bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatobiliary surgery in Taiwan: The past, present, and future. Part I; biliary surgery
Authors: Ker Chen-Guo 
Published: October 2023

Abstract
In Taiwan, most surgical services were mainly provided by Japanese or Western surgeons before World War II. Tsuchiya Kunita first reported surgical treatment of gallstone diseases in 1915 in Taiwan. After World War II, experienced Japanese surgeons returned to Japan, and well-trained surgeons moved to Taiwan from different hospitals in Mainland China after 1949. In 1954, Liao had reported surgical gallstone diseases treated by cholecytostomy, cholecystectomy, and cholecystogastrostomy or cholecystoduodenostomy from National Taiwan University Hospital (Formos J Surg. 1954;53:833–4). By using of operative cholangiography, diagnosis and removal of intrahepatic stones could be done through choledochostomy reported first by Lee HC from National Defense Medical Center in 1966 and 1968 (Chin Med J ROC. 1966;13:301–8; Chin Med J ROC. 1968;15:124–34). Wei from the National Taiwan University Hospital reported the first left hepatectomy for treating hepatolithiasis on one patient among his series in 1971 (Formos J Surg. 1971;4:178–96). Treatments of hepatolithiasis were well analyzed by Wen and Lee from Triservice General Hospital and Veterans General Hospital in 1972 (Ann Surg. 1972;175:166–77). Hwang was the first to use choledochofiberscope for removing retained stones since 1974 reported from Show Chwan Memorial Hospital in 1978 (Am J Surg. 1978;139:860–4). The first laparoscopic cholecystectomy was performed by Huang from Taipei Cathay General Hospital in 1990 in Taiwan (J Formos Med Assoc. 1991;90:893–9). Nowadays, Taiwan hepatobiliary surgeons were extensively using either laparoscopic or robotic surgery for treatment of hepatobiliary diseases.
In conclusion, we should never forget the great contributions from many clinics in rural villages hosted by Christian or Catholicism organizations in Taiwan hundred years ago. We should express our appreciations to the history of the evolutions of biliary surgical skills. In Taiwan, a great surgeon today is always standing on the shoulders of our ancient giants, our surgical teachers.
Botulinum Toxin A Injection for Hemihypertrophy-related Unilateral Gastrocnemius Hypertrophy
Authors: Zhang Ziming , Wei Qingqian , Li Yingzi , Zhuang Jun , Su Xueshang , Liu Tun , Hu Jintian 
Published: October 2023

Summary:
Hemihypertrophy is a rare congenital disorder that causes unequal growth of the extremities, trunk, face, or half of the body. We report a case of a 32-year-old woman with hemihypertrophy-related gastrocnemius hypertrophy treated with botulinum toxin A injection. The patient has received two botulinum toxin A injections, and we measured the thickness of the gastrocnemius muscle using ultrasound and measured the maximum circumference around the calf with the patient in the prone position. The patient’s maximum calf circumference was reduced by 1 cm. The thickness of the medial head of the gastrocnemius was reduced by 0.3 cm, and the thickness of the lateral head of the gastrocnemius was reduced by 0.6 cm. Botulinum toxin A injection therapy was effective in treating hemihypertrophy-related gastrocnemius hypertrophy.
Combined, elobixibat, and colestyramine reduced cholesterol toxicity in a mouse model of metabolic dysfunction-associated steatotic liver disease
Authors: Iwaki Michihiro , Kessoku Takaomi , Tanaka Kosuke , Ozaki Anna , Kasai Yuki , Kobayashi Takashi , Nogami Asako , Honda Yasushi , Ogawa Yuji , Imajo Kento , Usuda Haruki , Wada Koichiro , Kobayashi Noritoshi , Saito Satoru , Nakajima Atsushi , Yoneda Masato 
Published: October 2023

Background:
Cholesterol levels and bile acid metabolism are important drivers of metabolic dysfunction-associated steatohepatitis (MASH) progression. Using a mouse model, we investigated the mechanism by which cholesterol exacerbates MASH and the effect of colestyramine (a bile acid adsorption resin) and elobixibat (an apical sodium-dependent bile acid transporter inhibitor) concomitant administration on bile acid adsorption and MASH status.

Methods:
Mice were fed a high-fat high-fructose diet with varying concentrations of cholesterol to determine changes in fatty liver according to liver status, water intake, defecation status, insulin resistance, bile acid levels, intestinal permeability, atherosclerosis (in apolipoprotein E knockout mice), and carcinogenesis (in diethylnitrosamine mice). Using small interfering ribonucleic acid (siRNA), we evaluated the effect of sterol regulatory element binding protein 1c (SREBP1c) knockdown on triglyceride synthesis and fatty liver status following the administration of elobixibat (group E), colestyramine (group C), or both (group EC).

Results:
We found greater reductions in serum alanine aminotransferase levels, serum lipid parameters, serum primary bile acid concentrations, hepatic lipid levels, and fibrosis area in EC group than in the monotherapy groups. Increased intestinal permeability and watery diarrhea caused by elobixibat were completely ameliorated in group EC. Group EC showed reduced plaque formation rates in the entire aorta and aortic valve of the atherosclerosis model, and reduced tumor counts and tumor burden in the carcinogenesis model.

Conclusions:
Excessive free cholesterol in the liver can promote fatty liver disease. Herein, combination therapy with EC effectively reduced free cholesterol levels in MASH model mice. Our study provides strong evidence for combination therapy as an effective treatment for MASH.
Serum 25-hydroxyvitamin D, type 2 diabetes, and liver-related outcomes: Secondary data analysis of a prospective recruited cohort
Authors: Wang Yu , Dan Lintao , Fu Tian , Sun Yuhao , Chen Jie , Mao Ren 
Published: October 2023

Background:
The association of vitamin D deficiency, which is prevalent in type 2 diabetes mellitus (T2DM), with liver disease and related mortality has not been quantified. Our study aimed to (1) investigate whether there is a synergistic association of vitamin D deficiency and T2DM with liver-related outcomes and (2) explore whether high 25-hydroxyvitamin D [25(OH)D] concentrations are associated with a lower risk of liver-related outcomes in T2DM.

Method:
Leveraging the data from UK Biobank, we conducted 2 studies: study I assessed the joint associations of vitamin D deficiency [25(OH)D <50 nmol/L] and T2DM with liver-related outcomes among 439,276 participants, and study II explored the associations of vitamin D status with liver-related outcomes among 21,519 individuals with T2DM. Baseline T2DM was identified through medication, laboratory test, and electronic health-related records. Serum 25(OH)D was measured by direct competitive chemiluminescent immunoassay. Liver-related outcomes included 6 liver disease end points and mortality by overall liver disease, chronic liver disease, and severe liver disease.

Results:
During an average follow-up duration of 11.6 years, we observed a significant positive additive interaction effect (all synergy index>1.0) of T2DM and vitamin D deficiency on the risk of liver-related outcomes. Compared with participants without either T2DM or vitamin D deficiency, the multivariable-adjusted HRs of overall liver diseases were 1.29 for participants without T2DM but with vitamin D deficiency, 1.73 for participants with T2DM but without vitamin D deficiency, and 2.19 for participants with both T2DM and vitamin D deficiency. In individuals with T2DM, we observed that participants without vitamin D deficiency were inversely associated with incident liver disease and related mortality (multivariable-adjusted HRs 0.41–0.81) when compared with individuals with vitamin D deficiency.

Conclusions:
There are positive synergistic associations of vitamin D deficiency and T2DM with liver-related outcomes. Inverse associations between serum 25(OH)D concentrations and liver-related outcomes were observed in individuals with T2DM.
Short-term Changes in Epithelial and Optical Redistribution Induced by Different Orthokeratology Designs
Authors: Meng Ziqi , Chen Siping , Zhe Nan , Cao Tongxin , Li Zhangliang , Zhang Yunjie , Wei Ruihua 
Published: October 2023

Objectives:
This study aimed to investigate corneal epithelial and topographic changes caused by two commercial myopia orthokeratology (ortho-k) designs.

Methods:
Twenty-six subjects fitted with vision shape treatment (VST) lenses and 30 subjects fitted with corneal reshaping therapy (CRT) lenses were reviewed 1 day, 1 week, and 1 month after lens initiation. A spectral-domain optical coherence tomography system was used to create epithelial maps that were in turn used to determine the average epithelial thickness of each zone and the diameter of treatment zone. By measuring the topographic tangential differential map, the treatment zone diameter and the power and width of the high convex zone (HCZ) were obtained. All epithelial thicknesses and topographic corneal variations recorded were analyzed.

Results:
At the central zone, the epithelial thickness changes (△ET) decreased significantly after 1 day of ortho-k in two groups. At 2- to 9-mm peripheral zone, ortho-k increased △ET until 1 week in the VST group, whereas it kept increasing in the CRT group after 1 week. At 1 month, the central △ET is −9.51±2.38 mm in the VST group, which was comparable to −8.72±3.43 mm in the CRT group. The nasal HCZ power and the △ET of nasal and inferior nasal were significantly larger in the CRT group. A positive correlation was found between the HCZ power and △ET generated by VST-type lenses inferiorly and temporally. For the CRT group, a positive correlation was found between inferior HCZ power and △ET.

Conclusions:
At the early stage of ortho-k, epithelial thickness and topography change quickly and simultaneously. Epithelial changes were in line with corneal topography reshaping. Epithelial and optical remodelling were affected by different lens types.
Early Endophthalmitis Rates and Risk Factors After Corneal Transplant Surgeries in Medicare Beneficiaries From 2016 to 2019
Authors: Ali Muhammad , Dun Chen , Chen Ariel , Saeed Safa , Prescott Christina R. , Makary Martin A. , Srikumaran Divya , Woreta Fasika A. 
Published: October 2023

Purpose:
The aims of this study were to determine rates of early postkeratoplasty endophthalmitis and identify sociodemographic and medical risk factors in the Medicare population.

Methods:
Using a retrospective cohort design, patients aged 65 years and older undergoing penetrating keratoplasty (PK), endothelial keratoplasty (EK), and anterior lamellar keratoplasty (ALK) from 2016 to 2019 among 100% Medicare Fee-or-Service database were included. Rates of early endophthalmitis within 42 days of keratoplasty were determined using the International Classification of Diseases, 10th Revision-Clinical Modification diagnostic codes. Patient and physician characteristics were compared using x2 tests, and a multivariable logistic regression model was used to evaluate factors associated with endophthalmitis.

Results:
The overall early endophthalmitis rate after keratoplasty was 0.39% (n = 216/54,822) with a median time to diagnosis of 14 (interquartile range: 5–25) days. Rates by keratoplasty types were 1.31% for cataract surgery combined with PK, 1.13% for PK, and 0.22% for EK. On multivariable analysis, the odds of endophthalmitis were higher for PK [odds ratio (OR): 5.46, 95% confidence interval (CI), 3.98–7.49] and ALK (OR: 5.45, 95% CI, 2.59–11.49) relative to EK. Patients with a Charlson Comorbidity Index (CCI) ≥3 had higher odds of endophthalmitis (OR: 1.82; 95% CI, 1.28–2.58) relative to patients with a CCI of 0. Practices located in the Midwest (OR: 0.59, 95% CI, 0.36–0.96), West (OR 0.57; 95% CI, 0.35–0.93), and Northeast (OR: 0.59 95% CI, 0.35–0.99) had lower odds of reporting endophthalmitis when compared to the South.

Conclusions:
Patients undergoing PK and ALK and those with a CCI ≥3 had higher odds of endophthalmitis relative to EK and patients without comorbidities, respectively. Practices in the West, Midwest, and Northeast had lower odds of endophthalmitis relative to the South.
Burden, clinical features, and outcomes of post-tuberculosis chronic obstructive lung diseases
Authors: Sehgal Inderpaul Singh , Dhooria Sahajal , Muthu Valliappan , Salzer Helmut J.F. , Agarwal Ritesh 
Published: October 2023

Purpose of review
Post-tuberculosis lung disease (PTLD) is an increasingly recognized and debilitating consequence of pulmonary tuberculosis (PTB). In this review, we provide a comprehensive overview of PTLD with airflow obstruction (PTLD-AFO), focusing on its burden, pathophysiology, clinical manifestations, diagnostic methods, and management strategies.

Recent findings
The relationship between PTLD and airflow obstruction is complex and multifactorial. Approximately 60% of the patients with PTLD have some spirometric abnormality. Obstruction is documented in 18–22% of PTLD patients. The host susceptibility and host response to mycobacterium drive the pathogenic mechanism of PTLD. A balance between inflammatory, anti-inflammatory, and fibrotic pathways decides whether an individual with PTB would have PTLD after microbiological cure. An obstructive abnormality in PTLD-AFO is primarily due to destruction of bronchial walls, aberrant healing, and reduction of mucosal glands. The most common finding on computed tomography (CT) of thorax in patients with PTLD-AFO is bronchiectasis and cavitation. Therefore, the ‘Cole's vicious vortex’ described in bronchiectasis applies to PTLD. A multidisciplinary approach is required for diagnosis and treatment. The disability-adjusted life-years (DALYs) attributed to PTLD represent about 50% of the total estimated burden of DALYs due to tuberculosis (TB). Patients with PTLD require comprehensive care that includes psychosocial support, pulmonary rehabilitation, and vaccination against respiratory pathogens. In the absence of trials evaluating different treatments for PTLD-AFO, therapy is primarily symptomatic.

Summary
PTLD with airflow obstruction has considerable burden and causes a significant morbidity and mortality. However, many aspects of PTLD-AFO still need to be answered. Studies are required to evaluate different phenotypes, especially concerning Aspergillus-related complications. The treatment should be personalized based on the predominant phenotype of airflow obstruction. Extensive studies to understand the exact burden, pathogenesis, and treatment of PTBLD-AFO are needed.
Effects of intracerebroventricular administration of calcitonin gene-related peptide (CGRP) on sex hormones and sperm quality in rats
Authors: Rahimi Kaveh , Riyahi Moslem , Sajedianfard Javad , Nazifi Saeed 
Published: October 2023

Background:
Therapeutic strategies with calcitonin gene-related peptide (CGRP) or its receptor have been investigated, but there are few studies regarding the possible harmful effects of CGRP in other body organs.

Objective:
This study aimed to investigate the effect of intracerebroventricular (ICV) injection of CGRP on sex hormones and sperm quality in rats.

Methods:
Twelve male rats were divided into two groups (n=6 per group). The first group (control) rats were injected with 5 µl artificial cerebrospinal fluid intra-ICV; the second group rats, 5 µl (1.5 nmol) CGRP. The levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone were measured. Epididymal sperms were used to determine the sperm parameters.

Results:
The levels of testosterone, LH and FSH in CGRP group was significantly lower than in artificial cerebrospinal fluid (ACSF) group (P<0.05). The concentration and motility of sperm in CGRP group was significantly lower than in ACSF group (P<0.05). In CGRP group live spermatozoa and intact acrosome significantly reduced compared to the ACSF group (P<0.05). In addition, in CGRP group dead spermatozoa and lose acrosome significantly increased compared to the ACSF group (P<0.05).

Conclusion:
ICV injection of CGRP may reduce sperm quality, probably through induction of an imbalance in FSH and LH production as well as testosterone.
Giant sacrococcygeal teratoma in an infant: a case report with a literature review
Authors: Sabir Wirya N. , Ahmed Sasan M. , Hasan Karzan M. , Mohammed Bilal A. , Kareem Honar Othman , Najmadden Zana B. , Abdalla Berun A. , Salih Rawezh Q. , Mohammed Shvan H. , Kakamad Fahmi H. , Azaldeen Hevar A. 
Published: October 2023

Introduction and importance:
A sacrococcygeal teratoma (SCT) is a rare embryonal tumor that emerges in the sacrococcygeal area. It affects one in every 35 000–40 000 live births. Herein, we report a case of a substantial SCT in a neonate.

Case presentation:
A neonate girl from consanguineous parents was delivered by cesarean section with a large mass (18×17 cm) in the sacrococcygeal area. The baby’s birth weight was 5 kg, of which 2.5 belonged to the mass. The vital signs were within normal ranges and she had weak movement with bluish peripheral limbs. Oxygen saturation was around 85% for a short period after birth. According to the American Academy of Pediatric Surgical Section, the tumor was type I. After the fifth day of delivery, a complete resection was done through a chevron incision. The patient was put on ‘nil by mouth’ for about 24 h and given intravenous fluid.

Clinical discussion:
The histopathological examination of the surgical specimen confirmed extragonadal immature teratoma. The histological classification of SCT is divided into three types: malignant teratomas (consisting of malignant germ cells); immature teratomas (incompletely differentiated structures with a high risk of malignancy or embryonal components); and mature teratomas (fully differentiated tissues).

Conclusion:
SCT has rarely been reported as a giant mass. Radiologic examinations in the early stages of pregnancy may be essential to the early diagnosis of the condition.
A case report of sarcoidosis overlapped with Sjogren’s syndrome
Authors: Kudsi Maysoun , Drie Tasneem , Khalayli Naram , Obaid hassnah Hashem Ammar , alghawe Fatima alzahraa , alhham Leen 
Published: October 2023

Introduction and importance:
The diagnosis of sarcoidosis and Sjögren’s syndrome (SS) in the same patient is a challenge since sarcoidosis is considered an exclusion criterion for SS.

Case presentation:
The authors described a 62-year-old woman, who had SS for 8 years and presented with dry mouth, dry eyes, dyspnoea, and erythema nodosum. High resolution computed tomography of the chest showed symmetrical pulmonary micronodules, interstitial changes, and enlarged mediastinal lymph nodes. Anti-nuclear antibodies and anti-SSA antibodies were positive. Schermer’s test was also positive. A biopsy of lung nodules revealed non-caseous granuloma. Salivary gland biopsy showed focal lymphocyte infiltration. Diagnosis of sarcoidosis and SS were done according to the classification criteria in this patient.

Clinical discussion:
Although the diagnosis of Sjogren requires the exclusion of conditions that cause dry eyes and mouth, such as sarcoidosis, Few studies have reported the coexistence of sarcoidosis and SS such as this case report.

Conclusion:
This case extends our understanding of overlapped SS with sarcoidosis and provides a referential value for clinical diagnosis.
Anxiety, Depressive Symptoms, Health-Related Quality of Life, and Their Associated Factors Among Caregivers of Children With Cancer
Authors: Phiri Lophina , Li William H. C. , Phiri Patrick G. M. C. , Cheung Ankie T. , Wanda-Kalizang’oma Watipaso 
Published: October 2023

Background
A child’s cancer diagnosis and treatment are stressful for family caregivers, who may experience anxiety, depressive symptoms, and poor health-related quality of life (HRQoL) related to the care they provide.

Objective
This study assessed the prevalence of anxiety, depressive symptoms, HRQoL, and associated factors among caregivers of children with cancer.

Methods
A cross-sectional study was conducted on 167 caregivers of children with cancer in Malawi. A multivariate analysis was conducted to identify the determinants of anxiety, depressive symptoms, and HRQoL.

Results
All 167 caregivers who consented to participate in this study completed all the questionnaires. Severe anxiety and severe depressive symptoms accounted for 17.5% and 10.2%, respectively. Being Muslim (B = 7.800, P < .001) and Pentecostal (B = 3.067, P = .023) by religious denominations was more likely to be anxious, whereas Catholic caregivers (B = 3.702, P = .033) were more likely to be depressed. Being unemployed was more likely to result in lower anxiety (B = −4.080, P = .016). Furthermore, caregivers demonstrated a lower mental health component (mean, 39.33 [SD, 6.35]), whereas being a female and aged between 31 and 40 years was more likely to result in better physical health (B = 3.962 [P = .031] and B = 3.415 [P = .020], respectively).

Conclusion
This study supports evidence that caregivers of children experience moderate and severe anxiety and depressive symptoms and poor HRQoL in Malawi.

Implication for Practice
Nurses need to include psychological interventions for caregivers of children with cancer during childcare.
Approach to the Febrile Infant (<3 Months)
Authors: Grief Mari M. , Yamamoto Loren G. 
Published: October 2023

Abstract
Evaluation and management of the febrile infant has long been an area of variability. Recent guidelines were released by the American Academy of Pediatrics in August 2021 to help provide evidence-based clinical guidelines to decrease variability and improve outcomes.
1
These guidelines largely focus on management and treatment guidelines for 3 age groups: 8 to 21 days, 22 to 28 days, and 29 to 60 days. The inclusion criteria for these guidelines are previously healthy, term infants born at 37 weeks gestation or later, with a temperature of 100.4°F (38°C) or higher. The most significant changes to historical practice are in the 22- to 28-day and 29- to 60-day age groups. If initial laboratory work is reassuring, patients may not need cerebrospinal fluid studies, and patients may be monitored at home or at the hospital using shared decision-making with the family.
Orbital Fractures: A New CT-Based Protocol to Guide the Surgical Approach and Reconstruction Material Decision-Making
Authors: Consorti Giuseppe , Betti Enrico , Catarzi Lisa 
Published: October 2023

Preoperative computer-assisted planning and intraoperative navigation are becoming popular for orbital fracture treatment. However, not all institutions currently have access to these computer-aided applications. The authors present a simple and intuitive operative algorithm to guide orbital fracture reconstructions. The operative algorithm was based on linear measurements of orbital defects on high-resolution Computer tomography (CT) scans using specific axial, coronal, and sagittal plane images. The fractures were then divided into 3 types based on site and defect-size area. For each type, the authors suggested a surgical approach and material reconstruction.
Between February 2022 and January 2023, 57 patients were treated according to the described CT-based protocol. The quality of reconstruction was classified as ideal, satisfactory, acceptable, and poor based on postoperative CT. Diplopia, enophthalmos, and postoperative complications were assessed. Fifty-seven patients were included. Forty-four (77.2%) patients were included in the type 1 group, 4 (7.01%) in the type 2 group, and 9 (15.79%) in the type 3 group. The reconstruction was considered ideal in 54 (94.7%) cases, satisfactory in 2 (3.5%), and acceptable in 1 (1.8%). No revision surgery was required. In all cases, preoperative diplopia was settled out, and only 1 patient reported postoperative enophthalmos. No complications occurred, with good clinical results and orbital symmetry. The linear CT measurement-based protocol is a simple and reliable workflow to guide the surgeon’s choice of reconstruction material and surgical approach for primary orbital reconstruction. It allows good management of orbital trauma and could help standardize treatment decisions with an imaging technique available in all institutions.