not considered in a study or preferences for adverse-event attributes held constant in risk-tolerance calculations may affect estimated risk tolerance. Further research is needed to understand the right balance between realistically reflecting clinical treatments with many potential adverse events and the cognitive burden of evaluating risk-risk tradeoffs in research and in practice. Conclusions and Implications SMART analysis should be considered in preference studies evaluating the joint acceptance of multiple potential adverse events. Highlights Conventional approaches to calculate maximum-acceptable risk (MAR) using discrete-choice experiment data account for 1 adverse-event risk at a time, requiring that decision makers infer the acceptability of treatments when patients are exposed to multiple risks simultaneously. The Simultaneous Maximum Acceptable Risk Threshold (SMART) maps combinations of adverse-event risks that would be jointly acceptable given a specific treatment benefit and provides a transparent and precise portrayal of acceptance of multiple risks. Risk levels that would be accepted using individual MAR estimates might not be acceptable when simultaneous risks are considered, especially when marginal expected disutility of risk is decreasing nonlinearly with risk probabilities. Preference researchers should calculate SMARTs in any discrete-choice study in which 2 or more adverse-event risks are presented, particularly if risk preferences are nonlinear.
Ventilator avoidance among critically ill COVID-19 patients with acute respiratory distress syndrome
Authors: Fletcher Jeffrey J , Aughenbaugh Arielle , Svabek Catherine , Hahn Peter Y , Grifka Ronald G 
Published: November 2022

Objective To determine the incidence and significance of ventilator avoidance in patients with critical coronavirus disease 2019 (COVID-19). Methods This prospective observational cohort study evaluated hospital mortality and 1-year functional outcome among critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated acute respiratory distress syndrome (ARDS). The explanatory variable was ventilator avoidance, modeled as ‘initial refusal’ of intubation (yes/no). Modified Rankin Scale (mRS) scores were obtained from surviving patients (or their surrogates) via phone or email questionnaire. Results Among patients for whom intubation was recommended ( n = 102), 40 (39%) initially refused (95% confidence interval [CI] 30%, 49%). The risk of death was 79.3% (49/62) in those who did not initially refuse intubation compared with 77.5% (31/40) in those who initially refused, with an adjusted odds ratio for death of 1.27 (95% CI 0.47, 3.48). The distribution of 1-year mRS scores was not significantly different between groups. Conclusion Among critically ill patients with COVID-19-associated ARDS, ventilator avoidance was common, but was not associated with increased in-hospital mortality or 1-year functional outcome.
Synergistic Effect of Reverse Drilling and Bone Dust on Femoral Tendon-Bone Healing After Anterior Cruciate Ligament Reconstruction in a Rabbit Model
Authors: Yang Weinan , Li Congsun , Ji Xiaoxiao , Yao Minjun , Hong Jianqiao , Qu Zihao , Liu An , Wu Haobo 
Published: November 2022

Background: Anterior cruciate ligament (ACL) injuries and bone tunnel enlargement (BTE) after ACL reconstruction (ACLR) remain frequent issues. Bone dust (BD) produced by tunnel preparation with osteogenic ability and reverse drilling (RD), an easy compaction technique, make it accessible to enhance tendon-bone healing in the clinic. Hypothesis: RD and BD synergistically promote tendon-bone healing by improving peritunnel bone and preventing BTE in femurs. Study Design: Controlled laboratory study. Methods: In total, 96 New Zealand White rabbits underwent ACLR. The semitendinosus tendon was freed before medial parapatellar arthrotomy. After the native ACL was transected, bone tunnels were prepared through the footprint of the native ACL. All animals were randomly assigned to 1 of 4 groups according to different tunnel preparation methods: group 1 (irrigation after extraction drilling [ED]; control group), group 2 (irrigation after RD), group 3 (no irrigation after ED), and group 4 (no irrigation after RD). BD was harvested by irrigating tunnels and was characterized by morphology and size. The specimens underwent microarchitectural, histological, and biomechanical evaluations at 4, 8, and 12 weeks postoperatively. Results: Micro–computed tomography demonstrated more peritunnel bone and less BTE in the femurs of group 4 compared with the other groups. Histologically, BD possessed osteogenic activity in bone tunnels postoperatively. Meanwhile, group 4 regenerated a higher amount of the tendon-bone interface and more peritunnel bone than group 1. Biomechanically, group 4 showed higher failure loads and stiffness than group 1. However, peritunnel bone loss, active osteoclasts, and significant BTE were found in the femurs of group 1 and group 3 at 12 weeks postoperatively, while no strong correlation was found between BTE and inflammatory cytokines. Scanning electron microscopy and particle size analysis suggested that BD produced by ED and RD had no difference in size. Conclusion: Tendon-bone healing was facilitated by the synergistic effect of RD and BD in femurs. Clinical Relevance: This study provides a more accessible and effective surgical strategy to promote tendon-bone healing after ACLR by increasing peritunnel bone and preventing BTE in femurs.
Reliability of Radiographic Imaging Characteristics for Osteochondritis Dissecans of the Capitellum
Authors:   The ROCKET Group, Nissen Carl , Bohn Deborah C. , Crepeau Allison , Edmonds Eric , Ganley Theodore , Kostyun Regina , Lawrence J. Todd R. , Pace J. Lee , Saluan Paul , Uquillas Carlos , Wall Eric , Wilson Philip L. , Bae Donald S. 
Published: November 2022

Background: A primary challenge in the treatment of capitellar osteochondritis dissecans (OCD) is accurate imaging assessment. Radiographic classification consensus is not available in the current literature, and correlation of radiographs with lesion stability and resultant best treatment is lacking. Purpose: To determine the inter- and intrarater reliability of the presence or absence and common radiographic characteristics of capitellar OCD lesions. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Anteroposterior, lateral, and oblique radiographs for 29 cases were reviewed by 7 orthopaedic surgeons. Images were assessed for elbow anthropometry and morphology, OCD presence, lesion characteristics, the presence of progeny bone and progeny features, and radial head abnormalities. Intra- and interrater reliability was assessed using Fleiss and Cohen kappa for nominal variables and intraclass correlation coefficients (ICCs) for continuous variables. Results: Surgeons demonstrated substantial to excellent inter- and intrarater reliability when assessing elbow characteristics: anthropometric (interrater ICC, 0.94-0.99; intrarater ICC, 0.82-0.96) and morphologic (Fleiss, 0.61-0.76; Cohen, 0.68). When the OCD lesion was assessed, fair to moderate interrater agreement was found for classifying the absence or presence of a lesion (Fleiss, 0.28-0.46) and the location of the OCD (Fleiss, 0.24-0.52), poor agreement for assessing the contour of the lesion (Fleiss, 0.00-0.09), and excellent agreement for measuring the size of the lesion (ICC, 0.82-0.94). Poor to fair interrater agreement was found for radial head abnormalities (Fleiss, 0.00-0.27). Progeny bone visualization and fragmentation demonstrated moderate interrater agreement (Fleiss, 0.43-0.47) where displacement of the bone demonstrated poor interrater agreement (Fleiss, 0.11-0.16). Intrarater agreement for OCD lesion characteristics, progeny bone visualization, and progeny bone features was moderate to excellent. Conclusion: Given only the fair to moderate agreement among raters for identifying OCD on radiographs, this imaging modality may not serve as a dependable screening tool in isolation. Additional imaging should be obtained if the clinical presentation suggests capitellar OCD and a definitive diagnosis is not possible with radiographs. However, clinicians can reliability measure the size of radiographically apparent OCD, suggesting that radiographs may serve as an appropriate imaging modality for follow-up care.
Venous Thromboembolism Chemoprophylaxis in Knee Arthroscopy: A Break-Even Analysis of Cost
Authors: Martinazzi Brandon J. , Kirchner Gregory J. , Lorenz F. Jeffrey , Bonaddio Vincenzo , Hines Shawn , Kim Raymond Y. , Gallo Robert A. 
Published: November 2022

Background: Symptomatic venous thromboembolism (VTE) is a serious and costly complication after knee arthroscopy. There continues to be debate regarding the use of VTE prophylaxis after knee arthroscopy, and minimal research has explored its cost-effectiveness. Hypothesis: Both aspirin and enoxaparin would be cost-effective in preventing symptomatic VTE. Study Design: Economic and decision analysis; Level of evidence, 3. Methods: The literature was searched and the TriNetX research database was queried to determine a range of initial rates of VTE. An open-access retail database was used to determine the mean retail price for aspirin (325 mg) and enoxaparin (30 mg and 40 mg). Our institutional records were used to determine the cost of treating VTE. A “break-even” analysis was then performed to determine the absolute risk reduction necessary to make these drugs cost-effective. This value was then used to calculate the number of patients who would need to be treated (NNT) to prevent a single VTE while still breaking even on cost. Results: The cost of treating VTE was $9407 (US Dollars). Aspirin (325 mg), enoxaparin (30 mg), and enoxaparin (40 mg) were found to cost $1.86, $188.72, and $99.99, respectively. The low, TriNetX, and high rates of VTE were 0.34%, 0.86%, and 10.9%, respectively. Aspirin was cost-effective at all 3 rates if the initial rate decreased by 0.02% (NNT = 5058). Both formulations of enoxaparin were cost-effective at the high initial rate if they decreased by 2.01% (NNT = 50) and 1.06% (NNT = 94), respectively. However, at the low and TriNetX rates, the 2 doses of enoxaparin were not cost-effective because their final break-even rate exceeded the initial VTE rate. Conclusion: Aspirin and, in some cases, enoxaparin are cost-effective treatments for VTE prophylaxis after knee arthroscopy.
Efficacy and safety of electroacupuncture for oxaliplatin-induced peripheral neuropathy in colorectal cancer patients: a single-blinded, randomized, sham-controlled trial
Authors: Chan Kaiyin , Lui Louisa , Lam Yukting , Yu Kaling , Lau Kwongwai , Lai Manchi , Lau Waiwai , Tai Lokyin , Mak Chunkin , Bian Zhaoxing , Zhong Linda LD 
Published: November 2022

Background: Oxaliplatin-based chemotherapy is a major first-line conventional therapy for advanced and metastatic colorectal cancer (CRC). However, oxaliplatin causes chemotherapy-induced peripheral neuropathy (CIPN). Acupuncture has long been used to alleviate limb numbness in Chinese medicine practice. Aim: The aim of this study was to examine the efficacy and safety of electroacupuncture (EA) for the alleviation of CIPN in CRC patients. Design: This was a pilot single-blinded, randomized, sham-controlled trial. Setting/participants: Sixty eligible patients, who had been diagnosed with CRC and were undergoing oxaliplatin-based chemotherapy, were randomized in a ratio of 1:1 to the EA intervention group or sham acupuncture (SA) control group. During a 12-week treatment period, patients in the EA group received EA once a week, while patients in the SA group received SA; both groups were followed up for 12 weeks. Results: Compared with the SA group, the EA group exhibited significant alleviation of CIPN severity during chemotherapy. Moreover, EA also improved the physical function, role function, and social function of CRC patients. However, there were no significant differences in tests of vibration or light touch sensation. In addition, EA appeared to be a safe treatment for CIPN and was both feasible and acceptable to CRC patients during chemotherapy. Conclusion: This study showed preliminary evidence for the efficacy and safety of EA in acute CIPN among CRC patients, although further studies are needed to verify these effects and to further explore the potential role of EA in chronic CIPN (effects on which remain unclear). Trial registration number: NCT03582423 (ClinicalTrials.gov)
Macronutrient Composition of Preterm-Mother’s Milk: A Prospective Observational Study at a Tertiary Level Special New-Born Care Unit in North India
Authors: Mehta Shefali , Singh Jasbir , Sethi Amanpreet , Kaur Gurmeet , Goyal Gitanjali , Kaul Varun , Pahwa Simran 
Published: November 2022

Objective: To determine the macronutrient and energy content of preterm mothers’ milk in our tertiary care center for planning optimum nutrition strategies. Methodology: This prospective observational study evaluated the macronutrient and energy contents of preterm mother’s milk. The breast milk composition of 50 mothers was analyzed on 3±2, 7±2, 14±2, 21±2, and 28±2 days of birth. The carbohydrate, protein, and fat content in milk were measured by Polberger alkaline copper reduction method, Lowry method (modified by Peterson), and colorimeter method respectively, and we also studied their correlation with body mass index (BMI) of mothers. Results: Initially, median (inter-quartile range [IQR]) carbohydrate contents were 1.2 (1.0-1.6) g/dL, which increased to 2.1 (1.5-2.4) g/dL; the protein contents were 1.7 (1.2-2.2), later declined to 1.4 (1.0-2.2) g/dL; and fat contents were 0.8 (0.6-1.2), increased to 1.2 (0.7-1.5) g/dL at end of the study. The median energy contents were 23.3(20.7-29.5), increased to 28.5(25.3-33.7) kcal/dL during the study. The carbohydrate, fat, and energy contents showed a moderate correlation with the BMI of the mothers. Conclusion: Due to variable macronutrient and energy contents of the preterm mother’s milk; individualized milk fortification policies should be developed.
Ever-Increasing Caesarean Section and Free Delivery Schemes in India: How Much the Households are Still Paying?
Authors: Bose Montu , Sarkar Olivia , Dutta Sabitri 
Published: November 2022

Aberrant rise in c-section deliveries and associated cost have raised concern to achieve the development goals. Given this, India has launched various schemes to directly serve the mother and newborn and to protect the households from financial hardship for childbirth. Using nationally representative unit level data, the article aims to explore the extent of c-section delivery in India and to capture the financial burden on the households due to c-section deliveries. It is observed that the c-section delivery has increased substantially in almost all Indian states. Both rural and urban sector of the states have reported alarmingly high c-section rates. Urban-India reports around 35% c-section cases and the figure for rural region is 19%. However, out-of-pocket expenditure has decreased marginally in the public facilities for c-section. Surprisingly, in many states poorest class pays much higher than the other expenditure classes even in the public facilities for c-section. Additionally, in the public sector, a considerable proportion of the households are spending substantially high share of their annual consumption expenditure to purchase medicine and diagnostic tests in the public facilities. Therefore, information asymmetry about the government schemes and related informal expenses needs to be addressed for better outcome.JEL: I14, I15, I18
Familial Factors Associated With Symptom Severity in Children and Adolescents With ADHD: A Meta-Analysis and Supplemental Review
Authors: Jendreizik Lea T. , von Wirth Elena , Döpfner Manfred 
Published: November 2022

Objective: Both genetic and environmental factors contribute to the development of ADHD, but associations between risk factors and ADHD symptom severity in affected children remain unclear. This systematic review and meta-analysis synthesizes evidence on the association between familial factors and symptom severity in children with ADHD (PROSPERO CRD42020076440). Method: PubMed and PsycINFO were searched for eligible studies. Results: Forty-three studies ( N = 11,123 participants) were meta-analyzed. Five additional studies ( N = 2,643 participants) were considered in the supplemental review. Parenting stress ( r = .25), negative parenting practices ( r = .19), broken parental partnership ( r = .19), critical life events ( r = .17), parental psychopathologies ( r = .14–.16), socioeconomic status ( r = −.10), and single-parent family ( r = .10) were significantly associated with ADHD symptom severity. Conclusion: These results suggest that psychosocial familial factors show small but significant associations with symptom severity in children with ADHD. Implications are discussed.