bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of the acupuncture combined with auricular acupressure for dry eye disease：study protocol for a multicenter randomized clinical trial
Authors: Li Zhuoyi , Mou Yika , Sun Shiyun , Fu Luyao , Chen Lingqian , Fu Yana , Du Cheng , Guo Qin , Liu Jing , Ma Ruijie 
Published: December 2024

Abstract

Introduction:
Dry eye disease (DED) is a chronic disorder of the ocular surface (OS) that is influenced by a variety of factors, resulting in ocular discomfort and visual impairment. Studies have also shown that dry eye syndrome detrimentally impacts patients' sleep quality (SQ), mental well-being, and overall mental health. This study aims to assess the efficacy and safety of the acupuncture combined with auricular acupressure in reducing ocular symptoms and enhancing sleep and mood among patients with DED.
Methods
In this multicenter, randomized controlled trial (RCT), 126 patients will be enrolled and randomly assigned in equal proportions to the intervention or control group. Participants in the intervention group will undergo three 30-minute sessions weekly over 8 weeks, whereas the control group will be treated with 0.1% sodium hyaluronate eye drop. Following the intervention, an eight-week follow-up will be conducted. Primary outcomes include the Ocular surface disease Index (OSDI), Breaking up time (BUT), Conjunctival Impression Cytology (CIC), and cornea fluorescein staining (CFS). Secondary outcomes are Tear meniscus height (TMH), Meibum quality score (MQS), Meibomian gland score (MGS), Meiboscore, Function of the meibomian gland, Pittsburgh Sleep Quality Index (PSQI), Self-rating depression Scale (SDS), and Self-rating anxiety scale (SAS). Evaluations will take place at weeks 0, 4, 8, 12, and 16.
Discussion
This research is intended to elucidate the advantages of acupuncture in mitigating symptoms of DED and in regulating disturbances in sleep and mood among patients.
Trial registration:
http://itmctr.ccebtcm.org.cn , ID: ITMCTR2024000673. Registered 7th November 2024.
Efficacy of topical corticosteroids and non-steroidal anti-inflammatory drugs for the treatment of diabetic macular oedema not in the context of intra-ocular surgery: a systematic review
Authors: Vassallo James , Galea Martin 
Published: December 2024

Abstract

Purpose
The aim of this systematic review was to assess whether current best evidence supports the use of topical anti-inflammatory medications for diabetic macular oedema (DMO).
Methods
A systematic review, limited to randomised controlled studies published from 2015 onwards, was carried out. MEDLINE, EMBASE, PubMed, Scopus, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched on the 11th October 2024. Subjects with DMO treated with topical corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) were included. The effect on central macular thickness was the primary outcome of interest.
Results
Seven out of the eight studies included partly/fully support the use of topical anti-inflammatory therapy to reduce macular thickness in DMO. Studies were very heterogenous and no meta-analysis was possible. The overall quality of the evidence was deemed to be moderate.
Conclusion
Topical corticosteroids and NSAIDs may be a viable therapeutic strategy for DMO. However, further studies are required to assess which agents and regimens would be most beneficial, and to allow better patient selection for this approach. Drugs with improved ocular penetration and efficacy may improve the success of this approach.
Developing and validating an innovative risk stratification model for non-metastatic clear cell renal cell carcinoma patients with venous tumor thrombus
Authors: Zhu Baohua , Mo Ziyang , Ta Na , Wang Linhui , Zhang Wei 
Published: December 2024

Abstract

Purpose: Exploring the survival influencing factors in patients with non-metastatic clear cell renal cell carcinoma (ccRCC) and venous tumor thrombus (VTT) is vital for tailored therapies. Our objective was to develop and validate a novel risk scoring system for the patients to predict the survival time and probability.
Methods: Data were gathered from non-metastatic ccRCC patients with VTT treated between 2011 and 2024. Participants were retrospectively assigned in a 7:3 ratio to training and testing cohorts. We evaluated and quantified clinicopathological characteristics of the primary tumor (PT) and VTT, constructing multivariable models to predict overall survival (OS).
Results: The study included 124 patients, with a median follow-up of 35 months. We developed a risk score system based on PT Sarcomatoid differentiation (p = 0.034), PT perirenal fat invasion (p = 0.046), VTT grade (p = 0.045) and Neutrophil to Lymphocyte Ratio(NLR) (p = 0.007). This system accurately identified a high-risk cohort exhibiting adverse outcomes among non-metastatic ccRCC patients with VTT, findings consistent in the testing group.
Conclusion: Our study presents a nomogram integrating clinicopathological features—PT Sarcomatoid differentiation, PT perirenal fat invasion, VTT grade and NLR—facilitating risk stratification and enhancing the precision in managing non-metastatic ccRCC patients with VTT.
68Gallium-FAPI-positron emission tomography for dignity assessment of mass-forming chronic pancreatitis and pancreatic ductal adenocarcinomas compared to laboratory parameters, ultrasound and computed tomography
Authors: Lang Matthias , Preussig Markus , Spektor Anna-Maria , von Goetze Isabelle , Wessendorf Joel , Glatting Frederik M. , Gutjahr Ewgenija , Pausch Thomas M. , Heger Ulrike , Mayer Philipp , Buchholz Hans-Georg , Schreckenberger Mathias , Kauczor Hans-Ulrich , Tjaden Christin , Hackert Thilo , Michalski Christoph , Haberkorn Uwe , Röhrich Manuel 
Published: December 2024

Abstract

Purpose:
The differentiation of mass-forming chronic pancreatitis (MFCP) and pancreatic ductal adenocarcinomas (PDAC) based on conventional imaging methods like ultrasound, CT and MRI is frequently not possible. Here, we applied static (60 minutes post injection) and dynamic PET/CT with 68Gallium-labelled Fibroblast Activated Protein Inhibitors (68Ga-FAPI-PET/CT) in 26 preoperative, treatment-naive patients with unclear pancreatic masses to evaluate its potential diagnostic value for MFCP and PDAC.
Methods:
26 Patients underwent static and dynamic 68 Ga-FAPI-PET/CT as well as dedicated fundamental (US) and contrast-enhanced ultrasonography (CEUS) before surgical resection or biopsy of pancreatic masses and subsequent histological analyses. Static parameters (SUVmax and SUVmean and target to background ratios) were generated from VOIs of pancreatic masses. Time activity curves and dynamic parameters were extracted from dynamic PET data.
Results:
Histology revealed 12 PDAC, 2 high-grade IPMN and 12 MFCP. We observed higher 68Ga-FAPI-uptake in PDACs (average SUVmax/mean 18.09 +/- 5.5 / 10.55 +/- 2.97) than in MFCP (average SUVmax/mean 11.55 +/- 3.88 / 6.83 +/- 2.20). In dynamic PET-imaging, PDAC and MFCP showed differential time activity curves and the average time to peak was markedly longer for PDAC (1094 +/- 945 seconds ) than for MFCP (449 seconds +/- 203). In ROC curves, static and dynamic imaging parameters showed higher sensitivity and specificity than laboratory parameters, CT- and US-size.
Conclusion:
68Ga-FAPI-PET/CT displays the fibrotic activity of MFCP. Static and dynamic 68Ga-FAPI-PET/CT should be considered, when clinical parameters and other imaging methods are not able to distinguish between PDAC and MFCP.
Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study
Authors: Gashe Abiyie Demelash , Worku Fentahun Agegnehu , Mahamud Kedir Ali , Woldemichael Dawit Zenebe , Eshete Tewodros , Endries Aman Yesuf 
Published: December 2024

Abstract

Background The timeframe from antihypertensive medication initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. In Ethiopia, while studies have explored BP control rates, data on the time required to achieve control are limited. This study aimed to estimate time to BP control and identify predictors in Afar region of Ethiopia.Method A facility-based retrospective cohort study was conducted among adult hypertensive patients aged 18 years and older in five public hospitals between September 7, 2019 and January 8, 2023. Data were collected using a structured questionnaire, entered into EpiData version 3.1, and analyzed using Stata version 14.2. Kaplan-Meier survival analysis was used to estimate time to BP control. Cox regression analysis was applied to identify predictors of time to BP control. The adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were computed at p < 0.05Result A total of 443 hypertensive individuals were retrospectively followed, of which, 410 (92.6%) met the inclusion criteria. The median duration of follow-up was 10 month. The median age of the participants was 56 year. The median time to achieve BP control was 13 months (95% CI: 11⎼15). Factors associated with quicker BP control included combination therapy (AHR = 1.849, 95% CI: 1.276–2.679) and the absence of comorbidities (AHR = 1.86, 95% CI: 1.276–2.679). In contrast, factors leading to delayed BP control included age ≥ 60 years (AHR = 0.378, 95% CI: 0.236–0.605), severe hypertension (AHR = 0.626, 95% CI: 0.467–0.839), creatinine ≥ 1.5 mg/dL (AHR = 0.371, 95% CI: 0.173–0.799), and fasting blood sugar (FBS) ≥ 126 mg/dL; AHR = 0.335, 95% CI: 0.152–0.738).Conclusion The median time to BP control in this study exceeds recommendations from clinical trials and prior estimates. Combination therapy and the absence of comorbidities significantly reduce time to BP control, while advanced age, higher baseline BP, and elevated creatinine and FBS levels are linked to delayed BP control. Our findings highlight the necessity for enhanced counseling, management of comorbidities, regular end-organ evaluation, and use of combination therapies to expedite timely BP control.
Effect of early parenteral nutrition versus enteral nutrition alone on all-cause mortality in critically ill adults: A systematic review and meta-analysis
Authors: Cai Yixuan , Liu Airan , Bao Jiaotong , Yin Xinyi , Yang Xi , Wang Wenya 
Published: December 2024

Abstract

Background
For nutritional support in critically ill patients, the early initiation of enteral nutrition (EN) in the presence of gastrointestinal function has been agreed upon by most scholars. However, EN support alone cannot fully meet the needs of the body in some cases, so considering supplemental parenteral nutrition (SPN) become the solution to meet patients’ energy target. However, there is no consensus on whom and when parenteral nutrition should be considered in critically ill patients as a total form of nutrition. So, we aimed to compare and evaluate the effect of early PN on the outcome and their safety in critically ill adults.
Methods
Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, Cochrane Library, and Web of Science (up to March 2024). Adults with critical illness treated with total parenteral nutrition (TPN) or SPN versus EN alone were enrolled. We screened studies and extracted data independently. The primary outcome was all-cause mortality which was evaluated by pooled risk ratio (RR) with the fixed-effects model. The risk of bias was evaluated using Cochrane risk bias of tool and a meta-analysis was conducted using RevMan 5.4 software. This study was prospectively registered in PROSPERO database (CRD42023462386).
Results
Twenty RCTs enrolling 11303 patients were eligible. No significant disparities were observed in 30-day all-cause mortality (relative risk [RR] 0.96, 95% confidence interval [CI] 0.90–1.03, P = 0.29), hospital mortality (RR 0.96, 95% CI 0.90–1.02, P = 0.17), or 90-day mortality (RR 0.95, 95% CI 0.86–1.04, P = 0.26) between the PN (TPN or SPN) and enteral nutrition (EN) alone groups. However, the use of PN in conjunction with EN was associated with a reduced ICU mortality rate compared to EN alone (RR 0.92, 95% CI 0.86–0.99, P = 0.03). PN therapy was linked to a modest elevation in the risk of infection (RR 1.12, 95% CI 1.05–1.21, P = 0.002), predominantly due to bloodstream infections (RR 1.24, 95% CI 1.08–1.51, P = 0.005). Additionally, PN was associated with a significant reduction in the duration of mechanical ventilation (standardized mean difference [SMD] = -1.47, 95% CI -2.72 to -0.23, P = 0.02) and a decreased incidence of gastrointestinal intolerance events (RR 0.85, 95% CI 0.77–0.94, P = 0.002).
Conclusion
Administration of PN can reduce ICU mortality, duration of mechanical ventilation and gastrointestinal intolerance events, although it increases total infection especially bloodstream infection rate among critically ill patients. More studies are warranted to confirm these findings.
Dysphagia Megalatriensis: A Case Report of Potentially Treatable Etiology of Dysphagia.
Authors: Nazeera Nahas Nazeer. , C.K Anees , Paul Ajay , Basheer Aneesh 
Published: December 2024

Abstract

Background - Dysphagia is commonly associated with structural or neuromuscular disorders of the oesophagus, but cardiovascular causes are rare. Dysphagia megalatriensis is an unusual condition characterized by oesophageal compression due to an enlarged left atrium, often secondary to decompensated heart failure. Timely recognition of this rare etiology can prevent unnecessary interventions and enable targeted therapy. Case Presentation - A 78-year-old male with a history of coronary artery disease and chronic heart failure with reduced ejection fraction presented with breathlessness and chest discomfort for 3 days. He also reported progressive difficulty swallowing solids over the past 20 days. Examination revealed hypoxia and bilateral pitting pedal oedema, while imaging demonstrated cardiomegaly with significant left atrial dilation compressing the oesophagus. The patient was diagnosed with dysphagia megalatriensis, a rare form of cardiac dysphagia. He was treated with diuretic therapy and nasogastric tube feeding, resulting in symptomatic improvement. Conclusions - Dysphagia megalatriensis, though rare, should be considered in the differential diagnosis of dysphagia, particularly in patients with significant cardiac comorbidities. This case highlights the role of non-invasive imaging and individualized management strategies, including medical optimization of heart failure, in addressing this unique condition.
Ankle pain after total knee arthroplasty: a study of lower extremity imaging parameters
Authors: huang ZiShuai , Zhang ShuAng , Yang Guang , feng haotian , Wang Jian 
Published: December 2024

Abstract

Purpose: This study investigates the relationship between ankle pain and lower extremity imaging parameters in patients following total knee arthroplasty (TKA).
Methods: From September 2023 to February 2024, 41 patients with knee osteoarthritis (KOA) who underwent primary TKA were included in this study. The incidence of ankle pain was assessed six months post-surgery, and lower limb imaging parameters were measured to analyze their relationship with ankle pain.
Results: Among the 41 patients, 13 experienced ankle pain six months after TKA, representing 31.7% of the cohort, while 28 patients (68.3%) reported no ankle pain. Preoperatively, the Hip-Knee-Ankle (HKA), Tilt Angle of the Ankle (TAA), Talar Tilt Angle (TTA), and Talus Inclination (TI) in the pain group were significantly greater than those in the ankle painless group (p<0.05). Six months postoperationly, the TAA, TTA, TI, and mechanical Lateral Distal Tibial Angle (mLDTA) in the ankle pain group remained significantly elevated compared to the no ankle pain group (p<0.05). No statistically significant differences were observed in the Anterior Distal Tibial Angle (ADTA) and Hindfoot Alignment view Angle (HAVA) between the two groups, both preoperatively and at six months post-TKA (p>0.05). Receiver operating characteristic (ROC) curve analysis indicated that the area under the curve (AUC) values for ΔHKA and ΔmLDTA in predicting postoperative ankle pain were 0.893 and 0.955, respectively.
Conclusion: The findings suggest that excessive correction of knee varus and inadequate compensation at the ankle joint may contribute to the development of ankle joint pain in patients following TKA.
Light-driven Lattice Soft Microrobot with Multimodal Locomotion
Authors: Xiong Wei , Zhang Mingduo , Liu Yuncheng , Deng Chunsan , Fan Xuhao , Zhang Zexu , Shi Shaoxi , Chen Fayu , Hu Huace , Xue Songyan , Deng Leimin , Liu Lige , Sun Tao , Gao Hui 
Published: December 2024

Abstract

Untethered microrobots hold significant promise in fields such as bionics, biomedicine, and micromechanics. However, replicating the diverse movements of natural microorganisms in artificial microrobots presents a considerable challenge. This paper introduces a laser-based approach that utilizes lattice metamaterials to enhance the deformability of hydrogel-based microrobots, resulting in untethered light-driven lattice soft microrobots (LSMR). Constructed from single-walled carbon nanotubes-poly(N-isopropylacrylamide) hydrogels and a truncated octahedron lattice structure, the LSMR benefits from reduced relative density, which increases flexibility and accelerates light-driven deformation. By employing sequential laser scanning, the LSMR achieves various locomotion modes, including linear peristalsis, in situ rotation, and hopping, through adjustments in scanning frequency, trajectory, and laser power. The LSMR achieves a remarkable continuous in situ rotation speed of 29.38°/s, nearly 30 times faster than previous studies, and exhibits the fastest peristaltic locomotion speed among sub-millimeter scale microrobots. The LSMR can autonomously perform programmed motions under closed-loop feedback control and navigate through narrow openings as small as 75% of its resting width by actively deforming. Compared to solid structure microrobots, the lattice design enhances energy conversion efficiency by 16.49 times under identical conditions. These advancements mark a significant leap forward in the design and functionality of light-driven soft microrobots, offering promising avenues for future research in biomedicine, bionics, and micromechanical engineering.
Impacts of Moderate Severity COVID-19 on Functional Capacity, Exercise Tolerance, Muscle Strength, Hang Grip and Quality of Life.
Authors: Alshammari Maha , Shanb Alsayed , Alsubaiei Mohammed , Ahsan Mohammad , Shanb Belal 
Published: December 2024

Abstract

Background
The COVID-19 pandemic has posed significant challenges to global health, affecting millions of individuals worldwide. While acute and severe cases COVID-19 receive considerable attention, those with moderate severity of COVID-19 are also prone to substantial functional impairments that make them warranted for investigations. This study aimed to investigate the impacts of COVID-19 with moderate-severity on functional capacity, exercise tolerance, isometric muscle strength, hand grip, and quality of life.
Methods
Ninety-six participants (48 with COVID-19, 48 without COVID-19) were recruited in this cross-section study. The effects on functional capacity, exercise tolerance, isometric muscle power, hand grip, and quality of life were measured by the 6-minute walk test, One-minute sit-to-stand test, Hand-held dynamometer, Hand grip dynamometer and Quality of Life Questionnaire respectively. Shapiro-Wilk's test was used to test normality of data, Mann-Whitney test was used to compare the significant differences between COVID-19 and matched groups. The Spearman correlation was used to determine the relationships among outcome measures.
Results
Mean values of functional capacity, isometric muscle power, hand grip, and quality of life reduced significantly in patients with moderate COVID-19 on comparison with their matched (p-values < 0.05), except exercise tolerance (p-values > 0.05). Positive relationships were detected between exercise tolerance, and strength of the hand grip and knee extensors; also, between distance of the 6-minute walk test and exercise tolerance, strength of the hand grip and knee extensors (p = < 0.001).
Conclusion
Patients with COVID-19 moderate severity have impairments in functional capacity, exercise tolerance, isometric muscle strength, hand grip, and quality of life. Exercise tolerance correlated positively with the 6 MWT, strength of the hand grip and knee extensors, thus multi-dimension health care training programs need to be extended for those patients whatever the severity degree of infection.
Intraoperative Parameters in Anterior Lumbar Interbody Fusion (ALIF) Surgery: A Case Series of 5299 Operated Levels
Authors: Filho Aécio Rubens Dias Pereira , Baptista Vinicius Santos , Bertolini Matheus , Júnior Francisco Cialdine Frota Carneiro , Uehara Milton Kiyonory , Aguiar Nuno Rodolfo Colaço , Baston Arthur Cristiano , Desideri Alexandre Vinhal , Benites Vinicius de Meldau 
Published: December 2024

Abstract

Context:
Anterior Lumbar Interbody Fusion (ALIF) is performed via an abdominal approach to remove the intervertebral disc. Although academic reports suggest low intraoperative complication rates, the available data show significant variability. There is a lack of large-scale, robust studies that consistently evaluate the morbidity rates associated with this procedure.
Objective
This study evaluates the operative parameters of this procedure based on a substantial number of cases.
Study Design:
A retrospective case series.
Methods
Patient data were retrospectively collected from the database of the Instituto de Acessos à coluna Aécio Dias (IAAD). All patients aged 18 years or older who underwent ALIF surgery were included in the study. Patients who underwent other surgical approaches were excluded. Data on intraoperative morbidity (vascular injuries, injuries to intra- and extraperitoneal organs, dural sac injuries, and nerve root injuries), operative time, and blood loss were collected and analyzed.
Results
A total of 3,438 patients were evaluated. 1,671 (48.6%) were male, and 1,767 (51.4%) were female. The mean age was 47.87 ± 12.10 years, ranging from 18 to 88 years. The reported incidence of complications was as follows: vascular injuries (3.25%), nerve root injuries (0.09%), dural sac injuries (0.06%), and injuries to intra- and extraperitoneal organs (0.03%).
Conclusions
ALIF surgery demonstrated safety and low morbidity. A multidisciplinary team, including access surgeons, played a pivotal role in reducing vascular complications, optimizing surgical times, and minimizing blood loss, aligning with the standards reported in the literature.