bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Relationship between Obesity and Trigger Point-specific Outcomes after Headache Surgery
Authors: Ormseth Benjamin H. , Kavanagh Kaitlin J. , Saffari Tiam M. , Palettas Marilly , Janis Jeffrey E. 
Published: March 2024

Background:
Trigger point deactivation surgery is a safe and effective treatment for properly selected patients experiencing migraine, with 68.3%–100% experiencing symptom improvement postoperatively. However, it is still unknown why certain patients do not respond. Obesity has been shown to be associated with worsened migraine symptoms and a decreased response to select pharmacotherapies. This study aimed to determine whether obesity may also be associated with an attenuated response to surgery.

Methods:
A retrospective chart review was conducted to identify patients who had undergone trigger point deactivation surgery for migraine. Patients were split into obese and nonobese cohorts. Obesity was classified as a body mass index of 30 or higher per Centers for Disease Control and Prevention guidelines. Outcomes and follow-up periods were determined with respect to individual operations. Outcomes included migraine attack frequency, intensity, duration, and the migraine headache index. Differences in demographics, operative characteristics, and operative outcomes were compared.

Results:
A total of 62 patients were included in the study. The obese cohort comprised 31 patients who underwent 45 total operations, and the nonobese cohort comprised 31 patients who underwent 34 operations. Results from multivariable analysis showed no impact of obesity on the odds of achieving a more than 90% reduction in any individual outcome. The overall rates of improvement (≥50% reduction in any outcome) and elimination (100% reduction in all symptoms) across both cohorts were 89.9% and 65.8%, respectively.

Conclusion:
Obese patients have outcomes comparable to a nonobese cohort after trigger point deactivation surgery for migraine.
New forays into measurement of ocular biomechanics
Authors: Hammelef Emma , Rapuano Christopher J. , Benedetto Dominick A. , Syed Zeba A. , Myers Jonathan S. , Razeghinejad M. Reza , Silver Fred H. , Pulido Jose S. 
Published: March 2024

Purpose of review
The field of corneal biomechanics has rapidly progressed in recent years, reflecting technological advances and an increased understanding of the clinical significance of measuring these properties. This review will evaluate in-vivo biomechanical properties obtained by current technologies and compare them regarding their relevance to established biomechanical properties obtained by gold-standard ex-vivo techniques normally conducted on elastic materials.

Recent findings
Several new technologies have appeared in recent years, including vibrational optical coherence tomography (VOCT) and the corneal indentation device (CID). These techniques provide promising new opportunities for minimally invasive and accurate measurements of corneal viscoelastic properties.

Summary
Alterations in corneal biomechanics are known to occur in several corneal degenerative diseases and after refractive surgical procedures. The measurement of corneal biomechanical properties has the capability to diagnose early disease and monitor corneal disease progression. Several new technologies have emerged in recent years, allowing for more accurate and less invasive measurements of corneal biomechanical properties, most notably the elastic modulus.
Understanding network meta-analysis methodology for the ophthalmologist
Authors: Phillips Mark , Chaudhary Varun 
Published: March 2024

Purpose of review
Over the past decade, the number of studies published using network meta-analyses (NMAs) has rapidly increased, and there have been continued advancements to further advance this analysis approach. Due to the fast moving and changing landscape in the infancy of NMA methodology, there is a lack of consistency and standardization for this approach. This article aims to summarize the crucial components of an NMA for both future readers, and for potential NMA authors.

Recent findings
Key components of NMAs include, but are not limited to, reporting the proposed analysis methods, assessment of risk of bias within the included studies, reporting the overall quality of the available evidence, and defining the parameters in which the results will be presented. Although NMA allows for a comprehensive evaluation of all available treatment options for a given condition, we believe that there is importance in ensuring clear understanding and appropriate interpretation of results to inform clinical practice.

Summary
While many components of NMA mirror those of traditional pairwise meta-analysis, there are many novel methodologies that are specific to this approach. It is imperative that future NMAs follow guidance from key methodology groups, as these provide valuable tools for conducting and reporting NMAs.
‘Dumpling suture method’ versus traditional suture method of protective loop ileostomy in laparoscopic anterior rectal resection with specimen extraction through stoma incision: a retrospective comparative cohort study
Authors: Gu Jiani , Wang Jin , Hu Xingwang , Ding Wenjun , Cui Long , Du Peng , Liang Zhonglin , Wu Tingyu 
Published: March 2024

Background:
A diverting loop ileostomy (DLI) is performed in laparoscopic anterior rectal resection (LAR) surgery at high risk of anastomotic fistula. Minimally invasive surgery promotes postoperative recovery and cosmetics. To reduce abdominal trauma, specimen extraction through stoma incision (EXSI) is usually performed to avoid auxiliary abdominal incision with enlarged stomal incision. The traditional suture method (TSM) reduces the incision size by suturing the ends of the enlarged incision, leading to peristomal incisions and a higher risk of stomal complications. The study aimed to introduce the dumpling suture method (DSM) of PLI and compare this new method with TSM.

Materials and Methods:
The authors propose a novel stoma suture technique, which utilized a method of skin folding suture to reduce the enlarged incision size. A retrospective analysis was conducted on 71 consecutive patients with rectal cancer who underwent LAR-DLI with EXSI, and the intraoperative details and postoperative outcomes of the two groups were measured.

Results:
The DSM group showed a lower stomal complication rate (10.3 vs. 35.7%, P=0.016) than that of the TSM group. The scores of DET (Discoloration, Erosion, Tissue overgrowth), stomal pain, quality of life were all significantly lower in DSM group than in TSM group. In multivariate analysis, DSM was an independent protective factor for stoma-related complications. Operative time, time to first flatus, defecation and eat, nonstomal related postoperative complications were similar in both groups.

Conclusion:
DSM utilizes a method of skin folding suture to reduce the enlarged incision size, which is safe and effective in reducing the incidence of peristomal skin infections and stomal complications. This procedure offers a novel suturing approach for loop ileostomy with enlarged incision, effectively reducing the postoperative trauma and incidence of stomal complications.
Comparative long-term outcomes of natural orifice specimen extraction surgery and conventional laparoscopic colectomy for left-sided colorectal cancer: a propensity score-matched analysis
Authors: Xu Shu-Zhen , Wang Zhen-Fa , Ding Zhi-Jie , Zhang Shi-Feng , Yuan Si-Bo , Yan Feng , Liu Guo-Yan , Cai Jian-Chun 
Published: March 2024

Background:
Natural orifice specimen extraction surgery (NOSES) is currently widely used in left-sided colorectal cancer. Some clinical comparative studies have been conducted, providing evidence of its safety and oncological benefits. However, these studies are typically characterized by small sample sizes and short postoperative follow-up periods. Consequently, in this research, the authors adopt the propensity score matching method to undertake a large-scale retrospective comparative study on NOSES colectomy for left-sided colorectal cancer, with the goal of further augmenting the body of evidence-based medical support for NOSES.

Methods:
This retrospective study involved patients who underwent NOSES colectomy and conventional laparoscopic (CL) colectomy for left-sided colorectal cancer between January 2014 and April 2021. In the NOSES group, specimens were extracted through the anus with the help of a Cai tube (homemade invention: ZL201410168748.2). The patients were matched at a ratio of 1:1 according to age, sex, BMI, tumor diameter, tumor location (descending and splenic flexure colon/ sigmoid colon/ middle and upper rectum), tumor height from anal verge, ASA grade, previous abdominal surgery, clinical pathologic stage, preoperative CEA. After matching, 132 patients in the NOSES group and 132 patients in the CL group were eligible for analysis.

Results:
Compared with CL group, NOSES group was associated with decreased postoperative maximum pain score (2.6±0.7 vs. 4.7±1.7, P=0.000), less additional analgesia required (6.8 vs. 34.8%, P=0.000), faster time to passage of flatus (2.3±0.6 days vs. 3.3±0.7 days, P=0.000), less wound infection (0.0 vs. 6.1%, P=0.007), and longer operative time (212.5±45.8 min vs. 178.0±43.4 min, P=0.000). No significant differences were observed in estimated blood loss, time to resume regular diet, postoperative hospital stay, conversion to open surgery or conventional minilaparotomy, total morbidity, readmission, mortality, pathologic outcomes, and Wexner incontinence score between groups. After a median follow-up of 63.0 months, the 5-year overall survival rates were 88.3 versus 85.0% (P=0.487), disease-free survival rates were 82.9 versus 83.6% (P=0.824), and the local recurrence rates were 4.4 versus 4.0% (P=0.667) in the NOSES and CL groups, respectively.

Conclusions:
This study suggests that NOSES colectomy using a Cai tube for left-sided colorectal cancer is a safe and feasible option with better cosmetic results, less pain, faster recovery of gastrointestinal function, and comparable long-term clinical and oncologic outcomes to CL colectomy.
Symptoms and Functional Outcomes Among Traumatic Brain Injury Patients 3- to 12-Months Post-Injury
Authors: Gerber Kathryn S. , Alvarez Gemayaret , Alamian Arsham , Behar-Zusman Victoria , Downs Charles A. 
Published: March 2024

BACKGROUND:
Patients with traumatic brain injury (TBI) experience a variety of physical, cognitive, and affective symptoms. However, the evolution of symptoms, especially during the 3- to 12-month convalescence period (when recovery of function is still possible), is understudied.

OBJECTIVE:
This study aims to identify symptoms and the relationships with functional outcomes that occur during the 3- to 12-month period after a TBI.

METHODS:
Participants who were 3 to 12 months post-TBI were recruited from a South Florida TBI clinic from May 2022 to June 2023. Clinical data were obtained from the electronic health record. Participants completed the Brain Injury Association of Virginia Symptom Checklist, Neuro-Quality of Life Cognitive Function, Anxiety, Depression, and Sleep Disturbance assessments to report symptoms, and the Disability Rating Scale and Satisfaction with Life Scale. Descriptive statistics were used to characterize demographics and symptoms. Linear regression was performed to analyze the relationships between symptoms and outcomes.

RESULTS:
A total of N = 39 patients participated in the study. Memory problems and difficulty concentrating were the most common symptoms. Hospital length of stay, intensive care unit length of stay, cognitive, and physical symptoms were significantly associated with the Disability Rating Scale score. Physical, cognitive, depressive, and anxiety symptoms had significant associations with the Satisfaction with Life Scale.

CONCLUSION:
Cognitive symptoms should be integrated into the clinical care of rehabilitating TBI patients. Nurses should monitor for physical, affective, and cognitive symptoms during the recovery phase of TBI.
Evaluation of a Novel Mechanical Venous Thromboembolism Compression Device in Trauma Patients: A Pilot Study
Authors: Girardot Kellie , Powers Jan , Morgan Lisa , Hollister Lisa 
Published: March 2024

BACKGROUND:
Venous thromboembolism (VTE) is the fourth most common preventable hospital-acquired complication for hospitalized trauma patients. Mechanical prophylaxis, using sequential compression or intermittent pneumatic compression (IPC) devices, is recommended alongside pharmacologic prophylaxis for VTE prevention. However, compliance with device use is a barrier that reduces the effectiveness of mechanical prophylaxis.

OBJECTIVE:
This study aimed to determine whether using the Movement and Compressions (MAC) system compared with an IPC device impacts compliance with mechanical VTE prophylaxis in trauma patients.

METHODS:
This study used a before-and-after design with historical control at a Level II trauma center with a convenience sample of adult trauma patients admitted to the intensive care unit or acute care floor for at least 24 h. We trialed the MAC device for 2 weeks in November and December 2022 with prospective data collection. Data collection for the historical control group occurred retrospectively using patients from a point-in-time audit of IPC device compliance from August and September of 2022.

RESULTS:
A total of 51 patients met inclusion criteria, with 34 patients in the IPC group and 17 patients in the MAC group. The mean (SD) prophylaxis time was 17.2 h per day (4.0) in the MAC group and 7.5 h per day (8.8) in the IPC group, which was statistically significant (p < .001).

CONCLUSION:
Our findings suggest that the MAC device can improve compliance with mechanical prophylaxis.
Renal dysfunction in adults following cardiopulmonary bypass is linked to declines in S-nitrosohemoglobin: a case series
Authors: Moyal Andrew , Nazemian Ryan , Colon Edwin Pacheco , Zhu Lin , Benzar Ruth , Palmer Nicole R. , Craycroft Martha , Hausladen Alfred , Premont Richard T. , Stamler Jonathan S. , Klick John , Reynolds James D. 
Published: March 2024

Background:
Impaired kidney function is frequently observed in patients following cardiopulmonary bypass (CPB). Our group has previously linked blood transfusion to acute declines in S-nitrosohemoglobin (SNO-Hb; the main regulator of tissue oxygen delivery), reductions in intraoperative renal blood flow, and postoperative kidney dysfunction. While not all CPB patients receive blood, kidney injury is still common. We hypothesized that the CPB procedure itself may negatively impact SNO-Hb levels leading to renal dysfunction.

Materials and methods:
After obtaining written informed consent, blood samples were procured immediately before and after CPB, and on postoperative day (POD) 1. SNO-Hb levels, renal function (estimated glomerular filtration rate; eGFR), and plasma erythropoietin (EPO) concentrations were quantified. Additional outcome data were extracted from the patients’ medical records.

Results:
Twenty-seven patients were enroled, three withdrew consent, and one was excluded after developing bacteremia. SNO-Hb levels declined after surgery and were directly correlated with declines in eGFR (R=0.48). Conversely, plasma EPO concentrations were elevated and inversely correlated with SNO-Hb (R=−0.53) and eGFR (R=−0.55). Finally, ICU stay negatively correlated with SNO-Hb concentration (R=−0.32).

Conclusion:
SNO-Hb levels are reduced following CPB in the absence of allogenic blood transfusion and are predictive of decreased renal function and prolonged ICU stay. Thus, therapies directed at maintaining or increasing SNO-Hb levels may improve outcomes in adult patients undergoing cardiac surgery.
Efficacy and outcomes of antiplatelet therapy versus oral anticoagulants in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis
Authors: Goyal Aman , Abbasi Fatima Qayyum , Tariq Muhammad Daoud , Kanagala Sai Gautham , Changez Mah I. Kan , Safi Darsh , Basit Jawad , Sulaiman Samia Aziz , Marsool Mohammed Dheyaa Marsool , Daoud Mohamed , Sohail Amir H. 
Published: March 2024

Background:
Recent guidelines suggest that antiplatelet therapy (APT) is the standard of care in the absence of long-term oral anticoagulation (OAC) indications in patients post-transcatheter aortic valve replacement (TAVR). The superiority of one method over the other remains controversial.

Materials and methods:
Several databases, including MEDLINE, Google Scholar, and EMBASE, were electronically searched. The primary endpoint was the all-cause mortality (ACM) rate. Secondary endpoints included cardiovascular death, myocardial infarction (MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism, and valve thrombosis in post-TAVR patients receiving APT and oral anticoagulants (OACs). Forest plots were generated using Review Manager version 5.4, with a p value less than 0.05 indicating statistical significance. Subgroup analysis was performed to explore potential sources of heterogeneity.

Results:
Twelve studies were selected. No significant differences were observed in APT and OAC group for ACM [risk ratio (RR): 0.67; 95% CI:0.45–1.01; P=0.05], cardiovascular death [RR:0.91; 95% CI:0.73–1.14; P=0.42], MI [RR:1.69; 95% CI:0.43–6.72; P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58–1.06; P=0.12], ischaemic stroke [RR:0.83; 95% CI:0.50–1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI: 0.23–5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51–1.21; P=0.28], minor bleeding [RR:1.09; 95% CI: 0.80–1.47; P=0.58], life-threatening bleeding [RR:0.85; 95% CI:0.55–1.30; P=0.45], any bleeding [RR:0.98; 95% CI:0.83–1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44–1.70; P=0.68]. The risk of valve thrombosis was higher in patients receiving APT than in those receiving OAC [RR:2.61; 95% CI:1.56–4.36; P =0.0002].

Conclusions:
Although the risk of valve thrombosis increased in patients receiving APT, the risk of other endpoints was comparable between the two groups.
Moyamoya disease in a 2-year-old patient from the middle east: a case report and literature review
Authors: Habes Haneen Mahmoud Nimer , Alshareef Raneen B. , Amleh Areen , Doudin Ali A.A. , Habes Yousef Mahmoud Nimer , Abdulrazzak Mohammed , Basal Sharif Issa 
Published: March 2024

Introduction and importance:
Moyamoya disease (MMD) is a condition characterized by progressive narrowing of arteries in the brain and abnormal development of small collateral vessels. It is commonly found in East Asia but has never been reported in Palestine.

Case presentation:
A 2-year-old female, part of a twin born to non-consanguineous parents, presented with recurring seizures and developmental regression. The physical examination revealed signs of hypotonia, reflex abnormalities, and bilateral Babinski signs. Comprehensive laboratory tests and imaging investigations confirmed the diagnosis of MMD, marking this patient as the reported case in Palestine.

Clinical discussion:
The diagnostic criteria for this condition were revised in 2021 to focus on findings seen in angiography and magnetic resonance angiography (MRA) scans. MMD has not been curative so far, and the management is focused on preventing complications, sometimes with surgical revascularization, including its different approaches: direct, indirect, and a combination of both.

Conclusion:
This case highlights the importance of identifying MMD in regions where it is uncommon to be diagnosed. It emphasizes the need for diagnosis and appropriate intervention to reduce complications.
Cardiac Surgery-Associated Acute Kidney Injury in Neonates Undergoing the Norwood Operation: Retrospective Analysis of the Multicenter Neonatal and Pediatric Heart and Renal Outcomes Network Dataset, 2015–2018
Authors: Bertrandt Rebecca A. , Gist Katja , Hasson Denise , Zang Huaiyu , Reichle Garrett , Krawczeski Catherine , Winlaw David , Bailly David , Goldstein Stuart , Selewski David , Alten Jeffrey ,   on behalf of the Neonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) Investigators
Published: March 2024

OBJECTIVES:
Cardiac surgery-associated acute kidney injury (CS-AKI) is associated with adverse outcomes. Single-center studies suggest that the prevalence of CS-AKI is high after the Norwood procedure, or stage 1 palliation (S1P), but multicenter data are lacking.

DESIGN:
A secondary analysis of the Neonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) multicenter cohort who underwent S1P. Using neonatal modification of Kidney Disease Improving Global Outcomes (KDIGO) criteria, perioperative associations between CS-AKI with morbidity and mortality were examined. Sensitivity analysis, with the exclusion of prophylactic peritoneal dialysis (PD) patients, was performed.

SETTING:
Twenty-two hospitals participating in the Pediatric Cardiac Critical Care Consortium (PC4) and contributing to NEPHRON.

PATIENTS:
Three hundred forty-seven neonates (< 30 d old) with S1P managed between September 2015 and January 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Of 347 patients, CS-AKI occurred in 231 (67%). The maximum stages were as follows: stage 1, in 141 of 347 (41%); stage 2, in 51 of 347 (15%); and stage 3, in 39 of 347 (11%). Severe CS-AKI (stages 2 and 3) peaked on the first postoperative day. In multivariable analysis, preoperative feeding was associated with lower odds of CS-AKI (odds ratio [OR] 0.48; 95% CI, 0.27–0.86), whereas prophylactic PD was associated with greater odds of severe CS-AKI (OR 3.67 [95% CI, 1.88–7.19]). We failed to identify an association between prophylactic PD and increased creatinine (OR 1.85 [95% CI, 0.82–4.14]) but cannot exclude the possibility of a four-fold increase in odds. Hospital mortality was 5.5% (n = 19). After adjusting for risk covariates and center effect, severe CS-AKI was associated with greater odds of hospital mortality (OR 3.67 [95% CI, 1.11–12.16]). We failed to find associations between severe CS-AKI and respiratory support or length of stay. The sensitivity analysis using PD failed to show associations between severe CS-AKI and outcome.

CONCLUSIONS:
KDIGO-defined CS-AKI occurred frequently and early postoperatively in this 2015–2018 multicenter PC4/NEPHRON cohort of neonates after S1P. We failed to identify associations between resource utilization and CS-AKI, but there was an association between severe CS-AKI and greater odds of mortality in this high-risk cohort. Improving the precision for defining clinically relevant neonatal CS-AKI remains a priority.