bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally invasive pancreaticoduodenectomy: A bibliometric method applied to the top one hundred cited articles
Authors: Feng Jia-Jie , Zhao Yi-Wen , Liang Hong-Yin , Jiang Ke-Xin , Dai Rui-Wu 
Published: December 2024

BACKGROUND
Minimally invasive pancreaticoduodenectomy (MIPD) is considered one of the most complex procedures in general surgery. The number of articles on MIPD has been increasing annually. However, published reports often have complex research directions, and the focal points frequently change. Therefore, a comprehensive review and organization of the literature in this field is necessary.
AIM
To summarize current research, predict future hotspots and trends, and provide insights for MIPD development.
METHODS
To conduct the study, the Web of Science Core Collection was searched for relevant articles. The analysis focused on the top 100 articles in the field. Two widely used bibliometric tools, CiteSpace and VOSviewer, were used to examine various aspects, including research directions, authors, countries, institutions, journals, and keywords.
RESULTS
The top 100 articles were published between 2005 and 2022, with the majority originating from the United States (n = 51). Among the contributing institutions, Pancreas Center of the University of Chicago and the Health System of the University of Chicago had the highest number of publications (n = 17). In terms of individual authors, “Zeh HJ” and “Zureikat AH” led with 13 articles each. The high-frequency keywords in the literature encompassed three main areas: Surgical modality, perioperative outcomes, and the learning curve. These keywords were further categorized into seven primary clusters, with the largest being “laparoscopic pancreaticoduodenectomy”.
CONCLUSION
The most influential studies predominantly originate from the United States, and there is growing interest in robotic surgery. Despite MIPD’s potential benefits, further research is required to address technical challenges and improve outcomes.
Endoscopic retrograde cholangiopancreatography, endoscopic papillary balloon dilation, and laparoscopic hepatectomy for intra- and extrahepatic bile duct stones
Authors: Chen Zhi-Liang , Fu Hong 
Published: December 2024

BACKGROUND
Intrahepatic and extrahepatic bile duct stones (BDSs) have a high rate of residual stones, a high risk of recurrence, and a high rate of reoperation. It is very important to take timely and effective surgical intervention for patients.
AIM
To analyze the efficacy, postoperative rehabilitation, and quality of life (QoL) of patients with intra- and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic papillary balloon dilation (EPBD) + laparoscopic hepatectomy (LH).
METHODS
This study selected 114 cases of intra- and extrahepatic BDSs from April 2021 to April 2024, consisting of 55 cases in the control group receiving laparoscopic common bile duct exploration and LH and 59 cases in the observation group treated with ERCP + EPBD + LH. Efficacy, surgical indicators [operation time (OT) and intraoperative blood loss (IBL)], postoperative rehabilitation (time for body temperature to return to normal, time for pain relief, and time for drainage to reduce jaundice), hospital stay, medical expenses, and QoL [Gastrointestinal Quality of Life Index (GIQLI)] were comparatively analyzed. Further, Logistic regression analysis was conducted to analyze factors influencing the QoL of patients with intra- and extrahepatic BDSs.
RESULTS
The data demonstrated a higher overall effective rate in the observation group compared to the control group (P = 0.011), together with notably reduced OT, less IBL, shorter body temperature recovery time, pain relief time, time for drainage to reduce jaundice, and hospital stay (all P < 0.05). The postoperative GIQLI of the observation group was more significantly increased compared to the control group (P < 0.05). The two groups demonstrated no marked difference in medical expenses (P > 0.05).
CONCLUSION
The above indicates that ERCP + EPBD + LH is effective in treating patients with intra- and extrahepatic BDSs, which is conducive to postoperative rehabilitation and QoL improvement, with promising prospects for clinical promotion.
Construction of a nomogram prediction model for early postoperative stoma complications of colorectal cancer
Authors: Ba Ming-Qin , Zheng Wen-Lin , Zhang Yu-Ling , Zhang Lin-Lin , Chen Jing-Jing , Ma Jie , Huang Jia-Li 
Published: December 2024

BACKGROUND
Postoperative enterostomy is increasing in patients with colorectal cancer, but there is a lack of a model that can predict the probability of early complications.
AIM
To explore the factors influencing early postoperative stoma complications in colorectal cancer patients and to construct a nomogram prediction model for predicting the probability of these complications.
METHODS
A retrospective study of 462 patients who underwent postoperative ostomy for colorectal cancer in the Gastrointestinal Department of the Anhui Provincial Cancer Hospital. The patients’ basic information, surgical details, pathological results, and preoperative inflammatory and nutritional indicators were reviewed. We used univariate and multivariate logistic regression to analyze the risk factors for early postoperative stoma complications in colorectal cancer patients and constructed a nomogram prediction model to predict the probability of these complications.
RESULTS
Binary logistic regression analysis revealed that diabetes [odds ratio (OR) = 3.088, 95% confidence interval (CI): 1.419-6.719], preoperative radiotherapy and chemotherapy (OR = 6.822, 95%CI: 2.171-21.433), stoma type (OR = 2.118, 95%CI: 1.151-3.898), Nutritional risk screening 2002 score (OR = 2.034, 95%CI: 1.082-3.822) and prognostic nutritional index (OR = 0.486, 95%CI: 0.254-0.927) were risk factors for early stoma complications after colorectal cancer surgery (P < 0.05). On the basis of these results, a prediction model was constructed and the area under the receiver operating characteristic curve was 0.740 (95%CI: 0.669-0.811). After internal validation, the area under the receiver operating characteristic curve of the validation group was 0.725 (95%CI: 0.631-0.820). The calibration curves for the modeling group and validation group are displayed. The predicted results have a good degree of overlap with the actual results.
CONCLUSION
A previous history of diabetes, preoperative radiotherapy and chemotherapy, stoma type, Nutritional risk screening 2002 score and prognostic nutritional index are risk factors for early stoma complications after colorectal cancer surgery. The nomogram prediction model constructed on the basis of the results of logistic regression analysis in this study can effectively predict the probability of early stomal complications after colorectal cancer surgery.
Microbiota in patients with cefuroxime resistance and anal fistula revealed by 16S ribosomal DNA
Authors: Ling Yi-Ting , Yao Fei , Li Sen-Juan , Cao Chen-Xi , Chen Zhen-Wei , Qiu Min , Li Bu-Zhuo , Hu Bi-Wen , Zhong Shen-Yan , Hu Guang-Lei , Li Jia-Hua 
Published: December 2024

BACKGROUND
Anal fistula is increasingly prevalent due to modern lifestyle factors, and surgery remains the primary treatment. However, the rising incidence of antibiotic resistance, particularly to cefuroxime, complicates perioperative management. The role of gut microbiota in influencing this resistance is not well understood.
AIM
To investigate the relationship between gut microbiota composition and cefuroxime resistance in anal fistula patients and to assess probiotic intervention impact.
METHODS
This study included 30 anal fistula patients categorized into cefuroxime-sensitive (Cefur-S) and cefuroxime-resistant (Cefur-NS) groups. Gut microbiota samples were collected during colonoscopy, and 16S ribosomal DNA sequencing was performed to analyze microbial diversity. Patients in the Cefur-NS group received a 7-day course of Clostridium butyricum tablets. Post-intervention, microbial composition and cefuroxime resistance were reassessed.
RESULTS
Alpha and beta diversity analyses showed no significant differences in microbial diversity between the Cefur-S and Cefur-NS groups. However, effect size analysis identified Roseburia and Butyricicoccus as dominant genera in the Cefur-S group, with higher butyrate production potentially protecting against cefuroxime resistance. Post-intervention, the Cefur-NS group showed a significant reduction in cefuroxime resistance, improved stool consistency, and reduced bowel movement frequency.
CONCLUSION
This study suggests that specific gut microbiota, particularly Butyricicoccus and Roseburia , may mitigate cefuroxime resistance in anal fistula patients by increasing butyrate production. Probiotic intervention targeting gut microbiota composition presents a promising strategy for reducing antibiotic resistance and improving clinical outcomes.
Laparoscopic hepatectomy using indocyanine green attenuates postoperative inflammatory response for hepatocellular carcinoma: A propensity score matching analysis
Authors: Wu Wei-Xun , Huang Ming-Bin , Wang Mei-Xia , Chen Li-Hua , Hu Bo , Ding Zhen-Bin 
Published: December 2024

BACKGROUND
Improving the intraoperative and postoperative performance of laparoscopic hepatectomy was quite a challenge for liver surgeons.
AIM
To determine the benefits of indocyanine green (ICG) fluorescence imaging in patients with hepatocellular carcinoma (HCC) who underwent laparoscopic hepatectomy during and after surgery.
METHODS
We retrospectively collected the clinicopathological data of 107 patients who successfully underwent laparoscopic hepatectomy at Zhongshan Hospital (Xiamen), Fudan University from June 2022 to June 2023. Whether using the ICG fluorescence imaging technique, we divided them into the ICG and non-ICG groups. To eliminate statistical bias, a 1:1 propensity score matching analysis was conducted. The comparison of perioperative outcomes, including inflammation-related markers and progression-free survival, was analyzed statistically.
RESULTS
Intraoperatively, the ICG group exhibited lower blood loss, a shorter surgical time, lower hepatic inflow occlusion (HIO) frequency, and a shorter total HIO time. Postoperatively, the participation of ICG resulted in a shorter duration of hospitalization (6.5 vs 7.6 days, P = 0.03) and postoperative inflammatory response attenuation (lower neutrophil-lymphocyte ratio on the first day after surgery and platelet-lymphocyte ratio on the third day, P < 0.05). Although the differences were not significant, the levels of all inflammation-related markers were lower in the ICG group. The rates of postoperative complications and the survival analyses, including progression-free and overall survivals showed no significant difference between the groups.
CONCLUSION
The involvement of ICG fluorescence imaging may lead to improved perioperative outcomes, especially postoperative inflammatory response attenuation, and ultimately improve HCC patients’ recovery after surgery.
Preoperative serum total bilirubin-albumin ratio as a prognostic indicator in patients with hepatitis-related cirrhosis after splenectomy
Authors: Chen Yi-Fan , Lin Yu-Xin , Chi Miao-Miao , Li Da-Qing , Chen Lin-Tao , Zhang Yu , Wu Rong-Qian , Du Zhao-Qing 
Published: December 2024

BACKGROUND
Splenectomy is an effective yet invasive intervention for alleviating portal pressure in patients with hepatitis cirrhosis. However, the current prognostic indicators for predicting long-term overall survival of these patients have several limitations.
AIM
To assess the potential of preoperative total bilirubin-albumin (B/A) ratio as a prognostic indicator for patients with hepatitis cirrhosis undergoing splenectomy.
METHODS
A total of 257 patients diagnosed with hepatitis cirrhosis were retrospectively enrolled in the study. Normality test, t -test, Wilcoxon test, χ 2 test, or Fisher’s exact test was employed to analyze the intraoperative and postoperative conditions of the patients. Receiver operating characteristic (ROC) curve analysis was utilized to depict the 10-year overall survival rate.
RESULTS
During the follow-up period, 85.99% of the patients survived, with a median survival time of 64.6 months. Multivariate analysis revealed that total serum B/A ratio was an independent risk factor for overall survival (P = 0.037). ROC curve analysis demonstrated that a B/A ratio of 0.87 was the optimal cut-off value. Consequently, the patients were categorized into two groups: High B/A group (n = 64) and low B/A group (n = 193). The median follow-up time for the high B/A group and low B/A group was 56.8 months and 67.2 months, respectively (P = 0.045). Notably, the high B/A group exhibited a significantly lower 10-year overall survival compared to the low B/A group (P < 0.001). Patients with hepatocellular carcinoma (HCC) had lower overall survival rates. Patients with a high B/A ratio exhibited a lower overall survival than those with a low B/A rate in the overall cohort and the subgroups of patients with HCC or not, early Child-Pugh grade, low albumin-bilirubin grade, and model for end-stage liver disease score ≥ 10 (log-rank test, P < 0.001 for all).
CONCLUSION
The B/A ratio can serve as an effective prognostic indicator for overall survival in patients with hepatitis B virus-related cirrhosis following splenectomy, and a higher B/A ratio may suggest a poorer prognosis.
Synergistic inhibition of colorectal cancer progression by silencing Aurora A and the targeting protein for Xklp2
Authors: Sheng Gui-Xian , Zhang Yu-Jia , Shang Tao 
Published: December 2024

BACKGROUND
Unraveling the pathogenesis of colorectal cancer (CRC) can aid in developing prevention and treatment strategies. Aurora kinase A (AURKA) is a key participant in mitotic control and interacts with its co-activator, the targeting protein for Xklp2 (TPX2) microtubule nucleation factor. AURKA is associated with poor clinical outcomes and high risks of CRC recurrence. AURKA/TPX2 co-overexpression in cancer may contribute to tumorigenesis. Despite its pivotal role in CRC development and progression, the action mechanism of AURKA remains unclear. Further research is needed to explore the complex interplay between AURKA and TPX2 and to develop effective targeted treatments for patients with CRC.
AIM
To compare effects of AURKA and TPX2 and their combined knockdown on CRC cells.
METHODS
We evaluated three CRC gene datasets about CRC (GSE32323, GSE25071, and GSE21510). Potential hub genes associated with CRC onset were identified using the Venn, search tool for the retrieval of interacting genes, and KOBAS platforms, with AURKA and TPX2 emerging as significant factors. Subsequently, cell models with knockdown of AURKA, TPX2, or both were constructed using SW480 and LOVO cells. Quantitative real-time polymerase chain reaction, western blotting, cell counting kit-8, cell cloning assays, flow cytometry, and Transwell assays were used.
RESULTS
Forty-three highly expressed genes and 39 poorly expressed genes overlapped in cancer tissues compared to controls from three datasets. In the protein-protein interaction network of highly expressed genes, AURKA was one of key genes. Its combined score with TPX2 was 0.999, and their co-expression score was 0.846. In CRC cells, knockdown of AURKA, TPX2, or both reduced cell viability and colony number, while blocking G0/G1 phase and enhancing cell apoptosis. Additionally, they were weakened cell proliferation and migration abilities. Furthermore, the expression levels of B-cell lymphoma-2-Associated X, caspase 3, and tumor protein P53, and E-cadherin increased with a decrease in B-cell lymphoma-2, N-cadherin, and vimentin proteins. These effects were amplified when both AURKA and TPX2 were concurrently downregulated.
CONCLUSION
Combined knockdown of AURKA and TPX2 was effective in suppressing the malignant phenotype in CRC. Co-inhibition of gene expression is a potential developmental direction for CRC treatment.
Evaluating risk factors for surgical site infections and the effectiveness of prophylactic antibiotics in patients undergoing laparoscopic cholecystectomy
Authors: Wang Shao-Hua 
Published: December 2024

BACKGROUND
Surgical site infections (SSIs) are a significant complication in laparoscopic cholecystectomy (LC), affecting patient outcomes and healthcare costs.
AIM
To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.
METHODS
A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024. Patients were divided into infected (n = 36) and non-infected (n = 364) groups based on the occurrence of SSIs. Data collected included age, diabetes mellitus status, use of prophylactic antibiotics, and specific surgical complications. Statistical analyses using SPSS (Version 27.0) involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.
RESULTS
The use of prophylactic antibiotics significantly reduced the incidence of SSIs (χ ² = 68.34, P < 0.01). Older age (≥ 60 years) and comorbidities such as diabetes mellitus were identified as significant risk factors. Surgical complications like insufficient cystic duct stump, gallbladder perforation, and empyema also increased SSI risk. Notably, factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.
CONCLUSION
Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC. Age, diabetes mellitus, and certain surgical complications significantly contribute to the risk. Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.
Endoscopic submucosal dissection in the treatment of adult cystic lymphangioma: A case report
Authors: Qu Luo-Wei , Li Qiu-Xia , Zhu Wen-Ying , Kang Min 
Published: December 2024

BACKGROUND
Cystic lymphangioma is a rare hamartoma that is especially found in the adult gastrointestinal tract. In the early stage, most patients are asymptomatic; after the onset of symptoms, there is often no specificity regarding symptoms.
CASE SUMMARY
Here we report the endoscopic diagnosis and treatment of an adult patient with cystic lymphangioma of the ascending colon. One patient who came to our hospital with “dull pain in the left lower abdomen for 2 days” was initially misdiagnosed with a colon cyst according to endoscopy and then underwent endoscopic submucosal dissection. The final pathological results suggested cystic lymphangioma. One year later, no recurrence was found on re-examination via colonoscopy.
CONCLUSION
Cystic lymphangioma in the gastrointestinal tract rarely occurs in adults and is easily misdiagnosed or missed. Endoscopy, imaging, histology, and immunohistochemical staining are useful for diagnosis. Surgical resection is the preferred treatment.
LEVERAGING DIGITAL MARKETING OPPORTUNITIES FOR THE DEVELOPMENT OF GEORGIA'S ECONOMY
Authors: Makasarashvili Tamar , Giguashvili Giuli 
Published: December 2024

Tamar Makasarashvili
E-mail: tamarmakasarashvili@gu.edu.ge
Doctor of Economics, Professor Gori State University
Gori, Georgia
https://orcid.org/0000-0003-0424-1816

Giuli Giguashvili
E-mail: giuligiguashvili@gu.edu.ge
Doctor of Economics, Professor Gori State University
Gori, Georgia
https://orcid.org/0000-0001-5657-7544

Abstract: Digital reality presents new challenges to the modern world. The development of technology drives the thorough reorganization of traditional systems and the emergence of new fields. Digital marketing represents one of the essential sectors of the 21st century.
This paper examines and analyzes the use of digital marketing within Georgia's economy, the role and importance of digital marketing in the Georgian ecosystem, and the involvement and role of the scientific community, educational institutions, investors, entrepreneurs, and the state in this process. The study evaluates the objectives of using digital marketing tools, the primary challenges in this field, and measures that have been implemented. The research is based on a review of statistical data, an assessment of the government's anti-crisis policies, and the main directions of state programs. Additionally, it offers insights into the current opportunities and new prospects for digital marketing in Georgia.
Based on research findings, the paper presents conclusions and recommendations for utilizing digital marketing capabilities in Georgia, improving the current level of application, addressing existing challenges, and exploring new, promising directions for development in the sector to grow Georgia's economy.

Keywords: Digital Technologies, Digital Marketing, Artificial Intelligence, Economic Growth.

JEL classification: M15, M31
THE IMPACT OF THE PANAMA CANAL DISRUPTIONS ON INTERNATIONAL TRADE
Authors: Poladashvili Tamari , Makharadze Iakob 
Published: December 2024

Tamari Poladashvili
E-mail: tamari.poladashvili@bsu.edu.ge
Assistant Professor, Batumi Shota Rustaveli State University
Batumi, Georgia
https://orcid.org/0000-0002-7597-7997

Iakob Makharadze
E-mail: Iakob.makharadze0104@gmail.com
Master of Economics, Batumi Shota Rustaveli State University
Batumi, Georgia
Abstract: Maritime transport hubs are vital for the development of international trade. Their disruptions can have far-reaching effects on global trade. The Panama Canal is one of the most important ports in the world. Due to the drought caused by the El Niño phenomenon in 2023, due to the record low depth of Lake Gatuna, the Panama Canal Agency imposed restrictions on daily transits, which significantly reduced the volume of transported cargo, significantly changed the scale of international trade and negatively affected the trade indicator of Central and South American countries due to restrictions imposed on ships crossing the channel. Some have to use alternative routes, which causes cargo delays, further strains international supply chains, increases transportation costs and freight prices. The purpose of the article is to research the impact of restrictions imposed in the Panama Canal from 2023 on such aspects of international trade as: maritime trade routes, transportation costs, pressure on supply chains, impact on regional economies, and others.
Quantitative analysis of primary, secondary and tertiary sources is used in the article. The discussed issue is multi-layered and located at the intersection of several disciplines, which requires consideration of many factors. The study focuses on those variables that provide the clearest picture of the impact on aspects of international trade following the imposition of restrictions on transit through the Panama Canal. Statistical data is compiled from reports in the Panama Canal Agency database, data posted on PortWatch, and others.
Cross-referencing of information from different sources was used to confirm the accuracy and reliability of the findings. It was possible to find and confirm common findings in the research process by comparing data obtained from different types of sources through the triangulation technique.
The study found that the Panama Canal restrictions are less burdensome for container ships, crude oil tankers and LNG tankers because they agree to pay additional fees to book transit through the canal. The imposed restrictions are more severe on ships with low operating costs and prefer to use alternative trade routes.

Key words: International trade, International trade policy, Competition, International trade organizations.

JEL classification: F1, F2, F13