bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pyridoxine Prevents Postoperative Nausea and Vomiting in Gynecological Laparoscopic Surgery: A Double-blind Randomized Controlled Trial
Authors: Zhang Qirui , Ye Xuyang , Shi Shuqing , Zhou Songhua , Ma Daqing , Ouyang Wen , Tong Jianbin , Le Yuan 
Published: December 2024

Background:
Postoperative nausea and vomiting (PONV) are common complications after gynecological laparoscopic surgery. Pyridoxine has been recommended as a first-line drug to prevent and treat nausea and vomiting during pregnancy; however, its efficacy in preventing PONV remains unclear.

Methods:
Patients of 18 to 65 years old, who received elective gynecological laparoscopic surgery under general anesthesia, were randomized into either the pyridoxine or control group. The pyridoxine group received 0.2g vitamin B6 before anesthesia induction, and the control group received normal saline intravenously. Both groups received a similar regimen of combined intravenous and inhalation general anesthesia. All patients received dexamethasone(intravenous) after anesthesia induction and ondansetron(intravenous) before surgery completion. PONV occurrence was recorded according to the patients’ self-reported data. Other clinical data were collected from hospital system, and concentrations of blood interleukin-6 and substance P were measured by ELISA.

Results:
A total of 442 patients were screened and 240 patients were equally randomized to the pyridoxine or control group. The incidence of PONV was statistically significant lower in the pyridoxine group than in the control group (16.7% [20/120] vs. 35.8% [43/120]; relative risk (RR) = 0.47 [95% CI: 0.29, 0.74]; absolute risk reduction (ARR) = 0.20 [95% CI: 0.08, 0.30]; P = 0.001), and pyridoxine decreased the incidence of postoperative nausea (12.5% [15/120] vs. 35% [42/120]; RR = 0.36 [95% CI: 0.21, 0.61]; ARR = 0.23 [95% CI: 0.12, 0.33]; P < 0.001). There were no statistical differences in postoperative vomiting, time to the first PONV occurrence, pain, serum interleukin-6 and substance P, and white blood cell and neutrophil counts.

Conclusion:
In this single center randomized trial, pyridoxine plus dexamethasone and ondansetron reduced the incidence of PONV in patients undergoing elective gynecological laparoscopic surgery under general anesthesia. These findings need to be validated in multicenter studies in diverse populations to ensure generalizability.
Physical Therapy Outcome Measures Used in Persons With Long Covid: A Systematic Review of Interventional Studies Up to 1-Year Postglobal Health Emergency
Authors: Lopes Sauers Andrea , Johnson Liana , Mortensen Marissa , da Silva Laura Bianca Dorásio , de Jesus Luciana Angélica da Silva , González Jaime , Oliveira Cristino 
Published: December 2024

Purpose:
To identify the most frequently used outcome measures in interventional studies for Long Covid in outpatient, home-based, and telerehabilitation physical therapy settings.

Methods:
Registered in PROSPERO (registration number: CRD42021286714) and conducted according to PRISMA guidelines, this review included interventional studies performed in outpatient, telerehabilitation, or home-based physical therapy settings, assessing adults with persistent Long Covid symptoms in at least 3 months post-COVID-19 infection and published in English, Spanish, or Portuguese. A comprehensive search strategy was executed across PubMed, Embase, Scopus, PEDro, SciELO, Web of Science, and CINAHL. Data were managed via Covidence, with studies independently screened and extracted by multiple authors. The risk of bias was assessed using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool. Outcome measures were mapped to constructs based on core outcome sets (COS) for Long Covid by an international Delphi consensus and American Physical Therapy Association Cross Sections and Academies for COVID-19. The frequency of use of each outcome measure, between-group comparisons, clinical meaningfulness, and reference values from previous studies were reported.

Results:
Fourteen studies met the inclusion criteria, utilizing 43 distinct outcome measures to assess constructs such as health-related quality of life, functional mobility, endurance, cognition, mental health, strength/power, and fatigue. Notably, 76.4% (33/43) of these measures were used in only one study, with the EQ-5D being the most frequently employed (50%, 7/14).

Conclusions:
While the outcome measures largely aligned with recommended core domains for Long Covid, significant heterogeneity was observed. Given the variability in outcome measures, the EQ-5D is recommended for assessing health-related quality of life in individuals with Long Covid.
Associations of blood pressure with white matter hyperintensities later in life; influence of short-term menopausal hormone therapy
Authors: Kara Firat , Tosakulwong Nirubol , Lesnick Timothy G. , Fought Angela J. , Kendell-Thomas June , Kapoor Ekta , Faubion Laura L. , Schwarz Christopher G. , Senjem Matthew L. , Fields Julie A. , Min Paul H. , Lowe Val J. , Jack Clifford R. , Bailey Kent R. , James Taryn T. , Lobo Rogerio A. , Manson JoAnn E. , Pal Lubna , Hammers Dustin B. , Malek-Ahmadi Michael , Cedars Marcelle I. , Naftolin Frederick N. , Santoro Nanette , Miller Virginia M. , Harman Sherman M. , Dowling N. Maritza , Gleason Carey E. , Kantarci Kejal 
Published: December 2024

Abstract

Objective
To assess the association of systolic and diastolic blood pressure (SBP and DBP) in recently menopausal women with white matter hyperintensity (WMH) volume later in life and determine whether short-term menopausal hormone therapy (mHT) modifies these associations.

Methods
Kronos Early Estrogen Prevention Study (KEEPS) was a multicenter, randomized, double-blinded, placebo-controlled 4-year mHT trial (oral conjugated equine estrogens or transdermal 17β-estradiol). KEEPS continuation was an observational follow-up of the participants 10 years after the end of mHT. The associations between KEEPS baseline blood pressure (BP) with KEEPS continuation WMH volume were examined adjusting for covariates in model 1 (age, total intracranial volume, study site, mHT type) and model 2 (additionally conventional CVD risk factors). Interaction terms (BP × mHT type) were added into the linear regression models.

Results
The mean ± SD ages of participants were 53 (±2) years at KEEPS baseline and 67 (±2) years at KEEPS continuation. Elevated BP at KEEPS baseline was associated with greater WMH volume measured 14 years later (model 1: SBP: β = 0.01 [95% CI, 0.001‐0.01] and DBP: β = 0.01 [95% CI, 0.003‐0.03]) and after additionally adjusting for CVD risk factors (model 2). We did not find any evidence that mHT versus placebo modified these associations. Topographically, higher BP was associated with greater periventricular WMH in the frontal and parietal lobes.

Conclusion
Our findings suggest the importance of maintaining normal BP in recently postmenopausal women with low CVD risk, irrespective of short-term mHT usage, to potentially reduce the risk of WMH later in life.
Patient-reported outcome based symptom management is a better option for early postoperative recovery after breast cancer surgery: a parallel controlled randomized clinical trial
Authors: Wang Weiwei , Ma Xingcong , Shan Changyou , Du Chong , Zhou Zhangjian , Yan Wanjun , Zhao Fang , Liang Baobao , He Rui , Chai Yichao , Mao Guochao , Zhao Yonglin , Yang Congying , Yang Ying , Zhang Tianxiao , Zhang Shuqun 
Published: December 2024

Background:
We aimed to assess the efficacy and feasibility of applying patient-reported outcome (PRO) based symptom management in the early postoperative period after breast cancer surgery.

Materials and methods:
Before surgery, patients diagnosed with breast cancer who met the inclusion criteria were randomly assigned in a 1:1 ratio to receive either postoperative PRO-based symptom management or usual care. All patients completed the MD Anderson Symptom Inventory-Chinese version (MDASI-C) via the electronic PRO system preoperatively, on a daily basis postoperatively, and twice weekly after discharge, for a duration up to 2 weeks. In the PRO-based care group, in addition to receiving usual care, patients whose symptoms reported by completing MDASI-C with a score of ≥4 will be managed symptomatically by the attending surgeon. Patients in the usual care group received routine care and their MDASI-C scores were unknown to their attending surgeon. The primary outcome was the MDASI-C score of patients at the time of discharge. Analyses were conducted in accordance with the established protocol.

Results:
Of the 134 participants, 67 were randomly assigned to each group. At discharge, the total score of MDASI-C scale was significantly higher in the usual care group comapred to the PRO-based care group (median [interquartile range], 22 [19] vs. 35 [36]; P = 0.002). The score of FACT-B scale (adjusted mean difference, 0.39; 95% confidence interval, 0.11–1.06; P = 0.009) was significantly lower in the usual care group than in the PRO-based care group during the 14 days after surgery. In the PRO-based care group, 87.2% of patients found the PRO-based symptom management approach helpful in their early postoperative recovery.

Conclusion:
The implementation of a PRO-based symptom management system within 2 weeks after breast cancer surgery effectively alleviates symptom burden and improves quality of life compared to usual care.
The association between diabetes mellitus and postoperative cognitive dysfunction: a systematic review and meta-analysis
Authors: Liu Hongbo , Chen Jiali , Ling Jitao , Wu Yuting , Yang Pingping , Liu Xiao , Liu Jianping , Zhang Deju , Yin Xiaoping , Yu Peng , Zhang Jing 
Published: December 2024

Abstract

Background:
Postoperative cognitive dysfunction (POCD) is a typical consequence following surgery, particularly in cardiac surgeries. Despite its high incidence, the underlying aetiology remains unclear. While diabetes mellitus (DM) has been associated with cognitive impairment, its specific function in POCD development remains unidentified. This study aims to evaluate the connection between DM and the risk of POCD.

Methods:
We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library databases for studies of DM and risk with POCD, collecting data up to 14 September 2023. We assessed publication bias, heterogeneity, and study quality, adhering to PRISMA and AMSTAR guidelines.

Results:
Our study comprised 38 trials involving 8748 individuals, with 7734 patients undergoing follow-up. The pooled results showed that individuals with DM had an increased incidence of POCD compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26–1.65). The incidence of POCD was significantly higher in the group of patients with an average age older than 65 years (RR: 1.69, 95% CI: 1.30–2.20) compared with diabetic patients with an average age younger than 65 years (RR: 1.29, 95% CI: 1.09–1.64). Compared with diabetic patients undergoing cardiac surgery (RR: 1.33, 95% CI: 1.15–1.53), patients receiving non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI: 1.43–2.84).

Conclusion:
Current evidence underscores that diabetic patients face a significantly higher risk of POCD compared to their nondiabetic counterparts. Further research is warranted to clarify the precise mechanisms of this relationship and explore potential preventive strategies for diabetic patients.
Identification of hub biomarkers in liver post-metabolic and bariatric surgery using comprehensive machine learning (experimental studies)
Authors: Li Zhehong , Wang Liang , Tian Chenxu , Wang Zheng , Zhao Hao , Qi Yao , Chen Weijian , Wuyun Qiqige , Amin Buhe , Lian Dongbo , Zhu Jinxia , Zhang Nengwei , Zheng Lifei , Xu Guangzhong 
Published: December 2024

Background:
The global prevalence of non-alcoholic fatty liver disease (NAFLD) is approximately 30%, and the condition can progress to non-alcoholic steatohepatitis, cirrhosis, and hepatocellular carcinoma. Metabolic and bariatric surgery (MBS) has been shown to be effective in treating obesity and related disorders, including NAFLD.

Objective:
In this study, comprehensive machine learning was used to identify biomarkers for precise treatment of NAFLD from the perspective of MBS.

Methods:
Differential expression and univariate logistic regression analyses were performed on lipid metabolism-related genes in a training dataset (GSE83452) and two validation datasets (GSE106737 and GSE48452) to identify consensus-predicted genes (CPGs). Subsequently, 13 machine learning algorithms were integrated into 99 combinations; among which the optimal combination was selected based on the total score of the area under the curve, accuracy, F-score, and recall in the two validation datasets. Hub genes were selected based on their importance ranking in the algorithms and the frequency of their occurrence. Finally, a mouse model of MBS was established, and the mRNA expression of the hub genes was validated via quantitative PCR.

Results:
A total of 12 CPGs were identified after intersecting the results of differential expression and logistic regression analyses on a Venn diagram. Four machine learning algorithms with the highest total scores were identified as optimal models. Additionally, PPARA, PLIN2, MED13, INSIG1, CPT1A, and ALOX5AP were identified as hub genes. The mRNA expression patterns of these genes in mice subjected to MBS were consistent with those observed in the three datasets.

Conclusion:
Altogether, the six hub genes identified in this study are important for the treatment of NAFLD via MBS and hold substantial promise in guiding personalized treatment of NAFLD in clinical settings.
Robotic vs. laparoscopic gastrectomy for patients with locally advanced gastric cancer: a meta-analysis of randomized controlled trials and propensity-score-matched studies
Authors: Huang Wang , Tang Gang , Sun Hao 
Published: December 2024

Background:
The role of robotic surgery for the treatment of locally advanced gastric cancer remains controversial. This meta-analysis aimed to compare the short-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for patients with locally advanced gastric cancer using data collected from randomized controlled trials (RCTs) and propensity score-matched (PSM) studies.

Materials and methods:
We searched PubMed, Cochrane Library, EMBASE, and Web of Science databases for RCTs and PSM studies comparing RG and LG. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.

Results:
Fifteen studies encompassing one RCT and 14 PSM studies were included, with a total of 5079 patients (RG group: 2279 patients; LG group: 2800 patients). Although RG was associated with a longer operative time (MD, 19.82 min), patients may benefit from reduced blood loss (MD, −28.91 mL), shorter length of stay (MD, −0.69 days), lower morbidity (RR, 0.82), major complications (RR, 0.71), blood transfusion rate (RR, 0.60), conversion rate (RR, 0.38), and higher number of harvested lymph nodes (MD, 3.25). There were no significant differences observed in readmission (RR, 0.89), mortality (RR, 0.75), reoperation (RR, 0.71), and R0 resection (RR, 0.99) between the groups. In addition, RG shortened the time to first flatus (MD, −0.38 days), the time to first liquid intake (MD, −0.31 days), and the time to first soft diet intake (MD, −0.20 days).

Conclusions:
RG seems associated with improved short-term outcomes and enhanced postoperative recovery in locally advanced gastric cancer compared to LG. In the future, RG may become a safe and effective alternative to LG. Further research is needed to investigate long-term outcomes and confirm the promising advantages of RG in locally advanced gastric cancer.
Development and validation of a predictive model for overall survival in esophageal squamous cell carcinoma post-esophagectomy: the role of lymph node metastatic stations
Authors: Li Kexun , Lu Simiao , Du Kunyi , Wang Chenghao , He Wenwu , Wang Qifeng , Han Yongtao , Leng Xuefeng , Peng Lin 
Published: December 2024

Background:
Esophageal squamous cell carcinoma (ESCC) poses a substantial healthcare challenge, particularly in areas such as East Asia. The pathologic nodal (pN) stage of ESCC remains a controversial factor. Accurately predicting overall survival (OS) after esophagectomy is crucial for treatment planning and improving treatment outcomes.

Method:
An analysis was conducted using data from Esophageal Cancer Case Management Database of Sichuan Cancer Hospital and Institute, spanning from January 2010 to December 2017. Our study aimed to examine the clinicopathological characteristics, lymph node resection at individual stations, and treatment details of patients with ESCC who underwent esophagectomy. In addition, a novel nodal stage (N stage) was based on the number of lymph node metastasis (LNM) stations, and a prediction model for OS was devised using the pN stage and the newly proposed N stage.

Results:
After analyzing 49 indicators through univariate and multifactorial analyses, 25 of the most significant factors affecting OS after esophagectomy were identified. Further analysis using least absolute shrinkage and selection operator regression revealed six key factors. Models were developed based on the pN stage and the newly introduced N stage. Evaluation of the area under the curve indicated that Model 2 exhibited slightly superior clinical utility compared to Model 1.

Conclusions:
Our study demonstrates that the newly introduced N stage, based on the number of LNM stations, exhibits comparable performance to the current American Joint Committee on Cancer/Union for International Cancer Control pN system, with a slight advantageous edge.
Effect of different artificial tears on tear film parameters in dry eye disease
Authors: Maity Moumi , Allay Manindra Bikram , Ali Md Hasnat , Basu Sayan , Singh Swati 
Published: December 2024

SIGNIFICANCE
Artificial tears remain the cornerstone for managing dry eye disease. The current study's real-world efficacy test of carboxymethylcellulose (CMC), polyethylene glycol (PEG) 400, or sodium hyaluronate (SH)–based lubricants highlights their similar effects on noninvasive tear film parameters over the short term. However, patients reported better relief with SH-based lubricants.

PURPOSE
This study aimed to compare the short-term impact of different artificial tear formulations on tear film in moderate dry eye disease patients.

METHODS
A prospective, double-masked, controlled study randomly allocated moderate dry eye disease patients into five groups of artificial tears: 0.5% CMC, 1% CMC, 0.1% SH-trehalose, 0.4% PEG 400–0.3% propylene glycol (PG), and 0.1% SH–0.4% PEG 400–0.3% PG. Noninvasive tear breakup time (NIBUT), tear meniscus height, and bulbar redness (Keratograph 5M; OCULUS Optikgeräte, Wetzlar, Germany) were assessed (in a controlled environment chamber 68 to 70°F; 35% relative humidity) at baseline and every 15 minutes for 1 hour after a drop instillation in the left eye. The right eye was an internal control. At 1 hour, subjects were asked for a change in subjective symptomatology (scales 0 to 4). A linear mixed-effect model was used for analysis.

RESULTS
Each artificial tear group had 20 patients (100 patients). All groups had similar dry eye disease types and durations, baseline ocular surface disease index scores, and tear film parameters. All artificial tears showed significant improvement in NIBUT values at all time points from baseline compared with contralateral eyes. The change in NIBUT values was similar between different artificial tears at all time points. Bulbar redness scores and tear meniscus height showed no significant change in either eye with time or artificial tears. All patients reported improvement in dry eye disease symptomatology, with significant differences observed between 1% CMC and SH-PEG-PG (p=0.01), 0.5% CMC and SH-PEG-PG (p<0.0001), and 0.5% CMC and 0.1% SH-trehalose (p=0.01), where SH-based tear drops performed better.

CONCLUSIONS
Tear film stability improves following a single drop of CMC, SH, and PEG-based artificial tears, although these artificial tears do not differ in their short-term effect.
Reduce Flap Necrosis After Autologous Breast Reconstruction: A Systematic Review
Authors: Gao Yiwen , Yin Lu , Xiang Tinghong , Ni Tianyi , Shi Jingping 
Published: December 2024

Background:
Autologous breast reconstruction provides substantial benefits in terms of aesthetics and longevity. However, the risk of flap necrosis poses potential challenges to patients’ appearance and psychological well-being, while also escalating health care costs. Consequently, examining the risk factors, assessment techniques, and therapeutic approaches for flap necrosis is critically important.

Method:
The authors conducted a comprehensive search for relevant studies from January 2010 to August 2024 using PubMed, Web of Science, and the Cochrane Library. The search terms included “autologous breast reconstruction”, “flap necrosis”, “risk factor”, “assessment”, and “treatment”. The authors initially screened titles and abstracts, followed by a detailed review by 3 investigators to determine the studies that met the inclusion criteria.

Result:
A total of 68 studies were ultimately selected for analysis. Identified risk factors for flap necrosis include smoking, advanced age, obesity, diabetes, large breast volume, previous radiotherapy, and abdominal surgery. Various assessment methods (e.g., preoperative imaging, intraoperative blood flow monitoring, and postoperative evaluations) can enhance flap survival. The review also covered surgical treatment strategies and non-surgical interventions, including local wound care, hyperbaric oxygen therapy, and pharmacological treatments.

Conclusion:
This review highlights the critical role of thorough planning and management in minimizing the risk of flap necrosis after autologous breast reconstruction. Effective preoperative assessments, perioperative monitoring, and specific postoperative interventions can significantly lower the incidence of flap necrosis.