bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early physiotherapy referral for low back pain reduces healthcare utilisation for advanced imaging and specialist spine surgery consultations
Authors: Moorthy Vikaesh , Ong Pei Gin , Oh Jacob Yoong-Leong 
Published: November 2024

Abstract

Introduction:
Low back pain (LBP) is one of the most common presenting complaints among patients and the costliest orthopaedic condition. This study aimed to compare the healthcare utilisation rates of advanced imaging and specialist consultations for LBP between patients presenting with early physiotherapy (EPT) before specialist review and routine physiotherapy (RPT) after specialist review.

Methods:
Consecutive patients who (n = 311) had been referred to specialist spine surgery for LBP in 2021 were retrospectively reviewed. Baseline demographics, healthcare utilisation rates and clinical outcomes were compared between those who attended EPT before spine surgery consultation and those who attended RPT after specialist consultation.

Results:
There were no significant differences in baseline demographics or clinical outcomes of Visual Analogue Scale pain scores, EuroQol 5-Dimension scores and surgery rates between the EPT (n = 183) and RPT (n = 128) groups. At 6 months follow-up, EPT was associated with significantly lower magnetic resonance imaging (MRI) rates (P = 0.026), decreased likelihood of requiring MRI (odds ratio [OR] 0.865, 95% confidence interval [CI] 0.757–0.990), reduced number of specialist spine surgery consultations (P < 0.001), decreased likelihood of requiring additional specialist consultations (OR 0.770, 95% CI 0.655–0.905), fewer physiotherapy sessions (P = 0.001) and decreased likelihood of requiring additional physiotherapy sessions (OR 0.835, 95% CI 0.553–1.261).

Conclusions:
Early physiotherapy reduces the (a) overall treatment duration from the first referral by the primary physician, (b) number of advanced imaging ordered (and thus, associated imaging costs), and (c) total number of clinic and therapy sessions, and it is safe and allows patients to achieve comparable functional outcomes to their counterparts undergoing RPT. These findings support the implementation of EPT for patients with LBP to reduce healthcare utilisation and associated costs for patients, providers and healthcare systems.
Comparison of endoscopic and laparoscopic resection of gastric gastrointestinal stromal tumors: A propensity score-matched study
Authors: Gu Bin-Bin , Lu Yan-Di , Zhang Jin-Shun , Wang Zhen-Zhen , Mao Xin-Li , Yan Ling-Ling 
Published: November 2024

BACKGROUND
Endoscopic resection (ER) and laparoscopic resection (LR) have been widely used for the treatment of non-metastatic gastric gastrointestinal stromal tumors (gGISTs) (2-5 cm), but there are no selection criteria for their application.
AIM
To provide a reference for the development of standardized treatment strategies for gGISTs.
METHODS
Clinical baseline characteristics, histopathological results, and short-term and long-term outcomes of patients who treated with ER or LR for gGISTs of 2-5 cm in Taizhou Hospital of Zhejiang Province from January 2014 to August 2022 were retrospectively reviewed. Propensity score matching (PSM) was employed to achieve balance in baseline characteristics of the two groups.
RESULTS
Among 206 patients, 135 were in the ER group and 71 in the LR group. The ER group had significantly smaller tumors [3.5 cm (3.0-4.0 cm) vs 4.2 cm (3.3-5.0 cm), P < 0.001] and different tumor locations (P = 0.048). After PSM, 59 pairs of patients were balanced. After matching, the baseline characteristics of the ER and LR groups did not differ significantly from each other. Compared with LR, ER had faster recovery of diet (P = 0.046) and fewer postoperative symptoms (P = 0.040). LR achieved a higher complete resection rate (P < 0.001) and shorter operation time (P < 0.001). No significant differences were observed in postoperative hospital stay (P = 0.478), hospital costs (P = 0.469), complication rates (P > 0.999), pathological features (mitosis, P = 0.262; National Institutes of Health risk classification, P = 0.145), recurrence rates (P = 0.476), or mortality rates (P = 0.611).
CONCLUSION
Both ER and LR are safe and effective treatments for gGISTs. ER has less postoperative pain and faster recovery, while LR has a higher rate of complete resection.
Efficacy of multi-color near-infrared fluorescence with indocyanine green: A new imaging strategy and its early experience in laparoscopic cholecystectomy
Authors: Li Jia-Yi , Ping Lu , Lin Bo-Zheng , Wang Zhi-Hong , Fang Chi-Hua , Hua Su-Rong , Han Xian-Lin 
Published: November 2024

BACKGROUND
Near-infrared fluorescence imaging via using intravenous indocyanine green (ICG) has a wide range of applications in multiple surgical scenarios. In laparoscopic cholecystectomy (LC), it facilitates intraoperative identification of the biliary system and reduces the risk of bile duct injury. However, the usual single color fluorescence imaging (SCFI) has limitations in manifesting the fluorescence signal of the target structure when its intensity is relatively low. Moreover, surgeons often experience visual fatigue. We hypothesized that a novel imaging strategy, named multi-color fluorescence imaging (MCFI), could potentially address these issues by decreasing hepatic and background fluorescence pollution and improving biliary visualization.
AIM
To investigate the novel imaging strategy MCFI in LC.
METHODS
This was a single-center retrospective study conducted at Peking Union Medical College Hospital, Beijing, China. Patients who underwent LC from June 2022 to March 2023 by the same surgical team were enrolled. Demographic features, clinical and surgical information were collected. The clarity, visual comfort, and effectiveness of different imaging strategies were subjectively evaluated by surgeons.
RESULTS
A total of 155 patients were included, 60 patients were in the non-ICG group in which only bright light illuminance without ICG was applied, 60 patients were in the SCFI group, and 35 patients were in the MCFI group. No statistically significant differences were found in demographics or clinical history. Post-surgical complications were minimal in all 3 groups with no significant differences observed. MCFI improved the clarity of imaging and visual comfort. Clarity of imaging and visual comfort were improved with MCFI.
CONCLUSION
MCFI improves biliary visualization and reduces liver fluorescence contamination, which supports its routine use in LC. MCFI may also be a better choice than SCFI in other clinical settings.
Onset and prognostic features of anastomotic leakage in patients undergoing radical surgery after neoadjuvant chemoradiation for rectal cancer
Authors: Wang Lei , Zhang Wang-Shan , Huang Guo-Jin 
Published: November 2024

BACKGROUND
Anastomotic leakage (AL) is a significant complication of rectal cancer surgery, particularly in patients undergoing neoadjuvant chemoradiotherapy. This study aimed to evaluate the onset and prognostic factors influencing AL in these patients and provide insights for better postoperative management.
AIM
To explore AL incidence in patients who underwent neoadjuvant radiotherapy for rectal cancer and evaluate influencing factors and prognosis.
METHODS
We retrospectively analyzed data of patients with rectal cancer who underwent neoadjuvant chemoradiotherapy post-radical surgery admitted to our hospital from January 2020 to January 2023. Postoperative AL was recorded in all patients. Among 63 patients with AL initially enrolled, 2 were lost to follow-up; thus, 61 patients were included in the incident group. Another 59 patients without AL were included in the non-incident group. Clinical characteristics of both groups were analyzed to identify factors affecting postoperative AL and determine prognosis.
RESULTS
Multivariate analysis revealed that sex, operative time, bleeding, pelvic radiation injury, and intraoperative blood transfusion were independent risk factors for postoperative AL (P < 0.05). The Swiss Institute for Experimental Cancer Research (ISREC) grades for patients with postoperative AL were mainly A (49.18%) and B (40.98%), and most leakages occurred in the posterior wall (65.57%). Clinical manifestations included anal sacrococaudal pain (29.51%), anal pus (26.23%), and other symptoms. Invasive interventions were performed < 2 times in 80.33% of patients. Poor prognoses were mainly associated with chronic pressacral sinus formation (24.59%), anastomotic stenosis (29.51%), and long-term stoma (19.67%). Multivariate analysis revealed distance from the anal margin and ISREC grade as independent risk factors for poor prognosis following AL (P < 0.05).
CONCLUSION
Sex, operative time, bleeding loss, pelvic radiation damage, and intraoperative blood transfusion are independent risk factors for AL and the distance between tumor and ISREC grade potentially affect prognosis.
Effects of comprehensive nutrition support on immune function, wound healing, hospital stay, and mental health in gastrointestinal surgery
Authors: Zhu Ling , Cheng Jun , Xiao Fei , Mao Yan-Yan 
Published: November 2024

BACKGROUND
Postoperative patients undergoing gastrointestinal surgery often encounter challenges such as low immune function, delayed wound healing owing to surgical trauma, and increased nutritional demands during recovery.
AIM
To assess the effect of comprehensive nutritional support program on immune function and wound healing in patients undergoing gastrointestinal surgery.
METHODS
This retrospective comparative study included 60 patients who underwent gastrointestinal surgery, randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received comprehensive nutritional support, including a combination of enteral and parenteral nutrition, whereas the control group received only conventional comprehensive nutritional support. Evaluation indicators included immune function markers (e.g. , white blood cell count, lymphocyte subsets), wound healing (wound infection rate, healing time), pain score [visual analog scale (VAS) score], and psychological status (anxiety score, depression score) 7 days post-surgery) and duration of stay.
RESULTS
The immune function of patients in the experimental group was significantly better than that in the control group. The white blood cell count was 8.52 ± 1.19 × 109/L in the experimental group vs 6.74 ± 1.31 × 109/L (P < 0.05). The proportion of CD4+ T cells was higher in the experimental group (40.09% ± 4.91%) than that in the control group (33.01% ± 5.08%) (P < 0.05); the proportion of CD8+ T cells was lower (21.79% ± 3.38% vs 26.29% ± 3.09%; P < 0.05). The CD4+/CD8+ ratio was 1.91 ± 0.32 in the experimental group whereas 1.13 ± 0.23 in the control group (P < 0.05). The wound infection rate of the experimental group was significantly lower than that of the control group (10% vs 30%, P < 0.05), and the wound healing time was shorter (10.35 ± 2.42 days vs 14.42 ± 3.15 days, P < 0.05). The VAS score of the experimental group was 3.05 ± 1.04, and that of the control group was 5.11 ± 1.09 (P < 0.05); the anxiety score (Hamilton Anxiety Rating Scale) was 8.88 ± 1.87, and that of the control group was 12.1 ± 3.27 (P < 0.05); the depression score (Hamilton Depression Rating Scale) was 7.37 ± 1.41, and that of the control group was 11.79 ± 2.77 (P < 0.05). In addition, the hospitalization time of the experimental group was significantly shorter than that of the control group (16.16 ± 3.12 days vs 20.93 ± 4.84 days, P < 0.05).
CONCLUSION
A comprehensive nutritional support program significantly enhances immune function, promote wound healing, reduces pain, improves psychological status, and shortens hospitalization stays in patients recovering from gastrointestinal surgery.
Long-term survival and risk factors in esophageal squamous cell carcinoma: A Kaplan-Meier and cox regression study
Authors: Ren Zheng-Ting , Kang Mei , Zhu Li-Yang , Li Ping 
Published: November 2024

BACKGROUND
The global incidence of esophageal cancer (EC) remains high. Despite advancements in medical technology and deeper research into the causes and treatment methods of EC, the effectiveness of treatment for EC is still unsatisfactory. Therefore, it is crucial to address the urgent problem of improving the long-term survival rate of EC patients and providing personalized treatment.
AIM
To analyze the survival prognosis and influencing factors of esophageal squamous cell carcinoma (ESCC).
METHODS
A retrospective analysis was conducted on the clinical data of 115 patients with pT3N0M0 ESCC who underwent radical surgery alone from January 1, 2013, to December 31, 2019. The Kaplan–Meier method was used to evaluate the 1-year, 3-year, and 5-year survival rates and median survival time of the patients. The Cox proportional hazards regression model was used to assess the hazard ratios (HRs) and 95% confidence intervals (95%CIs) of risk factors.
RESULTS
The 1-year, 3-year, and 5-year overall survival (OS) rates for the 115 EC patients analyzed were 85.22%, 50.43%, and 37.48%, respectively. The median OS was 37.00 (95%CI: 24.93-49.07) months, and the median disease-free survival was 21.00 (95%CI: 14.71-27.29) months. Both univariate and multivariate Cox regression analyses revealed that high body mass index (BMI; HR = 1.137, 95%CI: 1.054-1.226), positive perineural invasion (PNI; HR = 13.381, 95%CI: 4.899-36.547), and smoking (HR = 2.415, 95%CI: 1.388-4.203) were independent risk factors for a poor prognosis. In contrast, compared to the upper thoracic location of the tumor, middle thoracic (HR = 0.441, 95%CI: 0.240-0.810) and lower thoracic (HR = 0.328, 95%CI: 0.144-0.750) locations were protective factors.
CONCLUSION
BMI, tumor location, PNI, and smoking are associated with the prognosis of ESCC patients. This study highlights the prognostic risk factors for T3N0M0 ESCC patients and offers personalized insights for clinical treatment.
Zinc pretreatment for protection against intestinal ischemia-reperfusion injury
Authors: Cheng Ming-Zhen , Luo Jia-Hao , Li Xin , Liu Feng-Yong , Zhou Wei-Jie 
Published: November 2024

BACKGROUND
Intestinal ischemia- reperfusion (I/R) injury (II/RI) is a critical condition that results in oxidative stress, inflammation, and damage to multiple organs. Zinc, an essential trace element, offers protective benefits in several tissues during I/R injury, but its effects on intestinal II/RI remain unclear.
AIM
To investigate the effects of zinc pretreatment on II/RI and associated multiorgan damage.
METHODS
C57BL/6 mice were pretreated with zinc sulfate (ZnSO4, 10 mg/kg) daily for three days before I/R injury was induced via superior mesenteric artery occlusion (SMAO) and abdominal aortic occlusion (AAO) models. Tissue and serum samples were collected to evaluate intestinal, liver, and kidney damage using Chiu’s score, Suzuki score, and histopathological analysis. Caco-2 cells and intestinal organoids were used for in vitro hypoxia- reoxygenation injury models to measure reactive oxygen species (ROS) and superoxide dismutase (SOD) levels.
RESULTS
Zinc pretreatment significantly reduced intestinal damage in the SMAO and AAO models (P < 0.001). The serum levels of liver enzymes (alanine aminotransferase, aspartate aminotransferase) and kidney markers (creatinine and urea) were lower in the zinc-treated mice than in the control mice, indicating reduced hepatic and renal injury. In vitro , zinc decreased ROS levels and increased SOD activity in Caco-2 cells subject to hypoxia- reoxygenation injury. Intestinal organoids pretreated with zinc exhibited enhanced resilience to hypoxic injury compared to controls.
CONCLUSION
Zinc pretreatment mitigates II/RI and reduces associated multiorgan damage. These findings suggest that zinc has potential clinical applications in protecting against I/R injuries.
Pulmonary hypertension post-liver transplant: A case report
Authors: Alharbi Sami , Alturaif Noura , Mostafa Yehia , Alfhaid Abdullah , Albenmousa Ali , Alghamdi Saad 
Published: November 2024

BACKGROUND
Liver transplantation (LTx) is vital in patients with end-stage liver disease, with metabolic dysfunction-associated steatotic liver disease being the most common indication. Primary sclerosing cholangitis (PSC) is an important indication. Portopulmonary hypertension, associated with portal hypertension, poses a significant perioperative risk, making pretransplant screening essential.
CASE SUMMARY
We report the case of a 41-year-old woman with PSC who developed severe pulmonary hypertension years after a successful LTx. She presented with worsening dyspnea on exertion and presyncope. Diagnostic evaluation confirmed severe precapillary pulmonary hypertension without evidence of recurrent portal hypertension. Initial management with Sildenafil and Macitentan led to a significant improvement in her symptoms, exercise capacity, and biomarkers. This case highlights the rare development of de novo pulmonary hypertension in a liver transplant recipient without recurrent portal hypertension, possibly linked to autoimmune processes or primary liver disease itself. The patient’s positive response to the combination therapy underscores the importance of prompt diagnosis and aggressive management.
CONCLUSION
In conclusion, pulmonary arterial hypertension post-LTx is a rare but serious complication with a poor prognosis, necessitating further research to better understand its mechanisms and to develop effective strategies for prevention and treatment.
¿Las leguminosas logran un aporte similar de proteínas de alto valor biológico en dietas veganas?
Authors: Santos Jonathan Hernandez , Ávila Daniela Fernanda López , Ortega Jose Alberto Ariza , Rojas Quinatzin Yadira Zafra 
Published: November 2024

Actualmente la alimentación vegana se está volviendo parte fundamental de los patrones alimentarios de la población mundial, sin embargo, existe la necesidad de conocer la importancia de los nutrientes escasos que se dan a partir de este tipo de alimentación, principalmente las proteínas de origen animal que constituyen gran parte de los aminoácidos esenciales para el organismo. Diversos estudios han establecido que las leguminosas, pueden jugar un papel muy importante en el reemplazo total de la proteína animal. El objetivo de este estudio es presentar alternativas de productos de origen vegetal que pudieran contribuir a completar los requerimientos proteicos en las dietas veganas estrictas. En general se identificó que el garbanzo logró el contenido total de proteína que aporta la carne de bovino, sin embargo esta presenta valores muy escasos en el aporte de aminoácidos esenciales (Lisina, Metionina, Treonina y Triptfano). Mientras que, la lenteja también se ubicó en un lugar primordial al aportar un contenido de proteína similar a la de la carne, con un mejor panorama, solo con un aporte bajo de triptófano. Esto representa en ambos casos tener una gran ventaja por su alto contenido de fibra y nulo aporte de colesterol. Finalmente se recomienda que la población que lleve una dieta vegana estricta, integre estas alternativas en su dieta, para evitar deficiencias proteicas.
ACESSIBILIZAÇÃO CURRICULAR NA PERSPECTIVA DO ENSINO COLABORATIVO
Authors: QUINTANILHA CLARISSA , MELO DE AGUIAR LUISE , SANTIAGO DE JESUS VITÓRIA ELLEN 
Published: November 2024

As temáticas relacionadas ao processo de inclusão escolar bem como o modelo utilizado para a efetivação das políticas públicas atuais tem sido o foco de muitas discussões no sistema educacional brasileiro. Por esse motivo, nossa pesquisa buscou refletir como a perspectiva do Ensino Colaborativo pode auxiliar no processo de acessibilização curricular. O ensino colaborativo busca promover a parceria entre o professor da classe comum e o professor da Educação Especial, construindo conjuntamente os processos avaliativos, estratégias de ensino e estruturação de um currículo inclusivo. Baseando-se nos princípios do Desenho Universal da Aprendizagem (DUA), o planejamento colaborativo surge como ponto principal nos desafios relacionados à implementação das práticas em questão. Desta forma, traçamos como objetivo a reflexão sobre o processo de inclusão dos estudantes público-alvo da educação especial (PAEE) e do trabalho do Atendimento Educacional Especializado (AEE) no formato citado a partir das narrativas de professoras da classe comum e da educação especial em entrevistas-conversas realizadas em maio de 2024. Nesse sentido, dentro do campo da pesquisa qualitativa, nossa proposta teórica-metodológica contou com as contribuições da abordagem (auto)biográfica, do campo do currículo e do ensino colaborativo. Entendemos que ao dialogar com estas experiências podemos vislumbrar outros caminhos no campo da Educação Especial em busca da fomentação na cultura escolar colaborativa e inclusiva.
Rajata Shalaka Agnikarma - An Ethnic Perspective towards post-operative recurrent corn
Authors: Kashikar Prathamesh Pradeep  
Published: November 2024

Melanocyte degeneration has a connection to vitiligo, an acquired macular depigmentation disorder. It is thought to be brought on by cells' autoimmune destruction of melanocytes. Frequently symmetrical, generalized vitiligo affects the hands, wrists, feet, knees, neck, as well as the skin around bodily orifices. According to Ayurveda all the skin diseases are categorized under the Kushtha Roga. In the classics Shwitra is mentioned under Kushtha Roga Chikitsa. Methodology: The 10-year-old male child, complaint of white discolored spots on his neck and left clavicle region; Shamana Chikitsa was used to cure the condition satisfactorily. Result: Patient showed encouraging result after Shamana Chikitsa, where subjective criteria evaluated using scoring method and objective criteria evaluated using VASI scoring method. Discussion: Patient was treated with Shamana Aushadhis, where white discolored patches turned to pinkish, and after that the patches turned into normal skin color. Subject was observed with 95% improvement in subjective criteria and VASI scoring improved from 0.25 to 0.10. Hence, the present case study highlights the importance of efficacy of Ayurvedic treatment in Shwitra, as mentioned in classics. Conclusion: Ayurvedic medicine's effectiveness in curing Shwitra was confirmed by the current case study.
Carbon Emission Reduction with Green Open Space Development in Jagorawi Toll Road, Indonesia
Authors: Sitawati Anita , Yahya Wisely , Fitri Rini , Andajani Rezkia Dewi , Ikhsan Satrio Maulana 
Published: November 2024

Objective: The objective of this study is to conduct a Green Open Space (GOS) planning that meets ecological, socio-cultural, economic, and aesthetic functions in the context of carbon capture, and assess the capability of the GOS in capturing CO2.

Theoretical Framework: This research supports SDG 13 by means of the development of GOS that are capable of capturing carbon while keeping the aesthetic aspects. The approaches used are the integration of landscape planning aspects into the development of green infrastructures, the calculation of emissions produced by vehicles driving through the toll road, and the calculation of the carbon capture capacity of the vegetation.

Method: The research is conducted through two stages of research: 1.) The GOS Planning on the Jagorawi toll road that can fulfill ecological, socio-cultural, economic, and aesthetic functions, specifically the CO2 emission absorption, and 2.) Assessment of the GOS’ capability in absorbing carbon.

Results and Discussion: The results of the study are: 1). The total number of trees to be planted in the GOS area is 10,917, and 2). The capability of the GOS to absorb CO2 emissions, as high as 30% of the total CO2 emitted by vehicles driving through the research area.

Research Implications: Efficient policies for combating climate change and reducing emissions to prevent future warming while also adapting to the unavoidable effects of climate change.

Originality/Value: Originality/Value: This research supplements the list of literature on the development of GOS based on carbon capture that are optimized in decreasing CO2 emissions.