bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comprehensive update on over the counter artificial tears
Authors: Simon Lilla , Murillo Brian A. , Sabater Alfonso L. 
Published: November 2024

Purpose of review
Artificial tears play a critical role in the management of dry eye disease (DED), providing patient symptomatic relief and improving ocular surface health. Its clinical importance has driven pharmaceutical innovation in terms of its formula and ingredients. The following article is an overview of the artificial tear products on the market.

Recent findings
The artificial tears on the market vary in terms of their active ingredients, inactive ingredients, preservatives, and formulation. The particular chemical composition of ingredients and formulation plays a clinical role in treating ocular pathology. Conversely, certain ingredients can cause more ocular damage than other ingredients.

Summary
Upon review of the artificial tears on the market, the authors conclude that clinicians should consider the products’ composition when designating a treatment for DED. Different artificial tear composition may benefit specific causes of DED such as evaporative, aqueous-deficient, glaucoma, ocular surface tumors, corneal ulcers, and viral conjunctivitis.
Assessment of Electrically Evoked Stapedius Reflex Threshold (eSRT) for Auditory Mapping in Pulse Width Modulation Cochlear Implants: The Effect of Multielectrode Stimulation
Authors: Martins Pedro Goiana , Luís Leonel , Segovia-Martinez Manuel , Molaee-Ardekani Behnam 
Published: November 2024

Objective
This study assesses the electrically evoked stapedius reflex threshold (eSRT) as an objective method for generating auditory maps in individuals with pulse-width-modulation cochlear implants (CIs). It investigates the impact of both single- and multiple-electrode stimulations on eSRT detection rates and their association with patients' comfort loudness levels (C-levels). Despite eSRT exploration by several CI brands incorporating pulse-amplitude-modulation stimulation technology, there is a lack of information on systems using pulse-width modulation.

Approach
The eSRT was measured in 19 ears ipsilaterally and contralaterally in response to stimulations in groups of 1, 3, and 5 electrodes across five distinct cochlear regions, spanning from apical to basal. For each group, the eSRT detection rate and its correlation with the C-levels were analyzed both regionally and overall.

Main results
In both contralateral and ipsilateral sides, higher electrically evoked stapedius reflex (eSR) detection rates were obtained for multielectrode (67%, 47%) than for single-electrode (41%, 23%) stimulation. Invoking eSR in the apical and basal regions was easier than in the middle region. The multiple stimulation just increased slightly the correlation coefficients between eSRT and C-levels from 0.73 to 0.77 and from 0.77 to 0.85 (p < 0.05) for the contralateral and ipsilateral ears, respectively.

Significance
Our research indicates that using a multielectrode stimulation approach enhances the detection rate of eSRT and slightly improves the correlation coefficient between eSRT and C-levels. It is found preferable to obtain measurements from the contralateral side due to its higher detection rate, although the ipsilateral side yields a marginally higher correlation coefficient. The findings suggest that eSRTs obtained from pulse width modulation implants could aid audiologists in programming the device.
Intraoperative Acoustic Monitoring Using Threshold and Suprathreshold Pure Tone Audiometry during Cochlear Implantation Under Local Anesthesia: A Simple and Novel Method to Potentially Enhance Hearing Preservation Cochlear Implant Surgery
Authors: Khandalavala Karl R. , Ostlie Sarah E. , Wallerius Katherine P. , Lohse Christine M. , Lohmann Amanda R. , Ladsten Max M. , Carlson Matthew L. 
Published: November 2024

Objective
To report the feasibility and potential utility of monitoring acoustic hearing on awake patients using intraoperative behavioral responses to threshold and suprathreshold stimuli while undergoing cochlear implantation (CI) under local anesthesia, without any form of sedation.

Study Design
Retrospective review of the first five cases performed by one surgeon.

Setting
Tertiary care academic medical center.

Patients
Adult patients with residual acoustic hearing undergoing CI.

Interventions
CI under local anesthesia, without any form of sedation.

Main Outcome Measures
Procedural tolerance, reliability of intraoperative pure tone threshold and suprathreshold audiometry, and correlation of intraoperative findings with early postoperative residual hearing.

Results
Five ears in four patients underwent CI, including three males and one female, with a median age of 61 years. Intraoperatively, patients reported reliable behavioral responses to pure tone threshold and suprathreshold stimuli and provided real-time feedback on perceived stimulus change to the surgeon just prior to, during, and immediately following electrode insertion. All patients were able to complete the operation under local anesthesia. During electrode insertion, three cases reported no change and two cases reported diminished stimulus perception that reversed with limited electrode pull back near terminal insertion. Immediate postoperative audiograms demonstrated preservation of bone conduction thresholds within 10 dB of their preoperative baseline for all cases, suggesting hearing preservation. Three-month postoperative AzBio in quiet scores were available for two patients, measuring 45% and 94%, respectively.

Conclusions
This report describes the feasibility of intraoperative behavioral audiometry during CI under local anesthesia, using patient feedback during electrode insertion to optimize hearing preservation surgery. Akin to other surgical subspecialties that use real-time patient feedback where objective intraoperative measures of neurofunction are imperfect, we demonstrate feasibility and potential utility of live acoustic monitoring during CI.
Progress in dysphagia management in older patients
Authors: Lueg Gero , Pourhassan Maryam , Wirth Rainer 
Published: November 2024

Purpose of review
The review summarizes current knowledge, recent findings and knowledge gaps about the pathophysiology and therapy of oropharyngeal dysphagia in older persons.

Recent findings
Oropharyngeal dysphagia is a major yet underrecognized health problem in older persons. Due to its high prevalence, its multifactorial etiology and multimodal treatment it has been classified as a geriatric syndrome. Although the knowledge of its pathophysiology and the effective diagnostic approach increased substantially during the last years, there is still minor evidence on how to effectively manage and treat dysphagia. However, treatment should be a multicomponent approach, combining swallowing training, nutritional therapy and oral hygiene. Emerging new fields are neurostimulation and chemical sensory stimulation which may be added in selected patients and indications. The individual components to be chosen should be based on the individual dysphagia pattern and severity as well as the capabilities of the patient. Frequently, the competing risks of inadequate nutrition and unsafe swallowing represent a challenge in determining the individual relevance of each component.

Summary
The understanding of the pathophysiology of oropharyngeal dysphagia increased substantially during recent years. However, due the multifaceted appearance of dysphagia, which requires an individualized treatment, the evidence for therapeutic approaches increases rather slowly.
Protein requirement in obesity
Authors: Weijs Peter J.M. 
Published: November 2024

Purpose of review
The combined obesity and ageing pandemic require action to avoid a total health system infarct. Obesity is largely challenged with caloric restriction and endurance exercise, likely to be assisted by drugs. The older adults with the highest obesity levels may face extreme loss of muscle mass and increased risk of sarcopenic obesity.
Within this context the question of what is the protein requirement is extremely urgent.

Recent findings
While the topic is essential, no trials have directly assessed protein requirements for obesity. Therefore, we will have to deal with more indirect evidence. Several systematic reviews have appeared for obesity treatment involving protein and a few randomized controlled trials during weight loss are worth mentioning considering the amount of protein needed, especially with increasing age.

Summary
Protein requirements are hard to derive for obesity defined by BMI over 30 perse. During weight loss the rebuilding of the body is likely to need at least 1.2 g/kg body weight/d with a maximum weight of BMI 30, especially in the aged. Obesity might increase protein requirements, however being obese with a healthy and active lifestyle might result in normal protein requirements.
Assessing institutional pediatric airway emergency readiness: key components and practices
Authors: Siu Jennifer M. , Wolter Nikolaus E. , Propst Evan J. 
Published: November 2024

Purpose of review
This contemporary review aims to outline the key components and protocols for assessing emergency readiness in institutional pediatric airway management. Emphasis is placed on identifying essential elements that ensure preparedness and effective response in pediatric airway emergencies within healthcare institutions.

Recent findings
Recent studies highlight several critical components of pediatric airway emergency readiness: dedicated pediatric airway teams, availability of specialized pediatric airway equipment, and simulation-based training to enhance the skills of healthcare providers. Additionally, interdisciplinary team coordination and regular drills have been shown to improve readiness and outcomes in pediatric airway emergencies.

Summary
Effective emergency readiness in pediatric airway management requires a multifaceted approach. Key components include availability of appropriate and accessible equipment, adherence to standardized protocols, and ongoing education and training. Regular simulation exercises and interprofessional collaboration are essential for maintaining high levels of preparedness. Implementing these strategies can significantly improve the quality of care and patient outcomes in pediatric airway emergencies.

Level of evidence
Level 3
Efficacy and safety of preoperative intravenous iron versus standard care in colorectal cancer patients with iron deficiency anemia: a systematic review and meta-analysis
Authors: Sydhom Pishoy , Shaaban Abdelgalil Mahmoud , Al-Quraishi Bakr , Shehata Nahla , El-Shawaf Mohamad , Naji Nourhan , Awwad Nouran , Tarek Osman Mohamed , Mahmoud Abdelmonem , Awad Ahmed K. 
Published: November 2024

Background:
Anemia, particularly iron deficiency (ID) anemia, is common in colorectal cancer (CRC) patients, affecting up to 58% of individuals. This study aimed to compare the effectiveness and safety of preoperative intravenous iron (IVI) with standard care (no iron or oral iron) in CRC patients with ID anemia.

Methods:
A systematic search across multiple databases identified studies comparing IVI versus no iron or oral iron in CRC patients with ID anemia. Pooled data were analyzed for changes in hemoglobin (Hb) levels, need for red blood cell transfusions (RBCT), overall mean number of transfused RBC units, overall survival (OS), disease-free survival (DFS), and complications.

Results:
The authors analyzed data from 11 studies with 2024 patients and found that IVI significantly increased Hb levels at crucial time points: preoperative (MD=1.17, 95% CI [0.95–1.40], P<0.01), postoperative day one (MD=1.32, 95% CI [0.89–1.76], P<0.01), hospital discharge (MD=0.76, 95% CI [0.28–1.24], P=0.002), and 30 days postoperative (MD=1.57, 95% CI [1.27–1.87], P<0.01). IVI significantly decreased the overall need for RBCT, particularly in the postoperative period (RR=0.69, 95% CI [0.52–0.92], P=0.01). It also reduced the mean number of transfused RBC units, total complications, and wound dehiscence. However, there were no significant differences in total death, hospital stay, infections, paralytic ileus, OS, or DFS.

Conclusion:
Preoperative IVI significantly increased Hb levels at critical time points and markedly reduced the overall need for RBCT, complications, and wound dehiscence. To further validate these findings and ensure robust conclusions, more well-designed randomized controlled trials are warranted.
The Mediating Role of Emotion Regulation Difficulties in the Correlation Between Mindfulness and Psychological Resilience in Patients Diagnosed with Depression
Authors: Arpacı Rabia , Tanrıverdi Derya 
Published: November 2024

Abstract
This study aimed to determine the mediating role of emotion regulation difficulties in the correlation between mindfulness and psychological resilience. This study was conducted with a total of 119 patients diagnosed with major depression. Data were collected with Personal Information Form, Mindfulness Scale, Emotion Regulation Difficulties Scale, and Psychological Resilience Scale. The study participants reported moderate levels of mindfulness and emotion regulation difficulties, and above-average levels of psychological resilience. It was found that there was a moderately negative correlation between mindfulness and emotion regulation difficulties (r = −0.553, p < 0.001), as well as between psychological resilience and emotion regulation difficulties (r = −0.429, p < 0.001). A moderately positive correlation was determined between mindfulness and psychological resilience (r = 0.344, p < 0.001). Emotion regulation difficulties fully mediated the correlation between mindfulness and psychological resilience. These findings will guide the development of interventions aimed at enhancing mindfulness, emotion regulation skills, and psychological resilience in depression treatment.
Extended release of ciprofloxacin from commercial silicone-hydrogel and conventional hydrogel contact lenses containing vitamin E diffusion barriers
Authors: Al Atrach Mehdi , Phan Chau-Minh , Jones Lyndon W. 
Published: November 2024

SIGNIFICANCE
Vitamin E could be used as a coating with commercial silicone hydrogel lenses to extend the release of various ophthalmic drugs. This concept could provide a promising approach to improve overall ocular therapeutic outcomes for topical ocular drugs.

PURPOSE
This study aimed to develop a contact lens–based ocular drug delivery system using vitamin E as a diffusion barrier to extend the release duration of ciprofloxacin.

METHODS
Five commercial lenses were soaked for 24 hours in various concentrations of vitamin E dissolved in ethanol (0.0125 to 0.2 g/mL). The lenses were loaded with ciprofloxacin for 24 hours in 3 mL of 3 mg/mL of ciprofloxacin/acetic acid solution. The drug release was evaluated in 3 mL of phosphate-buffered saline solution. At t = 0.5, 1, 2, 4, 6, 8, 12, 16, and 24 hours, the amount of ciprofloxacin released was measured using a UV-VIS spectrophotometer at 270 nm.

RESULTS
There was a decrease in ciprofloxacin loading with increasing amounts of vitamin E loaded into the silicone hydrogel lenses. For each lens type, there was an optimal amount of vitamin E loaded that extended the release duration of the drug from 1 hour (without vitamin E) to as long as 16 hours. In contrast, vitamin E loaded into hydrogel lenses had no effect on the amounts of drugs loaded or the release duration.

CONCLUSIONS
Vitamin E can be used as a diffusion barrier with commercially available silicone hydrogel lenses to provide sustained release of ciprofloxacin. The results suggest that vitamin E may form blockages in channels within a silicone hydrogel lens material, thereby forcing a longer path for drugs to diffuse into and out of the lens material. There is an optimal amount of vitamin E that needs to be loaded to extend the release duration, and this is lens material dependent.
Identification and Categorization of Technical Errors and Hazard-zones of Robotic versus Laparoscopic total Gastrectomy for Gastric Cancer
Authors: Jia Zhuoyu , Cao Shougen , Wang Daosheng , Tang Changshi , Tan Xiaojie , Liu Shanglong , Liu Xiaodong , Li Zequn , Tian Yulong , Niu Zhaojian , Tang Benjie , Zhou Yanbing 
Published: November 2024

Importance:
The current research aimed to conduct a detailed analysis of intraoperative surgical performance, short-term outcomes, identify and categorize technical errors, and hazard-zones enacted during total gastrectomy performed robotically and laparoscopically by surgeons. Prospective research is needed to determine whether the technical advantages of robotic surgery translate to patient outcomes.

Objective:
Identify and process risk areas in robot-assisted total gastrectomy (RTG) and laparoscopic total gastrectomy (LTG) to get the best patient results.

Design:
Patients undergoing RTG and LTG were recruited and randomized into the study. Six consultant/attending surgeons participated in this study and all surgical procedures were recorded. The unedited surgical video-recordings were handed over to third-party experts for granular analysis of the procedures using objective clinical human reliability analysis (OC-HRA) for the quality of intraoperative performance, technical errors, intraoperative complications.

Setting:
This study is a single center prospective randomized controlled trial.

Participants:
82 patients were recruited and participated in this study with 40 cases undergoing RTG and 42 cases for LTG.

Interventions:
RTG vs LTG.

Main Outcomes and Measures:
Determine whether RTG or LTG can provide the better intraoperative technical performance and identify the most hazardous zone (area) during total gastrectomy (TG).

Results:
The technical errors enacted and identified in the RTG and the LTG were (46.11±5.63 VS 58.79±8.45, P＜0.001) respectively. The highest number of technical errors was identified during the dissection of the supra-pancreatic lymph nodes (Task Zones3, TZ3), including No.5, 7, 8a, 9, 11p, and 12a to complete the nodal clearance around the celiac artery and its trifurcation (7.29±1.88 VS 9.43±2.24, P <0.001) in both RTG and LTG. The number of lymph nodes harvested with RTG was higher than LTG (35.36±7.51 VS 30.54±6.95, P=0.016), especially in the upper margin of the pancreas (13.32±4.17 VS 9.36±3.81, P＜0.001). The total cost of hospitalization in the RTG group cost 3% more than LTG group ($15953.41±3533.91 VS $12198.26±2761.27, P＜0.001).

Conclusions:
This study offers compelling OC-HRA evidence demonstrating that RTG facilitates significantly superior technical performance compared to LTG. Whether examining short-term clinical outcomes or intraoperative operations, the robotic surgery system consistently outperforms laparoscopic surgery. Lymph node dissection in the supra-pancreatic region emerged as a major hazard zone in both procedures.

Trial Registration:
chictr.org.cn: ChiCTR2000039193
ExtrAperitoneaL Plasty vs Intraperitoneal oNlay mEsh in ventral hernia repair – a multi-center randomized controlled trial: the ALPINE study protocol
Authors: Süsstrunk Julian , Baur Johannes , Sortino Rosita , Filser Jörg , Herzog Kim , Steinemann Daniel C. , Müller Beat P. , Angehrn Fiorenzo V. 
Published: November 2024

Introduction:
Minimally invasive ventral hernia repair (MIVHR) is a frequently performed surgical procedure to address primary or incisional ventral hernias and is recommended by numerous societies. Various techniques are available for MIVHR, including the intraperitoneal onlay mesh (IPOM) procedure and the enhanced view totally extraperitoneal (eTEP) approach.

While both techniques are increasingly applied, they continue to be subject of controversy in literature. Well-designed randomized controlled trials comparing both procedures are lacking. The objective of this study is to investigate whether eTEP is associated with a decreased level of postoperative pain compared to IPOM.

Methods:
This is a prospective, multi-center, randomized, and blinded controlled trial. Patients presenting with primary or incisional epigastric, umbilical, or infraumbilical hernia with a transverse diameter >1 cm and ≤4 cm, or multiple hernias with a cumulative transverse diameter ≤4 cm, will be randomly assigned to undergo either IPOM or eTEP procedures. All patients and assessors of the study outcomes are blinded to the treatment allocation. The trial will be conducted at the St. Clara Hospital Basel, at the University Hospital Basel (Switzerland) and at the Innklinikum Altötting (Germany). It remains open for additional sites to be included. The multi-center design is chosen to minimize environmental bias related to perioperative anesthesiology and nursing care and to enhance participant recruitment.

The primary outcome of this study is to evaluate postoperative pain (numeric rating scale and Patient-Reported Outcome Measurement Information System Pain Intensity Short Form 3a) 24 hours after the surgical procedure. Secondary outcomes include the assessment of pain at different times, length of hospital stay, operative time, readmission rate, intraoperative, and postoperative adverse events.
An Exact and Fast SAT Formulation for the DCJ Distance
Authors: Sarnaik Aaryan M. , Chen Ke , Diaz Austin , Shao Mingfu 
Published: November 2024

AbstractReducing into a satisfiability (SAT) formulation has been proven effective in solving certain NP-hard problems. In this work, we extend this research by presenting a novel SAT formulation for computing the double-cut-and-join (DCJ) distance between two genomes with duplicate genes. The DCJ distance serves as a crucial metric in studying genome rearrangement. Previous work achieved an exact solution by transforming it into a maximum cycle decomposition (MCD) problem on the corresponding adjacency graph of two genomes, followed by reducing this problem into an integer linear programming (ILP) formulation. Using both simulated datasets and real genomic datasets, we firmly conclude that the SAT-based method scales much better and runs faster than using ILP, being able to solve a whole new range of instances which the ILP-based method cannot solve in a reasonable amount of time. This underscores the SAT-based approach as a versatile and more powerful alternative to ILP, with promising implications for broader applications in computational biology.
TRPV4 overactivation enhances cellular contractility and drives ocular hypertension in TGFβ2 overexpressing eyes
Authors: Rudzitis Christopher N. , Lakk Monika , Singh Ayushi , Redmon Sarah N. , Kirdajova Denisa , Tseng Yun-Ting , De Ieso Michael L. , Stamer W. Daniel , Herberg Samuel , Križaj David 
Published: November 2024

AbstractThe risk for developing primary open-angle glaucoma (POAG) correlates with the magnitude of ocular hypertension (OHT) and the concentration of transforming growth factor-β2 (TGFβ2) in the aqueous humor. Effective treatment of POAG requires detailed understanding of interaction between pressure sensing mechanisms in the trabecular meshwork (TM) and biochemical risk factors. Here, we employed molecular, optical, electrophysiological and tonometric strategies to establish the role of TGFβ2 in transcription and functional expression of mechanosensitive channel isoforms alongside studies of TM contractility in biomimetic hydrogels, and intraocular pressure (IOP) regulation in a mouse model of TGFβ2 -induced OHT. TGFβ2 upregulated expression ofTRPV4andPIEZO1transcripts and time-dependently augmented functional TRPV4 activation. TRPV4 activation induced TM contractility whereas pharmacological inhibition suppressed TGFβ2-induced hypercontractility and abrogated OHT in eyes overexpressing TGFβ2.Trpv4-deficient mice resisted TGFβ2-driven increases in IOP. Nocturnal OHT was not additive to TGFβ- evoked OHT. Our study establishes the fundamental role of TGFβ as a modulator of mechanosensing in nonexcitable cells, identifies TRPV4 channel as the final common mechanism for TM contractility and circadian and pathological OHT and offers insights future treatments that can lower IOP in the sizeable cohort of hypertensive glaucoma patients that resist current treatments.